Healthy Aging

Natural Strategies for Bones and Joints

By Chris D. Meletis, ND

This is the seventh part in a series addressing the most common health concerns as we age. Previous parts have discussed cardiovascular health, weight loss, blood sugar, cognitive function and gastrointestinal health. In this installment, I will discuss bones and joints and natural strategies to keep them strong.

Pain and discomfort from osteoarthritis can reduce independence and mobility and can prevent us from doing the things we love to do, whether it’s gardening, golf, hiking, skiing or numerous other hobbies. Osteoporosis can be as devastating to the bones as osteoarthritis is to the joints, robbing us of our mobility and quality of life.

Osteoarthritis

Osteoarthritis (OA), the most common type of arthritis, is a degenerative joint disease characterized by the breakdown of the joint’s cartilage. From 1995 to 2005, the latest statistics available from The National Arthritis Data Workgroup show that the prevalence of osteoarthritis in the United States was 26.9 million—an increase of nearly 30 percent over that decade.¹ Pain, the primary symptom of osteoarthritis, can significantly impact patients’ quality of life, not only in regards to physical function but also psychological well-being.¹

Although articular cartilage damage is a major characteristic of OA, the condition is now considered a disease of the entire joint.² In addition to articular cartilage damage, OA is marked by bone spur (osteophyte) formation at the joint margins, muscle atrophy and spasm, and inflammation. The normal anabolic (rebuilding) properties and the catabolic (breaking down) properties within the cartilage become imbalanced, inhibiting the ability of cartilage to repair itself. Inflammatory cytokines (white blood cell proteins that play a role in the inflammatory process) are thought to cause this imbalance.²

The symptoms and signs of knee OA are persistent knee pain, limited morning stiffness, reduced function, crepitus (a crackling sound), restricted movement and bony enlargement.³ The American College of Rheumatology’s criteria for hip OA diagnosis includes the presence of hip pain and at least 2 of the following 3 criteria: evidence of femoral or acetabular (hip joint) bone spurs, joint space narrowing and an increase in erythrocyte sedimentation rate (a test used to measure inflammation, abbreviated Sed Rate often on lab reports), which should be less than 20 mm/hour.⁴

OA can progress in severity relatively quickly. A study published in 2004 followed a group of 32 patients with symptomatic knee OA to evaluate disease progression. These patients were followed for more than 2 years and overall suffered a significant loss in global cartilage volume of 6.1 percent at the end of the study. The loss in cartilage volume occurred as early as 6 months after the study’s start and increased at 18 and 24 months, reflecting a progression in cartilage volume loss over time.⁵

Although once thought of primarily as a disease of the elderly, osteoarthritis is now developing in a large number of people under the age of 60, often due to knee injuries (such as anterior cruciate ligament tears)⁶ or the increased prevalence of obesity.⁷ Until recently, researchers thought that obesity increases knee osteoarthritis risk because the increased weight strains the joints. But new research suggests that the excess levels of the “hunger hormone” leptin secreted by fat cells interacts with the leptin receptors found in normal joint cartilage cells (chondrocytes). The excess leptin causes the cartilage cells to respond in a way that promotes OA.⁷

Osteoporosis

Osteoporosis results in bone mass reduction and consequently an increased risk of fractures. In its initial stages, osteoporosis goes “under the radar” as it causes no symptoms until fractures later develop. The vertebral and hip fractures that occur result in considerable morbidity and mortality^8-10 as well as disability or impairment and a resulting decline in health-related quality of life.^11-13

Vertebral fractures are the most common osteoporotic fractures. Vertebral fractures have a severe long-term impact on health-related quality of life. One recent study showed that from ages 64-82 years, vertebral fractures resulted in more negative impact on quality of life, more severe osteoporosis and a poorer prognosis compared to hip fractures.¹⁴

Although osteoporosis is commonly thought of as a women’s disease, it also can affect men. In the U.S., eight million women and two million men are estimated to have osteoporosis.¹⁵ In men, osteoporosis generally develops approximately 10 years later than in females. Two of the causes of osteoporosis in men are thought to be low vitamin D levels and a decline in testosterone levels.¹⁶

Conventional doctors treating osteoporosis prescribe the bisphosphonate class of drugs, including Fosamax®, Actonel®, Boniva® and Reclast®. However, as ABC News recently reported, these drugs are coming under fire after hundreds of reports of spontaneous fractures in women using them. Studies in various medical journals have indicated that these drugs may have a long-term, bone-destroying effect.¹⁷ One group of researchers stated, “Prescribers should be aware of the possibility of these rare adverse reactions and the prolonged use of bisphosphonates should be reconsidered until long-term robust safety data are available.”¹⁸

Supporting Joint Health

As I describe to my patients looking to support joint health, it is essential to offset current and past wear and tear with equal and greater levels of nutrition to support healthy joints. In my practice, I use a number of natural compounds to support healthy joints including glucosamine sulfate, MSM (methylsulfonylmethane), chondroitin sulfate, Type II Collagen and silica (all found in Nutri-Joint). Researchers recently analyzed randomized controlled studies involving 1,502 patients with knee osteoarthritis and found that even though over the first year glucosamine sulfate did not show a significant effect on joint health, after 3 years, glucosamine sulfate demonstrated a small to moderate protective effect. The same was observed for chondroitin sulfate, which had a small but significant joint protective effect after 2 years.¹⁹

The authors concluded, “This meta-analysis of available data shows that glucosamine and chondroitin sulfate may delay radiological progression of OA of the knee after daily administration for over 2 or 3 years.”

MSM (methylsulfonylmethane), Type II collagen and silica are three other natural substances I like to use in patients concerned about joint health. In a randomized placebo-controlled trial of patients with knee OA, MSM was found to produce significant decreases in pain and physical function impairment.²⁰ Type II collagen has reduced the symptom scores of two standard osteoarthritis indexes by 33 percent and 20 percent in subjects with osteoarthritis of the knee.²¹ According to the researchers, subjects given type II collagen “showed significant enhancement in daily activities suggesting an improvement in their quality of life.” Silica has been shown to increase bone mineral density in calcium deficient animals.²²

Combining the ingredients in Nutri-Joint with Hyaluronic Acid Lozenges can be especially helpful since oral supplementation with HA has showed promising results in subjects aged 40 years and older with knee osteoarthritis.²³ I have discovered over the years that the addition of high molecular weight hyaluronic acid is essential for the creation of a truly comprehensive program, to support optimal joint health and control inflammation.

For patients who are suffering from joint discomfort, I often combine the above substances with turmeric, Boswellia serrata, DL-phenylalanine and nattokinase (all found in Back in Action™). I have found these synergistic substances to improve mobility and quality of life in my patients suffering from stiff joints. DL-phenylalanine acts as a natural analgesic by up-regulating the “endogenous analgesia system” (EAS), a neural pathway that when stimulated suppresses activation of second-order pain-receptive neurons.²⁴ Curcumin, the primary constituent of turmeric, has been shown to inhibit cyclooxygenase (COX), lipoxygenase (LOX) and inducible nitric oxide synthase (iNOS), important enzymes that mediate inflammatory processes.²⁵

Boswellia serrata inhibits the synthesis of pro-inflammatory leukotrienes, reduces swelling and knee pain in patients with knee osteoarthritis and increases knee flexion and walking distance.²⁶ The proteolytic (protein-dissolving) enzyme nattokinase may help control pain through its actions as a fibrinolytic enzyme, which means it breaks down fibrin deposits. The fibrinolytic system is closely linked to control of inflammation.²⁷

Another important component of a joint-support regimen is vitamin D3. Low vitamin D levels are associated with increased incidence of knee OA²⁸ and vitamin D deficient men are twice as likely to have hip OA.²⁹

Supporting Bone Health

Calcium, Vitamin D, Vitamin K and Ipriflavone (ingredients in Osteoflavone Complex) are all essential for promoting strong bones. A meta-analysis reviewing 29 randomized trials concluded that supplementation with calcium and vitamin D3 reduces risk of bone fractures by 24 percent and significantly reduces loss of bone mass.³⁰

High-dose vitamin K supplementation has been shown to improve indices of bone strength in the femoral neck, reduce the incidence of clinical fractures and decrease the subsequent incidence of vertebral fractures in osteoporotic postmenopausal women with a history of at least 5 vertebral fractures.³¹ Ipriflavone, another bone-supporting substance, acts primarily to suppress bone resorption (bone breakdown).³² Close to 500 patients given ipriflavone in double-blind, placebo-controlled studies have noted significant gains of between 0.5 to 7.1 percent in total body, forearm and vertebral bone mineral density.³³

Combining all the above ingredients in Osteoflavone Complex with extra vitamin D3 and vitamin K plus the mineral strontium has produced excellent results in many of my patients. Numerous studies have indicated strontium exerts beneficial effects on bones and produces improved mobility in subjects. Biopsy samples from subjects given strontium carbonate showed a 172 percent increase in the rate of bone formation.³⁴

It is very important to take strontium at least 2 hours away from calcium for maximal impact.

Conclusion

Protecting our joints and bones is an essential step to ensure our independence and mobility aren’t compromised. Consuming Nutri-Joint, HA lozenges and vitamin D3 can help maintain optimal joint health while adding Back in Action™ to this regimen can be helpful for individuals suffering from significant joint discomfort. For bone health, using Osteoflavone Complex together with extra vitamin D3, vitamin K2 and strontium can help us enjoy the activities and hobbies that we love well into our senior years.

References

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