–by Dr. Michael Colgan
It’s evident Western society has fallen prey to the rampant spread of joint and connective tissue disorders. Osteoarthritis, rheumatoid arthritis, gout, fibromyalgia and chronic fatigue disorders are the most prevalent forms of disability in the Western world.
Sadly there’s no end in sight to this misery if you depend on the current medical model for your treatment. For more than a century the major medical approach to joint and connective tissue disorders has offered little more than a mask of symptomatic relief.
This obsolete strategy allows the illness to progress beneath the mask. What’s worse is that the medical treatments often exacerbate and accelerate the progression of arthritis.
Table of Contents:
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- 1. Introduction
- 2. Get Ready To Beat Arthritis
- 3. Joint Physiology
- 4. The Drug Dilemma
- 5. Arthritis By Any Other Name
- 6. Gout Is A Guy Thing
- 7. Avoid Foods High In Purines
- 8. Drink Water & Take Folic Acid, B12
- 9. Eat To Beat ALL Forms Of Arthritis
- 10. Say No To Red Meats –Say YES To Fish
- 11. Arthritis And Fats
- 12. Fishing For Omega-3 Solutions
- 13. Flax Oil Works Miracles
- 14. The Omega-3 Combo
- 15. Don’t Forget Omega-6
- 16. The Dynamic Duo: Omega-3 and Omega-6
- 17. Use Of Essential Fats Not Enough
- 18. Glucosamine Sulfate A Must
- 19. Glucosamine Sulfate Beats Drugs
- 20. Glucosamine Repairs Cartilage
- 21. Chondroitin Sulfate Of Little Benefit
- 22. N-Acetyl Glucosamine Might Work
- 23. SAMe Definitely Works
- 24. SAMe vs Drugs
- 25. SAMe For Rebuilding Joints
- 26. Fibromyalgia Responds To SAMe
- 27. Beware The Rise Of Homocystein
- 28. The Rise And Fall Of Homocystein
- 29. Colgan Rx For High Homocystein
- 30. The Lowdown On Arthritis Blues
- 31. It’s All In Your Head
- 32. Nutrients vs Antidepressant Drugs
- 33. Joints Don’t Wear Out: They Rust Out
- 34. Antioxidants To The Rescue
- 35. The Colgan Antioxidant Rx
- 36. SAMe Is Antioxidant
- 37. The Menopause Connection
- 38. Hormones Influence Arthritis
- 39. Estrogen And Bone Loss
- 40. A Little DHEA Goes A Long Way
- 41. Progesterone, Not Progestin
- 42. HRT: The Pros And Cons
- 43. Alternatives To Hormones
- 44. Lose Bodyfat And Gain Muscle
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In the US alone, there are nearly 22 million reported arthritis patients according to the Arthritis Foundation. That’s only the number of patients who have been medically diagnosed. Millions more have not yet been to the doctor to have an official diagnosis.
Arthritis Attacks Millions
GET READY TO BEAT ARTHRITIS
As we move further into the new millennium, a fundamental shift is occurring in the medical treatments of arthritis and other joint disorders. It’s taken a long time to happen but finally the medical focus on arthritis is reaching beyond the narrow sighted goal of symptomatic relief.
It’s only been recently that physicians have begun to recognize that the long lasting-solution to arthritis is to actually provide the body with the structural materials to rebuild joints.
Increasingly, the prevention (and yes even the cure) of arthritis is within our reach. Intensive research in the last decade shows that the maintenance and restoration of the cellular matrix of membrane, cartilage and bone should replace drugs as the principle of intervention.
If you choose to follow my program and adhere to the strategies outlined in this book, I assure you that you will experience a physical transformation by the end of a year. In many cases the chronic pain of arthritis and joint disorders will disappear and you will enjoy life arthritis-free.
The construction and function of joints is pure engineering genius. Joints have been designed by the Master Builder to renew and rebuild themselves if we give them the right structural materials.
Visualize this: Your cartilage (pads of soft tissue that cushion your joints) contains cells called chondrocytes which renew bits continuously. Chondrocytes perform this magic by producing strong feathery threads called proteoglycans and strings of collagen fibrils.
These stringy components knit together to form a tough but spongy cushion of cartilage that reduces the shock of bone bumping on bone and stops the ends of the bones from rubbing each other raw.
The cartilage cushion the is lubricated by synovial fluid –joint oil, which enables the joints to slide effortlessly through their range of motion. Synovial fluid is produced by the synovial membrane, a slippery sheath which lines the joint capsule. The capsule itself as a strong and inelastic sleeve that seals the whole joint to the ends of the bones.
Nutrition The Answer
Now consider what happens when the nutritional components required for the endless renewal and reconstruction of joints and connective tissue are not available. Any of three main conditions initiate and perpetuate arthritis.
- The rate of destruction of the cartilage exceeds the body’s capacity to replace it.
- Inflammation of the synovial membrane inhibits production of synovial fluid (joint oil)
- Toxic substances, such as uric acid, get into the joint.
THE DRUG DILEMMA
To use or not to use? That is inevitably the question every arthritis sufferer must face. Sure, the use of drugs offers a measure of relief from relentless symptoms of arthritis. But at what cost? There is no free lunch when it comes to drugs. There’s always a price to pay. The price in this instance, is that the drugs most frequently prescribed by physicians –aspirin and non-steroidal anti-inflammatory drug (NSAIDs), do absolutely nothing to cure the disease.
In fact, as clinical studies have shown for 20 years, long term use of aspirin and other NSAIDs s prevents your body from repairing cartilage. The scariest part of this story is that this commonly accepted medical approach is known to actually accelerate progression of arthritis. Most physicians who prescribe and NSAIDs know this.
The story gets more grim. As arthritis progresses, medicine has little else to offer except even more destructive drugs, such as corticosteroids, gold salts, hydroxychloroquine, and the cancer chemotherapy drug —methotrexate.
The long-term use of these drugs results in the death of the affected joints and the ultimate replacement with crude robotic chunks of alien metal as owners of these joints will confide, are at best a hobble-de-hoy solution. Am I beginning to convince you that drugs are not the answer to arthritis as they have been cracked up to be by the pharmaceutical giants that produce them?
ARTHRITIS BY ANY OTHER NAME
Most folk recognize only three forms of the disease called “arthritis” –osteoarthritis, rheumatoid arthritis and gout. But it’s so much more inclusive than that. In fact, the term arthritis has become a grab bag for describing hundreds of different degenerative disorders ranging from multiple forms of lupus, ankylosing spondylitis, Crohn’s disease –and bursitis to arthritis caused by trauma and by infectious agents such as tuberculosis, Lyme disease and Epstein Barr virus, to the modern disorders of fibromyalgia and chronic fatigue.
In their various forms, all of these disorders involve progressive stiffness, swelling, tenderness, pain, deformity and loss of motion in the joints. The trickiest thing about diagnosing (and treating) arthritis, is that it’s a mixed bag of overlapping and intermittent symptoms, This fact makes the individual patient’s problem incredibly difficult to analyze by the usual medical tests.
Arthritis is no respecter of persons. But if your name is Robert instead of Mary, you have a much lower chance of having rheumatoid or osteoarthritis. The sad truth is that women get arthritis more often than men especially after age 45 –three to 10 times as many women have these forms of arthritis than do men.
GOUT IS A GUY THING
However, gout is another matter altogether. Only in the case of gout is there gender parity on the arthritis front. Men are the victims of the various forms of gout ninety-five percent of the time.
Many a man knows the agonizing pain of a gout attack, yet gout is primarily a self-inflicted disease. The enemy is us. We bring it upon ourselves as a natural consequence of an unbalanced diet. Gout occurs when crystals of uric acid invade the joints, causing excruciating pain, especially in joints rich in nerves such as a big toe. The major cause of gout is hyperuricemia –high levels of uric acid in the blood.
Uric acid is a normal component of your body but becomes toxic when serum levels rise above 6.0mg/100ml. If these levels reach 7.0mg/100ml, sharp crystals are forming in your joints and its only a matter of time before you feel it –BIG TIME!
The majority of cases of hyperuricemia occur from two causes: ingestion of edibles that increase bodily production of uric acid, and ingestion of edibles that reduce the body’s ability to excrete uric acid in urine by the kidneys. Gout is simply a matter of producing too much uric acid at the same time that you’re not getting rid of it fast enough.
A final common cause of deposition of crystals in the joints is prescription drugs. The worst offenders are diuretics which inhibit excretion of uric acid through the kidneys. If you have arthritis and your uric acid level is above 5.5mg/100ml, and you are using prescribed diuretics or another problem, such as water retention or hypertension, take these medical references to your physician. Alternative medication save you a lot of suffering.
AVOID FOODS HIGH IN PURINES
Foods high in purines will raise uric acid levels in almost anyone. The worst offender is beer. It’s a double whammy. Not only is its purine content over the moon, but the alcohol and other chemicals in beer also inhibit uric acid excretion from the body.
Distilled liquors are almost as bad because of their high alcohol content. So is red wine because of a multitude of chemicals it contains. White wine in moderation is the best but still does nothing to help reduce uric acid levels.
More high purine foods are given below, together with other foods that raise uric acid levels. Especially important to avoid a refined carbohydrates, which include all white flour products, white and enriched flour breads and baked goods. Although not high in purines, these foods will send your uric acid into the stratosphere. So will the sugar, fructose. Saturated fats and trans fats found in many processed and fast foods worsen this problem because they they inhibit uric acid excretion.
Foods High In Purines And Other Edibles That Raise Uric Acid Levels
Foods that are high in purines and should be avoided include: Beer and all Liquors, Red meats, Organ meats (heart, liver, kidneys, sweetbreads, brains) Pates, Herring, Sardines, Anchovies, Caviar, Roe, Mussels, Aged cheeses and all types of Beans.
DRINK WATER AND TAKE FOLIC ACID, B12
Drink water, not beer! In contrast to drinking alcohol, plain water dramatically increases purine and urate excretions from the body. Not only for gouty problems, but for many reasons, a steady intake of 10 – 12 glasses of water every day is powerful ammo in your war against arthritis.
One nutrient that dramatically lowers uric acid by inhibiting the bodily enzyme necessary for making it, is the essential vitamin folic acid. This remarkable nutrient as a preventive against gout warrants its use every day. A dose of 2.0 mg of folic acid combined with 200 mcg of vitamin B12 is a Godsend!
EAT TO BEAT ALL FORMS OF ARTHRITIS
Since the structural materials needed to rebuild joints come only from the nutrients you ingest, every morsel you put in your mouth makes a difference to the ultimate help of your joints.
Food can save you from the ravages of arthritis or it can speed up the process of joint deterioration. The choice is yours.
Studies show unequivocally that in societies that eat our ancestral diet, arthritis is virtually non-existent. These arthritis-free folk enjoy a regular diet of organic whole grains, fresh vegetables, fruits and essential fats. Their diets consist of very little meat, low saturated fats, low sugar, low carbohydrates and minimal man-made chemicals.
Some folk have called my regimen strict, and so it may seem at the beginning. But as arthritis fades away and you begin to feel the multiple benefits, it is no more onerous than cleaning your teeth, and a lot more beneficial to your health. After about a year when symptoms disappear, you can be confident you have transform your body. Thereafter, moderate indulgence in forbidden foods will no longer send you running for aspirin.
- eat whole grains, not refined carbohydrates
- eat fresh vegetables, not canned or preserved
- avoid all beans
- eat fresh fruits, not canned, dried or preserved
- eat fish first, then white meat, not red meats
- avoid organ meats, certain fish and fish roe
- eat a low-fat diet, especially avoid aged cheeses
- avoid essential fats that are saturated or trans fats
- eat a low-sugar diet, especially avoid fructose
- if you must, drink white wine –not beer, liquor or red wine
- drink 10-12 glasses of water every day
- avoid man-made chemicals, especially diuretic drugs
- eat moderately. Keep that body fat at bay
- make your diet and your body lean and clean
SAY NO TO RED MEATS –Say YES To Fish
Red meat is definitely out if you want to win the war against arthritis. Here’s why. Meats, especially red meats, are not only high in saturated fats, but also contain high levels of arachidonic acid. This preformed omega-6 fat is the precursor of a highly inflammatory compounds in your body called Prostaglandin E². Folk who eat high levels of red meats are likely to create a pro-inflammatory condition in all their tissues.
A few years back I did a 1 year series of case studies on strength athletes who ate large amounts of red meat as their main source of protein and were all subject to frequent joint problems. Every one of them had abnormal high levels of arachidonic acid in their blood.
When I took them off red meat and substituted ion-exchange whey protein concentrate as their main protein source, arachidonic acid levels declined and joint problems diminished. Other controlled studies report similar results in patients with rheumatoid arthritis.
Further research into the effects of diet is uncovering strong links between a high fish protein diet and protection against arthritis. In the latest study, Dr. J. A. Shapiro and his team at the University of Washington in Seattle showed that even two meals of baked or broiled fish per week dramatically reduced the risk of rheumatoid arthritis in women.
So fish is in and red meat is definitely out if you want to whack arthritis. Whenever the thought of a juicy steak sets the saliva flowing, remember be kind to your knees –cause you’ll miss them when they’re gone.
ARTHRITIS AND FATS
If I’ve said it once, I’ve said it a thousand times. You’ve got to eat essential fats and eliminate saturated fat in order to help beat all forms of arthritis. It may not directly cause rheumatoid arthritis, but saturated fat in the diet (found in meats and dairy foods, processed vegetable oils, margarine and hydrogenated or partially hydrogenated fats), definitely worsens rheumatoid disorders.
Eating saturated fat disrupts the metabolism of essential fats -the “good” fats. This disruption of essential fat metabolism is one likely mechanism by which saturated fat promotes arthritis.2 Coinciding with the high level of saturated fat our society eats, especially in the form of meats and dairy products, is the fact that we are not eating enough of the Omega-3 and Omega-6 essential fats.
This double-whammy of eating too much saturated fat and not enough essential fats literally throws open the door, rolls out the welcome mat, and invites joint and connective tissue disease to take up residence in our joints.
FISHING FOR OMEGA-3 SOLUTIONS
Western diets are woefully deficient in essential fats, especially omega-3 fats. Correction of just this one dietary deficiency has dramatic benefits for rheumatoid arthritis disorders.
It was not until the 1980’s, that Dr. Joel Kremer of Albany Medical College in New York, gave omega-3 from fish oil to rheumatoid arthritis patients. Without any other nutritional changes, the omega-3 fats alone reduced inflammation, pain, and tenderness of arthritic joints by 50%. Since then, more than 20 double-blind, placebo-controlled studies have confirmed Kremer’s findings. The omega-3 in fish oil most responsible for these benefits is eicosapentaenoic acid.
Something to note about omega-3 from fish oil is that you have to take a lot of it to get the optimum effect. For most folk, however, compliance is difficult because of the large number of horse pills to swallow, or the foul taste of fish oil if taken as a liquid. Fish oil is also expensive, and if bought in bulk to save money, poses the risk of the highly biologically active oil going rancid, even in capsule form. Lucky for us there is a more palatable alternative – flax oil.
FLAX OIL WORKS MIRACLES
The benefits of the omega-3 fats in flax oil for treatment of arthritis were first outlined by Dr. Johanna Budwig in 1959 in Zurich, Switzerland. Flax oil does not contain eicosapentaenoic acid, but your body converts the omega-3 fats in flax oil into eicosapentaenoic acid very efficiently – reducing inflammation, tenderness and morning stiffness. And it’s a lot less costly and less subject to spoilage than fish oil.
One problem with flax oil, however, is the dosage required to convert to sufficient eicosapentaenoic acid to be effective in folk with confirmed arthritis. Analysis of all relevant research by the Colgan Institute indicates that only about a quarter of the omega-3 in flax oil survives the journey through digestion, absorption, and conversion to eicosapentaenoic acid by your body.
Consequently, to provide an effective 5 gram increase in blood eicosapentaenoic acid for a 1751b (80kg) person, requires 40 grams of flax oil (2 large tablespoons). For such a big daily dose, it’s a boon that properly extracted organic flax oil is available today, from companies like Barlean’s, Omega, Flora, and Arrowhead Mills. These brands are very palatable in salad dressings, milk shakes and other foods.
Another especially nutritious food called ‘quark‘ deserves mention here. Dr. Johanna Budwig was the first to recognize that flax oil mixed with quark, a lightly fermented low fat cottage cheese, improves the absorption and utilization of essential fats. Flavored with fruit or savory tastes, it makes a great lunch dish. If you use flax oil with quark we calculate you can reduce the dose by 25% to 1 ½ tablespoons a day.
THE OMEGA – 3 COMBO
No matter how much flax oil they take, about 10% of arthritis patients don’t seem to be able to make sufficient eicosapentaenoic acid. Various factors, such as saturated fats or trans-fats in the diet, inhibit an enzyme in the body called delta-6-desaturase, which is essential for conversion of the alpha-linolenic acid in flax oil into eicosapentaenoic acid.
Folk affected in this way are often hard to identify without extensive testing. So, in order to increase the efficacy of omega-3 treatment of arthritis, in all cases we use some fish oil together with the flax oil. Vegetarians can use eicosapentaenoic acid from the sea vegetable nod.
How much fish oil or nori oil to take depends on the individual’s willingness to swallow large capsules. We find that 6 capsules a day is usually the limit. These supply about 3 grams of eicosapentaenoic acid, leaving the balance of the dose to be provided by flax oil.
Take good care of eicosapentaenoic acid, because it is one of the most biologically active oils in Nature and should be kept refrigerated in a tightly closed, opaque container.
DON’T FORGET OMEGA-6
Now that you’re in the know about Omega-3 fats, it’s time to hear the word about Omega-6 fat, gamma-linolenic acid (GLA). Found most plentifully in borage oil, GLA also benefits arthritis, especially the various forms of rheumatoid arthritis. In animal studies, and at least 10 controlled clinical trials with human subjects, GLA reduced arthritic symptoms of morning stiffness, joint pain, swelling, and tenderness by 25-50%.
Arthritis patients treated with GLA for six months showed a 25% improvement in symptoms. Not spectacular results, but the smart researchers then carried on the study a further six months. Improvements were progressive over the whole period. This study clearly illustrates an important principle of all nutritional healing. Whenever you adopt a nutritional strategy, you have to give the body time to grow sufficient new, improved tissues in the enriched nutritional environment to enable healing to occur.
At 24% GLA, borage oil contains the highest concentration of this essential fat and is my choice as the best source of GLA. But you still need a good source of linoleic acid, which, in most folk will readily convert to GLA. At the Colgan Institute we use organic pumpkin seed oil, which is 45% linoleic acid, as the main source of linoleic acid to convert in the body to GLA. But, as with the omega-3 fats, to allow for those folk whose conversion enzymes are compromised, we add whatever number of borage oil capsules the person will tolerate and adjust the dosage accordingly.
THE DYNAMIC DUO: OMEGA-3 & OMEGA-6
The first way in which GLA (omega-6) and eicosapentaenoic acid (omega-3) essential fats combat arthritis is by increasing bodily production of the anti-inflammatory compounds called prostaglandin E1, and prostaglandin E3, and reducing production of the pro-inflammatory prostaglandin E2. Researchers at the University of Strathclyde in Glasgow, Scotland, have recently shown these effects, both in arthritis patients and in healthy volunteers. But there’s more! The omega-3 fats from flax oil and fish oils also inhibit other inflammatory actions of the human immune system, and reduce auto-immune damage.
They have been found to modify pain directly so that many patients can eliminate their use of aspirin and other NSAIDs. This effect stops the progressive destruction of cartilage by NSAIDs and opens a very important treatment window for nutritional strategies that assist cartilage to regenerate.
This is very good news indeed. The GLA from borage oil and from conversion of pumpkin seed oil has further beneficial actions. You see, one of the big problems in rheumatoid conditions, is the body attacking itself via the immune system with tumor necrosis factor (TNF).
This immune system soldier, named for its ability to kill cancer cells, also destroys cartilage, membrane and bone. GLA directly inhibits the TNF attack against its own body. Another benefit of GLA is that, unlike the omega-3 fats, GLA suppresses synovitis in rheumatoid conditions.
Synovitis is inflammation of the synovial membrane of the joint socket. This inflammation not only causes pain directly but also reduces the production of synovial fluid by the membrane.
USE OF ESSENTIAL FATS NOT ENOUGH
Although essential fats provide significant relief from symptoms of arthritis, and also provide some of the nutrient components of joint and cartilage structure, their use alone is only a little better than the usual medical treatment of symptoms. Why? Because they do not rebuild degenerated cartilage nor synovial membranes, nor the degenerated ends of bones.
Essential fats relieve the pain, reduce inflammation and eliminate the use of NSAIDs. By doing so they set the stage for joint repair, so that the main nutritional components can perform their miraculous dance.
Once essential fats have set the stage by inhibiting inflammation, pain, and attacks by the immune system, and eliminating use of NSAlDs, the main goal of nutritional therapy is to provide the structural components that enable the joint to produce sufficient cartilage and synovial fluid to repair and maintain itself. Enter glucosamine sulfate.
GLUCOSAMINE SULFATE A MUST
From your grandmother to guys in the gym, just about everyone has heard about glucosamine. The popularity of glucosamine is well deserved. Here’s what glucosamine is and what it does: Glucosamine is an essential structural component of proteoglycans, the strong feathery threads made by the chondrocytes, that knit your cartilage together.
As the rate-limiting chemical step in proteoglycans production, glucosamine, together with the collagen fibrils also produced by the chondrocytes, determines the rate or speed at which you can replace cartilage. Your body makes glucosamine from glucose and the amino acid glutamine using an enzyme called glucosamine synthetase.
For unknown reasons, activity of this enzyme declines with aging, thereby limiting glucosamine production. Arthritis is an opportunistic disease, and when the rate of glucosamine production falls below the level required to maintain the supply of proteoglycans, arthritis begins.
All is not lost, however. Animal studies show that oral glucosamine sulfate can increase proteoglycans production by up to 170%.
GLUCOSAMINE SULFATE BEATS DRUGS
A pile of controlled studies since 1980 show that the increase in proteoglycans caused by glucosamine supplements has big clinical benefits. Just remember, all the convincing studies with glucosamine have used glucosamine sulfate. You will see products for sale using other forms, such as glucosamine HC1, but despite all sorts of fancy claims, they don’t work nearly as well.
The sulfate form was adopted in the first place, precisely because sulfur is an essential component of glucosamine in the manufacture of proteoglycans. Over the last decade at the Colgan Institute, we have used up to 5 grams of glucosamine sulfate per day with hundreds of athletes and arthritis patients.
In controlled case studies, using glucosamine in conjunction with essential fats, plus sports massage and rehabilitative exercises, we see a success rate (judged by return to full activity) of over 60%. This is a better rate by far than can be achieved by any combination of over-the-counter medications or prescription drugs.
A representative study of subjects with arthritic knees was done by Dr. Anthonio Vaz at St. Johns Hospital in Oporto, Portugal. In a double-blind trial, Dr. Vaz gave patients either 1.5 grams of glucosamine or 1.2 grams of ibuprofen. By the end of the research, the glucosamine subjects had significantly less pain and greater return of function than the ibuprofen group.
In another study comparing glucosamine to an inert placebo, a group of arthritic patients was given just 500 mg of glucosamine daily for only 14 days. The placebo group showed no change in condition, whereas the glucosamine group showed a 70% reduction in pain and swelling, plus a large increase in joint function.
GLUCOSAMINE REPAIRS CARTILAGE
Glucosamine also works to overcome cartilage damage. In a representative study, 51 male and 17 female athletes with cartilage injuries in the knees, were given 1500 mg of glucosamine sulfate daily for 40 days, then 750 mg daily for another 100 days. Of the 68 athletes, 52 showed complete cure of their injury and resumed full training. A follow-up 12 months later showed no signs of cartilage damage in any of them.
The effective dose of glucosamine sulfate is 2 – 8 grams per day depending on bodyweight and arthritis history. Four grams, taken in divided doses are effective for most folk.
CHONDROITIN SULFATE OF LITTLE BENEFIT
I know it’s all the rage, and all manner of claims are being made for chondroitin sulfate, but the science is simple not there. The truth is, we used chondroitin sulfate at the Colgan Institute for nearly a decade before glucosamine sulfate became readily available. Since then we have not used it because preformed glucosamine is far more effective.
There could be other chemicals delivered to the joints from chondroitin, but until scientific evidence shows a benefit separate from that of glucosamine – don’t bother with chondroitin. With a molecular weight of 30,000 the chondroitin molecule is too big and has a hard job getting through your intestinal wall. Studies show little if any absorption of oral chondroitin.
N-ACETYL GLUCOSAMINE MIGHT WORK
By itself N-acetyl glucosamine (NAG) doesn’t do much on its own, but in combination with glucosamine sulfate, it may prove useful. It is indeed one of the protein/sugar combinations in the proteoglycans structure, but NAG does nothing to stimulate proteoglycans production.
Its possible value, if used in combination with glucosamine sulfate, is that NAG provides one less component of proteoglycans that the body has to make. But until controlled studies prove the combination of glucosamine plus NAG to be beneficial, we at the Colgan Institute will not include it in our nutritional strategies against arthritis.
SAMe DEFINITELY WORKS
This may be one of the first times that you’ve heard anything about S-adenosylmethionine (SAMe), but I predict that soon you’re going to be hearing a whole lot more about this amazing substance. Biochemists rank SAMe almost equal in importance with the primary energy molecule of the human body adenosine triphosphate (ATP).
SAMe works in just about every cell in your body as the active form of the essential amino acid methionine. It performs an incredibly wide variety of functions, but at this time we are primarily concerned with its benefit for joint disorders. Studies with animals showed conclusively that intramuscular injections of SAMe increase the number of chondrocytes in cartilage, and the thickness of the cartilage pad.
Remember, the chondrocyte is the only living element in cartilage. It produces all the proteoglycans and collagen that make up the cartilage structure. So any nutrient that can increase the number of chondrocytes should be seized upon with glee. The big question was, does it work orally? The answer is an emphatic yes!
More animal studies in the mid ’80s demonstrated easy intestinal absorption of oral SAMe and subsequent anti-inflammatory and analgesic actions. Armed with this evidence, researchers throughout the world set to work. Extensive studies in Italy with 22,000 arthritis patients over five years, showed without a doubt that SAMe increases proteoglycans production by chondrocytes in human cartilage, with no toxicity and virtually no side-effects.
Most of these studies were done with patients classified as osteoarthritic. But SAMe also has beneficial effects on rheumatoid arthritis. One of the classic signs of rheumatoid conditions is the auto-immune attack on the joint and synovial membrane, especially by the potent immune component, tumor necrosis factor (TNF).
In 1997, researchers in Spain published important results in the British Journal of Rheumatology, showing that SAMe restores synovial cells after they have been damaged by TNF. SAMe’s specific inhibition of TNF damage suggests that using it to prevent auto-immune injury to the joints may be an even better way to go. As always, prevention is the best line of defense.
SAMe vs DRUGS
SAMe is equal in anti-inflammatory and analgesic effects to common medical drugs, has no harsh side-effects, and produces higher compliance. Avoiding the joint destruction wrought by non-steroidal drugs (NSAIDs) is another great advantage of SAMe. It reduces pain and loss of function sufficiently to enable patients to eliminate NSAIDs, thereby setting up the ideal conditions for joints to repair themselves.
In a recent double-blind comparison at the famous Arthritis Clinic in Bad Abbach in Germany, patients diagnosed with osteoarthritis of the knees, hips and spine, were given either 1200 mg of SAMe or 1200 mg of ibuprofen daily for four weeks. Clinical results of the two treatments were equal for reduction of pain, swelling, and stiffness, and for increased range of motion.
SAMe FOR REBUILDING JOINTS
More evidence supporting the efficacy of SAMe comes from Dr. A. Maccagno at Hospital Frances in Buenos Aires, Argentina. In his research on arthritis of the knee, Dr. Maccagno compared the anti-inflammatory drug piroxicam to SAMe. He showed not only that SAMe produced equal clinical results to the drug, but also that patients given SAMe maintained the improvements in symptoms and in function for a considerable period after the SAMe was withdrawn. Conversely, improvements quickly faded after piroxicam was withdrawn. This continuation of benefits long after the SAMe treatment ended adds clinical evidence to the biochemical evidence that SAMe helps to rebuild joints.
The longest controlled study with SAMe continued for two years. Under the control of Dr. B. Konig at the University of Maintz in Germany, physicians in various parts of Germany treated 108 patients diagnosed with chronic arthritis of knees, hips, and spine. Patients received 600 mg of SAMe daily for 4 weeks, then only 400 mg per day for the rest of the two years. Even with this small dosage, clinical improvements began within the first week, and continued, in many cases progressively, for the whole two-year period.
Examination of the patients at 6, 12, 18 and 24 months showed no further arthritic degeneration, indicating that SAMe was not only relieving pain and increasing range of motion, but was also preventing the progress of the disease. Most important, 18 patients showed total remission of symptoms, that is, their long-term arthritis disappeared.
FIBROMYALGIA RESPONDS TO SAMe
Since many cases of fibromyalgia and chronic fatigue syndrome are more properly classified as arthritis, SAMe should work on these cases also. And it does!
In a double-blind study at the University of Pisa in Italy, patients diagnosed with fibromyalgia were given SAMe or a placebo. SAMe significantly reduced the number of trigger points and tender areas. A more recent double-blind study by Dr. S. Jacobsen at Frederiksberg Hospital in Copenhagen, Denmark, confirms these findings.
Fibromyalgia patients were given either 800mg of SAMe or a placebo daily for 6 weeks. By the last week, the SAMe patients showed big reductions in pain, fatigue and morning stiffness – with no side effects. SAMe also showed a significant improvement on the depression that often accompanies fibromyalgia.
All of this research is representative of the growing body of evidence that, even when used alone, SAMe offers great promise for treatment of numerous types of arthritis. In combination with essential fats and glucosamine sulfate, it is proving to be a real breakthrough.
BEWARE THE RISE OF HOMOCYSTEINE
Homocysteine is a normal component of your body, an intermediate in the orchestrated symphony of biochemical events that keep you healthy, but too much indicates a strong risk factor for a host of health problems. When Dr. Kilmer McCully researched the toxic effects of elevated homocysteine, little did he know that he was also pioneering the route to the prevention and cure of arthritis.
Inspired by Dr. McCully’s research, we have also learned that elevated levels of homocysteine invade your brain, spinal cord and joints to promote a wide range of illnesses, including fibromyalgia, chronic fatigue, various forms of arthritis, depression, and Alzheimer’s disease. The evidence that high levels of homocysteine contribute to the development of arthritis is mounting.
The latest study of homocysteine and arthritis is by Dr. R Roubinoff and colleagues at Tufts University in Boston, Massachusetts. They report that nearly half of all rheumatoid patients tested showed folic acid deficiency, and a high proportion showed vitamin B12 deficiency.
All the patients showed elevated homocysteine. Their blood homocysteine levels were 33% higher than healthy hospital workers used as controls.
THE RISE AND FALL OF HOMOCYSTEINE
The co-dependent biochemical relationship that occurs between homocysteine and SAMe has been well-publicized thanks to the research of Dr. McCully. We also know from McCully’s work, and from the research of hundreds of scientists who now collaborate with him, exactly which essential structural materials are missing from our diets that allow homocysteine to rise. Folic acid, vitamin B 12, (and probably vitamin B6) all act in concert to prevent homocysteine from rising to toxic levels by converting it back to the non-toxic essential amino acid methionine.
This chemistry is intimately connected with SAMe because SAMe is the activated form of methionine used by almost every cell of your body in what are called methylation reactions. It’s another double whammy! If the body is short of folic acid, and vitamin B 12, then a lot of your methionine gets tied up as elevated homocysteine, reducing the amount available for the body to make a normal level of SAMe. Even a slight or intermittent deficiency of vitamin B 12 and folic acid, if continued over years, allows homocysteine levels to gradually rise and SAMe levels to gradually fall.
COLGAN Rx FOR HIGH HOMOCYSTEINE
If folic acid and vitamin B 12 deficiencies lead to high levels of homocysteine and contribute to arthritis, can intake of these nutrients reduce homocysteine levels? Fortunately the answer is a resounding YES !
After reviewing 35 recent studies, Dr. M Moghadasian and colleagues at St. Paul’s Hospital in Vancouver, Canada recommend that vitamin B 12 and folic acid be used together to lower homocysteine levels. It’s sensible to always include vitamin B 12 in a supplementation regimen, for two reasons. First, vitamin B 12 is required for the SAMe/homocysteine cycle. Second, many folk, especially older folk, have a vitamin B 12 deficiency, which would be masked by folic acid supplementation alone, and would continue to progressively damage the brain.
SAMe works too. A new study has just been published by Dr. F Loehrer and colleagues at University Children’s Hospital in Basel, Switzerland. They show that, even in healthy subjects, 400 mg of SAMe per day improves folic acid metabolism and reduces homocysteine levels.
Based on all controlled studies to date, we at the Colgan Institute are recommending the following dosages of these three vital nutrients to arthritis patients. If you have arthritis, don’t leave home without them.
- Folic acid – a dose of 800 mcg – 3.0 mg per day
- Vitamin B 12 – a dose of 100 – 400 mcg per day is both safe and effective
- SAMe – a minimum dose of 400 mg per day
THE LOWDOWN ON ARTHRITIS BLUES
The chronic depression and cognitive disturbance frequently experienced in combination with arthritic disorders used to be explained away as purely psychological reactions to the unremitting discomfort. “Of course, you’re depressed. You’re racked with arthritic pain,” is the textbook response from the medical world. We know better now. Not only does homocysteine damage joints and trigger auto-immune reactions, it literally poisons the brain, causing mental degeneration and depression.
Many recent studies show unequivocally that fibromyalgia, chronic fatigue, rheumatoid arthritis, and osteoarthritis are all accompanied by a very high incidence of chronic depression. The new evidence linking depression in arthritis with the syndrome of folic acid/vitamin B 12 deficiency and consequent high homocysteine/low SAMe levels indicates strongly that correction of this relatively simple problem could not only relieve arthritis, but could also eliminate its attendant mood disorders.
IT’S ALL IN YOUR HEAD
The latest review of studies of older people worldwide, has recently been completed at the Department of Clinical Medicine of Perugia University in Italy by Dr. L Parnetti and colleagues. The data reveal that low intakes of folic acid and vitamin B 12, and consequent high homocysteine and low SAMe, are accompanied by depression and dementia.
High brain homocysteine also causes high production of homocysteic acid in the brain, known to cause excessive brain stimulation and cognitive disturbance. Even worse, high brain homocysteine causes microangiopathy (micro-strokes), damaging small blood vessels with resulting permanent mental impairment.
Alzheimer’s disease provides further evidence that high levels of homocysteine are linked with brain damage. Alzheimer’s patients tested at University hospitals in Leuven, Belgium and in Munster, Germany, showed more frequent deficiencies of folic acid and vitamin B 12, and higher levels of homocysteine than mentally healthy controls.
In another recent study, Dr. L Morrison and colleagues of the University of Toronto in Ontario, Canada measured SAMe in Alzheimer’s. Every one of the Alzheimer’s patients had very low SAMe levels, only 15-33% of the levels of healthy controls. Yet in Parkinson’s disease, which is a different type of brain degeneration, SAMe levels are often normal. These findings indicate that low SAMe is not simply a consequence of general brain degeneration, but is an active cause of the depression and severe memory loss that are markers of Alzheimer’ s.
NUTRIENTS vs ANTIDEPRESSANT DRUGS
Unfortunately, the depression and other mental symptoms of arthritis patients are usually treated with a wide variety of toxic antidepressant drugs that have no place in the human body. The side effects of these drugs often cause more harm than the blahs they alleviate. Folk using the drug methotrexate to treat their arthritis should be especially warned, because methotrexate interferes with folate metabolism, and worsens the problem.
Two of the major advantages of using nutrients over drugs for arthritis-induced depression include their superior efficacy and their lack of side effects. Folic acid, vitamin B 12, and SAMe all work to correct the chemical imbalance that seems to be the main cause of depression in arthritis. But, it is SAMe that is proving most effective.
A review of SAMe and mood disorders by Dr. R Baldessarini at Harvard Medical School, Boston, indicates that SAMe supplementation relieves depression in both psychiatric patients and other patients. Studies also show that SAMe improves cognition and reduces depression in some cases of Alzheimer’s disease.
JOINTS DON’T WEAR OUT, THEY RUST OUT
You’re being attacked by oxygen as you read these words. Just like a slice of apple turns brown and shrivels when it’s exposed to the air, your joints are under constant siege from the forces of oxidation. Uncontrolled oxidation from any source – UV rays, pollutants, cigarette smoking – is the relentless villain responsible for joint deterioration.
You’ve always thought of oxygen as the good guy, right? Wrong! Oxygen wears two hats. When oxygen is stable, it has a positive influence in your life, but when an oxygen atom becomes unstable and uncontrolled, it becomes a “free radical” and goes on a rampage of destruction in your body. Crashing into healthy, stable oxygen atoms, these out of control free radicals grab at every nearby atom, attacking the actual substances that make up the body.
This is bad news for your joints because free radical damage is one of the primary causes of arthritis. Emerging studies on the relationship between the incidence of arthritis, free radicals and antioxidants are pouring in from around the world. It comes down to this: subjects whose antioxidant intake was high did not develop arthritis. Those who did develop rheumatoid arthritis or lupus, had low intakes of vitamin A, beta-carotene, and vitamin E.
In short, antioxidant intake predicted the development of arthritis up to 15 years later. The researchers concluded that low antioxidant status is a risk factor for arthritis.
ANTIOXIDANTS TO THE RESCUE
Do supplementary antioxidants help once you have arthritis? Yes they do. In a new study from Ludwig-Maximillian University in Germany, a group of rheumatoid arthritis patients were divided in half and given either 200 mcg of selenium per day, or a placebo, as an addition to their normal treatment. After 3 months the placebo subjects showed little improvement.
The subjects receiving selenium showed significantly reduced inflammation, plus large reductions in pain, swelling, and morning stiffness. What about osteoarthritis? Do antioxidants help this form of arthritis, too? Indeed.
In a typical study, Dr. T McAlindon and colleagues at the Arthritis Center of Boston University, Massachusetts found that high intakes of vitamin C reduced the risk of cartilage loss by 300%! Having a good supply of exogenous (from a nutritional source outside of the body) antioxidants in your body is one of the best weapons against arthritis.
Exogenous antioxidants are special nutrient molecules which can give up an electron or receive an extra electron without themselves becoming very damaging radicals. In the process, they do become radicals, but other antioxidants immediately step in to disarm them further, until step-by-step, the original free radicals are reduced to harmless carbon dioxide, which you breathe out, and water, which the body can re-use.
Consequently taking any one or two or three antioxidants as often advised in the popular health literature is unwise. Such a strategy leaves free radicals only partly neutralized, and may increase the uncontrolled oxidative stress on your body. That’s why you need a complete, synergistic mix of nutrient antioxidants.
THE COLGAN ANTIOXIDANT Rx
My recent book, Antioxidants: The Real Story, documents the main types of free radicals, and the types and amounts of nutrient antioxidants you need to combat them. Here I have room only to reproduce the essentials of the table from that book. The mixed antioxidant supplement you need is detailed in the following table 2.
Daily Antioxidant Mix to Combat Arthritis
|Antioxidant Nutrient||Daily Amount|
|Vitamin E (IU)** (D-alpha-tocopherol succinate)||800 - 1200|
|Vitamin C (gm) (Ascorbic Acid, mixed mineral ascorbates, ascorbyl |
|2.0 - 5.0|
|Beta-carotene (IU)**||15,000 - 30,000|
|Coenzyme Q10 (mg)||15 - 30|
|L-glutathione (mg)||100 - 150|
|N-acetyl cysteine (mg)#||100 - 175|
|Selenium (mcg) (L-selenomethionine)||200 - 300|
|Iron (mg) (Iron picolinate)||10 - 14|
|Zinc (mg) (Zinc picolinate)||15 - 25|
|Copper (mg) (Copper gluconate)||0.5 - 1.25|
|Manganese (mg) (Manganese gluconate)||2.0 - 4.0|
|Alpha-lipoic acid (mg)||100 - 200|
|Lycopene (mg)||50 - 100|
|Lutein (mg)||6 - 9|
|Rutin, hesperidin, naringin (mg) (mixed citrus flavonoids)||200 - 300|
|Procyanidins (mg) (grape seed extract, standardized to 95%||150 - 200|
|Catechins (mg) (green tea extracts standardized to 20%)||20 - 40|
|Bilobetin, amentoflavones (mg) (ginkgo biloba extract standardized to 24%)||8 - 12|
|Silymarin, taxifolin (mg) (milk thistle extract standardized to 80%)||50 - 100|
|Genestein, diadzein (mg) (soybean extract standardized to 10%)||10 -20|
|Anthocyanins (mg) (bilberry extract standardized to 25%)||10 - 15|
|Melatonin (mg)||1.0 - 1.75|
|S-adenosyl methionine SAMe (mg)||400 - 800|
© The Colgan Institute. San Diego, Ca
** IU, International Units are obsolete measures no longer used in science. But, because they continue to appear on supplement labels, they are used here for convenience.
Preferred forms of nutrients used by the Colgan Institute are given, because different forms of the same nutrient have widely different absorption rates and degrees of efficacy. The figures cannot be applied to other forms.
#N-acetyl cysteine should be used only in conjunction with at least three times the amount of vitamin C. Otherwise n-acetyl cysteine can precipitate as cysteine in the kidneys and possibly cause kidney stones in sensitive individuals.
SAMe IS ANTIOXIDANT
For folk with arthritis, SAMe is a bonus addition to the antioxidant list. New research shows that SAMe has antioxidant properties that are a boon to joints. Dr. JP De la Cruz and team at the School of Medicine of the University of Malaga in Spain, discovered in October 1997 that SAMe supplementation increases the vital endogenous (from a source within the body) antioxidant glutathione.
Another 1997 study by Dr. PJ Evans and colleagues, at Kings College, London University in England, confirmed that SAMe acts as a precursor for glutathione. Equally important, they showed that SAMe itself directly neutralizes one of the most toxic free radicals, the hydroxyl radical, and also inhibits hydroxyl radical production.’ Even if you do nothing else, persuade your physician that you should take your antioxidants and your SAMe every day.
THE MENOPAUSE CONNECTION
Could it be mere coincidence that the female body loses its hormones about the age it is degenerating into arthritis anyway? Some doom merchants claim that this correlation is nothing more than coinadence, but they are dead wrong. Hormones can cause – or prevent – arthritis: no doubt about it.
With menopause, women lose their estrogen, their progesterone, most of their testosterone, and most of their dehydroepiandrosterone (DHEA). The DHEA is first to go, starting a sharp decline during perimenopause, age 40-45. Along with it the brain hormone melatonin, the synchronizer of the whole hormone cascade in your body, also shows a sharp decline.
All five of these hormones decline with age and are highly correlated with the incidence of arthritis. In women, the various forms of rheumatoid arthritis increase rapidly in incidence between ages 35 and 50.
Overall, rheumatoid arthritis attacks at least three times as many women as men. At menopause, incidence of the various forms of osteoarthritis also rises dramatically. After age 45, osteoarthritis affects ten times as many women as men.
HORMONES INFLUENCE ARTHRITIS
Let’s look first at rheumatoid arthritis. In addition to the links between these disorders and menopause, three lines of evidence show that the hormonal loss at menopause is a direct cause of the higher incidence of arthritis in women.
First, in contrast to women, men rarely develop rheumatoid arthritis until age 45. Thereafter male incidence of rheumatoid arthritis rises in concert with their gradual loss of DHEA and testosterone (the male’s main source of estrogen) into old age.
Second, research on young women shows that rheumatoid arthritis fluctuates in concert with the hormonal changes during menstruation, pregnancy, and post-partum. In addition, new research shows that young women with rheumatoid arthritis also have severe hormone deficits.
In a recent representative study, Dr. F Flaisler and colleagues at the Carmeau Hospital in Nimes, France evaluated ovarian function in young women with rheumatoid arthritis. They used only women who were not on contraceptive pills because, as I have shown elsewhere, these drugs disrupt normal hormone function with disastrous side-effects. Flaisler found that all the women had very low levels of estrogen, so low that many of them were unable to become pregnant.
The third line of evidence linking low estrogen with rheumatoid conditions concerns new discoveries of specific estrogenic effects on immunity. Low levels of estrogen allow a particular part of your immune system, called Th 1 cellular immunity, to run wild. Increased Th 1 activity is now established as a major promoter of rheumatoid arthritis.
ESTROGEN AND BONE LOSS
Low levels of estrogen also cause rapid bone loss. What has bone loss got to do with rheumatoid arthritis? A whole lot. Bone decalcification is a big part of the disease, especially in the big thigh bone, the femur, where it sockets into your hip. Rheumatoid arthritis patients have double the usual risk of a hip fracture.
Recent research also shows that the higher a women’s bone mass the less chance she has of developing rheumatoid arthritis. Even if she has a rheumatoid condition, estrogen replacement and consequent increased bone mass relieves the disease considerably, though it does not cure it.
The evidence in favor of hormone replacement is very strong. Dr. MC Nevitt and colleagues at the University of California, San Francisco, studied 4366 women aged 65 and over enrolled in a study on hip fractures. Users of hormone replacement for 10 years or more had the greatest chance of avoiding the disease. This and many more carefully controlled studies are representative of the emerging evidence that a low level of estrogen in your body is yet another open invitation to arthritis.
A LITTLE DHEA GOES A LONG WAY
Estrogen decline in menopause and its connection with depression is well accepted, but only recently have long-term studies shown that a woman’s testosterone declines also. In older women, from perimenopause through the menopause, rates of depression escalate dramatically. Leading many other researchers worldwide, Dr. Barbara Sherwin of McGill University in Montreal has shown repeatedly that estrogen replacement reduces depression.
When a little testosterone is added to the mix many cases of depression disappear entirely. Fortunately, women don’t have to take testosterone itself, a hazardous strategy at best. DHEA will do the job nicely. DHEA is readily converted to testosterone in the female body. In addition, DHEA levels are abnormally low in young women with rheumatoid arthritis, further evidence that this intermediate hormone is involved in the hormone cascade that helps prevent arthritis.
You don’t need a lot of DHEA. A small dose of 25 mg per day is sufficient to restore DHEA levels and to raise testosterone in most post-menopausal women. A similar dose also works in men, not by raising male testosterone levels, but by supporting the whole system by which the male body produces testosterone and other steroid hormones.
It will take a decade or more before these new discoveries are incorporated into medicine. Meanwhile with the right estrogen replacement, plus 25 mg of DHEA per day, a menopausal woman can defend both her brain and her emotions.
PROGESTERONE, NOT PROGESTIN
Not yet well known is the effect of progesterone loss on arthritis. Women who use the usual estrogen replacement without progesterone still have a reduced risk of rheumatoid arthritis, but they can develop a much increased risk of lupus.
This is an important discovery, because the various forms of the auto-immune disease lupus affect 15 times as many women as men. Usual hormone replacement does not include progesterone but rather progestins, man-made chemicals that may offer little protection against lupus.
In contrast, real progesterone has specific effects in controlling estrogen, and also in suppressing immune reactions that may promote lupus. Real progesterone also helps to keep Th l immunity under control, thereby further reducing the risk of rheumatoid arthritis.
HRT: THE PROS AND CONS
The decision to use hormone replacement therapy (HRT) or not is an extremely important one. Hormones are not innocuous. Don’t mess with them without the right professional help. Individual biochemistry varies so greatly that only your health professional has the intimate knowledge of your case, to make the decision that such therapy may be right for you.
Many women are wary of the usual hormone replacement prescribed today. Rightly so. Usual hormone replacement utilizes the wrong forms of estrogen in too large a dose, together with synthetic progestins that do not control it properly. Women are rarely given the other hormones, specifically melatonin and DHEA, that the body also requires to balance the estrogen replacement.
In my book, Hormonal Health (Apple Publishing), I specifically recommend the correct forms of estrogen. I also recommend real progesterone, which can be obtained by prescription either as a pill or as a cream to be rubbed into face and body. Don’t be fooled, however, by all the false wild yam and other herbal creams claiming to contain progesterone. Our monthly magazine the Colgan Chronicles documents those creams on the market that contain real progesterone in any significant amount.
Remember, before you even think of trying any of these therapies, consult your physician.
ALTERNATIVES TO HORMONES
Nutritional effects on hormones are numerous: Chromium, boron, potassium, zinc, and essential fatty acids all promote healthy hormonal functioning. If you don’t get a full complement of these and other essential nutrients every day, your hormones decline and your risk of arthritis increases.
Traditional herbs that affect hormone levels are gaining new popularity as alternatives to hormones, especially for treatment of menopausal symptoms. Only three, however, have any controlled trials that support their use.
They are black cohosh, chasteberry, and soy isoflavones. A standardized extract of black cohosh (Cimicifuga racemosa) is medically approved for treatment of menopause in Europe. Current evidence shows that this herb dramatically reduces sleep disorders, hot flashes, and other symptoms of menopause, but there is no evidence that the herb protects bones, joints, or brain from long-term effects of the loss of estrogen or other hormones with menopause.
Another herb, chasteberry (Vitex agnus castus) is widely used in Europe as a treatment for menopausal symptoms and for menstrual problems.
As with black cohosh, however, there is yet no evidence that chasteberry can protect your brain, bones or joints. A lot of research remains to be done on these herbs before I would recommend them as effective alternatives to hormone replacement.
Soy isoflavones, notably genestein and diadzein have weak, but reliable, estrogenic effects that can reduce or eliminate many symptoms of menopause. Recent research shows that soy isoflavones also reduce the risk of reproductive system cancers and protect the cardiovascular system in older women.
These widespread beneficial effects on multiple bodily systems, indicate that soy isoflavones could be beneficial to joints also. Though no studies have yet been done, the Colgan Institute analysis of the interactive chemistry of soy and estrogen, supports isoflavone use as an aid to healthy joints. Isoflavones are most easily obtained from organic tofu and miso.
A particularly good supplement for joints is the combination of ion-exchange whey protein concentrate and soy protein with a high isoflavone content.
LOSE BODYFAT AND GAIN MUSCLE
My final admonishment to you in your fight against arthritis is “MOVE IT OR LOSE IT.” Develop the habit of regular resistance exercise. If you don’t, two big chunks of evidence fairly shout that you will never win the war against arthritis.
First, the medical literature shows that folk with arthritis do less exercise than average And folk with arthritis are weaker than average, despite the clear evidence that muscle strength alleviates this group of diseases.
Second, important new research shows that unless you stimulate your body to heal, nutritional supplement programs have little effect. The principles of weight training are covered in detail in my book, The New Nutrition and my soon-to-be published The All New Sports Nutrition Guide (Apple Publishing). The exact ways to do weight training exercises are fully explained and demonstrated with photographs in my forthcoming book, The New Power Program (Apple Publishing).
Always get clearance from your doctor before beginning any exercise program. Above all, start easy. Use only the weights you can handle with comfort. Contrary to all those machismo advertisements for fitness, your body does not have to become inflamed in order to improve. Start ea-s-s-s-y!
National Library of Canada Cataloging in Publication Data
Win the war against arthritis
ISBN 1-896817-20-3 (Progressive Health Series)
1. Arthritis—Diet therapy. 2. Arthritis–Nutrition aspects.
3. Minerals in human nutrition. I. Title.
RC933.C64 1998 2002 616.7’220654 C98-901303-0
Apple Publishing Company Ltd.