ARTHRITIS: THE MAGIC BULLET APPROACH

by Lynn Hinderliter CN, LDN

arthritisThe pain of Arthritis, the flaring of inflamed joints, can drive a person crazy – never any relief, making even sleep a chore,  every moment a misery. Perhaps this is why the field of alternative medicine offers more remedies for arthritis than for all other problems combined, and not a day goes by but someone comes to me asking for one of them. They have heard that burdock works, or alfalfa, or devil’s root, fish liver oil, shark cartilage, yucca, glucosamine sulfate….  the list goes on and on.

This is where I explain that addressing arthritis isn’t as simple as taking one particular pill, or any one single substance. 

I explain that what works for one person doesn’t necessarily work for another, natural remedies do not act like drugs, by addressing a symptom, nor is that what a holistic health professional works to achieve. The aim of natural medicine is to make progress towards an improved quality of life, and a rise in the sufferer’s overall level of health. Moreover, each person may owe their arthritis problems to a different basic cause, such as allergies, trauma, nutritional deficiencies, or possibly even a virus or bacterium.

A Canadian study found that women using synthetic hormones (whether HRT or birth control ) for 5 years or longer were twice as likely to develop osteoarthritis.  A separate study examining synthetic estrogen replacement therapy found a 96% increased risk among those using it 4 to 10 years.
Sahyoun et al Prev Med May 1999; 28(5): 458-464
Wilkins Health Rep Fall 1000; 11(2): 48-57

In osteo-arthritis, damage is done to the cartilage, a special tissue which cushions  the membrane-lined space filled with synovial fluid  (the joint  lubricant) and protects it  from  the ends of the bones.  In rheumatoid arthritis, it appears that the body’s own immune system triggers abnormal tissue growth (called Pannus) which covers the cartilage causing inflammation and deformity.. While osteo-arthritis can be addressed successfully with the following suggestions, rheumatoid arthritis additionally  requires more complex work with the immune system.

The journey towards better joint health involves three basic steps.

Step One is detoxifying . The reason is simple – a life-time of randomly putting stuff into the body and not completely clearing it out, means that the elimination process is clogged, right down to the most basic level of our cells. When our cells are unable to rid themselves of toxins, a process of deep inflammation starts and very often the areas that become inflamed are areas where we have weaknesses, such as an old injury, or joints and muscles that we stress disproportionately in our daily life. Equally, as long as the cells are clogged by undischarged toxins, they are not able to accept and use the nutrients needed to rebuild and restore proper function.Step Two is adjustment of the diet. In arthritis, very often allergies play a role. When a person has allergies, this means, put simply, that certain substances in the food have escaped the proper digestive process and been assimilated whole into our blood stream. There, the body perceives them as enemies, and an inflammatory cascade is set in action.

Dr. M. Werbach M.D. says that approximately 10 to 20% of people with arthritis suffer from insufficient production of Hydrochloric Acid, one of the functions of which is to digest proteins. “When the digestion of food proteins is inadequate, the gut lining absorbs more partially broken down products …. while amino acids, the fully broken down products of protein digestion, are invisible to the immune system, partially broken down protein products alert the immune system to the presence of perceived foreign invaders”. The immune response that follows might well be the cause of a flare-up.

I can personally attest to the fact that problems with my back almost always accompany a temporary problem with digestive inflammation. Certain people with arthritis respond to eliminating the “nightshade” family of foods from their diet. These are tomatoes, peppers, (to include chili, paprika but not black pepper) potatoes, nicotine and eggplants. With rheumatoid arthritis, wheat and dairy are often culprits.

Interestingly, new research is suggesting a link between carbohydrates and rheumatoid arthritis: Harvard researcher Dr. Julia Wang and her colleagues injected mice with GAGs. (Lynn: these are complex carbohydrates). GAG-binding cells accumulated in the animals’ joints, and the mice developed chronic RA-like symptoms, including synovitis, tenosynovitis and dermatitis. Some animals developed bone erosion. Since then, they have found GAG binding cells in human tissue, and they theorize that this may be an immune response to bacteria carrying GAG-like molecules on their surface. Up until now, carbohydrates have been considered rare triggers of the immune system, but patients with Rheumatoid Arthritis are found to have higher than normal levels of the GAG hyaluronic acid. LIMIT YOUR SUGAR INTAKE!

The other aspect of diet is that food choices low in certain nutrients can fail to support the systems in our body that repair and nourish joints and bone tissue. Equally, a diet high in the wrong nutrients can overburden the digestion, and a diet that is too rich and indulgent can contribute to the formation of free radicals, which also attack the body at the cellular level. Ours is a complicated organism!

A factor that is currently little regarded, but which I have found to be key to the control of arthritis ( as well as many other chronic disease problems) is balancing the acid/alkaline, or pH, factor in the body. This is particularly true where calcium deposits are a part of the problem, since calcium cannot be absorbed properly in an acid pH (as opposed to needing acid in the stomach to be absorbed). Most Americans tend to be highly acidic: nearly all proteins contribute to an acid pH, while green vegetables are mostly alkaline. You can buy pH papers at some pharmacies to check your own situation. You can also order them directly from us. Adding Super Green Foods in a powder or a tablet can be very beneficial for controlling this imbalance.  Also, some of the hype about Coral Calcium does have a basis:  it modifies pH, a balancing process which enables the body to defend itself better against chronic problems.

Step Three is the proper selection of the nutrients needed to help the body to rebuild, repair, and fight the inflammation that is causing the problem. Sometimes this may even include burdock, or yucca, or fish oil: though one of the most promising substances to come to the fore in helping osteoarthritis is Glucosamine Sulfate, and some find Glucosamine HCL even more helpful.

This natural remedy is described dramatically by Dr. Julian Whitaker; he says Glucosamine is to connective tissue what wheat is to bread! It’s main action in the body is to stimulate the formation of connective tissue, an ability which some people seem to lose as they age. Thus, while NSAIDS and other anti-arthritic drugs address only the symptoms of the disease (and some of them in the long run actually increase destruction of bone – you can find more details about this  here at www.mercola.com **) the nutrient Glucosamine sulfate addresses the cause.

If you have blood sugar problems that worsen when you are using Glucosamine, be aware that some people experience this effect. – http://altmedicine.about.com/cs/arthritis/a/Glucosamine.htm

It does not have its effect over-night; many nutritionally oriented doctors wean their patients off the drugs they are using slowly, at the same time introducing the Glucosamine: the dosage recommended by Dr. Whitaker is 500 mgs, three times daily. In most cases, improvement can be noted by the end of 30 days. These holistic Doctors also point out what I said previously, that a complete nutritional program needs to be followed for optimum success: and there are formulas available that pair the Glucosamine with important companion factors which improve its effectiveness.

Chief among these is Chondroitin Sulfate, also known as mucopolysaccharides, glycosaminoglycans and proteoglycans. I say this not to show that I can handle long names, but because the names indicate that CS is formed from Glucosamine sulfate or Glutamine (an amino acid in protein) on its way to repair and regenerate cartilage: NSAIDS are known to inhibit the synthesis of CS, therefore, if you are taking NSAIDS and Glucosamine without Chondroitin, you could actually be sabotaging your own efforts to rebuild cartilage.

We now know that COX-2 inhibitors (Vioxx, Celebrex)  carry with them their own risks 

There are many effective natural COX-2 inhibitors, among them Curcumin, Ginger, and Boswellia. There are some very effective formulae available that combine a number of these valuable herbs. 

The action of these herbs is anti-inflammatory in nature.  Inflammation can be defined as a situation where cells are being destroyed faster than they can be replaced.  The destruction takes place either because the cells are damaged by toxins,  or the body lacks either the hormones or the nutrients it requires for repair , or the situation is being aggravated by pro-inflammatory fatty acids. Inflammation is implicated in most chronic diseases such as cardiovascular problems, asthma, diabetes, and all itis” states – colitis, arthritis, etc.

Inflammation is addressed by determining the under-lying cause:  avoiding, expelling or neutralizing toxins, maximizing one’s intake of antioxidants, balancing with  the correct omega 3 fatty acids,  providing the nutrients needed for cellular health and selecting from the natural anti-inflammatories such as those listed in the previous paragraph.

Be wary of NSAIDS also: prolonged use inhibits cartilage repair, and actually contributes to a worsening of the osteoarthritic condition.

Glucosamine Sulfate

There are numerous double blind studies that have been done, showing not only that  it is effective, but also that it is totally non-toxic. I have the results I get with my own clients to tell me that, combined with the other life-style and diet changes, Glucosamine can  make a difference in the fight against this crippling disease. Adding Chondroitin Sulfate to the Glucosamine enhances the latter’s ability to repair cartilage. There are formulas available combining the two, or take higher potencies of GS and CS separately.

Latest on the scene is an amino acid called SAM-e which has been the subject of about 75 studies in Europe dating back to the 1980s, but only became available in the U.S a few years ago. Not only do experts claim that (by a process of methylation which detoxifies compounds damaging to the nervous system) SAM-e returns the pleasure to everyday living, it also appears to have the ability to repair and desensitize damaged joints.

Interestingly, people with severe liver problems, such as cirrhosis, tend to be deficient in SAM-e, because of problems metabolizing Methionine. It is a leap, I know, but perhaps cleansing the liver, or taking liver-supportive herbs might be helpful, particularly for women taking hormones and suffering from joint problems. Remember, hormones are deconjugated in the liver, which places a tremendous burden on it. On a practical note – when buying SAM-e, make sure the tablet is enteric coated, otherwise it will break down too soon and not be absorbed at the proper site: it will simply be digested and used as Methionine.  It is possible now to find SAM-e and Glucosamine together – see RESOURCES.

The most difficult to treat types of arthritic pain, accompanied by extreme inflammation, often are helped by the use of proteolytic enzymes taken not with, but between meals. Rheumatoid arthritis and systemic lupus erythematosus have also responded well in many cases to this approach. Studies have shown a considerable reduction in circulating immune complexes, and a reduction in flare-ups. This enzyme treatment also helps through another method – control of inflammation.  Enzymedica makes an excellent systemic enyzme called Repair.

Rheumatoid arthritis being partly a problem with an overstimulated immune system, I looked for many years to find a supplement that would balance rather than stimulate the immune system, and about 5 years ago I found the now well-known Moducare.  There can be no doubt that this should be the product of choice for RA sufferers, since I have seen too many good results to think otherwise.  I highly recommend it.

However, I feel that if an entire 3 Step program is not instituted, we are not addressing the problem holistically, we’re really only putting a Band-Aid on it. We are ignoring the possibility that infection and inflammation  may be setting in underneath, attacking our health at a deeper and more deadly level. Arthritis is in most cases a chronic disease state, and it is a melancholy fact that when one aspect of our health breaks down, if we do not dramatically alter our life style, other problems will follow. An approach of a total and healing nature which addresses and hopefully corrects whatever underlying imbalance caused the original problem to surface, gives more lasting benefit than a single Magic Bullet!

Since many people come to me asking whether there is any nutritional help for gout, I am appending some suggestions here. 

Gout is caused by uric acid crystallizing in the joints, and causing excruciating agony. This can be because of an overproduction of uric acid, or a problem eliminating it. Either way, diet certainly plays a part, and the first thing I recommend is eating a diet high in vegetables and fruits, particularly cherries and celery, while avoiding meats and alcohol. This is because maintaining a non-acidic pH is of the utmost importance.

Legumes, including peanuts, can pose a problem, and recently some research has suggested that high intake of fructose , which is universally present these days in soft drinks and other processed foods, can also contribute to the condition. Drink plenty of pure water, and NOTHING ELSE! (Except green tea, which is positively helpful, or other herbal teas with the plants mentioned below.)

Obesity may contribute to gout – some medications also are involved, specifically salicyclates, diuretics, cyclosporine, pyrazinimide and some chemotherapeutic drugs.

Nutrients that may be helpful for gout sufferers are Fish Oils (Omega 3) and Folic Acid. Herbs that have been shown to help are Skullcap, Chamomile, Celery Seed and Yarrow. Eating cherries and blueberries helps, as does taking supplements containing these cyanidins.

A herb from South Africa called Devil’s Claw shows some promise for controlling the inflammation and pain. I also suggest a digestive enzyme, which one depends on your blood type and the type of digestive problems you are experiencing. Frequently a liver balancing formula is also of help. Quercetin is showing promise as an anti-inflammatory with specific reference to gout.

** As if that weren’t enough, some studies have found a higher incidence of necrotising fasciitis among chickenpox patients treated with ibuprofen.The drugs are sold under brand-names including Motrin™, Nuprin™, Advil™ and others. It is in the group known as non-steroidal anti-inflammatories all of which have been linked to the disease.

Independently, three New Zealand doctors have published a study in the latest New Zealand Medical Journal on necrotising fasciitis.

Of the 13 people treated for the disease at the hospital’s intensive care unit in 1998 and 1999, 5 had been taking the drug Voltaren or other drugs in the same group.

2 of the 5- and one of the patients not taking those drugs – died.

A study of seven cases of the disease had found that five patients had been taking non-steroidal anti-inflammatory drugs (NSAIDs). The mechanism by which NSAIDs increase the risk of necrotising fasciitis may be by impairment of the immune response, or by masking of the symptoms of secondary infection, leading to delayed diagnosis and treatment.

New Zealand National News February 1, 2001.

I am indebted to Dr Mercola (http://www.mercola.com) for this information. His newsletter is always full of interesting facts – check it out!  Subscription is free.

More about Inflammation – http://www.vioxx-celebrex-side-effects.com/

Rheumatoid Arthritis and Smoking

 An overview of GOUT – http://www.spearsmacleod.com/links/g/gout/index.htm

 http://www.glucosamine-arthritis.org/
At the Arthritis & Glucosamine Information Center you’ll find top quality information on Arthritis and Glucosamine, the latest research, details on arthritis medications and treatments, and tips for effectively managing your pain.

Problems with Chondroitin and Prostate – http://www.malecare.com/new_page_26.htm

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