Tremors & Aftershocks 
 

Dear Reader, When the pharmaceutical giant Merck removed Vioxx from the market ..., I had a hunch there would be aftershocks as more details emerged. And that hunch was correct: aftershocks have been arriving right on schedule.

For anyone who's been using either Vioxx or Celebrex (the COX-2 inhibitors that relieve pain associated with osteoarthritis), these ... reports carry some sobering news. But for anyone who's looking for an alternative to these drugs, I have some new information about an alternative treatment that's not only safe, but also provides some of the healthiest nutrients you can find in any dietary supplement.

The alarm that failed
This should be a bombshell, but I doubt it will get much attention from the mainstream media. When Merck pulled the plug on Vioxx, we found out that the FDA had known for years that the drug was associated with an increased risk of heart attack and stroke. And as unsettling as that is, that's not the bombshell.

This is the bombshell: In early September, the FDA approved the use of Vioxx for kids. Amazing, isn't it? And according to WebMD Medical News, this approval was based on a trial that lasted only three months.

Not exactly what you'd call a "long-term" study.

Meanwhile, several reports have been touting Celebrex as a safe alternative to Vioxx. For instance, in August, a study led by an FDA researcher estimated that more than 27,000 heart attacks and sudden cardiac deaths might have been avoided if the patients had been using Celebrex instead of Vioxx.

Okay. Celebrex may be safer. But is it safe?

The Celebrex information flyer tells us that liver and kidney problems are among the most serious side effects �?just as they are (were) with Vioxx. But what about heart attack risk? According to a long-term study of more than 8,000 subjects that appeared in a 2000 issue of the Journal of the American Medical Association, the heart attack rate among both Vioxx and Celebrex users was "significantly higher" compared to placebo. And while the study indicated that Vioxx was the more dangerous of the two, Celebrex was by no means risk-free.

Expert advice

In the wake of the Vioxx controversy, we're told that many "experts" and doctors recommend using non-steroidal anti-inflammatory drugs (NSAIDs), which can be purchased over-the-counter. But NSAIDs present plenty of problems of their own. As we've discussed in e-Alerts and Members Alerts, all NSAIDs, including aspirin and ibuprofen, have been shown to contribute to liver and kidney impairment, an increased risk of hypertension, and gastrointestinal conditions such as bleeding and ulcers.

Fortunately there's a natural alternative to these drugs.

In the e-Alert "Grandma Knew the Secret for Relieving Arthritis Pain" (2/27/02) I told you about research that shows how cod liver oil may reverse the actions of the enzymes that break down cartilage. In fact, studies suggest that taking cod liver oil can even prevent the development of arthritis, while reducing symptoms in those already afflicted with the disease.

Now we have some new evidence that confirms the conclusions of the 2002 study. In research that was reported earlier this year, scientists at Cardiff University in Wales recruited more than 30 subjects who were scheduled to have knee joint replacement surgery. For a period of 10 to 12 weeks before surgery, half the subjects took high doses of cod liver oil (2,000 mg per day), and half took a placebo. During each patient's surgery, doctors removed samples of joint tissue and cartilage.

When the Cardiff researchers analyzed the samples, more than 85 percent of the cod liver oil group had significantly reduced the amount of enzymes that are known to trigger the cartilage damage typical of osteoarthritis. In some of the patients there was no trace of the enzymes. Only 26 percent of the placebo group showed reduced enzyme levels.

Take care 
For many people, cod liver oil provides an inexpensive and effective way to relieve the pain of arthritis. In addition, this supplement is one of the very best sources of omega-3 fatty acids and vitamin D; two of the most potent nutrients in the prevention of heart disease and cancer.

But a word of caution: Because cod liver oil is a natural anticoagulant, those who use blood-thinning medication like warfarin should not take it. Cod liver oil may also raise blood sugar levels in some patients, so diabetics should monitor its use very carefully. And, as always, check with your doctor or health care professional before adding cod liver oil to your daily supplements.

To Your Good Health, Jenny Thompson, Health Sciences Institute

Sources: 
"Vioxx Was Okd for Kids" Delthia Ricks, Newsday, 10/11/04, newsday.com

"Safety of Arthritis Drugs in Question" Steve Mitchell, WebMD Medical News, 7/10/01, my.webmd.com

"Risk of Cardiovascular Events Associated With Selective COX-2 Inhibitors" Journal of the American Medical Association, Vol. 286, No. 8, 8/22/01, jama.ama-assn.org

"Science Backs Old Wives' Tale �?Cod Liver Oil Helps Slow Osteoarthritis" NutraIngredients.com, 2/13/04, nutraingredients.com

Copyright (c)1997-2004 by www.hsibaltimore.com, L.L.C. The e-Alert may not be posted on commercial sites without written permission.

Secrets of Osteoporosis: What You Need to Know

ProHealthNetwork.com ,01-16-06

By Jeff Leach

Osteoporosis. Just saying the word makes my bones ache.

If you are a woman and over the age of 50, you have about a 40% chance of suffering from an osteoporotic fracture. That’s higher than your risk of developing breast or ovarian cancer. Even worse, 50% of osteoporotic hip-fracture patients never fully regain independence, and more than 20% will die within 6 months. Not good odds.

If you are someone who thinks osteoporosis is a “women’s disease,�?think again. It affects 25% of men over the age of 50 and an alarming number of young people. If the current trends continue, the problem is expected to worsen by 60% in the next 20 years �?regardless of gender.

Most folks are aware that osteoporosis is characterized by bone fragility and related to dietary intake of calcium, or the lack of. Simply put �?calcium is used to build bones and to a lesser extent, teeth. From the time we are born until our mid-twenties, our bones are continually growing and require calcium to do so. The goal during this critical growth period is to achieve peak bone mass. What you want is to develop thick, mineral-dense bones.

Your peak bone mass �?which, again, you can only control until your mid-twenties �?will strongly influence your risk of developing osteoporosis later in life.

From our mid-twenties to about age 50, the density of our bones is relatively stable. This means no matter how much calcium you consume, your bones are not going to get any denser. The goal now is to maintain the bone mass you developed in youth and minimize bone loss associated with aging. This is especially important for women, who must contend with a number of bone loss issues exaggerated during and after menopause �?not to mention the demands of pregnancy and lactation on bone health.

While you are older and wiser, the efficiency at which your body absorbs calcium in later years, like so many things associated with aging, isn’t what it used to be.

Despite the fact that we are confronted daily with the “eat more calcium�?message for “healthy bones�?on TV, in newspapers and magazines, on annoying billboards, and along the isles of our favorite grocery store, nearly 70% of Americans consume less than the daily recommended allowance of 1,000 mg of calcium a day �?give or take.

Our daily intake may in fact be lower when you consider that, depending on our particular genetic makeup and the composition of a given meal, our bodies may in fact only absorb 30-35% of the total calcium advertised for a given serving. Think about that little piece of critical information for a minute.

Calcium that is not absorbed is mostly excreted in our urine and feces, which brings up an important issue �?and the point of why I am writing this column on osteoporosis �?bioavailability.

The terms “bioavailability�?and “absorption�?are critical nutritional terms that are often used incorrectly. Absorption describes the process of transport of a mineral like calcium from your intestine across the intestinal mucosa (the wall) into the circulatory system, so that it may be utilized or stored by the body. On the other hand, the bioavailability of a mineral like calcium means the “proportion�?that is “actually�?absorbed and thus utilized or stored.

The key here is solubility. A swallowed penny, for example, has zero bioavailability. It will simply enter one end and come out the other, intact. Whereas a glass of water is highly soluble and will be easily absorbed �?nearly 100% bioavailability.

Even though you think you are getting 500 to 1,000 mg of calcium from a given food item, meal, or “supplement,�?you may not be.

Given this piece of information, it’s not only important that we increase our daily intake of calcium to recommended levels, we should seek out means to increase the bioavailability of the calcium that we do consume �?so that it’s not wasted.

One way of doing this is to lower the pH of your gastrointestinal system by delivering food to the trillions of tiny bacteria that live in your colon.

Food items that are not digested in the small intestine and therefore end up in the colon, are known collectively as fiber. Once in the colon, fiber is broken down by the bacteria through a process called fermentation, which produces, among other things, short chain fatty acids and lactic acid. These acids then in turn make the colon more acidic which increases the solubility of the calcium, making it more absorbable. One of the short chain fatty acids produced (butyrate) has been shown to induce cell growth in the colon, which in turn increases the “absorptive surface�?of the colon. This means more calcium is absorbed and less is excreted in feces.

Among the 500 plus species of bacteria living in your colon, you want to increase the number of the bifidobacteria and lactobacillus. These two particular groups are known to be especially useful in increasing the acidity of your colon �?and they thrive well on special inulin and oligofructose-type fibers that occur naturally in onions, garlic, artichokes, asparagus, and in lesser amounts in wheat-based products. They are also commercially extracted from chicory roots (think chicory coffee), and added as a food ingredient in a growing number of foods. These special fibers are known as prebiotics.

By increasing the bioavailability of the calcium we do consume by developing a more acidic colon, we can add an additional dietary measure to the preventive strategies for fighting the terrible disease of osteoporosis.

About the author:

Jeff Leach is a science writer, anthropologist, and health advocate. Jeff is the founder of the Paleobiotics Lab and heads an active research program to explore nutritional aspects of our ancestral diet and its possible application in understanding modern disease and nutrition. He is currently pursuing a PhD and is a Visiting Scholar at the University of Western Cape, South Africa (he currently lives in New Mexico).

(c) 2006 Jeff Leach. All rights reserved.

If you're a physically active baby boomer, you've probably come to realize that there's really no such thing as a completely risk-free form of exercise. Minor aches and pains are to be expected, and no matter how careful you are, there's always a chance you might trip and fall on the treadmill or drop a dumbbell on your toe.

If you're worried about the toll that your exercise program is taking on your knees, however, the results of a long-term study published in the February 2007 issue of Arthritis Care and Research may put your mind at ease. Researchers at Boston University reported that moderate exercise doesn't increase the risk of developing arthritis of the knee in older adults.

The study included more than 1,200 participants with an average age of 53. At the beginning of the study, the participants had knee X-rays performed and answered questions about their exercise habits and symptoms of knee aches, pains, or stiffness.

The same individuals repeated the process approximately a decade later. After analyzing the participants' X-rays, exercise patterns, and knee symptoms, researchers found no relationship between moderate physical activity--including walking and jogging--and the development of osteoarthritis of the knee.

Although osteoarthritis can strike virtually any joint in the body, the knee is the one most commonly affected. The risk of developing the condition increases with age: Approximately half of adults over the age of 65 have been diagnosed with osteoarthritis.

As a progressive, degenerative disease, osteoarthritis is caused by a breakdown of the cartilage within the joints. While healthy cartilage is a firm, rubbery substance that serves as a cushion and shock absorber for joints, the cartilage in arthritic joints is typically brittle and thin, and often becomes ragged or torn.

As the cartilage continues to wear away, the bone ends may begin to grind against each other. Bits of bone or cartilage can break off and enter the joint space, causing considerable pain, swelling, and even deformity.

Although osteoarthritis appears to be influenced by genetic factors, obesity is known to be a major risk. In overweight individuals, every pound of excess body weight adds about four or five pounds of additional load to each knee.

For this reason, even modest weight loss can significantly improve the symptoms of arthritis of the knee and slow the progression of the disease. Getting plenty of exercise is one of the most effective ways to lose weight, but for individuals with chronic knee pain, it's easier said than done.

Although aspirin, ibuprofen, and other anti-inflammatory medications can reduce arthritis pain, they're not entirely risk free. The drugs are notorious for causing gastrointestinal problems, ranging from mild stomach upset to bleeding ulcers.

Likewise, many prescription medications have proved to be less than satisfactory in the long-term management of osteoarthritis. The drug Vioxx, once a mainstay of treatment, was withdrawn from the market in 2004 after being linked to an increased risk of heart attack and stroke.

For folks who aren't willing or able to take conventional drugs to relieve the pain of mild to moderate osteoarthritis of the knee, the combination of two nutritional supplements, glucosamine and chondroitin sulfate, is a popular alternative. The supplements are generally well tolerated and are associated with few side effects.

Although their exact mechanisms of action still aren't fully understood, laboratory studies suggest that the supplements stimulate cartilage growth and inhibit the action of enzymes responsible for cartilage destruction. Both glucosamine and chondroitin sulfate appear to have mild anti-inflammatory effects that can ease discomfort and reduce swelling.

A number of scientific studies have demonstrated the supplements' effectiveness in reducing the pain and progression of osteoarthritis, especially in the knee joint. The results of the largest of these studies, the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), suggest that when taken together, daily doses of 1,500 milligrams of glucosamine and 1200 milligrams of chondroitin sulfate may produce a significant reduction in knee pain associated with osteoarthritis.

If you decide to take the supplements for symptom relief, don't expect immediate results. Because both are slow-acting agents, they must be taken daily for at least four to eight weeks to produce noticeable effects; and maximum pain relief may not occur until the third month of treatment.

Hopefully, baby boomers will live to see a cure for osteoarthritis of the knee. Until then, a treatment program that includes pain management, weight loss, and moderate exercise may be the next best thing.

========

Rallie McAllister, M.D., M.P.H., is a family physician in Kingsport, Tenn., and author of "Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim." Her Web site is [http://www.rallieonhealth.com].

arcamax.com  February 18, 2007