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*Arthritis and Osteoarthritis*
(Joint Health / Degenerative Joint Disease)

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Arthritis is a subject that dances pretty close to politics and big money in this country. I've heard it said, "If anybody says they can cure your arthritis they are a quack." There are several different types of arthritis. Some consideration to types is helpful when you consider arthritis from a naturopathic perspective. Osteoarthritis is much different from rheumatoid arthritis. Studies show that many times specific kinds of fats seem to help osteoarthritis, most specifically the fish oils. Glucosamine Sulfate is a substance that has received double blind studies, proving its effectiveness in helping Osteoarthritis. Homeopathics help arthritis dramatically in some instances. I would evaluate someone’s diet and digestion carefully before putting him or her on any kind of regimen to treat arthritis. The diet component of rheumatoid arthritis is usually much more significant than osteoarthritis, but in general a naturopathic evaluation of diet provides the most satisfactory results in treatment.

The most common form of arthritis is Osteoarthritis. This has also been referred to as "wear and tear arthritis" due to its association with aging and injury. It is characterized in X-ray findings by decreased joint space and bony spurs. The most common symptoms are morning stiffness, stiffness after periods of rest, pain associated with use of involved joints, swelling and loss of mobility of joints.

The remainder of this page will discuss only Osteoarthritis.

Index:
Glucosamine Sulfate and Chondroitin Sulfate
Chondrocyte Collagen Production
Herbal Support


Glucosamine Sulfate and Chondroitin Sulfate:
A very good treatment for Osteoarthritis from a Naturopathic standpoint is supplementation with Glucosamine Sulfate. Glucosamine Sulfate has undergone intensive double blind studies. The studies compared placebo, to Ibuprofen (like Advil), and to Glucosamine Sulfate. Initially the Ibuprofen lessoned the pain for up to two weeks, and then the effectiveness began to wear off. After a few more weeks the Ibuprofen actually began to exacerbate the condition. No results were experienced with the Glucosamine Sulfate until after about 6 to 8 weeks, but then the pain began to lesson, and continued to improve. As expected, the placebo had no effect.

A very large molecule makes up what one might refer to as the slippery layer between the bones, that which allows the bones in a joint to move without friction. However that particular molecule is too large to be digested via the intestinal tract. It must be injected into the joint. Glucosamine Sulfate was designed as a smaller molecule that is digestible, and will reassemble into that larger molecule, then be laid down in the bone joint, lubricating that joint. The reason for the 6 to 8 week delay in realizing any relief is it took that long for the Glucosamine Sulfate to cover the joint surfaces enough for relief of some of the pain.

After the Glucosamine Sulfate studies, other studies came out about Chondroitin Sulfate and its effect with Osteoarthritis.

The book "The Arthritis Cure" brought to the forefront the beneficial use of nutritional supplements for osteoarthritis. Both Glucosamine Sulfate and Chondroitin Sulfate have undergone scientific study in individuals with osteoarthritis.

The addition of anti-inflammatory agents to supplementation of Glucosamine Sulfate and Chondroitin Sulfate is a wise choice. These would include: White Willow Bark, Bron (AAC), Boswellia Extract, and Bromelain. In addition, Evening Primrose Oil (an essential fatty acid), has shown anti-arthritic properties in some studies. Manganese and Magnesium are also very beneficial, and very needed.

Glucosamine Sulfate & Chondroitin Sulfate, additional information
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Chondrocyte Collagen Production:
TeraForma Health makes a product called Arth-EEZ. Arth-EEZ supplies the necessary nutrients to joints to assist in chondrocyte collagen production. Arth-EEZ is a protein derived from the enzymatic hydrolyzation of bovine collagen. It consists of a series of 18 amino acids, which are joined in chains by peptide bonds. These are the same amino acids that make up the framework of human cartilage and are required for its formation and regeneration. Since it is a protein, it is absorbed in the intestines. The collagen is then carried via the cardiovascular system to the joints where the nutrients are utilized by the cartilage.

Arth-EEZ has shown dramatic effects especially when combined with Glucosamine Sulfate and Chondroitin Sulfate.

Ingredients:
Contains No starch, yeast, wheat, soy, corn, dairy products, artificial colors, flavors, or preservatives.

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Herbal Support:
A specific blend of some herbal support has beneficial influence on joint immobility and dysfunction. These, when combined with all of the above, provide extra support for pain relief. These herbs are: Devil’s Claw, Hydrangea, Brigham Tea, Sarsaparilla, Wild Lettuce, Valerian Root, Cayenne, Black Walnut Hulls, Black Cohosh Root, Burdock Root, Alfalfa, and Kelp.

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*Glucosamine Sulfate & Chondroitin Sulfate, additional information *

Glucosamine Sulfate -This nutrient supplies the raw materials (glycosaminoglycans), which the joint cartilage requires for building blocks to repair joint cartilage tissue. The body requires these glycosaminoglycans to produce proteoglycans prior to the deposition of collagen in the joint. The availability of these glycosaminoglycans is the rate-limiting step in cartilage formation. Glucosamine provides these important nutrients to the joints.

There have been a number of studies, which have utilized Glucosamine sulfate in individuals with known osteoarthritis. In one study in which the efficacy of 1.5 g/day of oral Glucosamine was compared to the drug oral ibuprofen at 1.2 g/day, it was noted that Glucosamine, although slower to achieve therapeutic effect than ibuprofen, was superior at the end of the 8-week trial. At this point in time, Glucosamine sulfate is the preferred form of Glucosamine, as other forms have not undergone rigorous study.

Chondroitin sulfate - Numerous studies have addressed the efficacy of Chondroitin sulfate in individuals with osteoarthritis. The following are representative.

One hundred and nineteen patients participated in a randomized, double-blind, placebo-controlled trial to evaluate Chondroitin sulfate in the treatment of finger joint osteoarthritis. Subjects received Chondroitin sulfate at 400 mg, 3 times a day, or a placebo. A significant decrease in the number of patients with new `erosive' osteoarthritic finger joints was observed in the Chondroitin sulfate group. Osteoarthritis of the fingers can become a clinical problem, resulting in pain and functional loss. These patients were protected against erosive evolution of the joints.

In evaluating 85 patients with knee osteoarthritis between 39 and 83 years of age, 80 completed the 6-month treatment period, while 5 dropped out after 3 months. Subjects took oral Chondroitin sulfate capsules at 400 mg, 2 times a day. The walking time, which was defined as the minimum time to perform a 20-meter walk, showed a statistically significant reduction only in the Chondroitin sulfate group. Patients who took the placebo reported higher levels of paracetamol (drug) consumption, but this was not statistically different. Both treatments were well tolerated. These data strongly suggest that Chondroitin sulfate acts as a symptomatic slow-acting beneficial natural agent in knee osteoarthritis.

The 3 main mechanisms of how Chondroitin sulfate may work in osteoarthritis include its anti-inflammatory activity; the metabolic effects on the synthesis of hyaluronate on the cartilage proteoglycans; and the direct anti degenerative actions which are realized by the inhibition of proteolytic activity and by the reduction of dangerous effects on matrix molecules determined by reactive oxygen species.

Evening Primrose Oil - This essential fatty acid has shown anti-arthritic properties in some studies.
Please see my section on essential fatty acids, found in the topic Herbs.

Bromelain - This proteolytic enzyme has demonstrated anti-inflammatory properties and enjoys wide use for problems involving pain and tissue inflammation.

Boswellia Extract -Studies have shown this herb to have anti-inflammatory and pain reduction properties similar to NSAID’s (Motrin like medicines) but without the gastrointestinal side effects of these drugs.

Side effects:

There have been no significant side effects reported with these ingredients. Glucosamine Sulfate is bound to either sodium or potassium salts. Individuals on sodium, potassium or salt restriction should consult with their physician prior to use. No reports of sodium overload have been reported to this point in time.

References:

1. Drovanti A, Bignamini AA, Rovati AL. Therapeutic activity of oral Glucosamine sulfate in osteoarthritis: a placebocontrolled doubleblind investigation. Clin Ther 1980;3(4):260–72.
2. Vaz AL. Double-blind clinical evaluation of the relative efficacy of ibuprofen and Glucosamine sulphate in the management of osteoarthritis of the knee in outpatients. Curr Med Res Opin 1982;8(3):145–9.
3.Chondroitin Sulfate: S/DMOAD (Structure/Disease Modifying Anti-Osteoarthritis Drug) in the Treatment of Finger Joint OA," Verbruggen G, et al, Osteoarthritis and Cartilage, 1998;6(Suppl. A):37-38.
4.Efficacy and Tolerability of Oral Chondroitin Sulfate as a Symptomatic Slow-Acting Drug for Osteoarthritis (SYSADOA) in the Treatment of Knee Osteoarthritis," Bucsi L and Poor G, Osteoarthritis and Cartilage, 1998;6(Suppl. A):31-36.
5.Anti- Inflammatory Activity of Chondroitin Sulfate," Ronca F, et al, Osteoarthritis and Cartilage, 1998;6(Suppl. A):14-21.
6. Safayhi H. Sailer ER, Amnon HPT. 5-lipoxygenase inhibition by acetyl-11-keto-b-boswellic acid. Phytomed 1996;3:71–72.
7.. Safayhi H, Mack T, Saieraj J, et al. Boswellic acids: Novel, specific, nonredox inhibitors of 5-lipoxygenase. J Pharmacol Exp Ther 1992;261:1143–46.

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The Following Nutrients Should Be Considered
When Osteoarthritis Support is Desired.

A combination of both Glucosamine Sulfate and Chondroitin Sulfate, with anti-inflammatory agents, such as:
Glucosamine Chondroitin Sulfate

A formula of necessary nutrients for joints to assist in chondrocyte collagen production, such as:
Arth-EEZ

An herbal formula that has specific beneficial influences on joint immobility and dysfunction, such as:
Arth-Aid

A high quality source of Omega 3, 6, and 9 essential fatty acids, such as:
Essential Fatty Acids
See write up on Essential Fatty Acids, in Herbs, for details.

Additional support items:

A high quality antioxidant such as:
Prevent Super Antioxidant
See section on Antioxidants for details.

A pure MSM product (free of useless "fillers"), such as:
(I have witnessed first hand, several so called pure MSM products that had more useless fillers than the actual product!)
MSM - Plus, MethylSulfonylMethane with an advanced enzyme blend delivery system to improve intestinal absorption.
See section of MSM for details.

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DISCLAIMER: This information is provided for Educational Purposes Only and has NOT been designed to diagnose, treat or cure any health conditions. Please consult a qualified Health Care Professional with Nutritional Training to diagnose your health conditions and avoid self-diagnosis. The U.S. Food and Drug Administration have not evaluated statements about these health topics or any suggested product compositions.