There are several nutritional supplements that have been used historically and clinically for the benefit of treating and possibly reversing osteoarthritis. A key point to remember is that the approach needs to have a multifaceted directive. One aspect is to control inflammation or to help restore function by reducing pain. The other component would be therapeutic options that help contribute to the overall connective tissue and joint repair processes that naturally occur in the body but can be augmented by various nutritional supplements. Other considerations would be that the supplement raw material quality needs to be of pharmaceutical grade and of enough therapeutic dosage range to actually have a clinical benefit. Most often, optimum results are better with combined therapies which operate synergistically. Below are a few of the adjuncts I have found most helpful in the clinical practice.
Tart Cherry Extract
The anti-inflammatory ability of tart cherry became evident some years ago in clinical studies which demonstrated that the consumption of 20 black cherries daily was at least equal in pain management to aspirin; however, cherry extract and fruit antioxidant extracts have been shown to be useful anecdotally for inflammation and tissue repair for many years. I find this particularly helpful as anti-inflammatory and pain reduction therapy. The usual dose of the tart cherry extract purified in capsule form would be two twice daily.
Perluxan
This is also an herbal derived anti-inflammatory working by a different mechanism; however, it does seem to be nearly as helpful as many over-the-counter anti-inflammatories without the typical side effect profile. Often, we will use this in combination with other preparations as well.
Niacinamide
This is a B Vitamin that has been used in various types of arthritis clinically and in published trials for many years. As an adjunct, it is often very useful in rheumatoid arthritis as well. I have not found this particularly helpful as a stand-alone therapy, but when added to other therapies, this seems to be much more efficacious.
Glucosamine and Chondroitin
Most people are familiar with these typical therapeutic avenues. The key is that these are not really pain medicine or inflammatory control medicines per se but actually operate more on providing the body the optimal nutritional tools for connective tissue and joint repair. The critical issue of importance here is that these products need to be of pharmaceutical grade quality, and the chondroitin needs to be of a micro-fractionated, highly absorbable type. In addition, the dosage ranges need to be adequate for efficacy. Generally, in the case of glucosamine, that may require anywhere from 2000 to 4000 mg daily depending on the individual. As function is improved, the dose can be reduced to maintenance which might be 500 to 1000 mg daily. Often injections of a particular type of glucosamine called N-Acetyl-D glucosamine are dramatically helpful in given situations.
Hyaluronic Acid
Used as a capsule or liquid suspension, this component provides the lubricating material to discs and joint spaces and is often used in the clinical setting as a direct injection in the knee (Synvisc). Again, this is not so much a pain medication as it is an adjunct to help with mobilization.
Endocrine Balance
The importance of hormonal balance cannot be emphasized enough. Certain hormones that have an anabolic quality contributing to connective tissue repair, such as growth hormone, testosterone, DHEA, and, to some degree thyroid, are very important in the regulation to the synthesis of connective tissue. When these levels are low, chronic pain issues can often be amplified.
Prolotherapy
This is a type of proliferant therapy in which concentrated solutions of glucose or other proliferates are injected into the connective tissue to improve general connective tissue strength, such as knees, hips, etc. As an adjunct, this seems to work very well with some of the other nutritional supplements in certain cases.
Antibiotic Therapy
The adjunctive role of certain antibiotics in the treatment of different types of body inflammation, particularly of the autoimmune type, has been longstanding. In recent years, there have been nearly twelve published studies in the field of rheumatology regarding the use of antibiotic therapy and inflammatory autoimmune diseases such as lupus and rheumatoid arthritis. For further information, a good website regarding this is The Road Back Foundation. However, the potential role of causative chronic infections should be a consideration in various types of autoimmune conditions.
Obviously, to achieve the best outcome, each protocol should be determined based on patient uniqueness and individuality.
