In an era where chronic pain affects millions of people worldwide, the search for effective and safe pain relief has never been greater.
PanaNatra is a line of herbal products from Haleon, the makers of Panadol. Haleon claims the three PanaNatra products, made from plant extracts, help manage and relieve joint pain, mild muscle aches and mild pain affecting sleep.
They contain different combinations of four plants.
- Boswellia serrata (contained in joint and muscle products)
- Curcuma longa (in joint and muscle products)
- Piper nigrum (only in co-production)
- Withania somnifera (just in sleep products).
These products are ‘scheduled medicines’ in Australia. This means that the ingredients are considered to be generally low risk, have been used in traditional medicine and have been produced to a high standard. But the manufacturer has not provided evidence to the state regulator that they work.
So, can herbal ingredients effectively and safely relieve various types of pain?
What does the evidence say?
Let’s look at the evidence for the four main components.
Boswellia serrata
Frankincense (Boswellia serrata) is described in traditional Indian Ayurvedic texts from c. From the 1st century. The main active compounds from the gum tree called boswellic acid are believed to have anti-inflammatory effects.
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It Boswellia serrata a dry concentrate extract (Rhuleave K) used in a muscle pain product contains 50 mg of the herb per tablet, while a joint pain product includes 33.3 mg in another formulation (Apresflex).
A review of various human clinical trials using a variety of formulations of this herb supports its ability to reduce some types of pain and improve function in osteoarthritis. But the main finding of the study was that improvement only begins when Boswellia serrata used continuously for four weeks and at a dose of at least 100-250 mg per day.
In clinical trials, 100 mg a day Boswellia serrata Gum-based products have been found to reduce pain and improve physical function in people with osteoarthritis.
Read more. 9 signs that you have inflammation in your body. Can an anti-inflammatory diet help?
Curcuma longa
turmeric (Curcuma longa) has been used in Chinese and Indian medicine for at least 2,000 years. It contains a well-known chemical called curcumin, a natural compound used for its anti-inflammatory properties, especially in osteoarthritis.
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Turmeric compounds such as curcumin are often combined Boswellia serrata compounds that improve their anti-inflammatory effects to reduce pain.
In 16 different clinical trials, turmeric extracts were found to be effective in knee osteoarthritis.
A similar conclusion was drawn from 11 clinical trials that looked at the use of curcuminoids (of which curcumin is one) for one to four months. It found that curcuminoids have the same pain-relieving properties as non-steroidal anti-inflammatory drugs.
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Piper nigrum
Black pepper (Piper nigrum) contains the chemical piperine, which has anti-inflammatory properties.
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Piper nigrum is often added to curcumin products to improve curcumin absorption, as is the case with the PanaNatra Joint Pain product.
For musculoskeletal pain, a preliminary human trial examining the effects of a 1,000 mg daily dose of Rhuleave K (the extract used in PanaNatra) found it to be as effective as paracetamol.
However, the study was not placebo-controlled, and the dose of paracetamol given (1,000 mg daily) was below the recommended daily dose for pain relief.
Read more. Knee pain. here’s why it happens and how you can fix it
Withania somnifera
Withania somnifera (also called Ashwagandha) has been used for thousands of years in traditional Indian Ayurvedic medicine to reduce stress and relieve inflammation.
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One of the key chemicals appears to be postapherin A, which interferes with the inflammatory signaling pathway.
PanaNatra’s Pain and Sleep product contains 300 mg per tablet of a Withania somnifera extract called KSM66.
A human trial found a dose of 600 mg per day Withania somnifera the extract improved sleep quality and helped manage insomnia.
During a separate trial. Withania somnifera It has been found to improve sleep quality, again when taken at a dosage of 600 mg per day.
Read more. From Ayurveda to Biomedicine. understand the human body
So what does this mean?
Whether and how effective an herbal medicine is depends greatly on the formulation (how it is prepared and the extract used) and the dosage given. The same herb used in one formulation may produce a different result than another formulation containing the same herb.
It is also important to note that effectiveness for one type of pain does not mean that the product will work for other types of pain.
In general, the extracts of such herbs included in PanaNatra products have some evidence that they are effective against pain and sleep. Whether these will work for you will depend on a number of factors, including the effectiveness of the PanaNatra formulation, how much you take, and the extent of your pain.
Are they safe?
PanaNatra should be used with caution by some patients.
Overall, human data are insufficient to recommend any of these herbal ingredients during pregnancy or lactation. In fact, there is some evidence that Withania somnifera may be dangerous during pregnancy, and apart from the amounts commonly found in food, turmeric and its compounds are also not considered safe for use during pregnancy.
Herbs can also affect the effectiveness and safety of other medications. For example, blood levels of the cancer drug tamoxifen may decrease when taken at the same time as turmeric supplements.
Withania somnifera associated with cases of somnolence and liver toxicity.
Curcuma longa products, including formulations containing curcumin and piperine, have also been associated with liver toxicity. As such, the Australian Therapeutic Goods Administration has proposed adding warning labels to any product containing these ingredients. But this discussion is ongoing and a decision will be made by next year.
Bottom line
Although there is a long history of traditional use of herbs in PanaNatra products, there is limited high-quality scientific evidence regarding the efficacy and safety of this particular product.
Pregnant and breastfeeding women should not take these products, and you should not exceed the daily dose recommended by the manufacturer.
If you have an underlying health problem or are taking other medications, check with your doctor or pharmacist before trying these to check if these products are right for you.
Read more. Do you know what is in the herbal medicine you are taking?
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