It is over a year since this column reviewed complementary arthritis treatments.
A review of supplements in joint health by dietician Tammy Wolhuter in the April Medical Chronicle p 66 notes the benefits of:
1. glucosamine chondroitin combo. no new trials are available to change the apparent recommended daily dose of about 1gm glucosamine and 0.5gm chondroitin, which in the latest trial of at least a few months increased joint cartilage thickness by a crucial few mm. (ie reversed cartilage loss).
2; fish oil omega3 EPA 3.5g (50mg/kg/d) + DHA 2g (30mg/kg)/day ie about 5.5gm a day total which is the content of about 8g omega3. This is provided by about 24gm – a day of natural ~30% (omega3) fish oil eg 8 tsp a day of (Cod Liver) oil or caps; or 10gm a day -of ~80% fish oil eg The Real Thing. This dose is borne out by the latest studies on Pubmed in some 18 randomized controlled trials (metanalysis to 2007) and the latest trial 2008 .
3. Galactolipid= Rose hips. 4 unimpressive small trials to 2010 in 286 patients for 3 to 6 mo showed significant pain relief.
4. MSM methylsulfonomethane : significant pain benefit from eg 1.5 – 6gm a day
That’s as far as that Medical Chronicle review went in what seemed to be an advertorial for rose hips- the large ad for rosehips on that page….
Thus the new revelations are that the dose of all-system beneficial fish oil needed and worth trying may be higher than previously recommended – ie (at current retail price) about R5/day for the codliver oil, or R20/day for 80% omega3 concentrate (The Real Thing).
and that rose hip powder may add to the pain-relieving benefit of
5.the traditional basket of some 40 other proven natural low-allergy multisystem-beneficial anti-inflammatories: the vitamins thiamine, nicotinamide, pantothenate, pyridoxine, B12 ,C E, & K; the minerals calmag, manganese, copper , boron, zinc, iodine & selenium ; the plants curcumin, cat’s claw, dandelion, nettle, garlic, onion, bromelain, boswelia, cinnamon, ginger, nuxvomica, and guaifenesin; and the dozens of (human) biologicals that we progressively underproduce – eg acetylcysteine, CoQ10, proline, MSM, methionine, glucosamine, chondroitin, fish oil(EPA and DHA). .
For almost 5000 years Chinese medicine has been and remains more advanced than the west in preventing and treating chronic disease: The Arthrella formula for arthritis contains the following; Suvarna Paan 05 mg; Erand Tel (Oil of Ricinus communis) 3 mg ;Shallaki Guggul Extract (Extract of Boswellia serrata) 100 mg , Nirgundi (Vitex negundo ) 500 mg ; Shyonak (Oroxylum indicum) 223.8 mg; Khurasani ajawayan (Hyosyamus niger) 20 mg Nagarmotha (Cyperus rotundus) 100 mg ; Shunthi (Zingiber officinale) 50 mg ; and Shuddha Kupilu (Purified Strychnos nuxvomica) 25 mg ]; but we already include ginger and boswelia in our blends, and the only new one for which one can find some trial base on Google to consider adding if obtainable and recommended by our importing pharmacists is nux vomica bark or seed extract.
There are no references to Arthrella on Pubmed; one trial of Arthrella does feature on google.
6. Arnica gel and other natural anti-inflammatory massages have long proven as effective for arthritis, unsurpassed by any synthetic NSAID gel.
7, Finally HRT SEX HORMONE REPLACEMENT : It is common cause that low testosterone predisposes both men and women to muscle and joint pain and frailty let alone cancer, vascular disease, depression, low libido and erectile dysfunction;
postmenopausal women have more pain, osteoporosis, and vascular disease from lack of estrogen ; hence justifying lifelong physiological balanced levels of estrogen, progesterone, testosterone, or in the old DHEA or the master steroid hormone pregnenolone (of which recommended doses may vary between 1 and 500mg/d) may give safer and better results than estrogen. Due to orohepatic degradation, all of these are probably better not administered by swallowing them but rather transdermally/transmucosally. .
But genuine back pain in the aging is often due as much to osteoporosis wedging vertebrae as to cartilage- disc degeneration. Hence adding vitamin D, proline and methionine as the anabolic proteins, and the relaxing GABA, melatonin and antidepressant 5HTP, and the human sex hormones, will help improve sleep, raise pain threshold and muscle and bone strength and thus improve mobility and mood in both osteoporosis and all types of arthritis, making prescription of the noxious bisphosphonates – and perhaps even the powerful but hazardous DMDs disease-modifying prescription drugs – unnecessary. . .