What is Arthritis?

Arthritis means inflammation of a joint and is a generic, nonspecific term that people often use to describe anything that hurts a joint. Pain, however, is not the only criterion; there must also be some visible sign of inflammation—that is, the joint must be red, warm to touch, swollen somewhat, as well as painful. Although there are many types of arthritis (over 100, really) for the purposes of this discussion, we will use "arthritis" to mean osteoarthritis, the wear-and-tear type of joint inflammation that comes with age. The other major conditions causing arthritic symptoms or pain around the joints we will list and discuss under their specific names: rheumatoid arthritis, lupus erythematosus arthritis, psoriatic arthritis, gout, bursitis, etc.

ArthritisOsteoarthritis, also called degenerative joint disease, or DJD, usually strikes the most frequently used (or overused) joints of women in their 50s and 60s and men in their 40s and 50s. Although either gender can develop this kind of arthritis in any joint, women more often tend to suffer from osteoarthritis in the small joints of hands and fingers and in their necks and backs, whereas this socalled wear-and-tear kind of arthritis usually afflicts men in the larger weight-bearing joints: the hips, knees, ankles, feet, and backs. Once thought to strictly be a consequence of years of use, recent medical study has uncovered a genetic link for osteoarthritis— meaning the tendency to develop it runs in the family, and it's more than just wearing out the joint surfaces. If your joints have begun to ache and this kind of arthritic problem runs in your family, does nutrition offer you any help? Sure. Let's take a look.

What helps Arthritis?

• A recent and widely accepted treatment for osteoarthritis combines glucosamine with chondroitin. This duo can actually repair damaged or eroded cartilage. Glucosamine is made up of glucose and an amino acid called glutamine. It provides structure to the bone and cartilage. It is available in four forms in the United States, glucosamine sulfate being the most popular. Although it relieves symptoms when used alone, its healing and restorative qualities are greatly enhanced when paired with the chondroitin sulfates. These sulfates act as liquid magnets, attracting proteoglycan molecules, which fill in the spaces within the cartilage "netting." The fluid is important because it acts as a shock absorber while it sweeps nutrients into the cartilage. Without this fluid, cartilage becomes malnourished and fragile. Daily dosage depends on your weight. Recommendation: If you weigh less than 120 pounds, take 1000 mg glucosamine plus 800 mg chondroitin sulfates. If your weight falls between 120 and 200 pounds, take 1500 mg glucosamine plus 1200 mg chondroitin sulfates. Anyone over 200 pounds should take 2000 mg glucosamine and 1600 mg chondroitin sulfates. Everyone's needs vary, so be sure to have a thorough consultation with a physician and make clear your intent to follow this treatment.

* Niacin appears to decrease pain and increase mobility of painful joints after as little as 2 to 6 weeks of supplementation. Case reports show the effect to be especially beneficial for osteoarthritis of the knees. Recommendation: Begin with 500 mg of niacin (as niacinamide) and 100 mg B-complex twice a day for a week. Increase your niacinamide dose to 500 mg 3 times daily for a week. Then increase your first morning dose of niacinamide to 1000 mg, then both the morning and noon doses to 1000 mg, and then increase all 3 doses to 1000 mg. Continue the B-complex at 100 mg twice daily throughout. Once you have seen a good response in relief of pain or increase in joint mobility, you may taper the dose back down to a single 500 mg dose of niacinamide plus 100 mg B-complex and remain there. Warning: Read the listings for niacin supplementation. Some people cannot tolerate increased amounts of niacin without symptoms of severe flushing, blood pressure increases, and racing pulse. Begin slowly and increase only if you tolerate the niacin without side effects. Stop the medication if you develop flushing.

• ArthritisPantothenic acid seems to help some people with arthritic joint pain and not to benefit others, but the same can be said for almost any arthritis treatment, prescription or otherwise. In studies that used pantothenic acid in conjunction with the other members of the vitamin B-complex, over three-quarters of the participants reported significant improvement of symptoms after 2 weeks, suffered relapse of discomfort when taken off the vitamin, and improved again upon resuming the therapy. Recommendation: Take 100 mg pantothenic acid along with 100 mg vitamin B-complex twice daily for 2 to 4 weeks.

Vitamin C plays a crucial role in the formation of collagen, the (chief protein component of cartilage and bone, and should always be a part of the vitamin and mineral regimen in the treatment of Arthritis. Your body needs vitamin C not only to be able to build and repair the smooth cartilage surfaces that cover the bone ends and build the framework for bones themselves, but also to build and maintain the tendons and ligaments that attach to the bones. Arthritis does run in the family, and for that reason, young people who carry an increased family risk for developing arthritis should begin to supplement extra vitamin C before they begin to develop joint wear and tear and pain. Vitamin C's powerful antioxidant capabilities also make it important in slowing down the aging of tissues, a process that would hasten the development of osteoarthritis. Recommendation: Based on weight, we recommend a starting dose of 10 to 20 mg per pound of body weight per day. Divide the dose into 2 or more doses throughout the day. By that calculation, a 50-pound child at risk for arthritis would take 500 to 1000 mg of vitamin C per day in divided doses, a 100-pound adult would take 1000 to 2000 mg per day in divided doses, and a 200-pound adult would take 2000 to 4000 mg per day in divided doses. If you currently suffer with osteoarthritis symptoms, begin and hold at this starting dose for 3 to 4 weeks, then increase in 500 mg per dose increments until you reach your bowel tolerance level. (See discussion of vitamin C in Section we, pages 50-54.)

• Vitamin E, because of its antioxidant protection of essential fats (see Section we, eicosinoids, pages 24-27, for more in-depth discussion) reduces pain both at rest and with movement, in osteoarthritic joints, as well as decreasing the need for pain and anti-inflammatory medications. Recommendation: 400 to 600 IU of vitamin E daily. Children old enough to swallow capsules can take 100 IU per day. Younger children can at least increase their intake of vitamin E by regularly eating seeds and nuts (sunflower seeds are a favorite for most kids).

• Selenium, which is necessary for the body to produce the natural antioxidant and free radical scavenger glutathione peroxidase, works well in conjunction with vitamin E toward reducing the symptoms of pain and stiffness in arthritic joints. By taking the two together, you can see good results on a lower dose of vitamin E per day. Recommendation: As an adult, you should take 100 to 200 micrograms of selenium (as sodium selenite or selenium aspartate) plus 100 to 200 mg vitamin E daily.

• A number of studies done in various countries have shown that in areas where the soil is deficient in boron, more people seem to develop arthritis. By the same token, supplementation with boron also seems to alleviate the pain and stiffness of arthritis once it does develop. Recommendation: Begin by taking 6 to 9 mg of elemental boron (50 to 75 mg borax) daily until your symptoms improve. Then you may drop your dairy dose to 3 mg (25 mg borax) and maintain there. Note: Borax is a boron-containing compound available at health and nutrition stores, not the laundry detergent by the same name.

• Essential fatty acids linoleic acid (GLA) and fish oils (EPA) are the basic nutrients from which your body makes potent natural anti-inflammatory chemicals called prostaglandins. Not all prostaglandins are "good" ones that ward off inflammation and pain— some actually cause inflammation. The diet you eat to a large degree governs whether you make "good" ones or "bad" ones, and therefore whether you increase inflammation and pain in arthritic joints or whether you relieve it. Please turn to the full discussion of these essential fats and the way that diet can control their effect in Section we, eicosinoids, pages 24-27. Recommendation: Take 2 EicoPro capsules, 1 to 3 times daily, or if you are unable to obtain this product, you can make a reasonable substitute by taking 500 mg evening primrose oil along with 1000 mg EPA fish oil and 100 IU vitamin E 1 to 3 times a day. (Warning to diabetics: EPA fish oil can cause blood sugar fluctuations in some diabetics. Carefully monitor your blood sugar if you use this supplemental oil and discontinue its use if your blood sugar becomes difficult to control.)

Arthritis• S-Adenosyl-L-Methionine (SAMe) isn't an herb or hormone. In fact, it is a chemical compound found in all living cells. In most people, the body manufactures all the SAMe it needs from the amino acid methionine, found in soybeans, eggs, seeds, lentils, and meat. SAMe appears to regulate more than 35 different mechanisms and helps the body maintain cell membranes, remove toxic substances, and produce mood-enhancing neurotransmitters. Studies have shown that patients with osteoarthritis benefit in pain relief, increased ability to move around, and less stiffness as greatly with this nutrient derivative than with prescription anti-inflammatory medications such as ibuprofen (Motrin), naproxen (Naprosyn), or indomethacin (Indocin), but with fewer side effects. Recommendation: Take SAMe twice a day on an empty stomach. Since dosage depends on many factors, check with your physician for the correct amount. Studies have shown that it doesn't appear to cause adverse effects, even at high dosages.

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