When cartilage breaks down and bone rubs against bone, the pain is excruciating. NOHA speaker, Luke Bucci, PhD, has written Pain Free: The Definitive Guide to Healing Arthritis, Low-Back Pain, and Sports Injuries through Nutrition and Supplements.* In the tape of his NOHA talk and in his book Bucci describes many nutrients and certain natural supplements that can gradually restore the cartilage in our joints.
Besides water, there are three principal components of cartilage: collagen, proteoglycans, and particular cells, called chondrocytes.
Collagen is the most abundant protein in our bodies and it provides great structural strength everywhere it is found, including in cartilage. "The collagen-making process depends on a steady flow of nutrients, including amino acids (protein), vitamin C, iron, copper, and manganese. If any of these are in short supply, the manufacture of collagen is impaired."
Cells and proteoglycans fill up the extra spaces in cartilage around the structural collagen. "Proteoglycans have the consistency of half-set Jell-O." They attract and hold water and make wonderful cushions for our movements. "Each proteoglycan subunit contains a long, core protein to which are attached hundreds of long chains of specially modified sugars. These are called glycosaminoglycans (GAGs), the most important of which is chondroitin (kon-DROE-it-in) sulfate. . . . GAG synthesis must take place before proteoglycan and collagen synthesis."
As mentioned already, the cells inside cartilage (the chondrocytes) have no direct access to either our blood or lymphatic systems. Therefore, they depend for nutrients on gradual seepage from surrounding tissues, such as the sinovial fluid. The chondrocytes produce enzymes that destroy injured or worn out cartilage. This is a slow process because collagen is tough. The chondrocytes also produce new cartilage, usually slowly. "Even bone remodels faster than cartilage!" Sometimes in degenerative diseases, such as some forms of arthritis, the remodeling function of the chondrocytes seems to be turned off. They are just destroying cartilage. However, Bucci points out that when the proper natural biochemicals are present there is evidence that formation of cartilage can recommence. Specifically, the nutrients for GAG synthesis (or GAGs themselves) need to be present for this production to start.
In Europe, a number of studies, using glucosamine sulfate orally, have shown good results both for arthritis and for sports injuries. Sometimes, after two weeks or so, glucosoamine is just as effective as conventional pain-killing drugs at stopping pain and later on it becomes even more effective. Also, the mobility of many glucosamine-receiving patients improves whereas the patients receiving drugs often remain as crippled as ever or get worse. Bucci cites studies showing that the usual large doses of certain pain-killing drugs (including aspirin) over long periods of time can exacerbate arthritic conditions whereas glucosamine supplements, other nutrients, plus excellent conventional physical therapy can reverse arthritis.
Unfortunately, some commercially available glucosamine supplements contain about thirty per cent salt (sodium chloride) as a stabilizer and other formulations are quickly metabolized by the liver so less is available for cartilage. Bucci recommends a particular supplement that contains both glucosamine and chondroitin, although none of the European studies were done with any combination.
In Europe, a number of studies, using glucosamine sulfate orally, have shown good results both for arthritis and for sports injuries. . . .Unfortunately, some commercially available glucosamine supplements contain about thirty per cent salt (sodium chloride) as a stabilizer and other formulations are quickly metabolized by the liver so less is available for cartilage.
Bucci emphasizes "Antioxidants against Arthritis," stating that "the big three" for joints are vitamins C and E plus selenium. Antioxidants can retard the erosion of cartilage. Vitamin C is essential for the formation of collagen; also, it reduces inflammation and enhances the healing of wounds. "At the cellular level vitamin E safeguards cell membranes from oxidation." He warns us to choose natural vitamin E, specifically, "d-alpha-tocopherol or mixed tocopherols."
Bucci provides detailed information on other nutrients that can help reverse arthritis, such as niacinamide (vitamin B3), vitamin B6, magnesium, manganese, copper, zinc, and boron. He mentions the omega-3 fats from fish and points out that they are precursors of biochemicals (prostaglandins) that reduce inflammation. "If you eat a high-fat diet (not recommended), you have to intake even more omega-3 to get results."
Bucci gives detailed "Nutritional Protocols for Joint Health" and his general statements on diet are excellent:
*1995, The Summit Group, Fort Worth, Texas, 248 pages, hard cover, $24.95.
Article from NOHA NEWS, Vol. XXI, No. 2, Spring 1996, pages 4-5.