Adam's Corner

Ouch, Ouch. Arthritis

There are 101 different kinds of arthritis, and 101 ways to treat each one.  Rather than try to go into all of that here we don’t want to get arthritis in our typing fingers! this is going to be a quick, hopefully simple, guide to some of the most basic concepts, and the most effective ways of treating this disease.

WHAT IS ARTHRITIS?  Arthritis is an inflammation of the joints, causing pain, inflammation, stiffness, and eventual destruction of joint cartilage.  The most common kinds are osteoarthritis and rheumatoid arthritis.  It is possible to have more than one kind at once.

1.       OSTEOARTHRITIS: Osteoarthritis is matter of simple wear and tear.  It comes on with age, but pounding of joints (for example power-lifting or hard distance running) can bring it on in younger adults.  It tends to strike cartilage in overused joints like knees, hands, feet, hips and spine.  Sometimes an injured joint becomes susceptible to osteoarthritis, even decades after injury has occurred.

2.       RHEUMATOID ARTHRITIS: Rheumatoid arthritis is an auto-immune disease where the immune system gets confused and attacks and inflames joints.  Here, inflammation is the cause of joint breakdown, not just an effect.  Rheumatoid arthritis tends to attack joints symmetrically on both sides of the body, and may affect any and all joints, regardless of how much we use them.  As the immune system starts working in earnest, you might feel overall malaise, like a low-grade flu.  Rheumatoid arthritis may be treated with supplements like most other types of arthritis, but diet for rheumatism can be very different and very, very important.

2.1.    Like many autoimmune diseases, rheumatoid arthritis may be set off by “trigger foods”, which can differ greatly from person to person, but by far the most common are nightshade (Solanacea) family vegetables.  Avoid nightshades for at least six weeks, and see if you don’t feel a profound difference.

2.1.1. Eggplants, tomatoes, tomatillos, potatoes, and peppers are the most common nightshade foods.

2.1.2. Black pepper and sweet potatoes, however, are different.

2.1.3. Some people can handle potatoes, but not if they have sprouted.  Others can handle red bell peppers and heirloom potatoes, but not other varieties.  The only way to tell is trial and error.

2.1.4. Tobacco is a nightshade, but it usually is not a problem in this way.

2.1.5. A number of medicinal plants are nightshades, including ashwaganda (Withania somnifera), cayenne (Capsicum spp.), and goji (Lycium barbarum).  And yet these, especially the ashwaganda, may actually help with rheumatism.  Again, trial and error is the only way to know for sure…

3.       GOUT: Also called “metabolic arthritis,” gout is very different from most others types.  Here, a compound called uric acid forms sharp microscopic crystal in the tissues surrounding the joints, making movement or pressure at times excruciatingly painful.  Like all types of arthritis, inflammation plays a key role in the process; unlike others, actual breakdown of joint cartilage does not necessarily occur.  There are a number of recommendations specific to gout:

3.1.    Uric acid is made in the body from dietary compounds called purines.  Purines are everywhere you’ll never avoid them completely but a low-purine diet is still one of the most important things you can do for this painful condition.

3.1.1. Most people advise to avoid protein, because protein contains purines.  But it’s not that simple.  Purines are highest in foods that come from metabolically active tissue, so meat, poultry, fish and shellfish are all problems and you don’t even think about eating nutritional yeast, or heart!

3.1.2. Dairy, on the other hand, doesn’t increase gout risk, despite being very high in protein.  That’s because milk isn’t metabolically active it has almost no purines.

3.1.3. For a more comprehensive list of purine content in foods, check a medical reference book, or the internet.

3.2.    Avoid alcohol.  Excessive alcohol makes anything worse, but even moderate consumption can be a problem in gout.

3.3.    Cherry juice can increase uric acid excretion, and reduce pain generally.  1-2 cups a day (or the equivalent in pills).  Tart, or Montmorency, cherry juice will work a little better than sweet cherry.

3.4.    Celery seed extracts are not nearly as well-known as the cherries, but can often be every bit as effective.  The two can be used together.

4.       FIBROMYALGIA:  As the mainstream medical community debates what exactly fibromyalgia is (and if it even exists), let me say that: a) yes, it exists; and b) no, it’s not arthritis.  Even though we feel pain around the joint area, it originates in problems with muscle tissue.  For the most part, fibromyalgia should be treated differently.

5.       OTHER KINDS OF ARTHRITIS: If you’re dealing with, say, psoriatic arthritis, or polymyalgia rheumatica, or even something more unusual, use common sense something that will reduce inflammation or strengthen cartilage in one type of arthritis should work in any other.

If joint pain came on relatively suddenly, around the same time as fatigue and other hard-to-explain symptoms, consider the possibility of undiagnosed Lyme’s disease.

* * * * *

LIFESTYLE:

6.       Healthy Weight:  The more we weigh, the more stress we put on joints.  This is an important factor with regard to knees, hips, and lower back, especially in osteoarthritis and gout.

7.       Certain kinds of exercise can be useful, especially in osteoarthritis.  Others can actually make things worse.  The idea is to avoid pounding, high impact motions (running on pavement, power-lifting), and look instead to gentle techniques which strengthen the muscles and tendons that hold the joints firmly and smoothly in place.  Yoga is excellent.

8.       DIET (specific recommendations for gout and rheumatoid arthritis are listed above):

8.1.    Look to balance the fats in your diet.  This won’t change things overnight, but by shifting the balance, you should see real, lasting improvements in 2-3 months.

8.1.1.  You want more of the omega-3 fats, found most richly in cold water, wild, fatty fish.  (The term “Atlantic” applied to salmon means “farm-raised.”)  Other very good sources include flax, hemp, walnuts, avocadoes, and chia.  Many other nuts and seeds are decent sources.

8.1.2. You want less of the pro-inflammatory omega-6s fats.

8.1.2.1.              The bad omega-6 (called arachidonic acid) is found most richly in industrially-raised meat, poultry, and dairy.  Note that even “organic” can be industrially-raised!  Instead, look for grass-fed animals, and truly free-range (foraging) poultry.  These animal fats aren’t just “less bad,” they’re actually good for arthritis!  Industrially-raised are some of the worst.

8.1.2.2.              Not all omega-6s are bad.  Those in most common vegetable oils are fine in moderation.

8.1.2.3.              An omega-6 called GLA found in primrose, borage, and black currant seed oils, is actually good for arthritis!  More details below.

8.1.3. Peanut and corn oil should only be used in moderation.

8.1.4. Avoid the partially hydrogenated trans-fats found in many margarines and baked goods.  A piece of holiday pie won’t kill you, but it’s amazing how much you can get in a day if you’re not paying attention!

8.1.5. Sesame seeds (with the hulls the only kind we sell) help the body process omega-3s and -6s, and are definitely worth including in the diet.  In arthritis, coconut oil is completely neutral.

8.2.    Alkalize thyself!  An overly acidic system makes arthritis worse.  (Please note that acid in the stomach does not correlate with acid in the rest of the body!)

8.2.1. Avoid refined carbohydrates sugar, high-fructose corn syrup, and white (a.k.a. “wheat”) flour.  Whole grains are fine.  Small amounts of unrefined sweeteners derived from fruit, malted grains, honey, agave, maple syrup, etc. are fine. Any sweetener consumed in excess, will be a problem.

8.2.2. Free-range and pasture-fed meats are fine in moderation, but balance with plenty of veggies.

8.2.3. Seek out whole fruits, plus non-starchy and/or bright orange veggies.

8.2.4. Try starting the day with a glass of warm or room temperature water with an ounce of lemon juice or raw apple cider vinegar.  Drink gentle, liver-nourishing teas throughout the day such as dandelion root, burdock, nettle, red clover, or boldo.  Coconut juice (different than coconut milk) is excellent and also rich in potassium and electrolytes.

8.2.5. No one food is going to “fix” this, but do try to incorporate fresh miso soup, vegetable broths, umeboshi plums, and kitcharee.

8.2.6. Coffee acidifies the system.  If you like the taste and can live without caffeine, try coffee substitutes made from chicory or dandelion roots, which are alkalizing.  If don’t care about the taste, but want caffeine, green tea is great and feel free to do a double- or triple-tea-bag cup.

8.3.    Nourish the joint cartilage itself.

8.3.1. Drink plenty of (non-caffeinated, non-alcoholic) fluids.

8.3.2. Seek out antioxidant rich foods.  Think especially of berries and spices which can stain your clothing (blueberries, pomegranate, concord grape, turmeric, saffron, etc.), and green tea.  These help maintain blood flow to the joint, and protect the joint directly.

8.3.3. Trace minerals from seaweeds, oysters, nettle and alfalfa tea, and supplements.

Traditional bone broths (chicken, beef, lamb, etc.) supply nutrients that mimic popular supplements like glucosamine, chondroitin, and hyaluronic acid.

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