Osteoarthritis Clinical Pearls
IT’S TIME TO FEEL GOOD AGAIN
“A primary goal is to discover processes that may be causing catabolic
excess & find ways to feed or enhance the anabolic process.”
Just as osteoclasts are simultaneously tearing down bone
while osteoblasts are building
bone; catabolic and anabolic
forces are at work in cartilage
and connective tissue. A
primary goal then is to discover
processes that may be causing
catabolic excess and find ways
to feed or enhance the anabolic process.
One factor affecting the catabolic process is the lack of nutrients needed to feed the
chondrocytes. The chondrocytes are the cells in cartilage
that are responsible for new
growth. That's where Purified
Chondroitin Sulfates, MSM and
glucosamine sulfate come into
the therapeutic picture.
See below for a TM on that
subject.
But how about the other side of
the coin, the anabolic process.
One agent that is almost never
considered as a "chondrocyte
enhancing" agent is insulin-like
growth factor-1 (IGF-1). IGF-1
is an anabolic mediator that
stimulates chondrocyte synthesis and repair while also inhibiting chondrocyte mediated
catabolism. So reduced
growth and repair observed in
degenerative cartilage disorders may be related to an inability of IGF-1 to exert its
physiological and anabolic
effects on chondrocytes.
According to Denko and Malemud, "restoration of normal
IGF-1 levels could play an important role in maintaining cartilage homeostasis in early
osteoarthritis." Animals treated
with both pentosan polysulfate
(a chondroitin sulfate like molecule) and IGF-1 demonstrated
a gross cartilage appearance
that was normal; however,
animals treated with pentosan
polysulfate or IGF-1 alone
showed gross signs of osteoarthritis pathology.
Other author’s data shows that
endocrine factors or the lack
thereof play a significant role in
osteoarthritis. Here's how it
unfolds in the osteoarthritic. "A
reduction in insulin-like growth
factor-1 (IGF-1) results in an
increase in insulin-like growth
factor binding protein (IGFBP)
which binds (further reducing)
the action of IGF-1. In osteoarthritis cartilage the synthesis of
insulin-like growth factor
binding protein (IGFBP) is
three times that of normal cartilage. However disruption of
insulin-like growth factor
binding protein restores anabol-
ic response in human osteoarthritic chondrocytes."
And according to Arthritis Research & Therapy,
"Down regulation of insulin-like growth factor
binding protein (IGFBP) through an increase in
IGF-1 increases the cartilage matrix."
So the next question is "how do we raise IGF-1
naturally?" I'm glad you asked. Dr. Brownstein
measured growth hormone (IGF-1) and then
gave Gammanol Forte with FRAC, 2 tablets, 3X
a day to 10 women ages 29-77 over a 5 week
period. Interestingly, all 10 had their growth
hormone increased. Eight out of ten had significant increases. Here's a clinical sign to listen for.
Growth hormone production at night is directed
to muscle repair. So if you have a patient that
says, "when I get up in the morning I'm hurting
more than when I went to bed" or if a patient is
still sore a few days after an adjustment, this is
a patient who is not repairing. To feed the pituitary the anabolic growth factors it needs to
repair, consider Gammanol Forte with FRAC
and Cytozyme PT/HPT. Gammanol Forte with
FRAC is a source of gamma oryzanol and free
transferulic acid (FRAC for short) both of which
are food based antioxidants, able to neutralize
both superoxide and hydroxyl radicals.
Clinicians use Gammanol Forte for support of
lean muscle mass with bodybuilders, PMS,
menopausal hot flashes, amenorrhea, elevated
blood fats, low blood pressure, angina, adrenal
hypo-function, gastric inflammation, nervous
tension, and exposure to free radical generators
such as chemicals and radiation.
For our discussion on osteoarthritis consider
Gammanol Forte with FRAC to optimize human
growth hormone, 2 tablets, 3 times a day with
meals. For athletes consider a higher dose, 2-4
tablets before and after a workout and 2 tablets
at bedtime. For elevated blood fats use 4
tablets after each meal.
For patients who complain of muscle soreness
after sleeping, use 4 tablets of Gammanol Forte
with FRAC at bedtime along with 3 tablets of
Cytozyme-PT/HPT. Cytozyme-PT/HPT is a
source of lamb pituitary and hypothalamus. Use
Cytozyme-PT/HPT with pituitary/hypothalamus
dysfunction, gastric hyperacidity, adrenal hyperfunction, insomnia, abnormal pain surrounding
menses cycles, epilepsy, anorexia, inability to
gain or lose weight, thyroid hypofunction secondary to hypofunction of the anterior pituitary,
carbohydrate sensitivity, and neuromuscular
disorders.
To assess pituitary using blood chemistry as a
guide, anytime the symptoms of thyroid hypofunction are present and the TSH is less than
3.0, initiate therapy with the pituitary to stimulate thyroid function. Use 1-5 tablets, 3 times a
day with meals.
I have included a more thorough discussion of
treatment options below.
Remember pathologist tell us we all have osteoarthritis. The question is, "are we making more
chondrocytes than we are losing?" This is an
important conversation for many patients.
From the statistics I can gather, 23% of the population is over 64. That means our aging baby
boomers are looking for ways to enhance performance and flexibility. Yes, it does takes time
to encourage them through the education
process but recommendations like this make
sense and will bring loyal and referring patients
to your door.
By the way, I created a great patient education
flyer and CD on joint care that may help you in
this process. Feel free to copy it and use it as
you wish.
Thanks for reading this week’s Tuesday Minute
edition. I'll see you next Tuesday.