Category: Musculoskeletal

An end to the old weakling

Claus Hancke

July 14, 2006

The deficiency of an important antioxidant enzyme seems to be the most important reason that the elderly develop weak muscles. This paves the way for interesting perspectives.

The most striking sign of aging is that muscle strength is reduced and movement becomes slower. Even the most persistent exerciser cannot avoid it. The weakening of the muscles is the most important reason that old people become frail.

Why does this happen? We know that with age more and more signs of oxidation by free radicals can be found in muscles and other tissue. But is this why the muscles weaken?

A group of 12 researchers from both Texas and Stanford University in U.S.A. have undertaken an unusual and very detailed study which indicates that this is precisely the reason. According to them, the age related muscle weakness is due to strain from free oxygen radicals. This can shine light on possible ways to slow this process and maintain mobility longer.

Aging mice are a reliable model for age related muscle weakness in humans. But the American study was just possible because they had a special genetically manipulated mouse which lacked the ability to produce SOD (superoxide dismutase), a very important anti-oxidative enzyme.

In order to understand this it is necessary to know that free radicals are broken down in a chain reaction. SOD is necessary in the first step. In this step “active oxygen” (superoxide anions) is converted to less dangerous hydrogen peroxide. Without SOD this occurs very slowly, but with SOD this occurs at breakneck speed. In the next step hydrogen peroxide, which is also dangerous, is converted to harmless water. This occurs with the help of a selenium rich enzyme. This is one of the best known reasons that selenium, which we get too little of, is necessary for life.

Vital SOD
Back to SOD. It is also necessary to know that there are many forms of SOD. One of them is found in the mitochondria, which are the small power plants of the cells where cell metabolism occurs. If a mouse lacks SOD here, it dies after no more than three weeks. The power plants are destroyed by the free radicals which they produce. Another form of SOD is found outside the mitochondria, but still inside the cells. If the mice lack this type they can survive, but their lifespan is shortened by about 30%.

The researchers worked with mice which lacked the latter SOD form. They saw that the mice already started to develop weakened muscles while young. When the mice were 29 months old, they lacked half of their muscle mass in their hindquarters, whereas normal mice of the same age retain all of their youthful muscle. The so called fast type II muscle fibres were the most affected. The mice were left with slower type I fibres. Heart muscle remained undamaged.

The strength and speed of the muscles were not the only things affected. The mice also became less curious and less willing to engage in exhausting exercises like running in a mouse wheel. When they become old, they shook slightly in their weakened muscles.

It is hard to contest that this damage was caused by oxygen radicals. SOD has no other function other than being an antioxidant. As always it can be added that more research is necessary. This was only a study on mice. But if the results can be transferred to humans it can be argued that it is beneficial to increase the body’s production of SOD. SOD production is decreased with age.

Because SOD is an enzyme, which is to say a protein, it cannot be eaten without being destroyed in the stomach unless given as a special preparation. In combination with other antioxidants and possibly vitamin D (but that’s another story) the effect is supposedly more pronounced. This is not certain, but it is interesting.

By: Vitality Council

References:
1. Muller, Florian L et al. Absence of CuZn superoxide dismutase leads to elevated oxidative stress and acceleration of age-dependent skeletal muscle atrophy. Free Radical Biology & Medicine 2006;40:1993-2004
2. Jackson Malcolm J. Lack of CuZnSOD activity: A pointer to the mechanisms underlying age-related loss of muscle function, a commentary on “Absence of CuZn superoxide dismutase leads to elevated oxidative stress and acceleration of age-dependent skeletal muscle atrophy”. Free Radical Biology & Medicine 2006;40:1900-01

Glusosamine is more that just glucosamine

Admin

March 2, 2006

Watch out. Read the declaration carefully, when you buy Glucosamine for your osteoarthrosis.

According to a new research study, Glucosamine did not help against osteoarthrosis of the knees. According to another study, glucosamine was so beneficially, that it ought to be standard treatment. Its important to know, that the Glucosamine in the two studies were not the same type.

If you are to believe the publicised GAIT-study, it is meaningless to take glucosamine for arthritis of the knees. It just doesn’t work.

The GAIT-study was both large and thorough. It encompassed 1,583 patients with arthritis and lasted for 24 months. The participants were on average 53 years old and 2/3 of them were women.

These many arthritis patients were organised into six groups by lottery. These groups receive the following treatment:

  1. 1,500 mg glucosamine daily
  2. 1,200 mg chondroitine sulphate (which is like glucosamine) daily
  3. A combination of the two first treatments
  4. 200 mg of the prescription medicine Celebra
  5. Placebo

No one knew what they received and all of the participants answered detailed questions about their pain, stiffness, walking distance, and so on before and after the 24 weeks. Each participant then received a score based on their answers which indicated the severity of their symptoms.

The goal of the study was to find out how many of the participants showed a 20% improvement after the 24 weeks, but the results were surprising. No fewer than 60% of those who received the placebo had a 20% or better improvement. The results were only slighty better in the other groups: 64% for the glucosamine group, 65% for the chondroitine sulphate group, 67% for the combination group, and 70% for the group taking the prescription medication. Only the last group differed from the placebo group enough to be statistically significant.

The combination treatment did work for a small group (354 of the participants) who related mild pain after the treatment as opposed to moderate-strong pain. 80% of these people were (at least 20%) better off.

But the glucosamine alone was not better than the placebo.

Protects the cartilage
Another study called the GUIDE study was presented in November at the yearly meeting of The American College of Rheumatology. It included 318 patients (88% women) who also had arthritis in their knees. They received daily supplements of:

  1. Placebo
  2. Glucosamine (1,500 mg per day)
  3. Paracetamol (1 gr. three times daily)

This study also lasted a half year, but this the groups which received paracetamol and glucosamine reported an improvement of 30% more than the placebo group, even though the study was structured the same way as the GAIT-study. There was also a tendency that the glucosamine was better than the pain relieving paracetamol.

Why was there such a large difference between GAIT and GUIDE? This can possibly be explained by an editorial in the New England Journal of Medicine, which originally published the GAIT-study.

The difference could be that glucosamine-hydrochloride was used in the GAIT study whereas GUIDE used glucosamine-sulfate. Sulfate is crucial for the effectiveness of glucosamine.

Two randomised studies have shown that glucosamine-sulfate puts the breaks on the development of arthritis in the knees. This could be proven using X-ray photographs.

Glucosamine sulphate counteracts the breakdown of cartilage!
The New England Journal of Medicine editorial comment on the GAIT study related the following: “Arthritis patients who wish to take dietary supplements… should… take glucosamine-sulfate, not glucosamine-hydrochloride.” The lead author of the GUIDE-study stated that, “1,500 mg glucosamine-sulfate once a day could become the preferred treatment for arthritis in the knees.” The studies ended differently, but their recommendations are the same!

So read the label carefully.
It should read: “500 mg Glucosamine-sulfate, corresponding to 400 mg Glucosamine.”

By: Vitality Council

References:
1. Clegg DO et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med. 2006 Feb 23;354(8):795-808.
2. American College of Rheumatology Annual Scientific Meeting in San Diego, California. Press release.

content.nejm.org

Selenium May Prevent Degenerative Joint Disease

Claus Hancke

November 24, 2005

For the first time ever, researchers have studied the correlation between selenium deficiency and osteoarthritis, which correlation is surprisingly strong and indicates that selenium supplementation may prevent the Western World’s most common cause of mobility-impairment.

There is a general agreement that selenium is a mineral which western Europeans get less and less of through their diets. Modern agricultural methods and the acidification of the soil has have caused a lowered amount of this vital antioxidant I crops, and thereby a lowered amount of selenium in our bodies. The deficiency is severe enough that, as early as the 1980’s, it widespread problems in Danish pigs so severe that, after some political tug-of-war, supplements were added to their feed. But does this deficiency mean anything for people?

So far the only answer is “probably.” Large population studies in Finland etc. have shown that members of the group which gets the least selenium via diet have the greatest risk of getting cancer.

Just as importantly, in an American randomised study with 1,300 participants undertake nine years ago, it was found that supplements of selenium halved the frequency of new cancer cases. The less selenium presents in the blood beforehand, the greater the positive effect with the supplement. The result was so certain that the study was stopped early for ethical reasons and is being repeated on a larger scale. If selenium prevents cancer so effectively, we should be absolutely certain of its effects.

Meanwhile, researchers from North Carolina’s university in cooperation with the American Center for Disease Control (CDC) discovered another relationship: Selenium deficiency causes an increased risk of arthritis of the knees. The risk of arthritis of the knees increases by 15-20% every time that the body’s selenium content is reduced by 10 micrograms (per kilo body weight). For comparison, the blood of the average Dane contains about 80 microgram/litre while the blood of the average American contains 110.

Among the nearly 900 people who were followed for 15 years, the risk was 40% lower in the third who received the most selenium. If they developed arthritis anyway, there was a tendency that it was to a lesser degree.

This is just a statistical relationship. It has not yet been published in the press, but has been presented in a congress (15.11.05) in San Diego for American arthritis doctors and can be read in an official press release from North Carolina’s university.

Nevertheless, the study’s leader, professor Joanne Jordan, has declared that the group is very excited about their findings. It could indicate that there is a possibility of preventing arthritis in the knee and possibly in other joints. In other words, it might be possible to prevent the most common reason for activity reduction in the western world. In China it is known that extreme selenium deficiency can cause severe cartilage injury in joints as early as during childhood. Does this point in the same direction?

Maybe, but it is not known for certain. According to Joanne Jordan, the next step in to study selenium’s effect on cartilage in the laboratory. The obvious hypothesis is that this effect is due to selenium’s function as an antioxidant. Clinical studies, in other words randomised studies, should be undertaken to find out whether selenium supplements effect pain and the level of function in people with arthritis.

The new finds are not final, but it is the first time that anyone has studied the correlation between arthritis and selenium. It is very surprising that the relationship is so apparent.

By: Vitality Council

References:
1. Rayman M. The importance of selenium to human health. The Lancet 2000:;356:233-41.
2. News Release. Study links low selenium levels with higher risk of osteoarthritis. The University of North Carolina at Chapel Hill: http://www.unc.edu/news/archives/nov05/jordan111005.htm
3. Clark LC. et al. Effect of selenium supplementation for cancer prevention in patients with carcinoma of the skin. A randomized controlled trial. JAMA 1996;276:1957-63.

www.thelancet.com
www.unc.edu/news/archives/nov05/jordan111005.htm
jama.ama-assn.org
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Vitamin K against osteoarthritis and atherosclerosis

Admin

August 22, 2005

Researchers recommend Vitamin K supplementation. The need for this vitamin may be even greater than was previously supposed. Vitamin K deficiency leads to weaker bones and calcification of the arteries and vitamin K supplementation will both treat and prevent these problems.

Vitamin K “should be strongly considered as a dietary supplement” for women after menopause and for diabetics, groups which have high risks of developing both osteoarthritis and atherosclerosis. The vitamin is very non toxic and seems to be able to combat these ailments.

This is the very uncompromising conclusion put forth in a new scientific summary of vitamin K which has been published in the American Journal of Health-System Pharmacy, which is a serious but lesser known professional journal.

In spite of this journals lack of prominence, it’s very direct message regarding vitamin K will spread throughout the world. It was quickly published in its entirety by www.medscape.com the worlds largest website for doctors. Medscape has millions of readers worldwide.

Vitamin K is found almost exclusively in green vegetables. It is practically nonexistent in other foodstuffs. It was previously believed that the bacteria in our intestines hold us well supplied with the vitamin. This is not the case!

It is officially recommended (in the USA) that one has an intake of no less than 100 micrograms vitamin K daily, corresponding to about 75 grams green salad, spinach, etc. This is supposedly enough for the blood to coagulate properly.

But according to the article ensuring proper coagulation is far from enough. The vitamin is just as important for bones and arteries, and its optimal effect requires much more than officially recommended. In studies with vitamin K1, 10 times the official recommendation (10,000 micrograms) is typically used. This can be done worry free, there are no side effects. No effects have been reported, even when 45,000 micrograms K2 was used per day, 400-500 times recommended, for up to many years.

Vitamin K is responsible for making certain proteins able to bind to calcium. This occurs by the vitamin attaching mild acids (carboxyl groups) to the protein enabling it, like a type of crane, to pick up and move calcium to where it is needed. The protein which has this effect in bones is called osteocalcin and is produced with the aid of vitamin D. With the help of a weak acid osterocalcin can pick up calcium from the blood and place it in the bones. Vitamin K has long been used in Japan to counteract osteoarthritis.

In clogged arteries, for example the coronary arteries, the opposite occurs. It is believed that vitamin K counteracts the depositing of calcium in these vessels by adding a certain protein to the same acids. If the protein is missing or damaged and inaccessible to the acid, the blood vessel clogs quickly. This has been shown in animal studies. Normally the “crane” removes calcium from the arteries so they do not become clogged.

That there is a protein which prevents atherosclerosis and that vitamin K is necessary for its production is a very revolutionary theory. The theory is supported by Dutch research. In a three year long randomised study on older women, half received a daily dose of 1,000 micrograms vitamin K while the rest unknowingly received placebo.

The stiffness of the women’s carotid arteries was measured before and after the three years as a measure for the degree of arthrosclerosis. After the three year period this was unchanged in the women who received the vitamin K whereas nature had marched on in the rest of the women. Their arteries became 8% stiffer.

The strange phenomenon where calcium disappears from the bones and is accumulated in the arteries with age is called the “calcification paradox.” Aging phenomena are without a doubt a part of the explanation, but vitamin K deficiency is probably also contributory. It is without a doubt important to consider this paradox.

Important
If you receive strong blood thinning medicine such as Marevan, you should unfortunately avoid vitamin K supplements. Any such supplement can counteract your treatment and be life threatening.

By: Vitality Council

References:
1. Adams J, Pepping J. Vitamin K in the treatment and prevention of osteoporosis and arterial calcification. Am J Health-Syst Pharm 2005;62:1574-81.
2. Braam LA et al. Beneficial effects of vitamin D and K on the elastic properties of the vessel wall in postmenopausal women: A follow up study. J Thromb Haemosta. 2004;91:373-80.

www.ajhp.org
www.blackwellpublishing.com/journal.asp
www.iom.dk

Carnitine, a Stimulant for Heart, Brain, and Muscles

Claus Hancke

May 9, 2005

Carnitine creates energy in aged cells. The message from a new scientific congress is that supplementation of carnitine seems to help against both heart disease, arteriosclerosis, and dementia.

Are your memory failing or are you loosing strength, then perhaps carnitine is the remedy for rescue

Carnitine is an – undeservedly – overlooked dietary supplement that is on its way into the ‘scientific warmth’. A clear signal is that the New York Academy of Sciences dedicate a whole volume of its famous scientific annals to carnitine alone.

Here you can read more than 197 pages from all 18 contributions given at a two-day conference on carnitine held by the academy in March 2004. The contributions are, among other things, about the importance of carnitine for the burning of fat, for the functioning of the muscles and the heart and about its promising role in the fight against a weakened memory.

………………………

By: Vitality Council

Reference:
Salvatore Alesci et al. (Eds.). Carnitine: The Science behind a Conditionally Essential Nutrient. Annals of The New York Academy of Sciences 2005, vol. 1033.

www.annalsnyas.org
www.iom.dk

Supporting Evidence: B-vitamins Strengthen the Bones

Claus Hancke

March 18, 2005

A year ago a correlation between osteoporosis, folic acid and Vitamin B12 deficiency was discovered. It might have been a statistical coincidence, but a Japanese study discovered that the two vitamins reduced the risk of bone fracture by 80%.

Just a year ago, Dutch and American researchers demonstrated that at high homocysteine level – which is very common and most often a consequence of folic acid or vitamin B12 deficiency – the risk of breaking the hip doubles. It was only a statistical context, but was there also a causal link?

By: Vitality Council

References:
1. Sato Y, Honda Y, Iwamoto J, Kanoko T, Satoh K. JAMA. 2005 Mar 2;293(9):1082-8. Effect of folate and mecobalamin on hip fractures in patients with stroke: a randomized controlled trial.
2. Krumdieck CL et al. Mechanisms of homocysteine toxicity on connective tissues: Implications for the morbidity of aging. J Nutr. 2000;130:365S-368S.
3. Van Meurs Joyce B J et al. Homocysteine levels and the risk of osteoporotic fracture. N Engl J Med 2004;350:2033-41.
4. Mc Lean Robert R et al. Homocysteine as a predictive factor for hip fracture in older persons, N Engl J Med 2004;350:2042-9.

jama.ama-assn.org
content.nejm.org

Vitamins Prevent Sport-related Attrition

Claus Hancke

August 23, 2004

Strenuous and exhausting physical exercise is not beneficial to your health, as it may result in damage to both the DNA (hereditary material) and the cell walls through the process of oxidation.

Vigorous and exhausting physical exercise is not beneficial to your health. The oxidation that takes place during this kind of exercise both damages the DNA (our hereditary material) and destroys the cells walls.

Actually, a general attrition takes place similar to the one our body is exposed to during an operation, a heart attack, or another kind of violent strain. The proofs of the damages can be found in blood samples and urine tests.

However, a new study has shown that a lot of the damages can be prevented in athletes if they take a supplement of the vitamins E and -C before demanding performances. Both of the vitamins are antioxidants, i.e. they prevent the unintentional oxidation of the cell walls and thereby the destruction of the cellular functions.

Many athletes take supplements but proof of the supplements actually working have now been established in a thorough study of American ultramarathon runners.

The study was carried out in a scientific sports institute under Oregon State University. Starting six weeks prior to the long 50 km. (31 miles) race, 11 out of the 22 participants each took 1 g. of vitamin C and 400 I.U. of vitamin E every day while the other 11 participants were given placebo. Both before and after the race a number of tests were performed on both groups.

It turned out that the vitamins completely prevented the fats in the cell walls from going rancid (oxidation) both during and after the race. In the men who had not taken vitamins, the consequences of the exertions were measurable for at least six days while they were non-existent in the ones who had been given vitamins. Interestingly, the women got off lighter in that their tests were only elevated for a couple of hours after the race even though they had not taken any supplements.

The spokesperson for the researchers is professor Maret Traber. With a background including several honorary tasks and more than 160 scientific articles, she is considered one of the world’s leading experts on the subject of Vitamin E.

Based on the study, she declared that if you suffer from chronic health problems, you may very well benefit from larger doses of the two vitamins than what is normally recommended. In this context, she mentions diabetes, Alzheimer’s disease, and cardiac diseases, but also overweight and smoking. They are all conditions involving increased rancidity of the fats in the cell walls.

By: Vitality Council

Reference:
Mastaloudis A., Morrow JA, Hopkins DW, Devaraj S, Traber M. Antioxidant supplementation prevents exercise-induced lipid peroxidation, but not inflammation, in ultramarathon runners. Free Radical Biology & Medicine 2004;36(10):1329-1341.

www.sciencedirect.com/science
www.iom.dk

B Vitamin (Folic Acid) May Strengthen the Bones

Claus Hancke

August 2, 2004

The vitamin B substance folic acid (Vitamin B9) may be able to counteract osteoporosis. This is concluded by an American and a Dutch population study, which were simultaneously publisized in the medical magazine The New England Journal of Medicine.

Folic acid prevents neural tube defect (spina bifida) which is a serious and relatively frequent congenital malformation. Moreover, it is assumed that the vitamin counteracts coronary thrombosis, strokes, and other sequelae from atherosclerosis. Folic acid deficiency is quite widespread. One of the results of folic acid deficiency is that the blood level of the amino acid homocysteine is raised to abnormal high levels.

In the Netherlands, a group of 2,406 people above the age of 55 located in Rotterdam and Amsterdam were followed over a period of up to nine years.

In the American study which was part of the well-known Framingham study, 1,999 elderly people participated and were followed for 15 years. In addition to fractures, a large number of other significant factors in the development of osteoporosis were registered: Smoking habits, age, height and weight, consumption of coffee and alcohol, calcium- and vitamin D intake, oestrogen supplements, etc.

The two studies demonstrated that a high level of homocysteine was linked to an increased risk of suffering hip fractures. Both studies showed that people who belong to the top 25% with regards to high homocysteine levels in their blood have twice as large a risk of breaking their hip as the ones who have much lower levels of homocysteine.

Several conditions point towards a cause and effect relationship here. For example, it was statistically rejected that the risk was related to and biased by other known causes of osteoporosis, such as smoking, a lack of dietary calcium, etc.

It is also known that osteoporosis is a pronounced phenomenon in the hereditary disease homocystinuria in which the levels of homocysteine are particularly high. Finally, it has been demonstrated in laboratory experiments that homocysteine weaken the cross-links in the wickerwork of connective tissue around which the bones are built.

According to the Dutch results, a high level of homocysteine – and thereby a resulting lack of folic acid – might be the cause of approximately 19% of all hip fractures!

By: Vitality Council

References:
1. Van Meurs Joyce B J et al. Homocysteine levels and the risk of osteoporotic fracture. N Engl J Med 2004;350:2033-41.
2. Mc Lean Robert R et al. Homocysteine as a predictive factor for hip fracture in older persons, N Engl J Med 2004;350:2042-9.
3. (Editorial) Raisz LG. Homocysteine and osteoportic fractures – culprit or bystander? N Engl J Med 2004;350:2089-90.

content.nejm.org
www.iom.dk

Alternative Treatment of Osteoarthritis

Admin

September 16, 2003

The (Danish) Arthritis Association must get their proportions right:
The association recently published a questionnaire study showing that 86% of osteoarthritis patients use alternative medicine, even if several products do not seem to have a documented effect.

For example, fish oil, which 65% of the osteoarthritis patients report using, and 62% of them are satisfied with the effect. This information the Danish arthritis association “Gigtforeningen” find surprisingly “paradoxically.”

“It is correct that there are not yet well-established clinical trials on fish oil and osteoarthritis, but data from population surveys and other studies suggest that there may be an effect,” says the chairman of the Vitality Council – specialist physician Claus Hancke.

By: Vitality Council

(No references)

www.gigtforeningen.dk
www.iom.dk

Vitamin C Soothes Pain from Osteoarthritis in 14 days

Admin

July 6, 2003

Vitamin C soothes pain from osteoarthritis in 14 days. That is the conclusion of a Danish scientific study recently published in the Danish medical magazine, Ugeskrift for Laeger.

133 patients with osteoarthritis of the hip joint and knee joint were treated with one gram of vitamin C or placebo twice daily for 14 days. In those who got vitamin C there was clearly better pain relief than in the other group.

The study was made because many people have said that vitamin C has helped with their osteoarthritis.

“Our study, which have been carried out to the highest scientific standard, have shown that vitamin C reduces the pain of osteoarthritis of the hip or knee joint within 14 days,” says Niels Hertz, specialist in general medicine.

“This effect was statistically exceptionally safe and led to very clear improvements in the functioning of those with arthritis. The magnitude of the effect is equivalent to half what you normally find with arthritis pills (NSAIDs), but unlike these, the treatment with vitamin C is free of side effects and can be tolerated indefinitely.

The finding is extra interesting because other studies have shown that people with arthritis who get a lot of vitamin C do not worsen as much over time as those who get ordinary Danish average amounts. This was found a few years ago in the famous American Framingham study, a result that attracted attention at the time.

In other words, one can imagine that vitamin C not only relieves the pain of osteoarthritis, but also counteracts aggravation of arthritis!

There are many examples of this happening. A retired nurse, I know, meant for approx. 10 years ago that she could no longer avoid a hip operation. She was in so much pain. Then she started taking vitamin C and today she is still not operated on. I see her regularly on the street, without a cane and in a good mood.

Every twentieth Dane receives less than 30 mg of vitamin C a day, and very few come close to the American averages from Framingham. This is highly unfortunate for public health.

Several of the world’s leading experts in vitamin C believe that the recommended daily allowances (RDA) should be significantly increased.

Vitamin C is, in my opinion, a fantastically exciting vitamin, which most likely has several other positive surprises in it. We are far from finished exploring it, ”concludes Niels Hertz.

By: Vitality Council

Reference:
Jensen, Niels H.P. Hertz, Ugeskr Laeger 2003;165:2563-6.

www.dadlnet.dk
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