Arthritis - Nutritional treatments
- Most of the nutritional supplements that I discuss in this article can be bought from my online shop Sales at Dr Myhill
"Arthritis" simply means pain in the joints. It names a symptom and is not a diagnosis; it therefore begs the question: What is causing it? Although arthritis has been classified into two types, inflammatory and degenerative, most sufferers usually have a bit of both. Regardless of the type of arthritis one has, my treatment is the same.
Be careful with pain-killers
Arthritis usually presents with pain. Pain is Nature's way of making you rest. Taking pain-killers (such as Paracetamol and Co-proxamol) and anti-inflammatory drugs (such as Aspirin, Ibuprofen, Indomethacin etc) is likely to make you use a joint which should be rested and will damage the joint and accelerate the rate of deterioration. "Indocid hip" is a well-recognised syndrome. That might be acceptable for someone on the waiting list for a hip replacement but not for those who want 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.
Nutritional treatment of arthritis
As I get older, my treatments seem to me to be more obviously logical! Whoever comes into my surgery, for whatever reason, gets the standard package of treatments that we should all be undergoing in order to optimize our current health and prevent future complications. This package of treatments is The general approach to maintaining and restoring good health as follows:-
- Ketogenic diet - the practical details - It is remarkable how many cases of joint-pain resolve on this diet! For me, avoiding dairy products is crucial, and I can now see how a long family-history of hip-pain could have been avoided. Do not skip the diet! Please see also My book The PK Cookbook - Go Paleo-ketogenic and get the best of both worlds. It may be the hardest thing to do initially, but is more than probably the most important. Also see Allergic muscles
- Nutritional Supplements - Include a multivitamin, Mineral Mix (MM), essential fatty acids, and vitamins C and D. Vitamin D is essential to prevent osteoporosis; so get plenty of sunshine or take a vitamin D supplement in the form of cholecalciferol 2,000i.u daily.
- Sleep - Get a good night's sleep on a regular basis (see Sleep is vital for good health).
- Fitness and Posture - Human beings never evolved to walk upright and our bodies only work if they are 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, yoga), then you will get joint and/or muscle problems at some stage. Joints are intrinsically unstable and all joints benefit from strong muscles supporting them, so keep yourself fit generally. This is not as hard to achieve as you may think. 12 minutes a week is all that is required! see Exercise and Exercise - the right sort
The "bolt-on extras" for joint and muscle pain and osteoporosis
For a great many people the above interventions, done properly, are all that is required to cure their muscle pain and arthritis. Most people like to skim through this handout and cherry-pick the things they can do most easily, often missing the most important things like diet and exercise! However, if the above has been done properly, and further improvement is sought, then the extra interventions are as follows:-
With any case of arthritis, an opinion from a good physiotherapist, osteopath or chiropractor is always helpful since 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.
More nutritional supplements
- Joint Mix
- There are other nutritional supplements which are extremely helpful and of proven benefit in all types of arthritis. These can be purchased individually but I now make up my own mix called Joint Mix (see Joint Mix), which contains what I consider to be the most important supplement. 10 capsules (3 grams) of the mix contains 2 grams of glucosamine (raw material for connective tissue), 250mgs strontium, 20mgs boron, 5,000iu vitamin D3 and 420mgs organic silica. The dose is one gram (2 capsules) of the mix per 3 stone in body weight. The Joint Mix is good for all connective tissue, including muscle, tendon, bone and gut. It is highly protective against osteoporosis. Start with the full dose and reduce to that which keeps you comfortable.
- High dose vitamin B3 (niacinamide)
- Dr Kaufman, a physician working in America, has shown how high dose B3 as niacinamide (not niacin) works extremely well for all sorts of arthritis. The best results are achieved by taking regular low doses, such as 100-500mgs, six times daily. Dr Kaufman was very particular about this - he insisted on small regular doses. Start with this and if you get benefit, try slow release niacinamide 1,500mgs daily, perhaps increasing to 2-3 daily. Results can be outstanding with less pain and marked improvement in joint mobility. Indeed Kaufman documented this carefully by measuring the range of joint movement of several joints before and after therapy in 1,386 patients with predictably good results. He suggested that niacinamide worked by accelerating the rate at which joints healed so arresting the degenerative process because it was effective regardless of the cause of the arthritis. My guess is that niacinamide is an essential part of energy delivery at the cellular level. Because joints are deprived of a good blood supply (they are white if you cut them open) niacinamide effectively improves energy delivery and so healing.
Rarely there can be upsets in liver function but this is accompanied by nausea - so if you feel a bit sick, get liver function tests checked.
- In inflammation, the white cells are overactive and reacting against things that they really shouldn't. The process of white cells being overactive results in the release of superoxides. If you think of your immune system as a little army, then superoxides are the bullets that they fire in order to kill bacteria and viruses. However, if these are aimed at one's own joints, then essentially one's joints become damaged by friendly fire. Trying to identify the cause of excessive white cell activity, such as allergy, will obviously be very helpful. However, one can also tackle this by using antioxidants. Antioxidants are the molecules which mop up these superoxides (free radicals) and limit the damage that they may cause. So attention to antioxidant status is going to be very helpful. See handout on Antioxidants and Inflammation'
- Vitamin B12
- This in high doses by injections is extremely useful because it effectively gives instant antioxidant cover whilst one is correcting levels of the above. I find vitamin B12 extremely useful in many cases of what I call useless inflammation (such as multiple sclerosis and rheumatoid arthritis) because I suspect it is acting as a damage limitation molecule. B12 is often helpful in bursitis (tennis elbow, golfer's elbow, Jeep bottom, housemaid's knee etc).
- Chinese remedy
- 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!
- This makes perfect logical sense as an anti-inflammatory and bone rebuilder. This is of proven benefit in horses and there are good theoretical and encouraging case histories for its use in humans. See George Eby's work at George Eby Research.
Keep your joints warm.
Joints have a very poor blood-supply. If a joint is cut open, it appears white because it has 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 to the joints is cut off. This causes a build-up of free-radicals and therefore pain. It is vital to keep all joints warm! 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 diets in hot climates are usually closer to the PK diet.
Keep muscles moving
Muscles are dynamic structures that hate stillness and welcome movement. This is because the circulation of blood to, and the venous and lymphatic drainage of, muscles is partly dependent on their rhythmical contraction and relaxation which pumps nutrients in and waste-products out. This is why massage is so good for almost any muscle problem. A build-up of waste-products such as lactic acid causes pain. See Fibromyalgia and Muscle Stiffness
"Inflammatory" arthritis e.g. rheumatoid, ankylosing spondylitis, Reiter's etc
Some people with arthritis are reacting allergically to their own gut flora and there has been interesting work that links rheumatoid arthritis with allergy to proteus mirabilis and ankylosing spondylitis to allergy to klebsiella. In these cases, taking high dose Probiotics may also be helpful. See Ankylosing spondylitis
Also see Autoimmune diseases for further ideas for reducing inflammation.
"Infection as a cause of arthritis and the fermenting gut"
Albert (an orthopoedic surgeon from Denmark) published a paper showing how in some cases of low back pain a cure could result from taking antibiotics. She cultured material from orthopedic operations and grew bacteria. These were not present insufficient amounts to cause an abscess, but enough to drive a chronic inflammation with all the pain that results from such. Do have a look at her work Antibiotic treatment in patients with chronic low back pain. I suspect she could have had even more success had she also targeted the source of these microbes from the fermenting gut. See Fermentation in the gut and CFS .
Many of these are of proven benefit, but I would not suggest them until all of the above have been well tried. This is because the above remedies are addressing the root causes of problems which to me seems the logical way to proceed. I do not know how many of the herbal remedies work; I just know they do!
Surgery or not?
Ultimately everybody has to work out their own package which helps them. The key obviously is to try to find the cause of the arthritic pain and if the above package is not giving worthwhile improvements then diagnostic x-rays and MRI scans can be extremely useful to look for structural changes that may need operative treatment. But do not consider surgery until all the above interventions have been properly tried and given a chance to work!
Also see Osteoporosis Many late cases of arthritis have periarticular osteoporosis, so these two subjects should be addressed together.
- For details on Dr Kaufman's article please see B-3, and arthritis
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