A randomized, double-blinded, placebo-controlled study of

the effect of a combination of lemon verbena extract and

fish oil omega-3 fatty acid on joint management

Christy Goff and Danielle Taylor

Research from article

• Lemon Verbena Extract• Used in South America and Southern Europe for

asthma, colds, fevers, flatulence, colic, diarrhea, indigestion

• Verbascoside – main compound with strong AOX and anti-inflammatory properties

• Plant phytochemicals can have significant protective effects against inflammation-related chronic diseases

• Fish Oil• Shown to have immunomodulatory effects• Reduce production of pro-inflammatory eicosanoids in

RA

Objective

• To test the ability of lemon verbena extract and fish oil supplementation to improve the general condition of joints (pain, stiffness, and function) in subjects already experiencing joint pain.

Methods• Double blind, placebo-controlled, randomized nine week

intervention

• 45 participants enrolled• 23 were given the supplement and 22 were given a placebo • 14 individuals did not complete the study

• Weeks 1-5: Consumed 6 capsules per day of 370mg fish oil powder and 230mg of lemon verbena extract for the first five weeks

• Weeks 6-9: Reduced to 3 capsules daily

• Completed disease specific questionnaires once a week to measure pain/stiffness, function and physical activity

Results

• At baseline: No significant different between the treatment group and the placebo group (age, gender, BMI, physical characteristics) using WOMAC and Lequesne’s Functional Index

• After nine week intervention: A significant improvement of joint stiffness/pain after 3 weeks of supplementation and with function after 4 weeks• WOMAC index increased approximately 53% after 9 weeks in

the supplementation group and did not decrease in placebo group

• Decrease in Lequesne’s functional index after 4 weeks, dropping 78% compared to baseline

Conclusion

• First intervention study to show improvement in joint pain management after supplementing with fish oil and herbs after 9 weeks

• Researches estimate the participants daily intake of lemon verbena extract was between 3000-7000 ORAC units

Limitations

• Strength: • Well constructed study – double-blind, placebo

controlled, randomized, weekly questionnaires, 2 week washout period

• Weakness:• 14 participants dropped out of the study• Did not separately test fish oil vs. lemon

verbena• Used ORAC value of lemon verbena extract as

a criteria for choosing this herb

Comparative information from Databases

• Natural Medicine Comprehensive Database• Lemon Verbena: Used for digestive

disorders, agitation, insomnia, asthma, cold, fever, skin conditions, constipation • Prepared as a tea, not extract

• Fish Oil: Used as a treatment for RA• Possible effective: Taking fish oil orally, alone or in combination

with naproxen, seems to significantly decrease the duration of morning stiffness in patients with RA

• Use of fish oil might also reduce non-steroidal anti-inflammatory drug (NSAID) requirements when taken together

• Up to date:• Lemon verbena - No information found• Fish oil - found to be associated with low rates

of coronary heart disease

• Natural Standard:• Lemon verbena - No information found• Fish Oil – Given the letter grade A for

rheumatoid arthritis • Significant reductions in tender joints and morning

stiffness vs dietary controls

Comparative information from Databases