December 19, 2011
Can Vitamin D Prevent Arthritis? – Johns Hopkins Health Alert
Can Vitamin D Prevent Arthritis?
That’s the title of an online Health Alert from Johns Hopkins (posted 2010, reviewed 2011).
Here’s the lead:
Many researchers now believe that the “sunshine vitamin” may one day play a key role in preventing the development and progression of arthritis. Researchers, including scientists at Johns Hopkins under the direction of Uzma Haque, M.D., Assistant Professor of Medicine in the Department of Medicine, Division of Rheumatology at Johns Hopkins, have been looking at the effect of vitamin D on rheumatoid arthritis and osteoarthritis and the data are quite suggestive. Vitamin D is proving to be a most promising area for arthritis research.
Read more at http://www.johnshopkinshealthalerts.com/alerts/arthritis/JohnsHopkinsArthritisHealthAlert_3300-1.html
NYBC stocks Vitamin D at some of the current common recommended dosages:
January 6, 2011
Glucosamine and omega-3s for arthritis
In a study published in 2009, a combination of glucosamine and omega-3 fatty acids (such as those found in fish oil) performed the best in reducing arthritis symptoms. According to this research, while glucosamine improves cartilage metabolism, EPA and DHA (two omega-3 fatty acids) further reduce joint deterioration by suppressing inflammation, which lowers swelling and pain.
Although this seems to be the first study that looked closely at the glucosamine / omega-3 fatty acid combination for arthritis, the results are perhaps not so surprising. After all, clinical studies over the past two decades have repeatedly shown the value of omega-3 fatty acids in treating inflammatory conditions ranging from atherosclerosis to osteoarthritis. And a 2005 study found that In people who have osteoarthritis, increased use of omega-3 fatty acids and adequate intake of monounsaturated fatty acids such as olive oil (and decreased consumption of omega-6 fatty acids) can improve symptoms and even sometimes permit a reduction in the use of NSAIDs, the pain killers that can have unwanted long-term side effects (Miggiano GA et al 2005).
Reference: Advances in Therapy 2009: “Effect of glucosamine sulfate with or without omega-3 fatty acids in patients with osteoarthritis” Authors: J. Gruenwald, E. Petzold, R. Busch, H.-P. Petzold, H.-J. Graubaum
For further recommendations, see NYBC entries under
Glucosamine chondroitin (the most common combination used to date in arthritis management), and the fish oil/ omega-3 fatty acid supplement Max DHA.
December 1, 2010
SAMe for osteoarthritis
We were interested to see in the recently published Mayo Clinic guide to alternative medicine a fairly strong statement supporting the use of SAMe (s-adenosylmethionine) for osteoarthrititis. So we checked with what regard as one of the best online resources for such questions, the University of Maryland Medical Center. Here’s their report, updated in 2009, which basically backs up the Mayo Clinic view:
A number of well-designed clinical trials show that SAMe may reduce pain and inflammation in the joints, and researchers think it may also promote cartilage repair, although they are not clear about how or why this works. In several short-term studies (ranging 4 – 12 weeks), SAMe supplements were as effective as nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen in adults with knee, hip, or spine osteoarthritis. SAMe was as effective as these medications in lessening morning stiffness, decreasing pain, reducing swelling, improving range of motion, and increasing walking pace. Several studies also suggest that SAMe has fewer side effects than NSAIDs. Another study compared SAMe to celecoxib (Celebrex), a type of NSAID called a COX-2 inhibitor, and found that over time SAMe was as effective as celecoxib in relieving pain.
From: http://www.umm.edu/altmed/articles/s-adenosylmethionine-000324.htm
Read more at the NYBC entry for SAMe:
http://nybcsecure.org/product_info.php?cPath=57&products_id=207
May 13, 2008
Adverse effects of NSAIDS (non-steroidal anti-inflammatory drugs)
As Dr. Hyla Cass points out in her excellent book Supplement Your Prescription: What Your Doctor Doesn’t Know about Nutrition, NSAIDs (including older ones such as aspirin, as well as newer ones like Celebrex), which are very widely used for arthritis pain, have the unfortunate side effect of inhibiting the enzymes needed to create cartilage. “Essentially,” she writes, “this means that the drugs used to relieve arthritis-related discomfort accelerate the progression of the disease.” (p. 86)
Indeed, as Dr. Cass goes on to note, there’s a study showing that people taking NSAIDs on a regular basis to relieve knee arthritis pain actually have a greater risk of worsening the disease over time than people who take a dummy pill! Moreover, another study showed that people taking NSAIDs for knee arthritis were at higher risk for developing arthritis in the hip or in the other knee, compared to people who did not take these drugs.
Just another reason to consider use of the supplement glucosamine chondroitin to support joint health. See additional information, including dosage recommendations, at NYBC’s Glucosamine Chondroitin entry.
March 12, 2008
SAMe (S-adenosyl-methionine) for osteoarthritis
We’ve discussed SAMe’s use as an anti-depressant on this Blog, as well as its potential to support liver health. But over the past twenty years there has also been much research into SAMe to counter osteoarthritis pain. In a number of trials in Europe and in the US, SAMe has equalled the effect of nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen in decreasing pain and improving function. Furthermore, it is better tolerated than NSAIDS, which cause clinical concern about side effects especially when taken at high doses over long periods of time.
Here’s one drawback to SAMe for osteoarthritis: trials have shown this supplement to have a slower onset of action than NSAIDs–an initial starting use of about 4 weeks is needed for full effectivesness. In the meantime, some patients may continue to take NSAIDS, gradually reducing the dose.
See the NYBC description of SAMe for additional information, including our recommendation to take adequate B-complex along with this supplement.
For further reading and references on SAMe for osteoarthritis, we recommend Natural Products: A Case-Based Approach for Health Professionals (American Pharmacists’ Assoc., Washington, DC: 2006), pp. 37-49
January 22, 2008
Arthritis Supplements reviewed in the journal “American Family Physician”
Our local paper, The New York Times, has just brought us a piece on “Making Sense of Arthritis Supplements” in its Jan. 21, 2008 issue. It’s motivated by a recent medical journal review, and has already attracted a long string of reader comments.
No surprise, given that arthritis is the leading condition for which Americans use alternative therapies, including dietary supplements. At this point there has been a lot of scientific research on supplements for osteoarthritis; the review in the journal “American Family Physician,” which is the starting point for the NYT piece, attempts to help people sort through the studies and come to some conclusions about what the best bets are.
Some of our own thoughts on the topic:
Glucosamine sulfate is the acknowledged front-runner, both for symptom relief and on account of evidence that it may have disease-modifying effects. Especially when side effects of ibuprofen or prescription medications cause concern, there’s reason to think about glucosamine sulfate as an alternative.
In 2005, results were made available for the NIH-sponsored “Glucosamine-Chondroitin Arthritis Intervention Trial” (GAIT), which looked at almost 1600 US patients with moderate-to-severe knee osteoarthritis pain. In the glucosamine-chondroitin combination group, 79.2% had pain relief, as opposed to 69.4% in the celecoxib (tradename you might know: Celebrex) group. The competition to interpret this trial to favor supplements or prescription drugs still rages pretty fiercely–see the comment from Dr Jason Theodosakis following the NYT review. (He was on oversight committee of the GAIT study, and is a well-known proponent of glucosamine.)
There is another supplement, more expensive than glucosamine, that has been extensively researched for osteoarthritis: SAM-e (S-Adenosyl-methionine). Below we simply reproduce the abstract of a frequently-cited review of this supplement, with Conclusion highlighted. (BTW, the caution raised in the NYT review about the stability of this product on the shelf is a point well taken.)
Safety and efficacy of S-adenosylmethionine (SAMe) for osteoarthritis
Soeken KL, Lee WL, Bausell RB, Agelli M, Berman BM.
University of Maryland, School of Nursing, Baltimore, MD.
OBJECTIVE: We assessed the efficacy of S-adenosylmethionine (SAMe), a dietary supplement now available in the Unites States, compared with that of placebo or nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of osteoarthritis (OA). STUDY DESIGN: This was a meta-analysis of randomized controlled trials. DATA SOURCES: We identified randomized controlled trials of SAMe versus placebo or NSAIDS for the treatment of OA through computerized database searches and reference lists. OUTCOMES MEASURED: The outcomes considered were pain, functional limitation, and adverse effects. RESULTS: Eleven studies that met the inclusion criteria were weighted on the basis of precision and were combined for each outcome variable. When compared with placebo, SAMe is more effective in reducing functional limitation in patients with OA (effect size [ES] =.31; 95% confidence interval [CI],.099-.520), but not in reducing pain (ES =.22; 95% CI, -.247 to.693). This result, however, is based on only 2 studies. SAMe seems to be comparable with NSAIDs (pain: ES =.12; 95% CI, -.029 to.273; functional limitation: ES =.025; 95% CI, -.127 to.176). However, those treated with SAMe were less likely to report adverse effects than those receiving NSAIDs. CONCLUSIONS: SAMe appears to be as effective as NSAIDs in reducing pain and improving functional limitation in patients with OA without the adverse effects often associated with NSAID therapies.
Citation: J Fam Pract. 2002 May;51(5):425-30.
