by Dr. Sarah Myhill, MD*
April 28, 2008
Arthritis simply means pain in the joints. It has been classified into two types:
Inflammatory [rheumatoid arthritis, caused by a malfunctioning autoimmune system that often leads to destruction of joints], and
Degenerative [osteoarthritis, the consequence of the gradual wearing out of the cartilage that covers the ends of the bones, causing damage and inflammation].
But the fact of the matter is that most sufferers have a bit of both. Both cause pain.
Pain is Nature's Way of Making You Rest a Joint
Therefore, taking painkillers such as paracetamol (acetaminophen in the U.S.) and nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen, indomethacin, etc. will make you use a joint which should be rested and will damage the joint and accelerate the rate of deterioration.
"Indocid hip" (an accelerated arthritis caused by taking pain killers inappropriately, requiring early hip replacement) is a well recognized syndrome. That might be acceptable for someone on the waiting list for a hip replacement, but not for someone who wants their joints to last as long as possible! I think it is reasonable to take pain killers to help sleep, but not if the joint is to be used.
Doctors like to distinguish between degenerative and inflammatory arthritis, because in the latter case they may choose to use immuno-suppressant drugs. However, regardless of the type of arthritis one has, my work-up is the same, simply because for many people there is a mixture of degeneration and inflammation.
So all sufferers must do the following.
1. Take my standard regimen of nutritional supplements. These include:
A multivitamin,
A multimineral,
Essential fatty acids (see below)
And vitamin C.
Vitamin D is essential to prevent osteoporosis, so get plenty of sunshine or take the vitamin D supplement cholecalciferol, 2,000 iu daily. [This is vitamin D3, which naturally forms in the skin with exposure to sunlight. Interestingly, vitamin D3 is also formed in animals’ fur and birds’ feathers when exposed to the sun, and these creatures ingest their needed vitamin D “supplement” by licking and preening, as described at the Vitamin D Council website.]
2. All types of arthritis will be helped by evening primrose oil (omega-6 essential fatty acid) and fish oil (omega-3 fatty acids). These essential fatty acids feed into the series of immune modulators which tend to reduce inflammation. I would try three months of 4 capsules (2 grams) of evening primrose oil and 4 capsules (2 grams) of fish oil. If you are improved by this, then continue to take. [Note a recent study of fish oil supplementation enabling many arthritis patients to significantly reduce their use of NSAIDS.]
3. Do the Stone Age Diet for six weeks. [This is an elimination diet that avoids common allergens such as dairy (about 50% of rheumatoid arthritis patients have food allergies) chemicals, and high carbohydrate intake/refined carbs, and suggests eating different types of food at different times of day. Carbohydrates tend to cause fatigue, even in "normal" people. We should be eating protein and fat in the day and saving carbohydrate until the evening, when it helps sleep. At present Western diets are completely upside down because we eat cereals and toast at breakfast, sandwiches at lunch and meat in the evening - it makes you feel tired in the day and wakes you up at night!]
I usually ask people to do this diet for 4 weeks, but arthritis often takes longer to respond. It is amazing what results can be achieved - I recently had a patient whose 'bunion' disappeared when she cut out dairy products!
4. Try additional boron (a trace mineral). Arthritis is common in countries where there is a lack of boron in the soil, and rare in countries where it is plentiful. So, if your joints are not good on a multi-mineral, ask for silboron tablets, which contain 20mg of boron as well as silica. I usually use at least 5mg and up to 25mg a day. Improvement should be seen within 3 months.
5. Cartilage rebuilders such as N-acetyl glucosamine or glucosamine sulphate. The early lesion in all forms of arthritis is destruction of cartilage. Cartilage is the "shock absorber" of joints. It cannot be seen but is perceived as the space between the joints on X-ray. If narrowed, there is loss of cartilage.
The cartilage can be rebuilt….An old Chinese remedy for arthritis is twice boiled chicken bones - this makes great sense because all the raw materials for making new bone and cartilage are to be found in stock from boiled bones. So do buy and boil up bones for stock for soups and stews. I do!
6. Antioxidants. Damage to joints is thought to be mediated by free radicals - these are highly reactive and destructive molecules produced as a part of normal metabolism. Antioxidants mop these up before they cause damage. There are lots of different antioxidant preparations on the market but I suggest trying grape seed extract, a rich source of anti-inflammatory anthrocyanidins (bioflavonoids)
7. Keep your joints warm. Joints have a very poor blood supply - if you cut open a joint it is white because there is no direct blood supply. The oxygen has to diffuse a long way from the blood vessels before it gets into the joint. I suspect that the reason why cold weather affects joints badly is because the blood supply is reduced and so the oxygen supply cut off. This causes a build-up of free radicals and therefore pain.
It is vital to keep all joints warm!
8. Exercise/muscle strength is vital. Human beings never evolved to walk upright and our back only works if it is kept in the correct position and muscles kept strong. My view is that unless you are conscientious about posture and do daily exercises (such as Pilates), then you will get back problems at some stage. But all joints benefit from strong muscle supporting them, so keep fit generally.
People often feel better in a hot climate:
Partly because their joints are warm,
Partly because of the sunshine making vitamin D and
Partly because foreign diets are closer to the "stone age" diet.
With any case of arthritis, an opinion from a good physiotherapist, osteopath or chiropractor is always helpful, since so much joint pain is caused by poor posture and poor musculature. The human skeleton evolved for a creature which was meant to walk around on all fours, and by adopting the upright position we have put great stresses on it.
Dr. Myhill’s patient-education site (http://www.drmyhill.co.uk) also offers the following information on different types of arthritis and joint/tendon inflammation:
"Rheumatoid arthritis (RA) – diagnosis and treatment"
"Rheumatic patches - a common cause of inexplicable pains and thought to be the earliest lesion of arthritis"
"Inflammation in certain tendons (tendonitis), and tendon coverings (bursitis) that often occur as a result of overuse."
"Carpel tunnel syndrome – a cause of pain and tingling in the hands"
"Gout – a cause of joint pain, not just in the big toe"
Information on osteoarthritis is offered at clinical websites such as MayoClinic.com.
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* Dr. Sarah Myhill, MD, is a UK-based ME/CFS/FM specialist with a focus on preventive care, nutrition, and patient education. This material is reproduced here with kind permission of the author, from her website (DrMyhill.co.uk) R Sarah Myhill Limited, Registered in England and Wales: Reg. No. 4545198.
Note: This information has not been evaluated by the FDA and is not meant to prevent, diagnose, treat, or cure any illness, condition, or disease. It is essential that you make no additions to or changes in your health support plan or regimen without first researching and discussing it in collaboration with your professional healthcare team.
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