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Living with Osteoarthritis, and Caveats

2008-05-05 13:31:10

Life Extension Foundation Recommendations

People who have osteoarthritis often benefit from exercise, including stretching and strength exercises. These exercises help to build the muscles around affected joints. Muscle weakness is a major cause of disability in people who have osteoarthritis.

It is extremely important that people with osteoarthritis launch their nutritional program as early in the disease process as possible. The goal is to provide nutrients to help rebuild damaged bone and cartilage. The following nutrients are recommended:

EPA and DHA—1400 milligrams (mg)/day of EPA and 1000 mg/day of DHA
ASU—300 to 600 mg/day
Curcumin—900 mg/day, with 5 mg of piperine
Ginger—60 mg/day
Bioflavonoids—300 mg/day, including nobiletin
Nettle leaf extract—375 to 500 mg/day
SAMe—400 to 1200 mg/day
Glucosamine—1500 mg/day
Chondroitin—1000 mg/day
MSM—1000 to 3000 mg/day
Green tea extract—725 mg/day of green tea powder, yielding at least 246 mg of EGCG
Vitamin C—1 to 3 grams (g)/day
Vitamin E—400 International Units (IU)/day, with 200 mg of gamma-tocopherol
NAC—600 mg/day
Hyaluronic acid—Most published studies have examined the benefits of intra-articular injections of hyaluronic acid. This treatment is effective in treating osteoarthritis of major joints. Discuss hyaluronic acid therapy with your physician.

Osteoarthritis Safety Caveats

An aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. These include:

Chondroitin Sulfate

Consult your doctor before taking chondroitin if you are taking warfarin sodium or if you have hemophilia. Chondroitin can have antithrombotic activity.
Use a salt-free chondroitin preparation if you need to restrict your salt intake.
Chondroitin can cause gastrointestinal symptoms such as epigastric distress, nausea, and diarrhea.
Curcumin

Do not take curcumin if you have a bile duct obstruction or a history of gallstones. Taking curcumin can stimulate bile production.
Consult your doctor before taking curcumin if you have gastroesophageal reflux disease (GERD) or a history of peptic ulcer disease.
Consult your doctor before taking curcumin if you take warfarin or antiplatelet drugs. Curcumin can have antithrombotic activity.
Always take curcumin with food. Curcumin may cause gastric irritation, ulceration, gastritis, and peptic ulcer disease if taken on an empty stomach.
Curcumin can cause gastrointestinal symptoms such as nausea and diarrhea.
EPA/DHA

Consult your doctor before taking EPA/DHA if you take warfarin (Coumadin). Taking EPA/DHA with warfarin may increase the risk of bleeding.
Discontinue using EPA/DHA 2 weeks before any surgical procedure.
Ginger

Do not take ginger if you have a bile duct obstruction or gallstones. Ginger may stimulate bile production.
High doses of ginger (6 grams or more) can cause damage to the stomach lining and ulcers.
Ginger can cause anllergic skin reactions.
Consult your doctor before taking ginger if you take blood thinners such as warfarin (Coumadin). Ginger can increase the risk of bleeding.
Glucosamine

Consult your doctor before taking glucosamine if you have diabetes. It is unknown if glucosamine will increase insulin resistance in humans but glucosamine has been shown to increase insulin resistance in healthy animals and in animals with diabetes. Animals given intravenous glucosamine were found to have a significantly decreased rate of glucose uptake in their skeletal muscle (this effect was not observed, however, in animals given oral glucosamine).
If you have diabetes, are overweight, or have difficulty with glucose tolerance and take glucosamine under medical advisement, monitor your blood glucose level frequently. Your doctor will need to adjust your medication levels accordingly.
Glucosamine can cause gastrointestinal symptoms such as nausea and iarrhea.
Green Tea

Consult your doctor before taking green tea extract if you take aspirin or warfarin (Coumadin). Taking green tea extract and aspirin or warfarin can increase the risk of bleeding.
Discontinue using green tea extract 2 weeks before any surgical procedure. Green tea extract may decrease platelet aggregation.
Green tea extract contains caffeine, which may produce a variety of symptoms including restlessness, nausea, headache, muscle tension, sleep disturbances, and rapid heartbeat.
MSM

MSM can cause headache or gastrointestinal symptoms such as nausea and diarrhea.
NAC

NAC clearance is reduced in people who have chronic liver disease.
Do not take NAC if you have a history of kidney stones (particularly cystine stones).
NAC can produce a false-positive result in the nitroprusside test for ketone bodies used to detect diabetes.
Consult your doctor before taking NAC if you have a history of peptic ulcer disease. Mucolytic agents may disrupt the gastric mucosal barrier.
NAC can cause headache (especially when used along with nitrates) and gastrointestinal symptoms such as nausea and diarrhea.
SAMe

Consult your doctor before taking SAMe if you have bipolar disorder. See your doctor frequently if you take SAMe and you have bipolar disorder.
Consult your doctor before taking SAMe if you take antidepressants. See your doctor frequently if you take SAMe in place of or in addition to antidepressants.
Consult your doctor before taking SAMe if you have cancer. Nucleic acid methylation patterns may change in people who have cancer and take SAMe.
Do not take SAMe if you are undergoing gene therapy.
SAMe can cause anxiety, hyperactive muscle movement, insomnia, hypomania, and gastrointestinal symptoms such as nausea and diarrhea.
Vitamin C

Do not take vitamin C if you have a history of kidney stones or of kidney insufficiency (defined as having a serum creatine level greater than 2 milligrams per deciliter and/or a creatinine clearance less than 30 milliliters per minute.
Consult your doctor before taking large amounts of vitamin C if you have hemochromatosis, thalassemia, sideroblastic anemia, sickle cell anemia, or erythrocyte glucose-6-phosphate dehydrogenase (G6PD) deficiency. You can experience iron overload if you have one of these conditions and use large amounts of vitamin C.
Vitamin E

Consult your doctor before taking vitamin E if you take warfarin (Coumadin).
Consult your doctor before taking high doses of vitamin E if you have a vitamin K deficiency or a history of liver failure.
Consult your doctor before taking vitamin E if you have a history of any bleeding disorder such as peptic ulcers, hemorrhagic stroke, or hemophilia.
Discontinue using vitamin E 1 month before any surgical procedure.
For more information see the Safety Appendix