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Natural Health News and Articles

Supplements for Micronutrient Deficiencies

Reviewed & edited by Dr. Jeffrey C. Lederman, DO, MPH and Julie A. Cerrato, PhD, AP, CYT, CAP

Not everyone can eat nutrient-dense foods for every meal. According to the Centers for Disease Control and Prevention, the average American consumes only one fruit and one or two vegetables per dayi. This may be one reason why millions of people do not meet the daily intakes, known as Recommended Dietary Allowance (RDA), for some vitamins and minerals provided by the United States Department of Agriculture (USDA)ii. If individuals fall short of RDA values, dietary supplements may help provide vital micronutrients required for optimal health that are not consumed through a daily diet.

Micronutrients, including vitamins and trace minerals, support a variety of physiological functions within humans and other living things. Vitamins are complex organic moleculesiii, and minerals are mostly inorganic chemical materials that can be found in nature in the form of deposits or salts. Both are needed for biological processes.

While there are several important vitamins and minerals to the body, 13 vitamins, are considered “essential,” for normal cell function, growth and developmentiv. These include four fat-soluble vitamins– A, D, E and K, and nine water-soluble vitamins – C, B1(thiamine), B2 (riboflavin), B3 (niacin), Pantothenic acid, Biotin, B6, B12 and Folate (folic acid). There are 15 minerals that are considered “essential” for proper bodily function, and they include calcium, phosphorous, magnesium, iron, copper, potassium, sodium, chloride, sulfur, iodine, fluoride, cobalt, selenium, manganese and zincvi.

In rare instances, states of clinical (“true”) deficiencies occur with the extended avoidance of certain vitamins or minerals; such conditions include deficiencies like Scurvy (vitamin C deficiency) or Rickets (vitamin D deficiency). Conversely, extremely high levels of vitamins and minerals that exceed recommended intakes, are not necessarily beneficial for the human body and may actually be harmful. For example, people with Wilson’s diseasevii,a rare genetic disorder that causes excess copper to accumulate in vital organs like the liver and brain, require a lower intake of copper from daily nutrientsviii. Similarly, too much vitamin A can cause birth defects, and excess amounts of vitamin E may increase the risk of hemorrhagingix.

On a more positive note, recent studies have shown how consuming dietary supplements can assist the absorption of vitamins and minerals found naturally in foods. One study, by The American Journal of Clinical Nutrition, points to the way dietary supplement use is linked to higher intakes of minerals. In the study, individuals who took mineral-containing supplements had higher mineral intakes from food sources in the diet than did non-users.x

Although supplements may provide a greater intake of valuable micronutrients, the question remains as to whether there is adequate absorption of these nutrients and exactly what benefit they may add. Recent investigation of this question includes results from a studyxi published in the Journal of Pediatrics, which assessed the effects of dietary supplements on vitamin absorption in children. In children older than 8 years, dietary supplements were shown to add micronutrients to diets inadequate for crucial vitamins and minerals like magnesium, phosphorous, and vitamins A, C, and E. Children 2-8 years old, on the other hand, had nutritionally satisfactory diets regardless of supplement use.

This new bulk of literature examining the effects of vitamins and minerals may help redirect current thinking on the use of dietary supplements for children and adults. Often, supplements are used in an attempt to increase life expectancy, however a more immediate goal may be to provide individuals with micronutrients that are often lacking on a daily basis in typical diets. To ascertain key deficiencies or overabundances of vitamins and minerals for an individual’s daily dietary needs, a blood test can be administered by a medical practitioner.

Since everyone’s nutritional requirements are unique, it may be beneficial to monitor one’s diet, observe how it affects one’s health, and identify where supplements may be of use. Using the recommended micronutrient intake ranges provided by the USDAxii will help increase mindfulness of the essential vitamins and minerals needed for an optimal diet. Deficiencies or excesses can then be targeted through diet first, and secondarily with supplements, if needed.

REFERENCES

  • http://www.cdc.gov/nutrition/downloads/State-Indicator-Report-Fruits-Vegetables-2013.pdf
  • http://ods.od.nih.gov/Health_Information/Dietary_Reference_Intakes.aspx
  • http://www.webmd.com/vitamins-and-supplements/nutritionvitamins-11/fat-water-nutrient?page=2
  • http://www.nlm.nih.gov/medlineplus/ency/article/002399.htm
  • http://www.livestrong.com/article/85848-list-essential-minerals/
  • http://www.nlm.nih.gov/medlineplus/minerals.html
  • http://www.mayoclinic.org/diseases-conditions/wilsons-disease/basics/definition/con-20043499
  • http://www.patient.co.uk/health/wilsons-disease-leaflet
  • http://www.webmd.com/vitamins-and-supplements/nutritionvitamins-11/fat-water-nutrient?page=2
  • http://www.ncbi.nlm.nih.gov/pubmed/21955646
  • http://www.ncbi.nlm.nih.gov/pubmed/?term=journal+pediatrics+Bailey+Fulgoni+micronutrient+sufficiency
  • http://ods.od.nih.gov/Health_Information/Dietary_Reference_Intakes.aspx

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Image Natural Health News and Articles

Maca Infographic

Maca is grown at high elevations in the Andes region of central Peru. It is a complex, nutrient-dense whole food source of vitamins, amino acids, plant sterols, essential minerals and essential fatty acids.

It has been used for centuries by indigenous Peruvians as a food source, as well as for increasing stamina and energy.

Maca powder can be blended into smoothies, drinks, baked goods, chocolates and cereal. It can also be taken as a supplement in capsule form.

Delicious Living and MegaFood teamed-up to produce this Maca infographic originally published on DeliciousLiving.com

Maca

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Natural Health News and Articles

5 Supplements for Migraines

A migraine headache is frequently described as an intense throbbing or pulsing on one side of the head, and it is commonly accompanied by nausea, vomiting, and extreme sensitivity to light and sound. It often causes significant pain for hours or days at a time. Migraine headache triggers include food allergies, hormonal changes as a result of the menstrual cycle or stress, and chronic dehydration.

Below are 5 supplements that may help ease migraine pain:

Magnesium
A magnesium deficiency can cause migraine headaches and many people have been shown to have a deficiency in this mineral. The recommended dosage of magnesium is 600 to 800 milligrams (mg) a day, taken in divided doses throughout the day to maximize absorption. There are various forms of magnesium on the market, but the one that has been shown to be the most beneficial for migraines is Magnesium Threonate.

Cayenne Pepper
The cayenne pepper herb has been shown to help prevent migraines, largely because it is an excellent source of magnesium. Plus, its active ingredient is capsaicin, which is an anti-inflammatory agent that could help ease migraine pain. Cayenne also might reduce the likelihood of a migraine by stimulating digestion, easing muscle pain and increasing the body’s metabolic rate.

Riboflavin (Vitamin B2)
Riboflavin is a vitamin required for energy metabolism, such as for the breakdown of carbohydrates for energy, and studies have shown that a deficit of mitochondrial energy metabolism could lead to a migraine. According to studies, a daily dose of 400 mg of riboflavin has helped reduce headache frequency. The vitamin also has been used for migraine prevention. Riboflavin is a water soluble vitamin, which means that the vitamin isn’t stored in the body and that it needs to be replenished every day.

Ginger (Zingiber officinale)
Ginger may help reduce the severity of migraine headaches because of its anti-inflammatory properties. Also, ginger may help reduce the inflammation in the stomach and liver that can lead to headaches related to digestive problems. About 500 to 600 mg of ginger is recommended at the onset of a migraine attack and then two more times during the day, with four hours between each dose. Ginger also can be chewed or used in cooking.

Feverfew
Feverfew has been shown to reduce the production of prostaglandins, an inflammatory agent that contributes to the onset of migraines. In one study, 70% of 270 migraine patients reported that a daily dose of feverfew decreased the frequency and intensity of migraines.

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Natural Health News and Articles

Can the B Vitamins Help Improve the Pain Associated with Osteoarthritis?

The B Vitamins have many beneficial effects. Vitamin B1, or thiamine, is important for our cells to work efficiently. Vitamin B6 is vital for healthy nerve function and Vitamin B12, or cyanocobalamin, has numerous functions including keeping our brain, nerves, and blood cells healthy. These three B vitamins, when taken together may have another important benefit: pain relief. Specifically, these three B vitamins may help decrease the pain associated with osteoarthritis (OA). Moreover, they may augment the anti-pain and anti-inflammatory effect of other medications and supplements you may  already be taking.

A study was undertaken to examine the pain-relieving effects of a commonly prescribed anti-inflammatory medication Diclofenac alone compared to Diclofenac plus the B vitamins together. The doses of the B vitamins were 100 mg of Vitamin B1, 100 mg Vitamin B6 and 5 mg of Vitamin B 12. Fifty patients were randomized to either receive an injection of Diclofenac alone or this medication plus the B vitamins.  In follow-up, the study investigators found that the group that had received both the Diclofenac and B vitamins reported improved pain relief when compared to the group that did not.

Other studies have demonstrated that pain-relieving effects of an anti-inflammatory medication or supplements are improved when combined with B vitamins. In an experimental model of OA, researchers demonstrated that when combining Vitamin B1 with Glucosamine and Chondroitin, they found that the Vitamin B1 enhanced the joint-protective effects of the Glucosamine and Chondroitin.

What does the above information suggest? If you have OA, especially severe OA, the combination of B vitamins, especially Vitamin B1, B6 and B12, can enhance the pain-relieving effects of anti-inflammatory medications that you may be taking. Remember that there are a significant number of natural supplements that have potent anti-inflammatory effects, including Turmeric, Glucosamine, Chondroitin, Methylsulfonylmethane (MSM), and Avocado Extract. Many of them can provide natural anti-inflammatory relief as well as anti-oxidant support without having to deal with the many side effects of a prescription medication.

By Rich Snyder, DO

References

  • Koboyashi T, Notoya K et al. “Fursultiamine, a vitamin B1 derivative, enhances chondroprotective effects of glucosamine hydrochloride and chondroitin sulfate in rabbit experimental osteoarthritis.” Inflammation Research. 2005 Jun;54(6):249-55.
  • Magana-Villa MC, Rocha-Gonzalez HI et al. “B-vitamin Mixture Improves the Analgesic Effect of Diclofenac in Patients with Osteoarthritis: A Double Blind Study.” Drug Research.  2013 Jun;63(6):289-92
  • Mibielli MA, Geller M et al. “Diclofenac plus B vitamins versus diclofenac monotherapy in lumbago: the DOLOR study.” Current Medical Research and Opinion. 2009 Nov;25(11):2589-99.

Natural Treatments for Osteoarthritis

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Natural Health News and Articles

New Ideas about Diet and Supplementation for Thyroid Health

Thyroid disease, in its many forms, seems to be more common today than ever before. In my holistic health coaching practice, whether people come to me for skin issues, weight loss, or other health issues, more than half of them either have an existing thyroid condition or have it in their immediate family health history.

Even I have a family history of thyroid disease

I didn’t learn this until I developed my own subclinical hypothyroid condition during the years I was overweight. Once I told my parents about it, they responded with “oh yeah, so and so in the family had that.” I was really fortunate that my thyroid levels were still considered “normal” in the eyes of most Western medical doctors, meaning they were too low to require medication or operation. After my initial freak out, I took a deep breath and realized this was an opportunity to really see if my condition could be managed—or reversed—naturally. I did a lot of research with many different health practitioners—naturopathic doctors, nurse practitioners, endocrinologists, herbalists, and health coaches who specialize in healing the thyroid naturally. I had already lost a significant amount of weight and felt that I was already doing what I needed to do. I was comforted by the understanding that natural healing takes time—the body knows how to heal itself and will do so if you give it what it needs in terms of proper nutrients, rest, physical activity, and self care. Even though my own condition is now under control, I still continue to pay attention to thyroid articles and studies when I see them pop up, whether they are from Western medicine or the more alternative realm of healthcare. I was offered an opportunity to interview endocrinologist Dr. Jason Wexler, who works closely with The Endocrine Society and I got some great information. I always enjoy asking traditional allopathic doctors questions about natural ways to manage or prevent diseases, because even though it’s not part of their medical education, it’s always good to hear if the latest research supports any of these more natural or preventative measures.

In this conversation, I had two specific areas of focus

Dr. Wexler and I discussed the benefits of a whole foods-based diet in general, in conjunction with healthy lifestyle changes in general—of course we agreed that any changes should complement medical care (I’m sure he was referring to Western medical care but I would expand that to include any properly licensed and qualified healthcare provider). I had two specific topics that I wanted to ask Dr. Wexler:

  1. Are there any supplements or foods that are known to improve thyroid levels or that can worsen them?
  2. Is there any evidence that consuming a large amount of poultry contributes to thyroid disease?

Iodine supplementation might not necessarily be a good thing

I asked the first question because one of the most common remedies for regulating the thyroid is iodine supplementation. In Western medicine this comes in the form of potassium iodine supplements, and in holistic health it comes in the form of kelp supplements or adding sea vegetables to the diet. Dr. Wexler did confirm that the treatment protocol for severe hyperthyroidism does include pharmaceutical strength iodine. However, on the subclinical level, any type of iodine supplementation concerns him. “Iodine-containing substances can exacerbate a subclinical thyroid condition either way—hypo or hyper.”

I then asked him if a diet rich in iodine-containing food or regular iodine supplementation could have a protective or preventative effect regarding thyroid disease. Dr. Wexler responded: “ If thyroid function is normal, it is not clear that these supplements or substances would cause a problem or inhibit disease progression…however many people have an existing subclinical condition and are unaware of it, in which case increased iodine intake would likely make their condition worse.”

Dr. Wexler went on to explain that “we need iodine—it produces thyroid hormone—and there are multiple reasons that a subclinical condition might exist, some of them we know, some we do not yet know.” My thinking cap was on during this interview and at this point in the discussion something clicked from my own holistic perspective.

The thought process went like this: If the body is already getting enough iodine from dietary sources (although the Standard American Diet has many issues, it is still thought to be an adequate source of iodine), and is not able to properly absorb and utilize it to produce the proper amount of thyroid hormone, then how would pouring more iodine into an already malfunctioning system possibly help regulate it? Shouldn’t we go deeper and find the reason WHY the body is not properly utilizing the iodine it already takes in before we flood it with more iodine? I posed this question to Dr. Wexler and he confirmed that it was a legitimate question.

What about other supplements?

Since I know my clients, and many health conscious consumers are always interested in supplements, I asked Dr. Wexler if there is any evidence of benefit from other supplements. He reported that the one micronutrient with positive data is selenium. Specifically, “selenium supplementation may be helpful for women who are either pregnant or postpartum who have tested positive for thyroid antibodies. It has been shown to decrease thyroiditis both during pregnancy and postpartum.

“It has also shown benefit for patients with mild Grave’s Disease (on the hyper side of the spectrum) with the symptom of orbitopathy. Selenium supplementation has been shown to decrease the amount of eye involvement in this condition.” I asked Dr. Wexler about the safety of selenium supplementation and he said that “the daily dosage should NOT exceed 200 mcg. A daily dose above 200 mcg has been linked to development of diabetes.”

The chicken question

You might be thinking “why on earth did she ask him if eating chicken contributes to thyroid disease?” I know. It seems totally random and farfetched. When I was going through my holistic nutrition education, I remembered hearing some study that people in cultures/countries that don’t consume poultry as part of their traditional diets are virtually free of thyroid disease. I even heard the joke that there is no such thing as thyroid disease…it really should be called “chicken eating disease”. I’ve gone back over my course materials and I’ve Googled the heck out of this question but can’t find any specific studies that confirm this. I tried eliminating poultry from my own diet for one month and I have to tell you that I experienced a significant reduction in my own thyroid symptoms. This is a more holistic/Eastern idea, which means that the only “evidence” in existence is probably anecdotal, like my own experience—but I figured I’d ask anyway.

Dr. Wexler had never heard of a thyroid-poultry connection, but he did say that there is a considerable link between soy consumption and thyroid disease. In fact, a study in the Journal of Clinical Endocrinology & Metabolism revealed that “excessive soy protein intake demonstrated a 3-fold increase of developing overt hypothyroidism.” Furthermore, soy has been linked to increased estrogenic effects on the body. Dr. Wexler pointed out that the links between high estrogen and thyroid disease have not yet been established in research, but it’s reasonable since thyroid disease is more prevalent in women than men. He also mentioned that certain toxins we take in from foods and personal care products are known endocrine disruptors, which have been shown to increase estrogen over time.

My light bulb went on again here—maybe the link between poultry and thyroid disease only includes conventional and commercially raised poultry. Chickens and turkeys raised in factory farms—even the “nice” factory farms that supply organic and “all natural” chickens and eggs are fed “vegetarian” pellets made primarily from corn and soy. When a person consumes “vegetarian fed” or conventional chicken, he or she is also consuming soy. Soy is also present in nearly all processed foods, many personal care products (soy lecithin is a very common emulsifier in foods and products). If you consider how much soy people actually consume in processed and packaged foods (even “healthy” options) in addition to how much they are taking in by eating eggs, chicken, and turkey, the rising prevalence of thyroid disease makes total sense.

While some of the information provided by Dr. Wexler surprised me, and some of it did not, the overall interview gave me a solid foundation to draw conclusions about a common thyroid remedy, as well as the not-so-common notion that eating poultry causes thyroid disease. Based on Dr. Wexler’s comments, and my own postulation, I will definitely be more cautious with iodine in my own diet. I also now only consume and recommend to my clients traditionally pasture raised poultry products. These can be hard to find even in specialty health food stores, but it’s a great opportunity to form a relationship with a local farmer.

Thank you to Dr. Jason Wexler and The Endocrine Society for the informative and very productive interview.

By Rachael Pontillo, AADP CHC, BS, LE

Rachael is AADP board certified holistic health coach, licensed aesthetician, and wellness entrepreneur. She is the founder of the health and wellness company, Holistically Haute™, LLC and is the publisher of the popular skincare and wellness blog, Holistically Haute™. Additionally, Rachael has had articles published in leading aesthetics trade publications and several leading online magazines. She currently works with individual clients and groups in the Philadelphia area, nationwide and in Canada and teaches classes in the Philadelphia metro area on the topics of natural skincare, health, nutrition, and wellness. Rachael also enjoys public speaking, and has lectured at national holistic health and skincare conferences.

Reference: 

  • The Endocrine Society, 2013
    endo-society.org
  • Massachusetts Medical Society, 2013
    nejm.org/doi/full/10.1056/NEJMoa1012985

Photo Credit: projects4success.com/projects/starch1/index.html

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Natural Health News and Articles

Turmeric – The New Super Supplement

There are a lot of trendy supplements hitting the market that claim to work miracles, and some may actually do so. But it’s an old back-of-the-pantry spice that is getting attention these days as a super supplement and health remedy – Turmeric.

Despite having a nice kick to add some flare to foods, Turmeric is being hailed as a major player in the world of supplementation. It has shown promise in treatment for multiple sclerosis, it is considered a natural detoxifier, and it has even been linked with breast cancer and Alzheimer’s prevention and spreading. But it is Turmeric’s immediate medicinal value that has everyone running to their spice cabinets.

Having natural antiseptic and antibacterial properties, Turmeric is an excellent choice for treating minor cuts and burns. It also can be used as supplement to help boost metabolic rate for dieters and an anti-inflammatory for those that suffering from psoriasis or other skin conditions.

While it is available in pill form, Turmeric can easily be incorporated daily in diet by simply adding it to salads, spiced teas, and side dishes. It is important to note that in its raw form, Turmeric’s medicinal values are best enhanced when you add ground black pepper to it for the most efficient digestion of the supplement. It’s yellow color and kicked up flavor will add interest and health benefits to your daily routine.

Reference

  • Healthdiaries.com
    healthdiaries.com/eatthis/20-health-benefits-of-turmeric.html
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Natural Health News and Articles

He Crushes Crohn’s with Diet, Yoga, Supplements and Exercise

Ari Meisel was diagnosed with Crohn’s disease.

Crohn’s is a chronic condition that causes inflammation of one's digestive tract. Symptoms are abdominal cramps, pain after eating, frequent diarrhea, weight loss, and a fever.

With the help of change in diet, yoga, natural supplements and exercise he's been able to stop the prescribed doctor's medication – and be deemed disease free!

He's now also an Ironman and Crossfit competitor!

Hear him tell his story in this TEDx video and read more about Ari on his blog, Less Doing

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Treatment

Supplements for Fibromyalgia that help with Sleep

Written by Sandy Cho, MD and reviewed by Julie A. Cerrato, PhD

These two supplements have shown to help people with Fibromyalgia get a restful night’s sleep.

Melatonin

Melatonin is a natural hormone that is helpful in helping you achieve a good night’s sleep. In those with FMS, one research article points out that melatonin levels are lower at night when sleeping compared to someone who does not have fibromyalgia. Supplementation with melatonin may also help pain in addition to improving the quality of sleep.

  • Start at low doses of 1-2 mg each night before going to sleep each night and increase slowly.

Valerian root

Valerian root is an herb that can help you get a good night’s rest. There have been several studies examining the efficacy of valerian root in the treatment of insomnia. In one review, the authors concluded that while further study was needed, valerian root seemed to able to improve the quality of sleep without experiencing any significant side effects.

Agosti R, Duke RK, Chrubasik JE, Chrubasik S. Effectiveness of Petasites hybridus preparations in the prophylaxis of migraine: a systematic review. Phytomedicine 2006;13(9-10):743-6.
Dall’Acqua S, Viola G, Giorgetti M, Loi MC, Innocenti G. Two new sesquiterpene lactones from the leaves of Laurus nobilis. Chemical & pharmaceutical bulletin 2006;54 (8): 1187–1189.
Gilmore B, et al. Treatment of acute migraine headache. American Family Physician. 2011;83:271-280.
Hildreth C, Lynm C, Glass R. Migraine Headache. Journal of the American Medical Association. 2009;301(24):2608.
NINDS Migraine information page. National Institute of Neurological Disorders and Stroke
Schoenen J, Jacquy J, Lenaerts M. Effectiveness of high-dose riboflavin in migraine prophylaxis. A randomized controlled trial. Neurology. 1998 Feb;50(2):466-70.
Vaughan T. The role of food in the pathogenesis ofmigraine headache. Clin Rev Allergy. 1994;12:167-180.

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Treatment

Supplements for Osteoarthritis that Support Bones and Joints

Written by Sandy Cho, MD and reviewed by Julie A. Cerrato, PhD, AP, CYT, CAP
Many over-the-counter nutritional supplements have been used in the treatment of osteoarthritis.

To ensure safety and avoid drug interactions, consult your doctor or pharmacist before using any of these supplements. This is especially true when you are combining these supplements with prescribed drugs.

Adding the right supplements to your treatment plan is important for providing nutrition to your joints.

Vitamin D

Being deficient in Vitamin D is associated with the development of worsening hip and knee pain. Given that millions of people are deficient in this important vitamin, supplementation is vital. The usual recommended dose is 1000 units of Vitamin D3 taken with food to enhance absorption. Remember that your healthcare provider can measure levels of Vitamin D3 and adjust the amount you need to take.

Vitamin C

Remember that Vitamin C is an antioxidant; in terms of cellular health, because it is an electron donor, it helps to reduce oxidative stress and keep the cells in a reduced or natural state. In one study, it was felt that Vitamin C may have a role in preventing osteoarthritis of the knee.

  • The ester form of Vitamin C is better absorbed than other formulations.
  • Vitamin C at a dose of 2000 mg a day is a good starting dose.

Vitamin K2

Vitamin K2 is very beneficial for bone health. It helps in maintaining the integrity of the bones and joints. It is integral in preventing calcium loss from the bone. It also helps to maintain the health of the blood vessels by preventing calcium influx into the blood. It also is very likely to be helpful in the treatment of osteoarthritis. One study demonstrated that joints that were affected with advanced OA were associated with lower levels of Vitamin K2.

Trace Minerals

Be aware that in addition to Vitamins C, D and Vitamin K2, that trace minerals are also important for bone health. These include Boron, Selenium, Zinc, Manganese, and Magnesium.

As you can see, there are several good supplements out there that are good for bone health.

References

  • Bruyere O, Reginster JY. Glucosamine and chondroitin sulfate, and the two in combination for painful knee osteoarthritis. Drugs Aging. 2007;24:573-580.
  • Cledd DO, Reda DJ et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. New England Journal of Medicine. 2006 Feb 23;354(8):795-808.
  • Debbi AM, Agar G et al. Efficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: a randomized controlled study. BMC Complementary and Alternative Medicine. 2011 Jun 27;11:50.
  • Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF. Obesity and knee osteoarthritis. The Framingham Study. Ann Intern Med. 1988;109:18–24.
  • Googs R, Vaughn-Thomas A et al. Nutraceutical therapies for degenerative joint diseases: a critical review. Critical Reviews in Food Science and Nutrition. 2005;45(3):145-64.
  • Gruenwald J Petzel E et al. “ Effect of glucosamine sulfate with or without omega-3 fatty acids in patients with osteoarthritis.” Advances in Therapy. 2009 Sep; 26(9): 858-71.
  • Hochber MC, Clegg DO. Potential effects of chondroitin sulfate on joint swelling: a GAIT report. Osteoarthritis and Cartilage. 2008;16 Suppl 3:S22-4.
  • Ishi Y, Noguchi H et al. Distribution of vitamin K2 in subchondral bone in osteoarthritic knee joints. Knee Surgery, Sports Traumatology and Arthroscopy: 2012 Oct 16. (Electronic Publication)
  • Jager C, Hrenn M et al. “Phytomedicines prepared from Arnica flowers inhibit the transcription factors AP-1 and NF-kappaB and modulate the activity of MMP1 and MMP13 in human and bovine chondrocytes.” Planta Medica. 2009 Oct;75(12):1319-25.
  • Kim LS, Axelrod LJ et al. Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial. Osterarthritis and Cartilage. 2006 Mar;14(3):286-94
  • Laslett LL, Quinn S et al. Moderate vitamin D deficiency is associated with changes in knee and hip pain in older adults: a 5-year longitudinal study. Annals of the Rheumatic Diseases. 2013 Apr 17. (Electronic Publication)
  • Lequesne M, Mahey C et al. Structural effect of avocado/soybean unsaponifiables on joint space loss in osteoarthritis of the hip. Arthritis and Rheumatism. 2002 Feb;47(1):50-8.
  • Li LC, Lineker S, Cibere J, Crooks VA, Jones CA, Kopec JA, Lear SA, Pencharz J, Rhodes RE, Esdaile JM. Capitalizing on the teachable moment: osteoarthritis physical activity and exercise net for improving physical activity in early knee osteoarthritis. JMIR Res Protoc. 2013 May 9;2(1):e17.
  • Manek N, Lane N. Osteoarthritis: Current Concepts in Diagnosis and Management. Am Fam Physician. 2000 Mar 15;61(6):1795-1804.
  • Maheu C, Cadet C et al. Randomised, controlled trial of avocado-soybean unsaponifiable (Piascledine) effect on structure modification in hip osteoarthritis: the ERADIAS study. Annals of the Rheumatic Diseases. 2013 Jan 23. (Electronic Publication)
  • Messier SP, Loeser RF, Miller GD, et al. Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. Arthritis Rheum. 2004;50:1501-1510.
  • Peregoy J, Wilder FV. The effects of vitamin C supplementation on incident and progressive knee osteoarthritis: a longitudinal study. Public Health Nutrition. 2011 Apr;14(4):709-15.
  • Ross SM. “Osteoarthritis: a proprietary Arnica gel is found to be as effective as ibuprofen gel in osteoarthritis of the hands.” Holistic Nursing Practice. 2008 Jul-Aug;22(4):237-9.
  • Shakibaei M, John T et al. Suppression of NF-kappaB activation by curcumin leads to inhibition of expression of cyclo-oxygenase-2 and matrix metalloproteinase-9 in human articular chondrocytes: Implications for the treatment of osteoarthritis. Biochemical Pharmacology. 2007 May 1;73(9):1434-45.
  • Shehzad A, Ha T et al. New mechanisms and the anti-inflammatory role of curcumin in obesity and obesity-related metabolic diseases. European Journal of Nutrition. 2011 Apr;50(3):151-61.
  • Shen CL, Hong KJ, Kim SW. Effects of ginger (Zingiber officinale Rosc) on decreasing the production of inflammatory mediators in sow osteoarthritic cartilage explants. J Med Food. 2004;6:323-328.
  • Tammareddi K, Morelli V, Reyes M. The Athlete’s Hip and Groin. Prim Care. 2013 Jun;40(2):313-33.
  • Wegener T, Lupke NP. Treatment of patients with arthrosis of hip or knee with an aqueous extract of devil’s claw (Harpagophytum procumbens DC.). Phytotherapy Research. 2003 Dec;17(10):1165-72.

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Treatment

Supplements for Osteoarthritis that Reduce Inflammation and Pain

Written by Sandy Cho, MD and reviewed by Julie A. Cerrato, PhD, AP, CYT, CAP

Glucosamine and Chondroitin

A large clinical trial called the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) that examined whether or not Glucosamine/Chondroitin together were effective in treating the pain associated with knee arthritis and if they could be used to treat the structural damage associated with OA was conducted. The authors concluded that these supplements were as effective as NSAIDS in treating pain. They also found that that they provided benefit for those experiencing moderate to severe pain. Another study concluded that chondroitin and glucosamine also helped reduce joint knee swelling. Glucosamine and chondroitin can also reduce total body inflammation, including lowering C-reactive protein levels.

Methylsulfonylmethane (MSM)

The use of this supplement, especially when used in combination with Glucosamine and Chondroitin, has been shown in studies to reduce the pain of osteoarthritis as well as help restore clinical functioning. In one clinical trial, the effects of 3 grams of MSM taken twice a day compared to placebo demonstrated a significant improvement in pain and clinical functioning.

Arnica Montana

Arnica montana may be especially effective for the treatment of knee and hand osteoarthritis. It has been demonstrated for reducing inflammation of the joints. The application of Arnica topically to the hands or knees can be very effective in reducing pain and inflammation.

Avocado-Soybean Unsaponifiable (ASU)

Several clinical studies have demonstrated the efficacy of ASU for the treatment of OA, especially hip OA which can be especially debilitating. In one study, approximately 400 patients were randomized to be given either 300 mg of ASU or placebo and followed over a three-year period. The authors felt that the ASU helped to reduce the joint space narrowing in the hip, meaning that it helped to reduce the degree of structural damage when compared to the placebo group.

Curcumin

The main ingredient of the commonly used spice turmeric, this antioxidant can help reduce the pain and inflammation associated with OA. It helps to reduce inflammation by reducing certain cellular pathways of inflammation, including Nf-KappaB. Another inflammatory pathway that Curcumin can inhibit is the cyclooxygenase enzyme, which is the same enzyme that is inhibited by NSAIDS. Curcumin also has other potential effects including improving heart health and has anti-cancer properties as well.

Antioxidants

The use of antioxidants are important in reducing inflammation and combating the free radical load and oxidative stress that can accompany osteoarthritis. Consider adding a supplement high in antioxidant value to your daily regimen.

Devil’s Claw

This herb has also demonstrated effectiveness for the treatment of OA. In one study examining Devils’ Claw in the treatment of hip and knee OA, the authors noted the effectiveness in reducing pain and improving joint mobility.

Omega 3 fish oil

Supplementation with Omega 3 fish oil can decrease the inflammation and reduce the pain associated with OA. In one study, the use of Omega 3 fish oil and glucosamine together markedly showed a decrease in stiffness and pain compared to those who just received glucosamine.

  • A good anti-inflammatory dose is at least 3-4 grams a day to start and slowly increase to a maximum of 7-8 grams.
  • As this supplement can thin the blood, if you are on any blood thinners, you may wish to start at a lower dose and increase upwards.

Morinda citrifolia (Noni)

This is a tropical plant from East Asia that has been used for many years. It has anti-inflammatory properties and can help in the treatment of pain due to osteoarthritis.

  • Noni can come in capsule or juice form. If you take the juice form, consider beginning at 1 oz twice a day and increase slowly to 4-6 oz a day.
  • Some forms of Noni can have a high potassium content so if you have kidney disease you need to be mindful of this.
  • Extremely high doses of this may have an adverse effect on the liver, although this is controversial. The several ounces a day that we mention here is very low dosage of this supplement.

Boswellia extract

This is an herb that has anti-inflammatory properties, especially in the treatment of arthritis. It can help maintain the structural health of the joint cartilage.

Ginger

Ginger may provide significant pain relief for osteoarthritis. Its effects appear to be attributable to inhibition of the pain pathway involving cyclooxygenase and lipoxygenase. Effective doses range from 170 mg ginger extract 3 times per day to 250 mg 4 times per day.

Note that there are many formulations that combine many of these important supplements that can reduce pain and inflammation. There are also wonderful bone and mineral formulations that can provide the nutrients to the bones that are so desperately needed in OA.

  • Bruyere O, Reginster JY. Glucosamine and chondroitin sulfate, and the two in combination for painful knee osteoarthritis. Drugs Aging. 2007;24:573-580.
  • Cledd DO, Reda DJ et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. New England Journal of Medicine. 2006 Feb 23;354(8):795-808.
  • Debbi AM, Agar G et al. Efficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: a randomized controlled study. BMC Complementary and Alternative Medicine. 2011 Jun 27;11:50.
  • Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF. Obesity and knee osteoarthritis. The Framingham Study. Ann Intern Med. 1988;109:18–24.
  • Googs R, Vaughn-Thomas A et al. Nutraceutical therapies for degenerative joint diseases: a critical review. Critical Reviews in Food Science and Nutrition. 2005;45(3):145-64.
  • Gruenwald J Petzel E et al. “ Effect of glucosamine sulfate with or without omega-3 fatty acids in patients with osteoarthritis.” Advances in Therapy. 2009 Sep; 26(9): 858-71.
  • Hochber MC, Clegg DO. Potential effects of chondroitin sulfate on joint swelling: a GAIT report. Osteoarthritis and Cartilage. 2008;16 Suppl 3:S22-4.
  • Ishi Y, Noguchi H et al. Distribution of vitamin K2 in subchondral bone in osteoarthritic knee joints. Knee Surgery, Sports Traumatology and Arthroscopy: 2012 Oct 16. (Electronic Publication)
  • Jager C, Hrenn M et al. “Phytomedicines prepared from Arnica flowers inhibit the transcription factors AP-1 and NF-kappaB and modulate the activity of MMP1 and MMP13 in human and bovine chondrocytes.” Planta Medica. 2009 Oct;75(12):1319-25.
  • Kim LS, Axelrod LJ et al. Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial. Osterarthritis and Cartilage. 2006 Mar;14(3):286-94
  • Laslett LL, Quinn S et al. Moderate vitamin D deficiency is associated with changes in knee and hip pain in older adults: a 5-year longitudinal study. Annals of the Rheumatic Diseases. 2013 Apr 17. (Electronic Publication)
  • Lequesne M, Mahey C et al. Structural effect of avocado/soybean unsaponifiables on joint space loss in osteoarthritis of the hip. Arthritis and Rheumatism. 2002 Feb;47(1):50-8.
  • Li LC, Lineker S, Cibere J, Crooks VA, Jones CA, Kopec JA, Lear SA, Pencharz J, Rhodes RE, Esdaile JM. Capitalizing on the teachable moment: osteoarthritis physical activity and exercise net for improving physical activity in early knee osteoarthritis. JMIR Res Protoc. 2013 May 9;2(1):e17.
  • Manek N, Lane N. Osteoarthritis: Current Concepts in Diagnosis and Management. Am Fam Physician. 2000 Mar 15;61(6):1795-1804.
  • Maheu C, Cadet C et al. Randomised, controlled trial of avocado-soybean unsaponifiable (Piascledine) effect on structure modification in hip osteoarthritis: the ERADIAS study. Annals of the Rheumatic Diseases. 2013 Jan 23. (Electronic Publication)
  • Messier SP, Loeser RF, Miller GD, et al. Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. Arthritis Rheum. 2004;50:1501-1510.
  • Peregoy J, Wilder FV. The effects of vitamin C supplementation on incident and progressive knee osteoarthritis: a longitudinal study. Public Health Nutrition. 2011 Apr;14(4):709-15.
  • Ross SM. “Osteoarthritis: a proprietary Arnica gel is found to be as effective as ibuprofen gel in osteoarthritis of the hands.” Holistic Nursing Practice. 2008 Jul-Aug;22(4):237-9.
  • Shakibaei M, John T et al. Suppression of NF-kappaB activation by curcumin leads to inhibition of expression of cyclo-oxygenase-2 and matrix metalloproteinase-9 in human articular chondrocytes: Implications for the treatment of osteoarthritis. Biochemical Pharmacology. 2007 May 1;73(9):1434-45.
  • Shehzad A, Ha T et al. New mechanisms and the anti-inflammatory role of curcumin in obesity and obesity-related metabolic diseases. European Journal of Nutrition. 2011 Apr;50(3):151-61.
  • Shen CL, Hong KJ, Kim SW. Effects of ginger (Zingiber officinale Rosc) on decreasing the production of inflammatory mediators in sow osteoarthritic cartilage explants. J Med Food. 2004;6:323-328.
  • Tammareddi K, Morelli V, Reyes M. The Athlete’s Hip and Groin. Prim Care. 2013 Jun;40(2):313-33.
  • Wegener T, Lupke NP. Treatment of patients with arthrosis of hip or knee with an aqueous extract of devil’s claw (Harpagophytum procumbens DC.). Phytotherapy Research. 2003 Dec;17(10):1165-72.

Categories
Treatment

Supplements for Fibromyalgia that Relieve Pain and Inflammation

Written by Sandy Cho, MD and reviewed by Julie A. Cerrato, PhD

These three supplements have shown success in helping people with fibromyalgia get relief from the pain and related inflammation.

Bioflavonoids

Good antioxidant support is vital in the treatment of Fibromyalgia. Bioflavonoids are excellent antioxidants that can relieve pain and inflammation. Bioflavonoids that have been studied in the treatment of fibromyalgia include turmeric and quercetin. Quercetin may be especially effective as it has antioxidant, anti-inflammatory and anti-allergenic properties.

    • Turmeric can be taken as a 400 mg capsule daily or as a powder that can be sprinkled on each meal.
    • Quercetin can be taken as a capsule. Usual starting dose is 500 mg a day.

Wobenzym N

This is an enzyme supplement that is used in the treatment of inflammation and pain. Enzymes in this supplement include bromelain (from pineapple) and papain (from papaya).

  • If you have allergies to pineapples or papaya, do not take this supplement.
  • It is best taken on an empty stomach; be aware that you may need to take 6-12 tablets a day for an inflammatory response.

Morinda citrifolia (Noni)

This is a tropical plant from East Asia that has been used for many years. It has anti-inflammatory properties and can help in the treatment of pain.

    • Noni can come in capsule or juice form. If you take the juice form, begin at 1 ounce twice a day and increase slowly to 4-6 oz a day.
    • Some forms of Noni can have a high potassium content so if you have kidney disease you need to be mindful of this.
    • Extremely high doses of this may have an adverse effect on the liver, although this is controversial. The several ounces a day that we mention here is very low dosage of this supplement.
  • Armstrong DJ, Meenagh GK et al. “Vitamin D deficiency is associated with anxiety and depression in fibromyalgia.” Clinical Rheumatology. 2007 Apr;26(4):551-4.
  • Bramwell B, Ferguson S et al. “The use of ascorbigen in the treatment of fibromyalgia patients: a preliminary trial.” Alternative Medicine Reviews. 2000 Oct;5(5):455-62.
  • Bent S, Padula et al. “Valerian for sleep: a systematic review and meta-analysis.” American Journal of Medicine. 2006 Dec;119(12):1005-12.
  • Cordero MD, Cotain D et al. “Oral coenzyme Q10 supplementation improves clinical symptoms and recovers pathologic alterations in blood mononuclear cells in a fibromyalgia patient.”  Nutrition. 2012 Nov-Dec;28(11-12):1200-3.
  • Geenen R, Jacobs W et al. “Evaluation and management of endocrine dysfunction in fibromyalgia.” Rheumatic Diseases Clinics of North America. 2002 May;28(2):389-404.
  • Ki Cha B, Man Jung S et al. “The effect of a multispecies probiotic mixture on the symptoms and fecal microbiota in diarrhea-dominant irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial.” Journal of Clinical Gastroenterology. 2012 Mar;46(3):220-7.
  • Lucas HJ, Brauch CM et al. “Fibromyalgia–new concepts of pathogenesis and treatment.” International Journal of Immunopathology and Pharmacology. 2006 Jan-Mar;19(1):5-10.
  • Teitelbaum J, Johnson C et al. “The use of D-ribose in chronic fatigue syndrome and fibromyalgia: a pilot study.” Journal of Alternative and Complementary Medicine. 2006 Nov;12(9):857-62.
  • Wikner J, Hirsch U et al. “Fibromyalgia–a syndrome associated with decreased nocturnal melatonin secretion.” Clinical Endocrinology. 1998 Aug;49(2):179-83.
  • Wilhelmsen M, Amirian I et al. “Analgesic effects of melatonin: a review of current evidence from experimental and clinical studies.” Journal of pineal Research. 2011 Oct;51(3):270-7.
  • Younger J, Noor N et al. “Low-dose naltrexone for the treatment of fibromyalgia: findings of a small, randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing daily pain levels.” Arthritis and Rheumatism. 2013 Feb;65(2):529-38.

Categories
Treatment

Supplements for Fibromyalgia that Help with Nutrition

Written by Dr. Rich Snyder and reviewed by Julie A. Cerrato, PhD, AP, CYT, CAP

Magnesium, vitamin D and vitamin C supplementation,  have shown helpful to a person with fibromyalgia in balancing their nutrition levels.

Magnesium

The role of low magnesium levels in the body and its importance in inflammation, pain, and fatigue is being researched. In one review article, the authors noted lower levels of zinc and magnesium than in the control groups. Magnesium supplementation is necessary to help counteract the fatigue and pain associated with fibromyalgia. Certain medications, such as diuretics, can lower your magnesium levels. There are several ways to increase your magnesium intake:

  • Increase the amount of leafy green vegetables, seeds (sunflower and sesame for example) and nuts (almonds and Brazil nuts for example) which contain a lot of magnesium. You should strive to at least consume 600-800 mg a day.
  • If needed, magnesium can also be supplemented either orally or in a gel or oil formulation applied directly to the skin. Chelated magnesium is a form of magnesium taken orally without the heavy metals. This can be started once a day and increased to twice a day for a total dose of 400-600 mg. Note that very high doses of magnesium can cause diarrhea. Magnesium Malate is a form of magnesium that is very well absorbed.
  • An alternative is to apply Magnesium gel or oil to your skin once or twice daily. If you have been told that you have kidney problems, you may need to have blood levels of your magnesium level followed and limit your magnesium intake.

Vitamin D

The role of Vitamin D deficiency in the development of fibromyalgia is being evaluated; however, in one research article it was noted that in evaluating over seventy-five patients who had been diagnosed with fibromyalgia, over two-thirds had low or low-normal Vitamin D levels. The authors of this study also noted that occurred very frequently in those patients with depression and anxiety. Don’t forget that Vitamin D supplementation is vital for your overall bone and muscle health.

  • Ask your healthcare provider to measure a Vitamin D level, which is a simple blood test.
  • Begin Vitamin D3 at 1000 Units daily with food. Because it is a fat soluble vitamin, it is better absorbed with food.

Vitamin C

Remember that Vitamin C is an antioxidant; in terms of cellular health, because it is an electron donor, it helps to reduce oxidative stress and keep the cells in a reduced or natural state. We think that supplementation with Vitamin C may be beneficial. In one small study, 12 individuals with fibromyalgia were given a combination of 100 mg of Vitamin C and broccoli powder. They were closely followed over a period of one month. By the end of the month the participants in the trial reported an improved quality of life and reduced sensitivity to pain. Deficiency of this vitamin can directly impact adrenal health, and FMS can cause a lot of stress on the adrenal glands and is strongly associated with the development of adrenal fatigue, which is strongly associated with Fibromyalgia Syndrome.

  • The ester form of Vitamin C is better absorbed than other formulations.
  • Vitamin C at a dose of 2000 mg a day is a good starting dose.
  • Armstrong DJ, Meenagh GK et al. “Vitamin D deficiency is associated with anxiety and depression in fibromyalgia.” Clinical Rheumatology. 2007 Apr;26(4):551-4.
  • Bramwell B, Ferguson S et al. “The use of ascorbigen in the treatment of fibromyalgia patients: a preliminary trial.” Alternative Medicine Reviews. 2000 Oct;5(5):455-62.
  • Bent S, Padula et al. “Valerian for sleep: a systematic review and meta-analysis.” American Journal of Medicine. 2006 Dec;119(12):1005-12.
  • Cordero MD, Cotain D et al. “Oral coenzyme Q10 supplementation improves clinical symptoms and recovers pathologic alterations in blood mononuclear cells in a fibromyalgia patient.”  Nutrition. 2012 Nov-Dec;28(11-12):1200-3.
  • Geenen R, Jacobs W et al. “Evaluation and management of endocrine dysfunction in fibromyalgia.” Rheumatic Diseases Clinics of North America. 2002 May;28(2):389-404.
  • Ki Cha B, Man Jung S et al. “The effect of a multispecies probiotic mixture on the symptoms and fecal microbiota in diarrhea-dominant irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial.” Journal of Clinical Gastroenterology. 2012 Mar;46(3):220-7.
  • Lucas HJ, Brauch CM et al. “Fibromyalgia–new concepts of pathogenesis and treatment.” International Journal of Immunopathology and Pharmacology. 2006 Jan-Mar;19(1):5-10.
  • Teitelbaum J, Johnson C et al. “The use of D-ribose in chronic fatigue syndrome and fibromyalgia: a pilot study.” Journal of Alternative and Complementary Medicine. 2006 Nov;12(9):857-62.
  • Wikner J, Hirsch U et al. “Fibromyalgia–a syndrome associated with decreased nocturnal melatonin secretion.” Clinical Endocrinology. 1998 Aug;49(2):179-83.
  • Wilhelmsen M, Amirian I et al. “Analgesic effects of melatonin: a review of current evidence from experimental and clinical studies.” Journal of pineal Research. 2011 Oct;51(3):270-7.
  • Younger J, Noor N et al. “Low-dose naltrexone for the treatment of fibromyalgia: findings of a small, randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing daily pain levels.” Arthritis and Rheumatism. 2013 Feb;65(2):529-38.