Osteoarthritis - Michael T. Murray, N.D.

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Osteoarthritis

JoAnn Guest

Jun 15, 2006 17:43 PDT

 

 

 

What is Osteoarthritis?

 

Osteoarthritis (also known as degenerative joint disease) is a form

of arhtritis (inflammation of a joint) caused by degeneration of

cartilage.

Cartilage serves an important role in joint function. Its gel-like

nature provides protection to the ends of joints by acting as a

shock absorber. Without the cartilage in the joint, bone literally

rubs against bone leading to pain, deformity, inflammation, and

limitation of motion in the joint.

 

The onset of osteoarthritis can be subtle. Morning joint stiffness

is often the first symptom. As the disease progresses, there is pain

on motion of the involved joint that is made worse by prolonged

activity and relieved by rest. There is usually local tenderness,

soft tissue

swelling, joint crepitus (cracking sounds), bony swelling,

restricted mobility, and bony nodules.

 

X-ray findings show narrowing of the joint

space (the area between the bones taken up by cartilage). The

weight-bearing joints such as the knees, hips, and spine as well as

the hands are the joints most often affected with the degenerative

changes of osteoarthritis. These joints are under greater stress

because of weight and use.

 

What causes Osteoarthritis?

 

Osteoarthritis is divided into two categories, primary and

secondary. In

primary osteoarthritis, the degenerative " wear-and-tear " process

occurs after a person turns forty years of age. The cumulative

effects of decades of use leads to the degenerative changes by

stressing the collagen matrix of the cartilage. Stress on the

cartilage results in the

release of enzymes which destroy cartilage components.

 

With aging, the

ability to restore and manufacture normal cartilage structures

decreases. So, what I am saying is that aging is the primary cause

of osteoarthritis. But, just because you may be getting older

doesn't mean that you have to suffer from the pain of osteoarthritis.

 

Secondary osteoarthritis is associated with some predisposing factor

which is responsible for the degenerative changes. Predisposing

factors

in secondary osteoarthritis include: inherited abnormalities in

joint

structure or function; trauma (fractures along joint surfaces,

surgery, etc.); presence of abnormal cartilage; and previous

inflammatory disease of joint (rheumatoid arthritis, gout, etc.).

 

What dietary factors are important in Osteoarthritis?

 

Perhaps the most important dietary recommendation for individuals

suffering from osteoarthritis is that they achieve normal body

weight.

Being overweight means increased stress on weight-bearing joints

affected with osteoarthritis.

 

Beyond that, it is critical that the diet

be rich in fruits and vegetables because their natural plant

compounds

can protect against cellular damage, including damage to the joints.

Foods especially beneficial for osteoarthritis are flavonoid-rich

fruits, such as cherries, blueberries, blackberries and

strawberries.

 

Also important are sulfur-containing foods, such as garlic, onions,

Brussels sprouts, and cabbage. The sulfur content in fingernails of

arthritis sufferers is lower than that of healthy subjects without

arthritis.

 

Ginger contains anti-inflammatory compounds called gingerols. These

substances are believed to explain why so many people with

osteoarthritis experience reductions in their pain levels and

improvements in their mobility when they consume ginger regularly.

 

Although most scientific studies have used organic powdered ginger

root, fresh ginger root at an equivalent dosage is believed to yield

even better results because it contains active enzymes.

 

Most studies utilized 1 gram of powdered ginger root. This would be

equivalent to approximately 10 grams or one-third of an ounce of

fresh ginger root, roughly 1/4 " inch

slice.

 

People with osteoarthritis may want to avoid foods from the

nightshade

family. It appears that in genetically susceptible individuals,

long-term, low-level consumption of alkaloids found in tomatoes,

potatoes, eggplant, peppers, and tobacco can worsen osteoarthritis.

 

Presumably these alkaloids inhibit normal collagen repair in the

joints

or promote the inflammatory degeneration of the joint. Although

remaining to be proved, elimination of nightshade vegetables from

the

diet may offer some benefit to certain individuals and is certainly

worth a try.

 

What nutritional supplements should I take for Osteoarthritis?

 

Foundation Supplements. There are three products from Natural

Factors that I think are critical in supporting good health:

 

MultiStart (age and gender specific multiple vitamin and mineral

formulas). Follow label instructions.

Enriching Greens - a great tasting " greens drink " containing highly

concentrated " greens " like chlorella, spirulina, wheat grass juice,

barley grass juice, etc., and herbal extracts. Take one serving (one

tablespoon) in 8 ounces of water daily.

 

RxOmega-3 Factors - A true pharmaceutical grade fish oil supplement.

Take two capsules twice daily if you have osteoarthritis.

Glucosamine sulfate has been the subject of over 300 scientific

investigations and over 3 double-blind studies. It has also been

used by

millions of people worldwide and is registered as a drug in the

treatment of osteoarthritis in over 70 countries. Glucosamine is a

simple molecule that can be manufactured in the body. The main

function

of glucosamine in joints is to stimulate the manufacture of

molecules

known as glycosaminoglycans (GAGs), which are the key structural

components of cartilage. It appears that as some people age, they

lose

the ability to manufacture sufficient levels of glucosamine. The

result

is that cartilage loses its ability to act as a shock absorber. The

inability to manufacture glucosamine has been suggested to be the

major

factor leading to osteoarthritis. The more than 20 published

clinical

trials with glucosamine sulfate have demonstrated an overall success

rate of 72-to-95% in various forms of osteoarthritis. In

osteoarthritis

of the knee, the success rate is over 80%. In addition to being

shown to

be more effective than a placebo, in head-to-head, double-blind

studies

comparing glucosamine sulfate to nonsteroidal anti-inflammatory

drugs

(NSAIDs), glucosamine sulfate was shown to produce better results

than

NSAIDs in relieving the pain and inflammation of osteoarthritis,

despite

the fact that glucosamine sulfate exhibits very little direct

anti-inflammatory effect and no direct analgesic or pain-relieving

effects. Glucosamine sulfate appears to address the cause of

osteoarthritis. By treating the root of the problem through the

promotion of cartilage synthesis, glucosamine sulfate not only

improves

the symptoms, including pain, but also helps the body to repair

damaged

joints. The typical dosage for glucosamine sulfate is 1,500 mg per

day.

 

MSM (methyl-sulfonyl-methane) is the major form of sulfur in the

human

body. Sulfur is an important element for all cells and body tissues.

It

is especially important nutrient for joint tissue where it functions

in

the stabilization of the connective tissue matrix of cartilage,

tendons,

and ligaments. As far back as the 1930s, researchers demonstrated

that

individuals with arthritis are commonly deficient in this essential

nutrient. Restoring sulfur levels brought about significant benefit

to

these patients. More recent studies have validated the benefits of

MSM

in osteoarthritis. The standard dosage of MSM is 1,200 to 2,000 mg

per

day.

 

Celadrin® is an all-natural matrix of special cetylated, esterifed

fatty

acids that reduce inflammation. The unique features of Celadrin® as

a

natural product include an ability to reduce inflammation and pain

quickly with no side effects as demonstrated in clinical trials

published in the internationally acclaimed Journal of Rheumatology.

Available in cream and capsule form, Celadrin® is clinically proven

to

produce results. Celadrin® cream can be applied to affected areas on

an

as needed basis. The dosage with oral preparations is three soft

gelatin

capsules daily.

 

Other natural products often used in osteoarthritis. The products

listed

above tend to more effective, but due to the popularity of some of

these

other products they are briefly discussed below.

 

Chondroitin sulfate is composed of repeating units of derivatives of

glucosamine with attached sugar molecules. The clinical studies that

have been done using orally administered chondroitin sulfate

demonstrate

that it is less effective than glucosamine sulfate. Far more

impressive

results have been achieved using glucosamine sulfate; glucosamine

sulfate is faster-acting and provides much greater overall benefit.

My

feeling has been that there is no added benefit by taking

glucosamine

sulfate and chondroitin sulfate together. The recommended dosage for

chondroitin sulfate is 1,200 mg daily.

 

S-adenosylmethionine (SAMe) deficiency in the joint tissue leads to

loss

of the gel-like nature and shock-absorbing qualities of cartilage.

SAMe

supplementation appears to be useful in the treatment of

osteoarthritis.

A total of 21,524 patients with osteoarthritis have been treated

with

SAMe in published clinical trials. In double-blind trials, SAMe (400

mg

three times per day) has demonstrated reductions in pain scores and

clinical symptoms similar to NSAIDs.

 

Boswellia serrata has been historically used in the treatment of

osteoarthritis in India. Boswellia yields an exudative gum resin

known

as salai guggul. Although salai guggul has been used for centuries,

newer preparations concentrated for the active components (boswellic

acids) are giving better results. Boswellic acid extracts have

demonstrated anti-arthritic effects in a variety of animal models.

There

are several mechanisms of action, including inhibition of

inflammatory

mediators, prevention of decreased cartilage synthesis, and improved

blood supply to joint tissues. Clinical studies using herbal

formulas

with Boswellia have yielded good results in osteoarthritis as well

as

rheumatoid arthritis. The standard dosage for boswellic acids in

treating arthritis is 400 mg three times per day.

 

Comment:

 

One class of drugs that I encourage people with osteoarthritis to

stay

away from are so-called " nonsteroidal anti-inflammatory drugs or

NSAIDs "

which includes aspirin and ibuprofen as well as the newer Cox-2

inhibitors like Vioxx and Celebrex. Although these drugs are

extensively

used in the United States despite their well-known side effects,

research is indicating that in the treatment of osteoarthritis these

drugs may be producing short-term benefit, but actually accelerating

the

progression of the joint destruction and causing more problems down

the

road. The way in which these drugs work is to inhibit enzymes

involved

in the production of inflammatory compounds. Enzymes are molecules

involved in speeding up chemical reactions. Enzymes to either join

molecules together or split them apart by making or breaking the

chemical bonds that join molecules together. With NSAIDs, they not

only

suppress the enzymes that produce inflammatory compounds, they also

inhibit enzymes that manufacture cartilage components. A person may

feel

free from pain while on the NSAID, but there arthritis is silently

getting worse as noted in several clinical studies that have shown

that

NSAID use is associated with acceleration of osteoarthritis and

increased joint destruction. If you need immediate pain relief due

to

osteoarthritis, give Celadrin® a try (both orally and topically).

 

How do I know if the program is working?

 

Celadrin® seems to be very fast acting, especially the cream.

Glucosamine sulfate and MSM take some time to work, usually 2-4

weeks,

but do not forego their use- they still are very important in

supporting

the manufacture of cartilage.

 

Feedback:

 

Please let Dr. Murray know how this program has worked for you by

clicking here.

 

Testimonials:

 

" Dr. Murray, I am just amazed at how effective your recommendations

for

osteoarthritis are without the side effects of the drugs. I could

barely

walk unless I was taking Vioxx, but after all of the concern about

its

safety I started taking Glucosamine sulfate and MSM. The relief was

almost immediate and was even more complete than the relief I got

from

Vioxx. Why would any doctor prescribed drugs like Vioxx and Celebrex

when there are such effective and safer natural products? " EH

 

 

www.doctormurray.com

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Condition Center Caution:

 

Dr. Murray's recommendations and protocols for nutritional support

are

not intended as a substitute for appropriate medical care.

The products and the claims made about specific products on or

through

this site have not been evaluated by the United States Food and Drug

Administration and are not approved to diagnose, treat, cure or

prevent

disease.

If you have a medical condition or disease, please talk to your

doctor

prior to using the recommendations given.

Do not self-diagnose. Proper medical care is critical to good

health. If

you have a health concern or undiagnosed sign or symptom, please

consult

a physician, preferably a naturopathic doctor (N.D.), nutritionally

oriented medical doctor (M.D. or (D.O.), or other health care

specialist. Please go to www.naturopathic.org to find a qualified

naturopathic doctor (N.D.) in your area to help you.

Make your physician aware of all the nutritional supplements or

herbal

products you are currently taking to avoid any negative interactions

with any drugs you are taking.

If you are currently taking a prescription medication, you

absolutely

must work with your doctor before discontinuing any drug or altering

any

drug regimen.

 

 

 

JoAnn Guest

mrsjo-

www.geocities.com/mrsjoguest/Diets