Arthritis, Depression and Eye Health Updates
April 23, 2010 Written by JP [Font too small?]I watched a tragically sad piece on last weekend’s edition of the news program 60 Minutes. A series of patients with life threatening illnesses fell prey to a con artist who claimed to be able to heal them via natural remedies and stem cell treatments. This segment really hit home because it was a stark reminder that hope must be doled out judiciously. I believe the defining difference between well placed and false hope can be summarized in one word: evidence. Hope with a foundation that is evidence-based can be constructive and sometimes yields dramatic outcomes. On the other hand, false hope leaves patients vulnerable to exploitation and heart break.

This is technically part two of an update that I started on Wednesday with an added focus on the theme of hope. My objective is to illustrate that hope can be well founded in the field of alternative and holistic medicine.
Osteoarthritis is an extremely common degenerative condition. Most conventional doctors have no expectation that the progression of arthritis can be halted or slowed by conventional or natural means. What’s more, they generally take the stance that powerful and potentially dangerous medications need to be employed in order to control the symptoms of this chronic condition. As a result, many patients turn to nutritional supplements in the hope that they might ease the pain and, maybe, just maybe, slow the rate of decline. Some people do, in fact, find that nutraceuticals such as glucosamine sulfate help to achieve these goals. But others aren’t so lucky. If you’re one of those people in the latter group, take heart. A new study suggests that a “once daily enzymatic hydrolyzed collagen” supplement may work significantly better than glucosamine sulfate. The trial in question involved 100 men and women and lasted 13 weeks. The specific dosage of the collagen used (Colatech) was 10 grams per day.
- 34% of the collagen users reported significant decreases in arthritic symptoms compared to 13% in the glucosamine group.
- The patients’ “global assessment of efficacy (good and ideal)” measured in at 80.8% for the collagen users and 46.6% in the glucosamine patients.
- Both supplements were well tolerated with a similarly low incidence of adverse events in the respective groups. (1,2)
Retinitis pigmentosa (RP) is another progressive disease. As its name implies, it affects the retinas of the eyes. The expected trajectory of this ocular condition leads to a decline in nighttime vision, peripheral vision loss “tunnel vision” and eventually central vision loss in its advancing stages. New evidence provided by the Massachusetts Eye and Ear Infirmary at Harvard Medical School provides real hope that lutein may slow the advancement of this dreaded eye disease. A group of 225 RP patients were given 12 mg of lutein or a placebo in addition to their standard therapy of 15,000 IU of Vitamin A. All of the study participants were followed over a 4 year period. The authors of the trial concluded that “Lutein supplementation of 12 mg/day slowed loss of midperipheral visual field on average among nonsmoking adults with retinitis pigmentosa”. Lutein is an antioxidant, carotenoid that is largely found in dark green vegetables such as avocados, collard greens, eggs, kale and spinach. (3,4)

Depression is a major health threat throughout the world for a multitude of reasons. Not only does it detract from the quality of life of those who suffer from it (and those who love them), but it also seriously impacts the health related outcomes of various conditions ranging from cancer to heart disease. A current publication in the Journal of Clinical Psychiatry shines a positive light on a natural treatment that may help to address depressive symptoms without the use of prescription medications. A meta-analysis of 17 peer-reviewed scientific studies suggest that “Massage therapy is significantly associated with alleviated depressive symptoms”. Based on this compelling data, scientists from the Department of Physical Medicine and Rehabilitation in Kaohsiung, Taiwan recommend that standardized (massage) treatment plans be established in order to provide reliable care for this target population. (5,6,7)
The research about massage therapy reminded me of a psychologist I used to see. Many years ago I slipped into a period of depression. I reluctantly went to visit this doctor, but made it very clear that I wasn’t interested in antidepressant medication. Instead of battling with me about my position, he accepted it as a challenge. Every week he’d bring in excerpts from medical journals that offered preliminary evidence that supported alternative remedies. One of the modalities he presented to me was massage therapy. It’s heartening to see continued research along those lines. This is exactly the kind of data that patients and physicians can look to with confidence and optimism. There is good reason for hope in medicine and in the world at large. But as with most things, the inherent goodness found in hope lies in how we apply it.
Be well!
JP
Tags: Arthritis, Eyes, Lutein, Massage
Posted in Alternative Therapies, Bone and Joint Health, Nutritional Supplements
April 26th, 2010 at 3:19 pm
great article, and like you I like to back my blogs with evidence based research studies. But I am open minded enough to realize somethings can’t be explained. The laws of Physics say a dolphin can’t jump out of water. But I have seen it happen. Somethings can’t be explained like how caster oil rubbed on a joint can ease pain. But like you I like the cold hard evidence as to give patients the best hope and confidence in me, their doctor.
April 26th, 2010 at 10:51 pm
Thank you, Mark!
I think we share a similar perspective about the role of anecdotes and science in medicine. 🙂
Be well!
JP
April 28th, 2010 at 3:31 am
A series of patients with life threatening illnesses fell prey to a con artist who claimed to be able to heal them via natural remedies and stem cell treatments. Thanks for sharing.
April 28th, 2010 at 11:44 am
You’re welcome, Adam.
Be well!
JP
March 2nd, 2015 at 2:56 pm
Update: Glucosamine & chondroitin lower systemic inflammation …
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0117534
PLoS One. 2015 Feb 26;10(2):e0117534.
Randomized trial of glucosamine and chondroitin supplementation on inflammation and oxidative stress biomarkers and plasma proteomics profiles in healthy humans.
BACKGROUND: Glucosamine and chondroitin are popular non-vitamin dietary supplements used for osteoarthritis. Long-term use is associated with lower incidence of colorectal and lung cancers and with lower mortality; however, the mechanism underlying these observations is unknown. In vitro and animal studies show that glucosamine and chondroitin inhibit NF-kB, a central mediator of inflammation, but no definitive trials have been done in healthy humans.
METHODS: We conducted a randomized, double-blind, placebo-controlled, cross-over study to assess the effects of glucosamine hydrochloride (1500 mg/d) plus chondroitin sulfate (1200 mg/d) for 28 days compared to placebo in 18 (9 men, 9 women) healthy, overweight (body mass index 25.0-32.5 kg/m2) adults, aged 20-55 y. We examined 4 serum inflammatory biomarkers: C-reactive protein (CRP), interleukin 6, and soluble tumor necrosis factor receptors I and II; a urinary inflammation biomarker: prostaglandin E2-metabolite; and a urinary oxidative stress biomarker: F2-isoprostane. Plasma proteomics on an antibody array was performed to explore other pathways modulated by glucosamine and chondroitin.
RESULTS: Serum CRP concentrations were 23% lower after glucosamine and chondroitin compared to placebo (P = 0.048). There were no significant differences in other biomarkers. In the proteomics analyses, several pathways were significantly different between the interventions after Bonferroni correction, the most significant being a reduction in the “cytokine activity” pathway (P = 2.6 x 10-16), after glucosamine and chondroitin compared to placebo.
CONCLUSION: Glucosamine and chondroitin supplementation may lower systemic inflammation and alter other pathways in healthy, overweight individuals. This study adds evidence for potential mechanisms supporting epidemiologic findings that glucosamine and chondroitin are associated with reduced risk of lung and colorectal cancer.
Be well!
JP