Tart Cherry Juice as an Anti-inflamatory
January 16, 2013 12:30 AM   Subscribe

I am on warfarin therapy permanently and, as a result, I cannot use NSAIDs (aspirin, naproxen, ibuprofen, etc.) easily. I have been thinking of tart cherry juice as an alternative. Do you have any experience with tart cherry juice for arthritis or other pain and inflamation? If you are on warfarin, what alternatives to NSAIDs have you tried?
posted by noonknight to Health & Fitness (12 answers total) 4 users marked this as a favorite
Anecdotal and non-scientific, but a few buds and I have religiously used it to avoid DOMS after heavy lifting. It does seem to make a difference.
posted by bfranklin at 1:38 AM on January 16, 2013

Hello, I am not on the medication you are on but I have my own issues with anti-inflammatories and I have found regular visits to an acupuncturist to be of great benefit.

This can be pricey but it has really helped me.
posted by dottiechang at 1:43 AM on January 16, 2013

I've found a home ultrasound unit to be super helpful. They are a couple hundred bucks though.
posted by fshgrl at 1:45 AM on January 16, 2013

I read the studies and participants saw a difference in the pain from inflammation in as little as a month drinking (i think) 10 ounces a day.
Is there any harm in just trying it? I started but my issue is remembering to drink it and then buy it when I run out ( I've got stage 3 osteo in my knees and am looking at a TKR). I drank it for two weeks but I also do things that I shouldn't that super inflame my knees, so it had no effect on me.
I think reading this askme though I'm going to stock up on the stuff and give it another try. I don't see a downside to it.
posted by newpotato at 5:36 AM on January 16, 2013

If/when you do go this route, I suggest checking out middle eastern grocery stores before going to a regular supermarket. I know it's an ingredient that my (middle eastern) ex's mom used a lot in cooking, so they're likely to have it.

If the markup is anything like it is on pomegranate juice and pomegranate molasses, you'll make out like a bandit.
posted by phunniemee at 5:55 AM on January 16, 2013

Tart/acerola cherries are indeed anti-inflammatory, but as with any other supplement, their effect will be minimized if you eat lots of other foods that are inflammatory. I encourage you to see a dietitian if possible, because this is really about making your diet less inflammatory overall.

Also, I made a single-page chart with categories of foods arranged by inflammatoryness-through-helpfulness. Message me (or see contact info on my site, listed in my profile) if you'd like a copy. I am NOT a dietitian, just a layperson who's been looking into these issues.
posted by kalapierson at 6:30 AM on January 16, 2013

I'm surprised no one has said this:
When you are under a doctor's care for a medical condition, you should always check with a doctor or pharmacist before adding dietary supplements. Just because cherry juice is from a fruit does not mean it can't have interactions with your medications or your particular health conditions. I think most people are familiar with the dangerous drug interactions of grapefruit juice and licorice.

I don't know a thing about the possibility for cherry juice to have interactions, but many things that have anti-inflammatory properties also have the stomach and bloodthinning effects of NSAIDs, so I would be concerned. In any case, for medical advice, you should definitely ask someone more knowledgable than the internet and be sure to inform your doctor if you decide to use it as a supplement.
posted by hydropsyche at 6:49 AM on January 16, 2013 [3 favorites]

I cannot advise as to the safety of using tart cherry juice instead of NSAIDS. I am not a doctor.
However, I poked around a bit in the literature and I found a few papers speculating that the mechanism of action of tart cherry anthocyanins is actually the SAME as NSAIDS - they may be COX inhibitors. (Example: http://www.sciencedirect.com/science/article/pii/S0166432803004650) If that doesn't mean anything to you, the point is that there is reasonable suspicion that tart cherry juice may pose the same danger to you as NSAIDS.

However, I can tell you that dried tart cherries are unbelievably delicious. Best snack ever, my absolute favorite. If you consult a doctor and find it's safe for you to consume tart cherries, get dried tart cherries sweetened with apple juice. SO. GOOD.
posted by Cygnet at 7:05 AM on January 16, 2013 [5 favorites]

Are you on Warfarin long term? If so, you will want to check your INR religiously and routinely. One thing I did with my doctor was get an at-home INR kit. The end result is that I'm checking my INR much more frequently and adjusting my diet - for example, in winter months when decent greens aren't as readily available, I'll add a glass of V8 or equivalent to my daily diet.

As to your direct question, tart cherry juice may be a low-level anti-inflammatory, but in quantity it affects your INR because of the vitamin C in it.

You can take NSAIDs (not aspirin, FYI), just not to the point where you bleed internally, but you wouldn't want that anyway. My GI guy, who is in the "better living with chemistry" camp of medicine once suggested I take naproxen, and when I mentioned that it didn't play well with coumadin, he said, "oh that's easy, we'll just put you on [some other drug] which will prevent any stomach irritation." I didn't act on this because, quite honestly, NSAIDs don't do anything at all for me. If you want to do this, consult with your doctor about options.
posted by plinth at 7:14 AM on January 16, 2013

I know absolutely nothing about warfarin. I know basically nothing about NSAIDs.

That said, my mom has an asprin allergy, and cannot take any of the standard pain medications (asprin, ibuprofen, acetomenofin, naproxen-sodium, etc) without an asthma reaction. She has arthritis in her hands, and was having a lot of general pain/swelling/stiffness that was keeping her from doing manual-dexterity tasks. She says that tart cherry is a huge help to her, and indeed she's back to doing a lot of things she'd put on hold for a while (sewing/quilting, drawing, crafts, etc).

She goes for dried cherries rather than juice; I think it's just practicality - easier to get in bulk, more power per unit volume, and easier to store in the pantry. Her daily breakfast is a slice of toast with peanut butter and 25 dried cherries. While she does include them in other recipes, I think 25 is the daily rate she aims for. I suspect juice would work as well, but I have no idea how much one should drink or where to buy it cheaply and undiluted.
posted by aimedwander at 9:01 AM on January 16, 2013

Tart cherries are delicious. I usually cut tart cherry juice about 50/50 with water and add a drop or two of stevia to taste. If you end up going for it and want to make it less intense. Also, I've found that while few standard groceries carry it the ones that do it is generally cheaper than things like pomegranate and also can see massive price swings to the low side when on sale. I go with R.W. Knudsen's 'Just Tart Cherry.' No idea on the anti-inflammatory info, but it has other good things for you.
posted by Feantari at 9:58 AM on January 16, 2013

IANADyet, but what was said above about compounds in Tart Cherry Juice having an identical mechanism of action to other NSAIDs (namely, COX-inhibition) bears repeating. What does that mean?

This is your clotting cascade. This is a fun little flash file that explains my chicken scratch.

Basically, warfarin treatment screws up every step of the clotting cascade highlighted in orange-- factors 10, 9, 7, and 2, but stops short of the very last step in which loosely-associated platelets (a platelet plug) actually bridge together and form a stable clot to stop you from bleeding out every time you cut yourself shaving.

In this last step, fibrinogen in your plasma crosslinks platelets at these little glycoprotein IIb/IIIa (Gp IIb/IIIa) anchor points to form a stable clot. What makes platelets express these Gp IIb/IIIa anchor points? thromboxane A2 (TXA2 in the far lower right of the diagram), of course. Without getting into too much detail, production of thromboxane very much depends on the function of cyclooxygenase, or COX. When COX is working, you have plenty of TXA2, which means that you have plenty of Gp IIb/IIIa poking out of your platelets and allowing fibrinogen to come in and cross-link them, and you have a pretty good time because you're not constantly bleeding all over the place.

But let's say you don't have working COX. Let's say you've inhibited it. With Aspirin, or Ibuprofen, or TART CHERRY JUICE. Now you're walking around with an impaired ability to form stable clots (because you screwed with COX, which decreased TXA2 production, which prevented platelets from expressing GpIIb/IIIa, which prevented fibrinogen from cross-linking platelets together, which prevented your body from forming a clot, which made you bleed all over the place).

But how do regular folks take aspirin and live to tell the tale? There's a lot of redundancy built into the system and even if you don't have great-working platelets, having functional clotting factor 2 (thrombin) allows their bodies to create these makeshift platelet plugs which are usually OK at making sure that blood stays on the inside of the body. And that's pretty cool.

Except you're on warfarin. All those clotting factors highlighted in orange? There's less of them because warfarin inhibited the vitamin K-dependent synthesis of clotting factors 10, 9, 7, and clotting factor 2. so it takes you a crazy long time to make a platelet plug. And you're taking some kind of COX inhibitor like TART CHERRY JUICE, so your ability to crosslink platelets to form a stable clot is impaired as well. This all results in BAD TIMES. Especially when there's no way of knowing exactly how much flavinol (the anti-COX compound in tart cherry juice) you're taking onboard with each dose of cherry juice.

There are, of course, plenty of other analgesic and anti-inflammatory things out there, and you should talk to your doctor about finding one that's right for you and doesn't interact so poorly with warfarin.
posted by The White Hat at 2:50 PM on January 16, 2013 [10 favorites]

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