In the last two columns I wrote about other forms of arthritis, so in this week’s article I shall discuss the most common form – osteoarthritis and its close relative osteoporosis. Some of this information may have come up previously in my article ‘Dem bones’ last year but it is just as relevant today.
Osteo arthritis is the degeneration of the joints of bones in the human body resulting in the destruction of the articular cartilage. It can be caused by uneven load bearing activities, trauma, age or metabolic disturbance resulting in chronic inflammation. Joints become painful and stiff and eventually in some people there is a complete loss of function.
Osteoporosis is a disease where there is an actual loss of bone tissue resulting in bones which become brittle and liable to fracture. It may be due to infection, trauma, inflammation of the joint capsule, metabolic disturbance, alcholism. It is more common in women who are post menopause. In my view, both, can be prevented with appropriate dietary interventions and no stimulation of the hormones such as oestrogen in post menopausal women. Both conditions are reversible.
Typically osteoporosis is treated in Canada with the use of Bisphosphonates, a class of drug designed to ‘freeze’ bone. Fosamax is probably the most well known drug but there are others in this class of drugs. The origins of bisphosphonates lies in the 1970’s when researchers first identified a protein called RANKL which erodes bone ( osteoclasts ) and in a normal person this mechanism is blocked by a second protein called osteoprotegrin. Bisphosphonates block osteoclast activity. By blocking one of three pathways designed for good bone health it prevents the other two pathways from working as the system is designed on a feedback basis.
All bone depends on an adequate reservoir of essential minerals. Osteoporosis is usually an indicator that there is no satisfactory reservoir of essential minerals circulating in the body to support bone function, resorption ie the marking of new bone which the body is designed for all its life. The secondary huge function of bone is that is the creation of an environment for the creation of the pluripotent stem cells which create the new red blood cells. (haemopoiesis). It does not occur in the body in any other location. Normal bone follows a lifelong severn year re modelling cycle for the whole skeleton.
If there are no adequate minerals then no drug will ever improve the situation. As is becoming clear, if one pathway of the body’s function is blocked it has a huge impact on the other pathways ie the osteoblasts and osteocysts for making new bone. Bisphosphonates by blocking osteoclast activity it effectively freezes bone which for 2-3 years gives the illusion via the Dexa scan that bone is hardening. After about 3 years bone then starts to become brittle and susceptible to fracture ( ie the same situation of osteoporosis prior to consumption of the drug ). Increasingly we have cohorts of women who have been given these drugs for 10 years or more presenting at hospitals with fractures and or broken bones. Women in their eighties are far less able to deal with broken bones than at an earlier age so this creates a situation where surgery is necessary and this is frequently followed by extended hospital care and long term care in a woman who was previously active and independent. Frankly, I consider this an avoidable scandal. The overall health of the patient is impaired long term and there is unnecessary further demands on the public health system which is all avoidable.
Of the minerals the bones need calcium is popularly recommended but it is only one of the necessary minerals. The parathyroid hormone regulated by the thyroid and in part the kidneys is believe to involve the regulation of calcium and the building up of the bone skeleton. In Ontario there is widespread sub clinical hypothyroidism which effects the parathyroid hormone but in practical reality this aspect is ignored in favour of the prescription pad.
In osteo arthritis the problem normally lies in the shoulder, hip and knee joints where the original structural integrity of the cartilage has been lost and the normal attempts by the body to replace it with new cartilage lack the structural integrity. Currently science does not fully understand these mechanisms – only the results of the loss of it and consequent ‘eburnation’ where bone rubs on bone and it is very painful. Undoubtedly modern surgery can achieve amazing prosthesis for these joints but they do not address the key issue of bone health for the long term. So we come back to the original issue I raised in the first column – what we eat and what physical exercise we do is key to maintaining bone integrity. Suppressing symptoms is not a long term solution.
As Medical Herbalists have a wide range of plants, along with dietary data, to support and resolve these conditions it makes sense to consult with one. Nearly always that very common weed Nettle is used for the simple reason it contains nearly all the micro minerals needed for osteoarthritis and osteoporosis but another plant not so widely appreciated is Eupatorium perfoliatum which our indigenous peoples have used for thousands of years. The name was translated as Boneset and originally used by the western settlers to combat fevers as found in Malaria a common complaint in the early development of Canada. I use it in the Indian way to repair bone. Matthew Wood, and eminent American Herbalist, describes several examples of using Boneset to heal shattered bones in his book The Earthwise Herbal. Boneset contains chemicals called quinolones which in the form of synthetic drugs are called antibiotics such as ciprofloxacin. Quinolones are also found in quinine – the anti malarial pill! Thus the application of boneset was entirely justified by both the Indians and our early settlers. Today that very same chemical synthesised as oxyquinoline is used for the treatment of rheumatioid arthritis ie bones!
Morwenna Given BA MA (OXON) BSc OHA BHG AHG RH is a Medical Herbalist practising in downtown Toronto. More information can be found at her website www.medicusherbis.com
General and Systemic Pathology 4th Ed Underwood
Oestrogen deficiency modulates particle-induced osteolysis. Nich C, Langlois J, Marchadier A, Vidal C, Cohen-Solal M, Petite H, Hamadouche M. Arthritis Res Ther. 2011 Jun 22;13(3):R100
Immunology and bone. Danks L, Takayanagi H. J Biochem. 2013 Jul;154(1):29-39.