What Causes Osteoarthritis?

Many women experience joint pain whether it’s in their knees, hips, fingers or shoulders.  The pain might come and go, be worse in the morning, or feel aching and stiff most of the day.  The diagnosis is typically done with symptoms and possibly an x-ray that shows joint changes.  Arthritis can start as early as the late teenage years/early twenties however more than 50% of people over 65 years old exhibit symptoms of arthritis.  What causes the joints to begin to deteriorate and create arthritis?

1.       Joint injury – Research shows that those who sustained a joint early at a young age are more apt to develop arthritis in that joint at a later age.  As an example, 51% of women developed knee arthritis 12 years after tearing their anterior cruciate ligament (ACL) in soccer.  Many can point back to a car accident, sports injury, broken bone or other trauma when discussing their problem area(s). 

2.       Obesity – Extra weight on the body coupled with daily activities and gravity means more load on the hips, knees, ankles and feet causing those joints to become more strained and inflamed over time plus it increases the wear and tear on the cartilage that leads to osteoarthritis. 

3.       Age – Sorry ladies, aging does take its toll on the joints considering more than 50% of people over 65 have arthritis symptoms (as stated above).  Many women will say “I didn’t have these problems in my 20’s or 30’s!” but over time joint injuries happen, diet/lifestyle choices take effect, genetics kick in, hormones change, weight fluctuates…and suddenly one day women find themselves waking up more stiff and aching.  Those of you who can still go from sitting cross-legged on the floor to a standing position without (much) assistance count yourselves lucky. It will probably change.

4.       Congenital abnormalities – If someone were born with joint problems or cartilage issues, then over time the stress on the joints will cause arthritic changes.  For example, scoliosis in the spine, or one leg shorter than the other will shift the way the body carries itself causing joint problems. 

5.       Endocrine disorders – Diabetics and those with low thyroid hormone are at risk for more joint and cartilage problems that can lead to arthritis.  Women heading into menopause often complain of more joint pain because their estrogen levels are gradually (or suddenly) decreasing. 

What does all this mean?  It means, take good care of yourself!  This is your one body.  Eat healthy, stay hydrated, maintain a healthy body weight, limit sugars and processed foods, and stretch regularly.  Thankfully there are articles here for tips to reduce the symptoms of arthritis if your joints are causing you pain on a regular basis.  Lastly, talk with your health care provider about appropriate work-up and treatment suggestions. 

References:

1.       Sofat, N., Ejindu, V., Kiely, P.  What Makes Osteoarthritis Painful?  Rheumatology. 2011;50(12):2157-2165.

2.       Roos, E.  Joint Injury Causes Knee Osteoarthritis in Young Adults.  Curr Opin Rheumatol. 2005;17(2):195-200.

3.       Kramer, P.  Prevalence and Distribution of Spinal Osteoarthritis in Women.  Spine. 2006;31(24):2843-2848.

May is Celiac Awareness Month!

Going gluten free appears to be the latest fad for many people and celebrities alike however there is a lot of misinformation surrounding gluten free and the reasons to give it a try.  As May is Celiac Awareness Month, this article serves to answer the most common questions about celiac and gluten issues in regards to health and disease.  Not all people who have a problem with gluten containing foods have celiac’s disease so keep reading to learn more.

1.       Celiac is the inherited autoimmune disease that causes damage and destruction to the small intestines when gluten containing foods are eaten.  This damage causes a lot of malabsorption of vitamins and minerals leading to symptoms and long term health issues.  Currently, being 100% gluten free is the treatment to eliminate the symptoms and heal the intestines.

2.       It is estimated that 1 in 100 (give or take) people have celiac disease.  It is strongly associated with other endocrine conditions such as thyroid disease, type 1 diabetes, bone problems, skin problems, iron deficient anemia, growth problems, delayed-puberty, neurological complaints, infertility and miscarriage, and more.  Celiac is not just a disease of the intestines therefore some people do not have intestinal complaints.

3.     Testing for celiac is controversial and confusing – there are blood tests such as the tissue transglutaminase(tTG) or anti-endomysial antibody test (EMA) however false negatives are common.  Many doctors want an intestinal biopsy to determine if the intestinal cells are inflamed and damaged however those who are already gluten free will have to eat gluten again daily for several weeks to months in order for the damage to return on the biopsy results.  As celiac is genetic, the HLA-DQ2 and DQ8 gene tests can be ordered to see IF someone has the risk.  Having the gene does not mean celiac is positive (just like having the breast cancer gene does not mean someone develops breast cancer).  Talk with your health care provider about this.

4.        Diagnosis at a young age is critical.  The University of Chicago, Celiac Disease Center reports, “children who are diagnosed between the ages of 4 and 12 have a 17% risk; from 12-20 years of age the risk goes up to 27% and an individual diagnosed above the age of 20 has a 34% chance of developing another autoimmune disorder.”  It is estimated that some 3 million Americans have celiac disease but 97% are undiagnosed.

5.       A new category, commonly called ‘non-celiac gluten sensitivity’ or gluten intolerance is not an autoimmune disease causing intestinal damage however these people still have an unfavorable response when they eat gluten containing foods.  Therefore their celiac testing may be negative however a gluten free diet eliminates many of their symptoms.

If you suspect that gluten containing foods are causing your symptoms, or if you look back at your family history and several of the conditions overlap with the ones listed above, talk with your doctor about getting tested for celiac disease.  Do this first before considering a gluten free diet as you may feel better but will have to eat gluten foods again for the celiac testing.  If you are considering a gluten free diet, please consult an expert such as a dietician, nutritionist, or Naturopathic Physician and take advantage of the incredible online celiac/gluten-free websites and books to increase your awareness and education about making the switch while continuing to maintain a healthy, balanced diet.  Gluten free donuts or cookies do not make them any healthier!  It just makes them gluten-free.

 

Read more at the women's health website, Empowher!

References:

1.       Philip, R., Patidar, P, Saran, S., Agarwal, P., Arya, T., and Gupta, K.  (2012).  Endocrine manifestations of celiac disease.  Indian J Endocrinol Metab. 16(Suppl 2): S506–S508.

2.       University of Chicago, Celiac Disease Center.  (2013).  Fact sheets.  Retrieved from http://www.cureceliacdisease.org/living-with-celiac/guide/fact-sheets

5 Health Questions To Ask Your Mom

Sunday was Mother’s Day and many were celebrating with cards, calls, flowers and brunch to honor the women in their lives.  Yet, how many know the full health history of their mom, grandmother and aunts?  This information could prove to be critical when it comes to your own health therefore these are 5 questions to ask the female family in your life.

1.       How was menopause?  This question is important as women tend to follow them other women in their family when it comes to peri-menopause and menopausal changes.  Do the hot flashes and night sweats start in the 40’s or 50’s?  How long did it take?  Was it rough?  Was it easy?  How did she treat it?  Any complications? 

2.       Who has had cancer in the family?  And at what age?  This applies to both the men and women however mom tends to know this information.  If grandma and the aunts had breast cancer at a younger age, this is more concerning than finding out grandma had it later in life.  Has anyone had thyroid cancer? Prostate cancer? Ovarian, cervical or uterine cancer? Skin cancer?  Know your family’s cancer history.

3.       What are the family trends?  If all the women eventually develop thyroid disease and go on thyroid medication, this helps both you and your health care provider to be extra diligent and pro-active.  Does heart disease run in the family?  What about obesity?  Fertility problems?  Endometriosis?  Osteoporosis?  Do the women tend to lose their hair as they age?  Everyone have their gallbladder?  What about digestive or food allergy problems?  All of this information is critical for future planning and may shed light into current symptoms.

4.       Any outliers in the family?  The 2^nd cousin with celiac’s disease may not strike you as important however as your gas and bloating worsens, it could be a direct link.  The weird uncle whose mood alternates from really happy and hyper to down and depressed may be suffering from undiagnosed bi-polar.  This can be genetically linked as can depression in the family.  If just grandma had aches and pains it could have been undiagnosed fibromyalgia or a certain type of arthritis – how is your pain?

5.       What about your siblings?  Not all brothers and sisters are close therefore they may not inform each other about different health issues, concerns, scares and symptoms but mom usually knows.  Ask her if your symptoms sound like anyone in the family or periodically check in on the health of the rest of the family.  You may find out that your older sister has been having problems getting pregnant too or that your brother experiences the same types of migraines that you do and the same medications are not working.

While some people may prefer to keep some of their health history private, the more you know the more you (and your family) can be pro-active and prevent when possible.  Let your health care provider know of any changes as well to routinely keep your chart up-to-date and help them provide the best care possible for you.

 

Learn more on the women's health website, Emowher!

References:

1.       Segurado, R., Deterawadleigh, S., Levinson, D., Lewis, C., Gill, M., Nurnbergerjr, J., Craddock, N. Depaulo, J.  (2003). "Genome Scan Meta-Analysis of Schizophrenia and Bipolar Disorder, Part III: Bipolar Disorder". Am J Human Genetics 73 (1): 49–62.

2.       Steiner, A., Baird, D., Kesner, J.  (2008). Mother’s Menopausal Age is Associated with her Daughter’s Early Follicular Phase Urinary, Follicle Stimulating Hormone Level.  Menopause. 15(5): 940–944.

5 Tips to Helping Arthritis Naturally

Many women suffer from arthritis aches and pains that linger for hours or stay for days.  The pain and stiffness can really inhibit daily activities such as putting on shoes, opening jars, and even walking.  Osteoarthritis is commonly known as degenerative arthritis and is due to repetitive use, injury, aging, genetics, and certain diseases.  Treatment can be difficult as many of the causes are not curable such as aging (sorry ladies) or genetics however these 5 natural tips may be helpful to reducing your inflammation.

1)      Tumeric – the spice that is also known as curcumin has pain reducing qualities as it inhibits the inflammatory pathway known as COX-2.  One cannot eat enough of the spice therefore taking a good quality supplement at 1500-2000mg one to two times per day.

2)      Green Lipped Mussels – these mussels from New Zealand have promising anti-inflammatory properties for those with arthritis.  The typical dose is 500-1000mg one to three times per day.  It can take 4-6 weeks to take effect however research is promising.  Be very careful for those who have an allergy to mussels.  Side effects may include nausea or diarrhea so start with a lower dose and work up.

3)      Devil’s Claw – also known as Harpagophytum procumens, is an herbal plant that comes from Africa and contains the active ingredient, harpagosides to lower pain and inflammation.  The typical dose is about 1000mg per day (totally 50-60mg harpagosides – read the label) in divided doses.  Those with ulcers or gallbladder disease should use this plant cautiously and those with blood sugar problems need to monitor their levels as Devil’s claw has been known to lower glucose levels.

4)      Krill oil – everyone knows about the vast importance of fish oil but Krill oil is quickly making a name for itself with it comes to reducing pain and inflammation (especially c-reactive protein) with arthritis.  The typical dose is 300mg per day (along with your normal fish oil supplement) for joint protection.  Like fish oil, side effects can include ‘fish burps’ especially in poorer quality supplements, heartburn and nausea.  Those who have allergies to certain seafood such as shrimp should avoid it and krill oil (like fish oil) can potentially act as a blood thinner so be aware with blood thinner medications or before surgery.

5)      Glucosamine and Chondroitin – these supplements are the most commonly used for arthritis and joint pain however they must be taken at the appropriate dose and can take up to 8 weeks to have an effect.  If they are stopped then the beneficial effect goes away.  Glucosamine and chondroitin have both been shown to lower c-reactive protein and lowers inflammatory cytokines.  Glucosamine must be taken at doses of 1500mg per day and chondroitin at 400-500mg per day.  Some supplements are from a seafood source therefore those with allergies need to be aware.  Side effects may be gastrointestinal in nature such as diarrhea or nausea.

Other than krill oil, the other four natural supplements should not be used in pregnant women and remember to discuss all supplements with your health care provider.

 

Read more at the women's health website, Empowher, here!

References:

1) Lev-Ari, S., Strier, L., Kazanov, D., Elkayam, O., Lichtenberg, D., Caspi, D., and Arber, N. Curcumin synergistically potentiates the growth-inhibitory and pro-apoptotic effects of celecoxib in osteoarthritis synovial adherent cells. Web. 7 May, 2013.

http://www.medscape.com/medline/abstract/16249246

2) De Silva, V., El-Metwally, A., Ernst, E., Lewith, G., and MacFarlane, G. Evidence for the Efficacy of Complementary and Alternative Medicines in the Management of Osteoarthritis. Web. 7 May, 2013.

http://www.medscape.com/viewarticle/741637_3

3) Deutsch L. Evaluation of the effect of Neptune Krill Oil on chronic inflammation and arthritic symptoms. J Am Coll Nutr. 2007 Feb;26(1):39-48.

4) Kelly, J. Glucosamine, Chondroitin, Fish Oil May Reduce Inflammation. Web. 7 May, 2013.

http://www.medscape.com/womenshealth

5) Rovati, L., Girolami, F., and Persiani, S. Crystalline Glucosamine Sulfate in the Management of Knee Osteoarthritis. Web. 7 May, 2013.

http://www.medscape.com/viewarticle/7657351)