Life Extension Magazine 2011
Why So Many Arthritis Sufferers Fail to Find Relief
By Tyler Chambers
Our society has been programmed to believe that complex medical problems can be fixed with simple solutions.
Everyone reading this article has probably seen thousands of TV commercials promoting immediate relief from arthritis pain by taking the right brand of aspirin, ibuprofen, acetaminophen, or naproxen.
If an arthritis sufferer takes any of these pain relievers on a consistent basis (at doses approved by the FDA), they are likely to encounter life-threatening side effects such as kidney failure, liver failure, or gastric hemorrhage.1-8
Natural approaches, on the other hand, such as fish oil and curcumin provide numerous lifesaving side benefits, in addition to helping to relieve chronic joint discomfort.9-40
The pharmaceutical industry has focused on developing only one drug intervention at a time to treat one underlying cause of arthritis. Not only has this strategy failed to address the many age-related factors involved in osteoarthritis, but it has led to lethal metabolic imbalances occurring in the body.
When COX-2-inhibitor drugs like Vioxx® and Bextra® were first approved, Life Extension® warned that by blocking only the COX-2 enzyme (and not also COX-1 and 5-LOX), users of these drugs increased their risk of heart attack and stroke. While most of our members were spared these lethal side effects, tens of thousands of Americans perished before these COX-2 inhibitors were withdrawn.41
What no one has done up until now is amalgamate all the known underlying causes of arthritis so lay people and physicians can understand why long-term relief requires a multi-pronged approach.
The good news for Life Extension® members is that they already utilize many natural ways to improve joint structure and function that provide considerable respite from joint discomfort. The next two pages provide an overview of twelve underlying mechanisms involved in osteoarthritis and safe methods to circumvent each of them.
Twelve Correctable Causes of Osteoarthritis
Like so many diseases of aging, arthritis is not normally caused by a single factor. Instead, multiple mechanisms conspire to slowly destroy the cartilage that lines our joints. The illustration below reveals underlying causes of arthritis and simple steps you can take to thwart them.
Excess body weight can lead to arthritis. This happens not only because heavier mechanical loads generate greater physical stress upon connective tissue and joint surfaces, but also from the effect that excess fat has in increasing inflammatory molecules that attack and damage joint cartilage. Weight loss is an effective way to protect against excess joint stress that can contribute to arthritis.42-46
High-impact physical trauma can damage joints. While the benefits of exercise cannot be understated, high impact, repetitive exercise like running can expose joints (especially in the hip and knee) to high mechanical loads that can contribute to joint damage over time. Engaging in exercise that builds muscle strength and flexibility without repetitive joint trauma can reduce arthritis complications.47-49
Prostaglandin E2 causes pain and inflammation in joints. The enzyme that converts arachidonic acid to prostaglandin E2 in the body is called COX-2 (cyclooxygenase-2).50 Drugs that inhibit only COX-2 (like Vioxx® and Bextra®) increase the risk of heart attacks because they create adverse effects on critical enzymes in vascular endothelial cells that line blood vessel walls.51 Safe ways to inhibit COX-2 and the subsequent production of prostaglandin E2 are to follow a low-arachidonic-acid diet, take a low-dose (81 mg) aspirin tablet each day, and supplement with nutrients like resveratrol, green tea extract, silymarin, and quercetin.52-67
Leukotriene B4 destroys joint cartilage. The enzyme that converts arachidonic acid to leukotriene B4 in the body is called 5-LOX (5-lipoxygenase).68,69 Safe ways to inhibit 5-LOX and the subsequent production of leukotriene B4 are to follow a low-arachidonic-acid diet and to supplement with nutrients like curcumin, boswellia, and fish oil.70-83
Nuclear factor-kappaB ignites production of systemic inflammatory molecules that attack joint linings. Nuclear factor-kappaB (NF-kB) can be suppressed with plant extracts like garlic, ginger, curcumin, and silymarin, along with fish oil concentrates and antioxidants.61-63, 84-91
Aging often results in accelerated loss of protective joint cartilage. Nutrients that help rebuild cartilage include glucosamine, chondroitin, and MSM (methylsulfonylmethane).92-104 These nutrients are unlikely to achieve complete results if chronic inflammatory factors continue attacking joint cartilage.
Immune system "sensitivity" has been suggested by recent research to play an important role in osteoarthritis.105 Immune system hyperreactivity (autoimmunity) has long been known to play an important role in rheumatoid arthritis.106,107 Cutting-edge research in the more prevalent osteoarthritis suggests that "sensitized" T-cells attack joint collagen and directly contribute to joint damage.106-108 Low-dose (40 mg) undenatured type II collagen helps regulate immune function so that T-cells don't become "sensitized" and attack joint cartilage.108-110
Hyaluronic acid is a major component of joint tissue. Its natural function is to lubricate and cushion the joint from repeated impacts.111 It is also involved in cartilage regeneration. One notable effect of hyaluronic acid is to inhibit an enzyme called matrix metalloproteinase-13 that degrades joint cartilage.112-114 Hyaluronic acid does not absorb well by itself, but when it is dissolved in a phospholipid-rich solution115 such as krill oil, its absorption is improved.
Inflammatory cytokines such as tumor necrosis factor-alpha directly attack joint linings. Krill oil reduces the infiltration of destructive cytokines into joint linings.116,117 Astaxanthin reduces the production of inflammatory cytokines.118-120
Mitochondrial dysfunction interferes with youthful repair processes in the joint.121 Nutrients that protect mitochondria function include CoQ10,122-125 lipoic acid,126-130 carnitine,130-134 and PQQ (pyrroloquinoline quinone).135-137
Free radicals are heavily involved in joint destruction. Daily use of antioxidants like lipoic acid and astaxanthin affords considerable protection.138-144
Prostaglandin E1 is a natural inflammation-suppressing hormone-like substance. It comes from a fatty acid called gamma-linolenic acid (GLA) that one obtains in their diet or via supplements like borage oil or oil of evening primrose.145 Whether GLA converts to pro-inflammatory arachidonic acid or anti-inflammatory prostaglandin E1 is determined by an enzyme in the body that is regulated by sesame lignans.146-151 Those who obtain sesame lignans in their supplements already benefit because the GLA obtained from dietary sources is more likely to convert to prostaglandin E1.Those who take supplements like borage oil should make sure the borage oil also contains at least 10 mg of standardized sesame lignans.
If you have any questions on the scientific content of this article, please call a Life Extension® Health Advisor at 1-866-864-3027.
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