Wednesday, January 30, 2013

Arthritis and the Role of Natural Products


Over three million Canadians suffer with the debilitating symptoms of arthritis - pain and inflammation. Arthritis encompasses over 100 forms of inflammatory disorders with osteoarthritis and rheumatoid arthritis the most common. Osteoarthritis is a degenerative condition caused by wear and tear of the connective tissue and cartilage that cushions the joint. It typically occurs later in life and affects the weight bearing joints - hips, knees and spine - leading to pain, swelling, and stiffness of the joints. Rheumatoid arthritis is an autoimmune disease that can appear suddenly at any age, and may fluctuate in severity. The immune system produces antibodies that cause damage to the joints leading to redness, pain, inflammation and deformation.

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to dampen the pain and inflammation of arthritis, yet their popularity is waning as many serious and life threatening side effects have emerged, such as stomach ulcers and bleeding, increased gut permeability, water retention and kidney damage. Recently, one class of these drugs (COX-2 inhibitors) has been linked to increased risk of heart attacks. Ironically, long term use of these drugs can actually worsen joint health by accelerating the breakdown of cartilage and destroying healthy cartilage tissue. With all these drawbacks, it is not surprising that many are turning to natural approaches to managing arthritis. Below are my top supplement recommendations for arthritis relief:

Celadrin

Celadrin is a blend of fatty acids that works to reduce inflammation, lubricate joints and promote healing, thus offering benefits for both rheumatoid and osteoarthritis sufferers. In a study of sixty-four individuals with knee osteoarthritis the use of Celadrin was found to reduce pain and swelling, and improve flexibility and range of motion compared to placebo. (Hesslink, 2002) Celadrin is sold by various companies in tablets, capsules and creams and has no side effects. The recommended dosage is 1500 mg daily. Cream is applied twice daily.

Essential Fatty Acids

Both the omega-3s (fish oil) and omega-6s (borage, primrose oil) have been found to help reduce the pain and inflammation associated with arthritis. These "good" fats work in part by boost levels of prostaglandins - hormone-like substances that have anti-inflammatory activity. Omega-3s are also very beneficial for heart health. Usual dosage of these oils is between 2 and 4 grams daily.

Glucosamine

Glucosamine is nutrient used by the body in the production of cartilage. It stimulates the production of new cartilage, blocks enzymes that break down connective tissue, and reduces pain and inflammation. Glucosamine has been studied extensively for osteoarthritis and found to be comparable to NSAIDs, yet better tolerated. The recommended dosage is 1500 mg daily.

S-adenosylmethionine (SAMe)

SAMe is a nutrient produced in the body that is vital to the health and development of my tissues and organs. In the joint, SAMe is involved in cartilage formation and repair.

Supplementing with SAMe has been found to reduce the pain and inflammation of osteoarthritis and to stimulate cartilage formation in numerous studies. Recently, the US government Agency for Healthcare Research and Quality conducted a review of 10 studies on SAMe for osteoarthritis and found it equally effective to NSAIDs. (Hardy et al, 2002) SAMe is very safe and well tolerated. The recommended dosage range is 400 to 1200 mg of natural (Isoactive) SAMe daily.

All of these nutritional supplements are backed by solid clinical research and can offer great help to those suffering with arthritis.

Calming Inflammation

Inflammation is a process by which the body's defense system or immune system (white blood cells and other chemicals) reacts to infection, contact with foreign substances, or injury. It happens when you stub your toe, contract a virus or are exposed to a harsh chemical. Your immune system mounts a defense by releasing various chemicals which increase blood flow to the area, causing some or all of the following symptoms: redness, swelling, warmth, and pain. Inflammation may also be associated with flu-like symptoms such as fever, chills, fatigue and aching.

Although inflammation is a natural process designed to help the body fight infection and promote healing, in some cases the body's immune system over-reacts or reacts inappropriately. Such is the case with autoimmune diseases, where the body's normally protective immune system causes damage to its own tissues.

Lifestyle factors such as stress, poor diet and lack of sleep also contribute to inflammation. While there are often obvious signs of acute inflammation, such as redness and swelling, chronic inflammation, which occurs from lifestyle factors, can be more insidious. It can affect many body tissues including blood vessels, organs and nerves with few or no obvious signs until a serious health problem develops. Researchers have now identified inflammation as a factor in the development and progression of many chronic diseases including diabetes, heart disease, cancer and multiple sclerosis. Thus it is essential to be aware of the factors that trigger inflammation and approaches to keep this process in check.

Inflammation and Disease

There is no debate that many chronic diseases that we face today are associated with inflammation. Below are some of the most common and concerning health problems linked to inflammation.

Arthritis

Arthritis is a general term used to describe various inflammatory conditions in the body. There are over 100 forms of arthritis, including rheumatoid arthritis, gout, lupus, fibromyalgia, osteoarthritis and Sj繹gren's syndrome. These diseases involve joint and musculoskeletal pain, and are often a result of inflammation of the joint lining. Some forms of arthritis are caused by autoimmune responses, such as rheumatoid arthritis and lupus, and others are caused by wear and tear to the joint (such as osteoarthritis) which leads to inflammation.

Cancer

Chronic inflammation resulting from infection or chemical exposure has been identified as a risk factor for various forms cancer. For example, research has found strong associations for the Human papiloma virus (HPV) and cervical cancer, Helicobacter pylori bacterial infection and gastric adenocarcinoma, the hepatitis B virus and cirrhosis and hepato-cellular carcinoma, asbestos-induced inflammation and lung cancer, and cigarette smoke-induced inflammation and lung, bowel and pancreatic cancer. These studies demonstrate that inflammation promotes tumor development.

Cancer and inflammation share another connection. It has been found that that chronic inflammation occurs due to tumor environment stress and that this generates a protective shield from the immune system. In other words, inflammation protects the tumor from attack by the immune system. Researchers have found that the release of inflammatory compounds such as cytokines, leucocytes, lymphocytes and macrophages contribute to the progression and metastasis. Furthermore, this inflammatory response can compromise the response to chemotherapy.

Diabetes

Mounting research is linking uncontrolled high levels of blood glucose to inflammation, which can lead to diabetic complication such as neuropathy, retinopathy and nephropathy. Researchers have found that high levels of blood glucose lead to glycation and oxidation of proteins, lipids and nucleotides, resulting in the formation of advanced glycation end products (AGEs). It is thought that AGEs trigger various inflammatory processes which can lead to damage of the blood vessels throughout the body. Thus, controlling blood sugar is vital to the prevention of inflammation and diabetic complications.

Heart Disease

Over the past decade researchers have discovered a link between inflammation and heart disease. Studies suggest that inflammation is important in the development of atherosclerosis, the process in which fatty deposits build up in the inner lining of arteries increasing the risk of heart attack and stroke. Factors that promote atherosclerosis, including cigarette smoking, hypertension, atherogenic lipoproteins, and hyperglycemia, give rise to a variety of noxious stimuli that cause the release of chemicals and the activation of cells involved in the inflammatory process. These events contribute not only to the formation of plaque but may also contribute to its disruption resulting in the formation of a blood clot.

C-reactive protein (CRP) is a substance produced in the liver during inflammation. Research has found that those with high CRP levels are at increased risk of heart attack, stroke, cancer, macular degeneration and Type 2 diabetes. Your CRP level can be determined by a simple blood test ordered by your doctor.

Multiple Sclerosis

Multiple sclerosis (MS) is a chronic inflammatory disease of the brain and spinal cord. Inflammation destroys the myelin, leaving multiple areas of scar tissue (sclerosis). Individuals with MS develop progressive neurological disability, and this is thought to be caused by degradation of the nerve cells. New research is looking at antioxidants that can protect nerve cells and reduce disease progression.

Lifestyle Factors that Promote Inflammation

Poor Diet - high glycemic (quick release) carbohydrates such as white bread and other refined foods raise blood glucose levels which trigger the release of advanced glycation end products which promote inflammation. Consuming saturated fat (animal products), eating overcooked (burned foods) and overeating also lead to inflammation in the body.

Lack of Sleep - adequate sleep is required by the body and immune system for regeneration and repair. Researchers have found that lack of sleep leads to the production of inflammatory compounds (cytokines). If you produce these inflammatory markers on a chronic basis it can increase your risk for heart disease, stroke, cancer and diabetes, and a shorter life span.

Stress - during stress, the body releases various hormones such as cortisol. Cortisol helps the body in the fight/flight situation by suppressing immune system function and reducing inflammation. If stress becomes chronic and the body can't make adequate stress hormones to turn the immune system off autoimmune diseases and inflammation can occur.

Obesity - fat cells secrete compounds, such as cytokines, that trigger inflammation and increase the risk of heart disease and diabetes. Excess weight also puts strain on the joints, primarily the hips and knees. Over time this pressure can wear down cartilage and cause bone to grind against bone, triggering inflammation.

Controlling Inflammation

To control inflammation and its consequences, consider the following lifestyle approaches:

Diet: eat a plant-based diet with lots of fresh fruits, vegetables, beans, legumes and whole grains. Fish, nuts, seeds (hemp and flax) and olive oil contains essential fatty acids that help reduce inflammation. Green tea contains antioxidants that reduce chronic disease risk.

Lifestyle: work on reducing your stress levels. Try yoga, Tai Chi, meditation and breathing exercises.

Supplements: to reduce inflammation, consider the following:

繚 Aged garlic extract - reduces multiple risk factors for heart disease. It helps lower blood pressure and cholesterol, reduces LDL oxidation and plaque formation.

繚 Boswellia - a tree resin with anti-inflammatory properties. Studies find it beneficial for rheumatoid arthritis.

繚 Celadrin - a mixture of cetylated fatty acids that reduces inflammation and lubricates joints. Research supports its use for rheumatoid arthritis. Preliminary evidence shows that it may help those with psoriasis and other inflammatory conditions.

繚 Fish oils - rich in omega-3 fatty acids which reduce multiple risk factors for heart disease (inflammation blood pressure, cholesterol, homocysteine, and clotting). Studies also support its use for reducing symptoms of rheumatoid arthritis, ankylosing spondylitis, lupus and other inflammatory conditions.

繚 Glucosamine - a substance naturally produced in the body; involved in cartilage repair. Studies show that it can reduce pain and improve mobility in those with osteoarthritis.

Exercise: aim for one hour of moderate intensity activity each day such as walking, cycling, swimming or doing lawn work.

Sleep: aim for 7 to 9 hour of sleep each night. There is no sleep bank, so you can't catch up on lost hours over the weekend.

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