March, 2006
 
 
James W. Forsythe, M.D., H.M.D.
 

Take charge of your Arthritis
Dr. James Forsythe recommends essential herbs and supplements to help battle arthritis.

by Lisa Marie Wark*

If you or someone you love struggles with joint pain, stiffness, and/or inflammation, arthritis pain may be the cause. Suffering from arthritis can make routine activities such as household chores, getting out of the bed in the morning, or even writing a letter increasingly strenuous.

It is a common misconception that arthritis is just an old-person's disease. It affects nearly 21 million Americans of all ages, gender, and race, according to the National Institutes of Health (NIH). There are over 100 types of arthritis and rheumatic diseases including osteoarthritis, rheumatoid arthritis, fibromyalgia, gout, polymyalgia rheumatica, spondylarthropathies, systemic lupus erythematosus (SLE or lupus), juvenile rheumatoid arthritis, and scleroderma.  The common denominator for all these conditions is joint and musculoskeletal pain, which is why they are grouped together as 'arthritis.' Often that pain is a result of inflammation of the joint lining.

Inflammation is involved in many forms of arthritis. It is the body's natural response to injury. The warning signs that inflammation presents are redness, swelling, heat and pain. These are the same kinds of reaction the body has to a sliver in the hand, for example. When a joint becomes inflamed, it may get any or all of these symptoms. This can prevent the normal use of the joint and therefore it can cause the loss of flexibility of the joint.

For the purpose of the newsletter we will discuss the causes and symptoms of Osteoarthritis and Fibromyalgia along with homeopathic treatments.

Osteoarthritis is the second most common diagnosis, after chronic heart disease, that qualifies for Social Security disability payments because of long-term absence from work. The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) reports that in the aging population, arthritis is the leading cause of disability.  It projects that osteoarthritis will increasingly burden American workers as well as the economy. NIAMS estimates half of the population older than 65 would show x-ray evidence of osteoarthritis in at least one joint.

Fibromyalgia is the second most common arthritis-related disease after osteoarthritis.  More than 10 million Americans have fibromyalgia, with 90 percent of sufferers being women over the age of 40. People with fibromyalgia suffer debilitating fatigue and widespread pain that lasts for years and years.

Dr. James Forsythe, who has been practicing medicine for over 30 years, has seen his arthritic patients have a host of side effects from nonsteroidal anti-inflammatory drugs (NSAID) such as Advil and aspirin. “Conventional medicine has all but ignored treating the causes of arthritis, offering only drugs (mostly NSAIDs) to treat symptoms and surgery to replace damaged joints. Some of these drugs (NSAIDs) can exacerbate arthritis by blocking cartilage repair and contribute to cartilage damage. They also trigger a slew of side effects, including gastrointestinal disturbances and peptic ulcers.”  (As with any drugs, make sure you discuss with your doctor the combination of medications you are taking to try to minimize unwanted side effects.)  
 
         
  Defining Osteoarthritis  

Osteoarthritis is the most widespread arthritic ailment. It occurs when cartilage in the joints becomes worn or damaged. This painful condition affects women more than men, and virtually everyone older than 75, according to NIAMS.

Causes of osteoarthritis include a family history of this condition, nutritional deficiencies, injuries to the joints, obesity, and simply aging. Years of use can lead to the wear and tear of the joint structure—specifically joint cartilage—resulting in osteoarthritis. In addition, researchers believe as we age, the body’s ability to repair joint cartilage decreases and joint erosion increases.

Key symptoms of osteoarthritis, according to the American Institute of Preventive Medicine, include
• stiffness and swelling in one or more joints;
• deep, aching pain in a joint; and
• any pain associated with movement of a joint.
Because osteoarthritis frequently affects the spine, back pain is another symptom. In addition, the joints of the fingers, base of the thumbs, neck, big toes, hips, and knees are commonly afflicted. If osteoarthritis takes hold, there are steps you can take to alleviate the pain and help restore joint movement without NSAIDs.

 
         
  Defining Fibromyalgia  

Fibromyalgia is a common, but misunderstood disease. On average, a person with fibromyalgia goes four to five years before receiving a correct diagnosis. In the past, physicians were not as well educated on the symptoms and often misdiagnosed the disease. Also, many of the symptoms of fibromyalgia are similar to other types of arthritis.  There isn’t a specific laboratory test for fibromyalgia and often it is diagnosed based on a good history and by ruling out other diseases.

The exact cause of fibromyalgia is unknown. However, experts have many ideas on what possible causes of the disease may be. Some researchers think that menopause or the loss of estrogen may play a role. Fibromyalgia is more common in women between the ages of 40 to 55, which is when menopause usually occurs. More tests are being conducted to find out if the loss of estrogen triggers this disease.

Other research shows that a deficiency in serotonin or magnesium may cause the disease. Serotonin is a chemical produced by the body that helps regulate your appetite, mood, sexual desire, and sleep. The low levels of serotonin may explain why people with fibromyalgia feel such a high level of pain and have more sleeplessness than the average person. Sometimes the disease will first appear after an injury or illness such as a back injury, the flu or Lyme disease. However, there is no specific evidence that an illness or an injury cause fibromyalgia.

There may be a link between depression and fibromyalgia. Depression may lead to changes in the chemistry of the brain and release substances that cause more sensitivity to pain, resulting in fibromyalgia.

Some studies have shown that both stress and poor physical conditioning may be factors in the cause of fibromyalgia. It is suspected that during times of stress, the symptoms will be worse and that the pain will subside during less stressful times. Regardless of what causes fibromyalgia, the symptoms can be successfully treated.

Key Symptoms
of Fibromyalgia are pain and fatigue. Almost every person with fibromyalgia complains of extreme, widespread pain. Unlike osteoarthritis, the pain and stiffness associated with fibromyalgia can be felt all over the body and is defined as deep, sharp or throbbing.

Most people with fibromyalgia have tender points, areas of the body that are painful when pressed. There are 18 tender points on the body that are recognized by doctors. Doctors usually must find 11 tender points to diagnose you with Fibromyalgia. However, the diagnosis depends on your individual condition.

Crippling fatigue is the other symptom that afflicts most sufferers. This fatigue is described as constant and occurs even after a full eight hours of sleep. Other common symptoms of fibromyalgia include:

  • morning stiffness
  • sleep problems
  • depression
  • anxiety
  • swelling, numbness and tingling in hands, arms, legs and feet
  • headaches (migraines)
  • irritable bowel syndrome

 It is important to note the fibromyalgia can occur by itself or with one of the other 100 types of arthritis. It is common to see rheumatoid arthritis patients who also have fibromyalgia.

 
         
  Dr. Forsythe’s Natural and Homeopathic Therapies

“... Herbs and supplements can help repair damaged joint cartilage and protect against joint erosion.”
 

Arthritis is a painful condition. While there isn’t a cure as of yet for fibromyalgia, there are treatments available. Fortunately, proper dietary, lifestyle changes, and nutritional supplements can help in the battle of arthritis. Dr. Forsythe adds, “In contrast to NSAIDs, specific natural substances can help repair damaged joint cartilage and protect against joint erosion.”

GLUCOSAMINE, a nutrient derived from seashells and other sources, is superior to NSAIDs for treating osteoarthritis. Glucosamine reduces pain, increases joint function, and keeps the affected joints from further deteriorating. Best of all, it is extremely safe. The recommended dose of glucosamine sulfate for osteoarthritis is 1,500 mg daily.

CHONDROITIN SULFATE, a major component in the lining of joints, is another pain-relieving and healing supplement. Studies indicate supplementing with chondroitin sulfate reduces pain, increases joint mobility, and contributes to healing. After reviewing numerous clinical trials, reviewers concluded glucosamine and chondroitin preparations provided moderate to large effects on osteoarthritis symptoms. In another study, researchers found the combination, as a topical cream, effectively reduced osteoarthritis pain within four weeks.

As with any health program, many experts advise taking a high quality multivitamin and mineral supplement, along with a comprehensive antioxidant formula. The multivitamin and mineral complex should contain sufficient magnesium and calcium, important minerals for bone health. Drugs often given to arthritis patients can deplete the body’s stores of calcium. Other supplements that Dr. Forsythe recommends:

  • VITAMINS A, B6, AND C,
  • COPPER and ZINC, are all required for the body’s manufacture of collagen and normal cartilage.
  • OMEGA-3 FATTY ACIDS provide reduces inflammation and lubricates swollen joints. Wild, coldwater fish such as salmon, herring, and sardines are excellent food sources of omega 3. Fish oil supplements also supply this essential nutrient.
  • VITAMINS A AND C, when used in combination, may help slow the deterioration of afflicted cartilage.
  • VITAMINS C AND E, used in combination, protect cartilage from free-radical destruction. In fact, white blood cell and plasma concentrations of vitamin C are significantly decreased in arthritis patients, indicating an increased need for this nutrient. Pay particular attention to your vitamin C intake. Researchers have found that diets rich in antioxidant micronutrients, especially vitamin C, may reduce the risk of cartilage loss and osteoarthritis progression.

S-ADENOSYLMETHIONINE (SAME) is found it to be as effective as NSAIDs in reducing pain and improving functional limitations in patients with osteoarthritis, but without the adverse effects of NSAIDs.  It is also know to be a mood enhancer which would help with the symptom of depression that can be associated with Fibromyalgia.

BOSWELLIA (Boswellia serrata), an Indian Herb, can improve flexibility and decrease swelling.

CAT’S CLAW(Uncaria tomentosa), from Peru, reduced pain in osteoporosis patients, leading researchers to suggest it as an effective treatment.

DEVIL’S CLAW (Harpagophytum procumbens) proved to be as effective as the drug diacerhein, but with fewer side effects. It has potent anti-inflammatory properties.

WILLOW BARK (Salix alba), which is often called “nature’s aspirin,” also helps relieve the pain associated with arthritis without the side effects of aspirin. In addition, it is reported to have antirheumatic and anti-inflammatory properties.

Diet Improvements
Diet can help you prevent and treat osteoarthritis. Choose foods rich in nutrients and fiber. Dr. Forsythe recommends the following dietary guidelines.

  • Eat a diet rich in complex carbohydrates. Eat at least one cup of whole grains, such as brown rice, oatmeal, or millet each day.
  • Get plenty of fiber. Include in your daily diet at least one of the following: one salad, one cup of  cooked leafy green vegetables, or one tablespoon of wheat or oat bran.
  • Drink at least eight cups of water per day.
  • Avoid processed or prepackaged foods, such as breakfast cereals, unless you are certain they are free of additives and made only from whole foods.
  • Limit your use of saturated fats, such as cooking oil, butter, and margarine.
  • Avoid nightshade vegetables. An allergic reaction to vegetables from the nightshade family may exacerbate arthritic symptoms.
  • Avoid tomatoes, potatoes, eggplant, and green peppers for at least two months. After that, reintroduce the foods, one at a time, and see if symptoms return. This can help you identify what foods trigger allergies or pain.
  • Eat berries. Eat one-half pound or more of cherries, blueberries, and other dark-red or blue berries daily to help reduce inflammation.
  • Avoid caffeine, which is found in coffee, soda, tea, chocolate, and many pain relievers.
  • Restrict your consumption of processed, high-calorie, high sugar, and high-fat foods. Instead, substitute a variety of fresh fruits, grains, legumes, and vegetables to obtain the hundreds of carotenoids and flavonoids that act as antioxidants and anti-inflammatory agents.

A successful “antiarthritis” diet also features ways to maintain a healthy weight. Excess weight strains joints and can cause pain. In addition, obesity may contribute directly to the development of osteoarthritis. Researchers who analyzed studies conducted between 1966 and 2000 describing obesity and hip osteoarthritis concluded that obesity increases the odds of osteoarthritis by roughly 25 percent.

CONSISTENT EXERCISE
is an essential component of any successful antiarthritis strategy. Stretching, strengthening, and postural exercises can support healthy cartilage, increase a joint’s range of motion, and build surrounding muscles so they absorb shock more effectively.

Exercise is vital in treating fibromyalgia. It can provide you with a feeling of energy and vitality while assisting with building strength and reducing the pain. Serotonin levels are boosted through exercise, which can lead to a reduction in feelings of anxiety and depression.

The American Institute of Preventive Medicine recommends moderate, low-impact exercise. Inactivity leads to loss of muscle tone and bone deterioration, but too much exercise can worsen pain.

HYDROTHERAPY
—exercise done in water—is effective and soothing. It puts less stress on the joints because the water supports almost all the body’s weight. Many people with fibromyalgia find that moist heat helps aching muscles feel better. You can find moist heat in the shower, bathtub or heated swimming pool or you can use a heating pad.

Before starting an exercise program, be sure to discuss your plans with your doctor or physical therapist. At the Century Wellness Clinic, Dr. Forsythe and his medical staff can tailor a program to fit your stretching and strength building needs
Don’t let arthritis pain get the best of you. By taking charge of your treatment and your life, you can start to feel better. Dr. Forsythe and his medical staff at the Century Wellness Clinic can put together a treatment plan to help you maintain your quality of life. When it comes to a treatment plan, each individual has different needs. Please call the Century Wellness Clinic during regular business hours 775-827-0707 or e-mail us questions by clicking here regarding your specific needs.

 
         
     

The information contained in this Health Report is intended for education purposes only. It is intended to complement—not replace—the advice provided by healthcare providers.

 
         
  *Lisa Marie Wark is currently a free lance writer and is a business development consultant with a concentration in medical spas and alternative clinics. Currently she is President of MedSpas, a business development firm that provides physicians the necessary business tools to help them build or expand their practices into medical spa facilities. Wark was formerly an anchor and financial reporter for ON24 Financial News in San Francisco. In 2001, she was promoted to the main female anchor of three financial news broadcasts, covering a broad range of financial sectors and industries.

Wark's hard work and persistence helped her land interviews with top executives from Fortune 500 companies that included the likes of Steve Forbes, former Republican Presidential candidate and Publisher of Forbes Magazine, Robert L. Crandall former American Airlines CEO who pioneered the first frequent flier mileage program AAdvantage, and Marc Andreesen, an Internet pioneer and creator of the Netscape browser.
 
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