Nov
16
2013

You Can Fight Back Against Arthritis

Osteoarthritis affects about 4 to 5% of the population with women outnumbering men by 2 to 1. The age of onset typically is less than 50 years, but becomes more evident and more disabling beyond the age of 50. About 40 to 60% of osteoarthritis is genetically linked as twin studies in women have shown (Ref.1).

Synonyms for osteoarthritis are degenerative joint disease, osteoarthrosis and arthrosis.

Till recently arthritis was accepted as something that was inevitable: people were getting old, were getting stiff and sore, and had to “take it easy” as a result when they got older. Things are not as uncomplicated, as arthritis affects about 53 million Americans, and it has become the leading cause of disability in the US.

Rheumatoid arthritis is an autoimmune disease. It is not a disease of “old age” but can affect people of every age group. The body reacts to components in joint tissue, and this immune reaction to collagen will produce inflammation, pain and ultimately disability.

So far osteoarthritis was believed to be the result of wear and tear affecting the aging population, but more recently it has been discovered that osteoarthritis is also accompanied by the same inflammatory immune factors that are involved in rheumatoid arthritis.

When the body attacks collagen, which is needed to keep the joints moving smoothly, microscopic particles of it wander into the blood stream. There they are perceived as foreign molecules, and the immune system produces inflammatory substances (cytokines). These are sending out an army of “killer T-cells” to combat the collagen, which is perceived as a foreign matter. They are bombarding the exposed cartilage with toxic substances. This means a chaotic combination of oxidative stress and more inflammation. Over time the cartilage that was meant to protect the joint in its function to move freely is eroded and destroyed. For the person suffering of this disordered reaction, it means that the joint is not only creaking but causing pain, which is made even worse by weight bearing (walking, standing). Any person suffering of osteoarthritis will complain that he or she feels stiff and sore especially after a period of inactivity.

Commercials for anti-inflammatory medication are plentiful, and many sufferers resort to the pain relief that is promised. The warnings are mentioned right after the commercial or on the medication package, if the patient reads the fine print. Most anti-inflammatory medications are causing irritation of the stomach, and the kidneys get damaged (nephropathy)with prolonged use from these pills despite the promises in commercials of a happy, active and pain free life.

You Can Fight Back Against Arthritis

Causes of arthritis

There are many varied causes that can all contribute to developing arthritis.

It is important to take a critical look at lifestyle choices. Excessive body weight puts an additional burden on the joints in the body. Increased body fat is not just sitting at the abdomen as an inert potbelly. Abdominal fat is a highly active metabolic organ that releases inflammatory substances into the blood stream, which distributes them throughout the body. It is known to damage blood vessels. Inflammation will damage the joints as well. The statistics show that 33.8 % of obese women have arthritis. The percentage for obese men shows that 25.2 % suffer of arthritis.

Smoking leads to circulatory problems, and lack of oxygenation in the body’s tissues. It is a mistake to believe that damage is done only to the lungs or the heart. The joints will be affected as well.

Mechanical stress with inadequate self-repair is one cause; misalignment of bones such as knock-knee (genu valgum) and bowleggedness (genu varum) will lead to premature osteoarthritis of the knees as can loss of muscle strength. Exercise without injury does not contribute the risk for developing osteoarthritis; it is actually part of the rehabilitation plan.

According to Ref. 2 there are other causative factors, such as increased age, female sex, race (black women have a twofold increase of arthritis over Caucasian women), estrogen deficiency, nutritional factors, genetics, metabolic and endocrine disorders, joint trauma, joint deformity, occupational factors and sports participation (accumulation of mini injuries).

One of the newer findings is that osteoarthritis is actually an inflammatory condition where numerous destructive processes occur within the affected joints leading to a breakdown of cartilage and supportive synovial fluid factors (proteoglycans). These findings lead to the possibility of new therapeutic approaches discussed below.

Diagnosis of osteoarthritis

According to Ref. 1 there are no blood tests and analysis of synovial fluid is non-diagnostic. Diagnosis of osteoarthritis is made by history, X-rays of the affected joints and clinical findings. There are joint tenderness and swelling of the affected joints. Heberden’s nodes (swelling of the distal interphalangeal joints or DIP joints) and Bouchard’s nodes (swelling of the proximal interphalangeal joints or PIP joints) are present. There can be a decreased range of motion and a grating sound of two ends of bones rubbing together (called “crepitus”).  X-rays show typical osteoarthritis details with a narrowing of the joint space of the affected joint, subchondral sclerosis (increased bone formation around the joint) and new bone formation at the joint margins, called “osteophytes”).

Integrative therapy of arthritis

Ref. 2 points out that integrative treatment of arthritis is aimed at reducing joint pain, increasing joint function and reducing further joint deterioration. Some measures are symptomatic only, others are disease modifying.

Nutrition

Dietary habits can promote good health or have disastrous consequences. The news has been out for some time that the typical North American diet with a high load of omega-6 fatty acids will stoke the fires of inflammation in the body and lead to arthritis, heart disease and cancer. Soybean oil, cottonseed oil and safflower oil contain the cheaper omega-6 oils that are widely used in food processing and bakery products. Refined carbohydrates contribute to unhealthy spikes in blood sugar levels and wreak havoc in their own way paving the downward slope to insulin resistance, metabolic derailment, and diabetes. Take a hard look at your shopping wagon. Stay away from processed foods, shop the periphery of the supermarket, and choose organic meats, vegetables and fruit. Use heart healthy fat in the form of virgin olive oil. A Mediterranean type diet will be a good choice. Just bear in mind, that a heap of pasta like Fettuccine Alfredo does not constitute what a healthy Mediterranean diet is all about. An anti-inflammatory diet such as a Mediterranean diet also includes deep-water fish as a source of omega-3 fatty acids or molecularly distilled omega-3 capsules (you need 7 to 8 high potency, molecularly distilled fish oil, 1000mg per capsule) every day.

This approach has shown beneficial effects in beginning stages of osteoarthritis.

It is important to cut out sugar and starchy foods to reduce insulin resistance, which would otherwise maintain the inflammatory chronic condition causing arthritis and cardiovascular disease. For the same reason cutting out wheat and wheat products has been shown to be beneficial in reducing inflammation. Such an anti-arthritis diet prevents heart attacks and strokes at the same time.

Weight loss

Ref. 2 points out that one study showed that weight reduction of only 10% had a 28% improvement in joint function. When this is combined with an exercise program the improvements are even more striking.

Exercise

Exercise consists of aerobic training, resistance training and muscle strengthening. When patients with osteoarthritis were observed throughout controlled exercise programs, flexibility and range of motion of the affected joints were improving. A minimum of three days per week of exercise was required to show improvements, but the best effects were observed when patients exercised most of the days. Joints become less swollen, show improved circulation and less pain. Before an exercise program is done, those with increased cardiovascular risk should first undergo an exercise stress test to measure their cardiovascular reserve and establish that it is safe to start a program. Secondly, an acutely inflamed or swollen joint should first be treated before an exercise program is started. Lack of exercise will promote more disability. While a person with arthritis may be unable to run a brisk race due to joint discomfort, he or she will find water exercises and swimming much more manageable. Group programs for people with arthritis are available and you may enjoy the supportive company.

Heat and cold therapy

Ref. 2 points out that three weekly 30 minute sessions of microwave diathermy for 4 weeks showed a significant reduction of joint swelling in knee osteoarthritis with improved joint function and reduced pain. On the other hand cold packs for aching muscles after strenuous exercises can decrease muscle spasm and increase the pain threshold. Range of motion increased with cold application and joint swelling was reduced. Patients who have cold sensitivity (such as Raynaud disease) need to refrain from the latter treatment modality.

Acupuncture and electro acupuncture

These treatments were found by Ref.2 to be useful as an adjunct to anti-inflammatory medication with NSAIDS (non steroidal anti-inflammatory drugs); the advantage was that the dosage of NSAIDS could be reduced, which reduced the potential serious side effects of gastric bleeds and kidney damage. Note that people with pacemakers or CNS stimulators cannot use electro acupuncture.

Intraarticular steroid injections

When only a few joints are affected by osteoarthritis (or rheumatoid arthritis), a physician can inject a corticosteroid into the joint. However, there are limitations, as each joint should not be injected more than 3 to 4 times per year. Otherwise there can be damage to the joint cartilage, which would make the arthritis worse. However, I have seen surprisingly good results for a long period of time, which allowed the patients to exercise and stabilize the joints that way.

Complementary treatments

A number of supplements and herbs are effective in reducing inflammation. Omega-3 fatty acids are the precursors for anti-inflammatory prostaglandins in the body, which helps both patients with osteoarthritis and rheumatoid arthritis. As indicated under nutrition above, higher doses are required for this effect and for safety (avoiding toxicity from mercury and PBC’s) molecularly distilled omega-3 fatty acid supplements should only be used (yes, they are more expensive).

Curcumin, the active ingredient of the spice turmeric, has been used in India and Asia for its anti-inflammatory and antioxidant properties for centuries. It helps not only arthritis, but also helps also against the illnesses that are often associated with it (obesity, diabetes, heart disease, autoimmune conditions). Ref. 2 points out that curcumin neutralizes inflammatory agents circulating in the blood of patients with arthritis.

Standardized ginger extract was shown to reduce pain significantly in patients with knee osteoarthritis.

Other common supplements for building up cartilage in the joint are glucosamine sulfate and chondroitin, both available at the health food store. They stimulate glycosaminoglycan formation, which in turn builds up hyaline cartilage, the enamel-like coating of the bone within the joint.

An oral desensitization to treat arthritis

Can joint health be helped in other ways? New answers have emerged. In the past, people who were suffering with colds or flus were consuming a steaming bowl of chicken soup. It should be mentioned that colds and flus are also an inflammatory reaction that occurs within the body.

While a lot of health professionals dismissed this home remedy as old-fashioned and useless, a team of scientist from the University of Nebraska decided to research the matter a bit closer. They discovered that it was not the vegetables, but a component in the chicken broth that showed anti-inflammatory activity. The chicken derived type II collagen functions to regulate the immune system, so it stops attacking proteins normally found in healthy joint cartilage. Results of a pilot study have shown remarkable results. A dose of 40 mg per day of un-denatured type II collagen (UC-II) showed a significant reduction in pain and swelling from arthritis. It also yielded good results in terms of relief from joint pain and stiffness due to exercise.

Animal studies on dogs and horses were also conducted demonstrating that both animal groups that frequently suffer from arthritis got significant relief. Human clinical trials with UC-II showed similar effectiveness.

A group of patients suffering from knee osteoarthritis were treated with the supplement for 90 days. 33% experienced a reduction in their osteoarthritis. The pain was reduced by 40%. Those patients who received the standard treatment without any supplement had 15.4% less pain. Joint function was improved by 20% in the group taking the supplement, while only 6% of improvement was seen in the patient group receiving standard care.

Healthy patients were also assessed who did not suffer of arthritis, but received the supplement to evaluate how they would fare with exercise-induced knee pain. They were treated with a daily dose of 40 mg of UC-II. After day 90 and 120 the group that was treated with the supplement could exercise for significantly longer periods before experiencing joint pain. They also recovered faster after joint pain. The placebo group who swallowed “fake pills” did not show these changes. When knee joint flexibility was examined, the supplement group had significant increases in their knee mobility, but no luck for the placebo group!

Numerous toxicological essays have evaluated the supplement. There is no oral toxicity. No mutations in bacterial genomes have been observed, which is a standard screen to ensure that a substance is non-carcinogenic.

The UC-II supplement works through a mechanism, where the immune system is desensitized by ways of oral administration. It reverses T-cell attacks on exposed cartilage. If our joints are healthy and intact, we normally do not react to our own cartilage. But the protective barrier between blood and cartilage diminishes as we age. Early treatment with UC-II may help induce immune tolerance even in healthy individuals and protect them from reactions of the immune system to their own cartilage.

Conclusion

The supplementation with UC-II offers a different approach to modify joint inflammation of arthritis. Standard treatment at this point consists mainly of symptomatic treatment. Side effects to the drugs can be serious, if they are used on a long-term basis. Few are tolerable to modify the course of the disease.

With the UC-II supplement the root of the disease (autoimmune disease) is being addressed, and relief can be achieved within a few weeks of starting it. With life style changes that were mentioned before and this supplement it is possible to fight back against arthritis!

More information on arthritis: http://nethealthbook.com/arthritis/

References

1. “Osteoarthritis. Basic information”. Ferri: Ferri’s Clinical Advisor 2014, 1st ed., © 2013 Mosby

2.  Rakel: Integrative Medicine, 3rd ed., 2012 Saunders

Last edited Nov. 7, 2014

Jan
03
2013

Thinking Of Health In The New Year

As we start a New Year it is a good time to reflect on our health, what makes us healthy, what keeps us healthy and what makes us age less quickly.
Here are a few thoughts, partially my own, partially influenced by the 20th Anti-aging conference in Las Vegas in December of 2012.

1. We know that cigarettes are no longer in, but in the casinos of Las Vegas and outside of restaurants a lot of people are still smoking! Here is a website that tells you why you should quit.  Cigarettes cause lung cancer, hardening of the arteries, strokes, and often reduce life expectancy by 10 to 15 years. So, if you are smoking do anything to quit this habit! Acupuncture helps, Nicorette assists you in overcoming the addiction part of smoking. Self hypnosis discs are also helpful.

2. Reduce toxins in your life: you may think that toxins consist of lead, mercury and other heavy metals and that only people in certain industries would be exposed to those. Not so. It is in the air we breathe. Your tooth fillings (silver amalgam fillings)may leech out mercury, old paints at home could still expose you to lead, as would fashion jewelry made in China. Various foods contain toxins in them in form of residues from herbicides and insecticides. How do we detoxify? Vitamin C is a good start. It can be taken as a daily vitamin supplement (see below). Detoxification can be done intravenously, if urine and blood tests show high levels of toxins. This is something an anti-aging doctor or a naturopathic doctor can help you with. Glutathione and vitamin C can be given intravenously for chelation treatment with the least side-effects. Here is a link that tells you more about chelation in general.

3. Cut out wheat and other genetically modified foods: What’s the thing about wheat? Read my blog about this.
All of the wheat we get today in bread, cereals, pasta, pizzas etc. has been genetically modified and has about 7 times the gliadin concentration that the original wheat species had before BASF did the chemical modification of  wheat in the 1960’s and 1970’s. Today practically all of the commercial wheat is this type.
As a result I have avoided wheat in my food intake since 2001. When you avoid wheat and sugar, which is another culprit (sugar is simply too strong for your body to handle and leads to hyperinsulinism and diabetes) you will likely loose whatever weight is too much for you without any effort.

Thinking Of Health In The New Year

Thinking Of Health In The New Year

4. Eat only organic food , if you can afford it. Or grow your own vegetables and lettuce in your vegetable garden, if you can. Because of what I said under point 2 above, I stay away from regular vegetables and lettuce that are sold in super markets as they contain residues of round-up (herbicides) and insecticides on them. Organic food nowadays is affordable as enough of us demand it. Even Wal-Mart has some organic foods! Keep an eye on your body weight and aim for a body mass index between 21.5 and 23.0. Several long-term studies have shown that the BMI is worth observing in order to reduce mortality.

The Singapore Chinese Health Study: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0014000

The Buffalo Health Study:  http://aje.oxfordjournals.org/content/146/11/919.full.pdf+html

5. Exercise regularly 5 to 7 times per week. Perhaps one of the most important points is regular exercise. If you engage in ½ hour of vigorous exercise three times per week you will reduce your probability of coming down with a serious illness that could kill you by 15%. If you exercise 5 to 7 days per week for 30 minutes or more this percentage goes up to about 40%. If you exercise 60 minutes 6 to 7 times per week in a gym, you reduce mortality by about 50 to 60%. Here is an interesting graph that shows that older adults benefit more from exercise than younger adults do.

6. Have a yearly check-up including a check-up of your hormone status: As we age, our hormones reduce in a characteristic patterns with melatonin and growth hormone production going on a downhill slope after the age of 30, followed soon by DHEA and cortisol. Often by the time a woman reaches menopause at the age of 35 to 50, there is a lack of estrogens, progesterone, and often also of thyroid hormones. In a man this decline (andropause) may take longer until the age of 55 to 65 before he experiences a lack of energy, erectile dysfunction and muscle weakness from testosterone deficiency. Sex hormones are best measured in saliva samples, the remaining hormones in blood samples. Here is a website that describes the various hormones that often need replacement (note that I am not endorsing this center, just citing it as an example of what to look out for).

7. Replace hormones only with bioidentical hormones: When there is a hormone deficiency, a doctor would usually replace the deficiency with synthetic hormones from Big Pharma. This was good for the profits of the companies, but bad for people as the Women’s Health Initiative has shown.
As a result of this study (showing heart attacks, strokes, breast cancer) a lot of American women and women around the world were unjustly horrified of hormone replacement. However, many trials with bioidentical hormones around the world have proven that bioidentical hormone replacement with hormone creams from compounding pharmacies add years of life expectancy as these hormones restore all body functions back to normal. No breast cancer, no heart attacks and no strokes were noted on these natural hormones. The key is to replace with low doses and slowly under the supervision of a naturopathic physician or anti-aging physician.
Here is a site that explains bioidentical hormone replacement (note that I am not endorsing this center, just citing it as an example of what to look out for).

8. Have hobbies, cherish friendships. Social networking is good for your emotional health. It reduces stress, re-balances your hormones, reduces your risk of heart attacks and strokes.

9. Don‘t neglect your spirituality. Be part of a church community that builds you up, if you are religious. For those who no longer belong to a church group, meditate instead, use yoga, do self hypnosis or read an inspiring book. Music can energize you or contribute to relaxation.

10. Use vitamin and mineral supplements. There are a number of vitamins and minerals that have anti-oxidative effects. They help to detoxify your body and protect you from some of the environmental challenges. I have discussed them elsewhere in more detail under this link.

So, here they are, the 10 steps to a healthier 2013. Review what you are doing in your life . You may need to only modify the one or the other point. Otherwise, if you have identified several points you want to change, just start with the ones you feel can be achieved the easiest first and then gradually tackle the rest. You will be rewarded with more energy and you will probably find it difficult to hide your successes from your friends.

Last updated January 3, 2013

Apr
01
2006

Back Pain Improves With Acupressure

Lower back pain can be a frustrating condition for patients. It also is a major cause for disability and a source of depression. For the physician it becomes a vexing problem to find successful therapies. Pain medications and their side effects are often not acceptable for long-term use, and surgery very frequently will not be an option at all.
Additional therapies, which have been frequently used, are chiropractic treatment, massage therapy and physiotherapy. The results can vary a great deal depending on the condition. Acupuncture has gained a solid position in the therapeutic approach of back pain, however the modality of acupressure treatment has not received much attention in conservative circles.
If so far conservative voices could dispute the efficacy of acupressure due to a lack of research data, new studies are now available coming from the National Taiwan University in Taipeh. Under the leadership of Professor Tony Hsiu-His Chen and a team of specialists, a randomized controlled trial with 129 patients suffering of chronic low back pain has been conducted. The patients received physiotherapy or acupressure for one month as a modality of treatment.

At the end of treatment, the group treated with acupressure showed significantly less disability than the group treated with physiotherapy. The improvement in the disability score of patients treated with acupressure remained at six-month follow up examinations. Pain scores also remained reduced after treatment and at 6-month follow-up in the acupressure group.

Back Pain Improves With Acupressure

Back Pain Improves With Acupressure

These results point to the use of acupressure treatment as a very promising therapy for patients suffering of chronic low back pain.

More information on:

1. back pain: http://nethealthbook.com/arthritis/lower-back-pain/

2. Electro-acupuncture: https://www.askdrray.com/electro-acupuncture-twice-as-effective-as-conventional-acupuncture/

Reference: BMJ 2006; 332:696-700 (25 March, 2006)

Last edited Oct. 31, 2014

Apr
01
2004

Acupuncture For Headaches Found Effective

For many years it was merely a clinical impression that some headache sufferers were helped by acupuncture. Over the years many attempted to show that acupuncture works for headaches, but the studies were done with too few patients to reach statistically meaningful results.

In a recent English study that was published by Andrew J Vickers et al. in the British Medical Journal on March 27, 2004 patients were randomly assigned to a conventional headache treatment protocol or to treatment with acupuncture. 401 patients were enrolled in this randomized study and the patients came from general practitioners in Wales and England. The patients all had similarly severe headaches or chronic headaches and had mainly migraines, but also tension type headaches. Several universities took part in the design of the study to ensure that the Cochrane criteria of evidence based medicine were adhered to. Headaches were measured according to a score that consisted of detailed standardized questionaires. Treatment with acupuncture consisted of 12 treatments over 3 months. The control headache group was treated with the usual care.

The headache sufferers were assessed at the 12 month point. There were significant differences in favor of the acupuncture treated patients. The acupuncture group had on average 22 fewer days of headaches per year than the control group. This resulted in 15% less medication use, 25% fewer doctor visits and 15% fewer sick days.

Acupuncture For Headaches Found Effective

Acupuncture For Headaches Found Effective

Acupuncture treated headache sufferers felt physically more active, they had more energy and they felt a positive change in their health.

More information about causes of headaches: http://nethealthbook.com/neurology-neurological-disease/common-causes-headaches/

British Medical Journal: BMJ 2004;328:744 (27 March).

Last edited October 26, 2014