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Osteoarthritis: A Review of Evidence-Based Natural

Osteoarthritis: A Review of Evidence-Based Natural
Dr. Daniel A. Wasserman

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OsteoArthritis: A Review of Evidence-based Natural Medicines

With limited options, patients are looking for safe and effective treatments for osteoarthritis. This disease affects over 40 million Americans and costs annually more than $82 billion. This article discusses evidence-based, non-drug alternatives in the treatment of osteoarthritis. At the Broward Spine Institute, we pride ourselves on making available any treatment, natural or pharmaceutical, that will provide safe and effective treatments to our patients

A Short Introduction to Natural Medicine

Although slight differences exist, this type of medicine is known by a variety of names: holistic, alternative, complementary, functional, and nutritional. The underlying philosophy behind all of these types of medicines is the recognition and respect of the body’s innate ability to heal itself. Therefore, with any of the modalities that fall under these headings, whether they be acupuncture, chiropractic, homeopathic, or osteopathic, the practitioner is either providing the raw materials or removing obstacles in order to allow the body to step up its own healing processes. As a corollary to this idea is the constant attempt to rectify the root of the problem and not just the symptoms. A good example would be the use of glucosamine vs. an analgesic drug in the treatment of arthritis. The glucosamine is attempting to provide the joint with the raw material necessary to produce better cartilage, while the drug is only reducing the sensation of pain and not bettering the joint whatsoever.

Osteoarthritis and the Joint Matrix

Osteoarthritis is characterized by progressive degeneration of the joint cartilage accompanied by joint pain and reduced mobility. This form of arthritis most often affects those of the hands, knees, hips, and spine, although any joint can be affected.

Normal cartilage is a complex material consisting of a solid matrix composed primarily of collagen and proteoglycan, which is saturated with water. The interaction of the physical and biochemical structures of cartilage is necessary to allow the normal function of providing nearly frictionless motion, wear resistance, joint congruence, and transmission of load to the bones surrounding the joint. Osteoarthritis occurs when there is disruption of normal cartilage structure and homeostasis.

Conventional Medicine’s Approach

At the current time, the main treatment for this form of arthritis is mostly directed at the symptoms. Pain medicines are the most common treatment. There are a few other options including surgery and injections. The lack of successful treatments leaves patients frustrated and feeling hopeless. Besides the well-known side effects of analgesics drugs, like aspirin and ibuprofen, on the stomach and intestinal lining, they affect the cardiovascular system. Recently, a number of pain medications were removed from the market due to an increased risk of heart disease and stroke. Vioxx, once a popular anti-arthritic drug was discovered to be to contributing to high blood pressure.

Click Here for Study

Worse yet, these anti-inflammatory drugs can directly contribute to the breakdown of the joint cartilage.

Click Here

Click Here for Study 2

As demonstrated by the medical studies cited, the medical community has known this ironic adverse effect for over 20 years.

It should be mentioned for those who must take a pharmaceutical anti-inflammatory medicine, there are safe substances that can be taken to safely protect the stomach and intestinal lining. In a study performed back in 1979, patients who were taking aspirin daily could reduce the amount of blood that was being lost in their stools by taking (deglycyrrhizinated) licorice with each dose of pain medication. A standardized form of this type of licorice, sometimes called DGL for short, is available at our online vitamin shop.


Evidence-Based Nutraceuticals


Glucosamine is the most fundamental building block required for the all of the primary components of cartilage. These include glycosaminoglycans, collagen, hyaluronic acid, proteoglycans, as well as other joint lubricants and protectants.

The first study regarding its role in osteoarthritis was published over forty years ago in 1965. Since then numerous research articles have been appearing in medical journals. Overall it has performed extremely well. Many of these studies were done in a head-to-head fashion against prescription pain medication. Glucosamine has actually outperformed many of these drugs. However, as opposed to pain medication, long term studies of glucosamine have demonstrated its protective function of the cartilage.

This approach is logical and in line with the general philosophy behind natural medicine. Give the body the raw materials that it needs and let it do its work. If the oil light in your car is on, there are two ways to turn off the light. The first is by simply unscrewing the light bulb. Although the goal is achieved, this strategy could prove quite detrimental in a holistic sense to the health of the automobile. The other way is to fix the leak and add more oil. This comparative analogy would be similar to the use of glucosamine versus an anti-inflammatory drug. (Of course, if the light bulb was so bright that it was difficult to drive, then you may want to temporarily unscrew the bulb, and at the same time fix the problem. This would represent the combined use of drugs with glucosamine.)

For our rebuttal of the most recent study by the National Institute of Health regarding glucosamine,

click here Glucosamine + MSM Forte

There are a few forms of glucosamine. We recommend ‘glucosamine sulfate’. This is the form that has shown the most consistent positive results in medical studies. The total daily dose for a person weighing 150 pounds is 1500mg. http://www.myehealthstore.com/product168.html<|a>Click Here for a Certified and Standardized Product

Warning: Glucosamine is usually derived from shellfish. If you have a shellfish allergy, use a glucosamine that is specifically from a non-shellfish source. Glucosamine + MSM Forte

A Word About Chondroitin

Oftentimes glucosamine is combined with chondroitin. Chondroitin also occurs naturally in joint cartilage. However, since it is 50-300 times the size of glucosamine, it is not well absorbed through the intestinal walls. In the medical research, it has emerged with mixed results. Therefore, we do not recommend chondroitin at this time.

MSM (MethylSulfonylMethane)

The joints of arthritic patients are typically low in sulfur. This mineral is the necessary building block for the proteins that make up the hair and joints. MSM is a well-absorbed form of organic sulfur. In a recent study, researchers found that the combination of MSM with glucosamine worked better than either substance alone.�Click Here

As an added bonus, MSM has been recently found to be helpful in sinus allergies.�Click Here

This substance might play a role in cancer prevention, as well. Click Here

Usual dosages are between 1500-6000mg per day.

Glucosamine + MSM Forte

Niacinamide (Vitamin B3)

Niacinamide is one of the two forms of Vitamin B3 (niacin). The body uses vitamin B3 in the process of releasing energy from carbohydrates. For over fifty years, it has been used for osteoarthritis. In 1996, it was put to the test in a double-blind trial. The conclusion of the study was that the treated group had modest improvements in their arthritis, including a reduction of pain medication. Being that it has a good track record of safety, there appears to be potential benefit without much risk. The total daily amount is between 1000-3000mg per day in doses of 250-500mg. Since it can interact with some medications, always check with your doctor before starting on niacinamide therapy. Click Here

Towards the end of this article I will mention ways to test your levels of various nutrients. This will help determine which of these vitamins and minerals are most likely to be effective.

Vitamin C (Ascorbic Acid)

Among its many functions, vitamin C stimulates collagen and cartilage synthesis. Vitamin C is a highly effective antioxidant protecting the body from oxidative damage. The most accepted theory on aging and age-related disorders is called the “free radical theory of aging”. This concept states that the body produces energy similar to the controlled burning of wood in a campfire. Energy is released by ‘burning’ food inside our cells. However, just like a campfire, there are sparks that fly off, uncontrollably. These sparks can potentially cause much unwanted damage throughout the forest. Free radicals are similar to these sparks. They can result in the breakdown of the body. Damage to the DNA inside the cells can result in cancer. The specific role that free radical damage plays in osteoarthritis is being debated. However, when researchers compared the intake of various antioxidants, like vitamin C, vitamin E , and beta-carotene, those patients taking the highest levels had the lowest incidences of arthritis. Click Here

Between 500 and 1000mg per day is the usual dose per day.

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Vitamin E (tocopherols/tocotrienols)

As mentioned above, antioxidant intake seems to be important in arthritis. Vitamin E and its 8 forms are strong free radical scavenger. Although there have been a few studies showing that vitamin E supplementation can impact arthritis, other studies were not positive. Since vitamin E is safe and inexpensive, a person does not stand to lose much by trying.

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Recently, vitamin E has received some bad press. To avoid any imbalance and to reap all of the benefits, all eight forms should be supplemented together. This ensures all the benefits of vitamin E. We carry this mix of vitamin E in a product called ‘Ultra-Synergist E’. The dose is one capsule per day. Always check with your physician before taking any additional supplements in order to avoid any negative interactions with current medications.

(((Ultra-Synergist E is the product)))

Towards the end of this article I will mention ways to test your levels of various nutrients. This will determine which of these vitamins and minerals are most likely to be effective.

Vitamin D

Vitamin D is most known for its use in aiding the absorption of calcium in the intestines. This ensures strong healthy bones. Its use in oateoarthritis is lesser known that its use in osteoporosis. Vitamin D has a direct effect on the synthesis of cartilage. In one study, lower blood levels of vitamin D was associated with higher levels of osteoarthritis. Click Here

Vitamin D has recently been found to be a very strong antioxidant, playing a role in the body’s fight against cancer. The usual dose is between 400IU-1000IU per day.

Towards the end of this article I will mention ways to test your levels of various nutrients. This will determine which of these vitamins and minerals are most likely to be effective.

Vitamin B12 (cobalamin)/Folic Acid

Although neither of these two B vitamins are commonly used for arthritic joints, they have been found to afford some relief in a 1994 study. The combination of these two vitamins outperformed a common anti-inflammatory medication. In addition, there were no side effects in the vitamin group, while the medication group had a significant number of adverse reactions.� Click Here

Doses of folic acid range from 400mcg-800mcg per day. Vitamin B12 doses range from 50-1000mcg per day. Be advised that with B vitamins there is usually an active and inactive form. What science is finding is that, for various reasons, not everyone is able to activate the B vitamins that they are consuming. So look for the active form. For example, with B12, the active form is methylcobalamin. The more common inactive form, cyanocobalamin, may be less expensive, but is less effective.


B/12 Folic

Towards the end of this article I will mention ways to test your levels of various nutrients. This will determine which of these vitamins and minerals are most likely to be effective.


While boron is not considered an essential mineral, it appears to affect the metabolism of calcium, magnesium, copper, phosphorus, and vitamin D. It has been shown to decrease the loss of calcium through the urine. Similar to vitamin D, it is more known for its use in the treatment of osteoporosis than arthritis. However, in 1990 it was discovered that in areas of the world where boron intakes is 1.0 mg or less/day the estimated incidence of arthritis ranges from 20 to 70%, whereas in areas of the world where boron intakes are usually 3 to 10 mg, the estimated incidence of arthritis ranges from 0 to 10%. A small study conducted by Dr. Richard Travers showed definite improvement in the group taking boron. The usual dose in between 1mg-6mg per day. We carry boron in a calcium/magnesium supplement Cal-6-MAG as well as by itself. Boron

SAM-e (S-Adenosylmethionine)

SAM-e is a natural occurring amino acid derivative that is found in every cell of the body. Amongst its many functions, SAM-e is involved in the production of cartilage, brain chemicals and liver cells. In the treatment of osteoarthritis, it has been tested in clinical trials on over 22,000 patients. SAM-e was shown to be as effective as many of the anti-inflammatory drugs. It was not only better tolerated, but it has been proven to have a beneficial effect on the cartilage. Click Here to See Article 1Click Here to See Article 2

Click Here

Again, unlike many pharmaceutical drugs which tax the liver, SAM-e is one of the strongest liver protectors that we know of. Click Here

The dosage for SAM-e is between 400mg-1600mg per day in 200mg doses. Always check with your physician before starting this or any substance.

(((SAM-e product by health concerns))))

Fish Oil/Omega-3

Almost all chronic diseases are in some way associated with a low intake of “good” fats. From the heart to the central nervous system to its role in reducing inflammation, fish oil has a multitude of beneficial effects. It would take several books to fully explain all of the benefits of fish oil. Regarding arthritis, these fats seem to influence the body on a cellular level that results in a decrease in inflammation throughout the body. Additionally, these oils also have a positive effect on the production of cartilage. Click Here

A recent study was performed evaluating fish oil to treat neck and back pain. Many of the patients felt such improvement that they were able to stop taking their prescription medication.�Click Here

Unfortunately, many omega-3 supplements on the market are not properly screened for toxic metals and other toxins. The company that manufactures your fish oil should be able to provide a ‘certificate of analysis’, which demonstrates that no such harmful ingredients are present. Certificate of Analysis Click Here to See Certificate of Analysis

The usual dose is 2-4 capsules per day. Since some of these oils can ‘thin’ the blood, caution must be used if a person is on certain medication. Check with your doctor before starting.

(((Omega Pure)0)) (((Ortho MEGA >>>>

Avocado/Soya Unsaponifiables (ASU)

This is a relatively new option for arthritis sufferers. ASU is a natural derivative from the fatty portion of avocado and soy. Although scientists are not sure exactly how it work, ASU stimulates cartilage production. The studies show that taking ASU regularly can maintain the space of the joints, thereby slowing degeneration.�Click Here

ASU was also shown to relieve the pain associated with arthritis in the knee and hip. Click Here

Usually 300mg of ASU is taken one time per day.

Herbal Medicine

Herbal Medicine has been around sicne the dawn of civilization. Each country has its own tradition of herbal remedies. Two main criticism were brought by the modern medical community against herbal medicine. First of all, herbs are not standardized in the same way that pharmaceutical drugs are. Therefore, we do not know exactly know how much of the active ingredient is in each herb. The second criticism was that these medicines have not been evaluated through rigorous scientific studies. Well, over the last 30 years, both of these criticisms have become almost obsolete. As far as the first criticism, all of the herbal extracts that we use in our facility are standardized to the active ingredient in that herb. Regarding the second, there has been an explosion of medical studies proving the long standing tradition of many herbal remedies.

The two main formulations that we have found extremely useful and effective are Kaprex and Saloxicin. Kaprex is a special mix of rosemary, hops and olive. This combination has been evaluated and proven to reduce inflammation for up to twelve hours. However, no significant side effects have been noted. Saloxicin is made from an extra of White Willow Bark, the original source of aspirin. Since, they extract from the whole plant, it is much safer for the stomach and intestines.

Homeopathic Medicine

The field of homeopathy developed in Germany in the 1700’s. For the most part, it was a response to the brutal medical treatments that were often worse than the actual disease. Many of these conventional treatment involved bloodletting large volumes of blood. Mercury Chloride was the primary medicine used for a wide variety of illnesses. Homeopathy became very attractive because of its gentle approach and lack of side effects. The main goal of homeopathy, like all of the natural medicines, is to activate the healing processes in the body. One of the most popular homeopathic medicines in the world is called ZEEL. There are no known side effects and it can be combined with any other medication. It was involved in a medical study where it was found to be as effective as a popular anti-inflammatory drug.


Due to its efficacy, acupuncture has recently become the most reffered to form of alternative medicine in the United States. It has a 3000 year history of treating pain of various types. The largest study evaluating acupuncture was completed a few years ago. The researchers wanted to prove or disprove the effects of acupuncture on osteoarthritis of the knee. The results were extremely positive proving this ancient form of healing.�Click here

Functional Testing

As soon as vitamins and minerals were discovered over 100 years ago, the scientific community has always looked for ways to assess a person’s nutritional status. All of these methods either were too costly or had flaws. In last few years, there has been a wonderful test by a laboratory named Spectracell that measures 30 different vitamins, minerals, amino acids and antioxidants with a simple blood draw. The test itself is often covered by most insurances including Medicare. It is incredibly accessible to everyone. The novelty of the test is that the laboratory measures the function of these substances inside the cells. Typical blood tests will assess how much of a certain vitamin is in the serum or blood stream. However, that does not tell us what amount is reaching their destination, i.e. inside the cells, nor does it tell us if the individual is able activate those nutrients. This is what Spectracell’s Functional Intracellular Analysis is measuring. See their website for more information.

The underlying goal of this article is to give hope to a population that oftentimes feels as though there are no options for their suffering. There are many evidence-based, natural medicines that have been found to work without worrisome adverse effects. Please ask your physician before starting any of these.