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Osteo_SS_kneejointdamageOsteoarthritis (OA) is a degenerative joint disease that mainly affects cartilage, causing functional limitation and disability particularly in the elderly. It is estimated that over 27 million individuals over the age of 65 suffer from osteoarthritis, which most commonly affects the knee. Vitamin D plays many biological and functional roles in joint health, so vitamin D status may play a role in the progression of knee osteoarthritis.

In a new study published online in the Journal of Nutrition, researchers investigated whether serum vitamin D and parathyroid hormone (PTH) concentrations might predict the progression of knee OA. PTH is responsible for regulating the metabolism of vitamin D. The study included 418 participants enrolled in the Osteoarthritis Initiative who had at least one knee with diagnosed osteoarthritis. Serum vitamin D and PTH were measured at the 30 or 36 month visit of the study, and progression of OA was defined as an increase in the joint space narrowing (JSN) score between the 2 and 4 year study visits.

The average serum vitamin D level of the participants was 26 ng/ml, while 16% of this population had levels below 15 ng/ml. Between the beginning of the study and follow-up visits, 14% of the subjects experienced joint space narrowing (increased JSN score). Subjects with a low vitamin D level (< 15 ng/ml) had twice the risk of elevated knee OA progression than the participants with vitamin D levels > 15 ng/ml. Although a high serum PTH itself was not associated with a significant increase in JSN score, individuals with both low vitamin D and high PTH (> 73 pg/ml) had a greater than 3 fold increased risk of OA progression.

The results of the present study suggest that individuals deficient in vitamin D have greater risk of osteoarthritis progression than those with normal vitamin D levels.

Fang Fang Zhang et al. J Nutr. 2014; 144(12):2002-8. doi: 10.3945/jn.114.193227.

By Jackie Khor

Osteoarthritis specialist and Professor of Medicine at Sydney’s Royal North Shore Hospital says, a massive 80 per cent of knee osteoarthritis could be prevented by addressing the issue of overweight and obesity in the community and by preventing joint injuries from occurring in the first place.

Other factors that may contribute to OA include:
•    Family history (a genetic tendency)
•    Overuse of the joint (as seen in people who do heavy, physical work)
•    Damage to the nerves that supply a joint
•    Infection of the joints and/or the bones
•    Rickets and osteomalacia (low vitamin D levels).

The Process

Joints are a bit like hinges, structures that allow for flexible movement. To protect them and maintain suppleness, joints contain fluids and other substances that cushion the area. This ensures that the bones can slide against each other without friction.

They need to be flexible to allow for movement; technically, they’re the point where two bones meet – a bit like your body’s hinges. To protect them and maintain suppleness, joints contain fluids and other substances that cushion the area keeping the bones separate. But over time, and due to a range of factors, the protective substances can erode resulting in the pain of OA.

Small amounts of cartilage break away from bone so that the bones rub together straining the ligaments (strong tissues that hold bones together). You feel pain when the bones rub together and/or the joints move out of their natural positions.

However, with age, through stress and strain on joints with an active and sporty lifestyle, and through injury, your joints can become damaged, causing pain and inflammation. This can lead to a condition called osteoarthritis.

Although it isn’t generally life-threatening, osteoarthritis is a major cause of physical disability for millions of people worldwide. And, as our population get older and heavier, its dramatic influence on healthcare costs and quality of life is likely to get worse.

What are the Symptoms?

Pain or stiffness after sitting or lying down for some time is common in OA. And, mild and/or occasional joint pain and stiffness can progress to more frequent and severe pain with affected joints becoming increasingly difficult to move. The muscles that usually move the joint get tighter and shorter as they are used less and less and it becomes increasingly difficult to straighten it. According to Professor Hunter from Sydney’s Royal North Shore Hospital, ‘as many as 50 per cent of people who have OA don’t realise they have it!’ Yet treating it early can bring great benefits, he says.

So what can you do?

As well as getting to a healthy weight range, low impact exercise such as walking and swimming are good choices; but medicines and surgery may be required – your doctor will advise you about your individual needs.

Glucosamine can relieve pain significantly better than the analgesic acetaminophen (paracetamol) or placebo say Spanish researchers in one major study. ‘Glucosamine is a safe compound and its use should be considered in the early stages of OA,’ says Gabriel Herrero-Beaumont MD lead author of the study called the GUIDE trial.

Unlike other glucosamine supplements, the type used in Procosamine is vegetarian and is a type called glucosamine hydrochloride (because it’s not derived from the shells of crustaceans). Procosamine has added potassium sulphate so you’ll benefit from the same potency as you’ll find in regular glucosamine sulphate supplements. Plus, Meriva curcumin offers potent anti-inflammatory benefits. The active ingredient not normally well absorbed via the regular spice which given Indian curries their golden glow. But Meriva contains curcumin wrapped in a protective lecithin layer which is broken down slowly in the intestines allowing more of the active ingredient to reach the cells that require its antioxidant/anti-inflammatory action.


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