Dear Ron,

I am a 60 year-old mother and grandmother of four young children. I find it very difficult to keep up with them. I enjoy the opportunity to take care of them, but I often find it difficult because I suffer from arthritis. What can you recommend for arthritis?

Sincerely, Harriett K., Framingham, MA

A recommendation for arthritis is dependent on which type of arthritis you are suffering from. Osteoarthritis (OA), which is the most common form, afflicts nearly 50 million Americans. OA is sometimes often called degenerative joint disease. Basically it is caused by normal wear and tear, although occupational hazards and lifestyle choices such as a football player's knees or a construction worker who carries heavy materials, can aggravate the condition. It most commonly affects the larger joints in the body such as the knees, hips, shoulders and elbows; however it also can affect the smaller joints. A guitar player for example may develop OA in his wrists.

Traditional drug therapies for treating OA are via anti-inflammatory drugs, most commonly the non-steroidal drugs known as NSAIDs. Sometimes steroids are also used. NSAIDs do a good job of blocking prostaglandin synthesis. Prostaglandin synthesis is the normal body function that produces inflammation and results in pain. By blocking this pathway, you can block inflammation and then decrease or eliminate pain. The negative side of this reaction is that there are many different prostaglandin in the body. As a result you also block other processes that require prostaglandin synthesis.

One of these areas is in the lining of the digestive tract. This is one reason why using NSAIDs often produces ulcerative effects. NSAIDs also block proteoglycan synthesis — the body's mechanism of self-repair in which enzymes digest the rough areas on the cartilage. Since NSAIDs block this repair mechanism, people who use them will often need more and more amounts of the drug over time to deal with increased pain. The drug stops working and soon needs to be replaced with another more   powerful agent with even more side effects.

My favorite product for OA is Stabilized Glucosamine Sulfate. Because of the cost, I will recommend a non-stabilized version for those who cannot afford it. Many people seek out a combination of Glucosamine with Chondroiton Sulfate. I normally don't recommend the combination for several reasons. Primarily, Chondroiton is a very large molecule and gets very poor absorption from the gastrointestinal tract (Gl). Combine that with the fact that many adults in the 50-year-old plus range who would be the primary users of this supplement may already have compromised digestion. The studies done on Chondroiton with Glucosamine were done with an injectable form of Chondroitin that was injected directly into the joint. There are some instances when I would recommend the combination, but they are relatively few. I would prefer to see someone use the better form of Glucosamine than spend the money on Chondroitin.

I will often recommend the use of flaxseed oil with Glucosamine. Flaxseed oil is beneficial because it has anti-inflammatory properties. It can help lubricate the joints and it helps increase the elasticity of the ligaments and tendons. Another product worthy of mention is Arthed®. Arthed is a hydrolyzed collagen product that helps with cartilage formation.

If we are dealing with rheumatism and/or rheumatoid arthritis, the process is very different. In Harriett's case we are dealing with an inflammatory response in the joint tissues that causes swelling loss of mobility, rigidity, disfiguration and joint pain. We can trace the origins back to problems with digestion. Normally, the digestive tract is a barrier that prevents foreign particles, bacteria and toxins from passing through it, but it allows nutrients to be absorbed. As we get older, the system begins to fail. Combined with the processed food diets we eat, we have a difficult time digesting our food adequately. We will often treat these indigestion problems symptomatically which further complicates the problem.

The lining of our digestive tact is dependent on organic sodium to protect it from breaking down. There are very few sources of organic sodium in our diets. This results in a breakdown of the mucosal layer of the Gl tract with an inability to digest foods completely. Partially digested foods, particularly proteins, are able to be transported through the lining into the blood stream. Normally, macrophages and immune responses in the blood engulf small particles. Because the proteins are so large, they cannot be engulfed. The body declares war on these large invaders. They float in the blood until they reach the small joints of the body. The body is attacking them and this forms scar tissue in the joints resulting in the symptoms discussed earlier.

My recommendation for this type of arthritis is a course of acidophilus, food enzymes and fiber to support digestion. Take goat's whey as a source of minerals, including organic sodium, flaxseed oil for its many benefits and possibly Devil's Claw or a combination that also has other herbs in it for added anti-inflammatory properties if they are needed.

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Ron Stock has been involved in the pharmaceutical profession for nearly 15 years and holds a certificate from the British Institute of Homeopathy. Send in questions for this column via email to ronstock@aol.com or write to Ron Stock directly to the Herbal Path, 839 Central Avenue, Dover, NH 03820. Or call 603-740-8400. Web site www.herbalpath.com

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