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WHAT IS OSTEOARTHRITIS?
The word arthritis literally means "joint inflammation" - that is, a joint that is painful, warm to the touch, possibly red, swollen, and associated with a loss of function. "Osteo" is Greek for "bone".
Arthritis is not a single ailment. In fact, more than 100 different conditions can affect the joints and their adjacent bones, muscles, and tissues. They are classified into various major types of arthritis, depending on whether or not inflammation, infection or bleeding is the major component. All of these types of arthritis are completely different, with different presentations, symptoms and treatment.
Osteoarthritis (OA) is the most common form of arthritis. It is a 'non-inflammatory' type of arthritis, which means that inflammation is not the key component. Osteoarthritis develops in a joint when cartilage - the smooth shiny tissue that lines and cushions the ends of the bones inside a joint, -begins to break down. This can happen from:
- Prolonged "wear-and-tear" as we age
- Prior injury or damage to the joint from trauma or infection
- Cartilage that is altered by other disease or is genetically weak
In most cases, it is impossible to know what causes it, but we definitely know has to do hormones not present in the system. Damaged cartilage cannot heal to become normal again. Osteoarthritis can involve a number of joints, but it is not a disease that spreads to involve other tissues or joints throughout the body. Osteoarthritis (OA) has been called a "degenerative" condition because it is caused, in part, by wear-and-tear of a joint over time.
HOW IT PROGRESSES?
Here is how OA progresses:
- The smooth cartilage that lines and protects the bone ends begins to retain water, and changes occur in some of the chemical substances that make up the cartilage.
- Tiny cracks develop in the cartilage, which then splits further forming clefts.
- The ends of the bones begin to thicken and grow out from the joint margin. these small bone growths are called osteophytes or "spurs". Actually, these spurs are nature's way of trying to help the damaged joint by allowing the load through the joint to be redistributed. But these bony outgrowths often interfere with the mechanism of joint movement.
- Cysts, which are small cavities, develop in the bone just beneath the damaged cartilage.
- Fragments of damaged cartilage or bone may break off and float around freely in the joint as 'loose bodies' and may cause additional problems.
- As the cartilage becomes more damaged, the joint space becomes narrower and narrower.
- The erosion of cartilage within a joint can irritate and inflame the inner lining of the joint called the synovial membrane and cause it to produce excess fluid. It normally produces a lubricant called synovial fluid, which helps to lessen friction in the joint. The fluid may then build up within the joint and lead to detectable swelling. When the cushioning system of the joint is lost, the bones may grind painfully against each other. The joint can begin to stiffen, and movement is impaired. Some people are fortunate in that despite having these rather severe osteoarthritis changes in a joint, they experience very little, or no pain at all.
Osteoarthritis typically strikes the:
- Weight-bearing joints (knees, hips, back, feet)
- Hands
- Spine
The knee is the most commonly affected joint. If osteoarthritis develops in the hips or knees, it often occurs in only one joint but may affect any number of joints.
If the hands are affected, a few finger joints may become arthritic at the same time.
Facts about Osteoarthritis.
- Osteoarthritis is an inevitable part of aging and can affect any joint.
- It is the oldest discovered health problem having been found in dinosaur joints and Egyptian mummies.
- Osteoarthritis is the most widespread form of arthritis, affecting about 16 million people throughout the United States . The Arthritis Foundation estimates that some 59 million Americans - nearly 20% of the population - will have arthritis by the year 2020, as age catches up with the baby boomers.
NUTRITION AND OSTEOARTHRITIS
Bones and cartilages feed from hormones our system produces. Over time some of these hormones are no longer produced by our system and certainly that's when we start noticing some problems (joint aches, bone density loss, etc.) - it all comes with age. Definitely, menopause may trigger and enhance some of these problems.
As it is explained in the Female Menopause section, menopause is a natural transition in a woman's life and occurs when estrogen production falls below a certain level causing ovulation to stop. In fact, at age 30 the body decreases estrogen production. When estrogen levels decline, the following changes occur in the body, blood vessels weaken, the liver doesn't get the message to convert bad cholesterol to good cholesterol, bone density falls at a rate of 1 to 3% a year and the benefits of serotonin, a neurotransmitter released in the brain to promote relaxation and sleep are compromised. These changes associated with menopause can contribute to a number of health concerns such as increased risk for cardiovascular disease high cholesterol, high blood pressure, bone density loss, joint aches, vaginal dryness, hot flashes, and mood swings. The degree to which women have these experiences varies greatly.
Women's natural estrogen levels help protect against cognitive decline. The adrenal glands, which in part function as a back-up system for the ovaries, also produce estrogen, progesterone and testosterone, the same hormones produced by the ovaries, as well as DHEA and Cortisol. Here is where nutrition comes to action.
Estrogen is a collective term for a class of female sex hormones produced in the ovaries and adrenal glands. These hormones circulate throughout the blood and help maintain heart, bone, and reproductive health by locking onto special estrogen receptors. Much like a lock and key, the estrogen and estrogen receptor fit together and form a unit that enters the nucleus of the cell, setting off a chain of events within the DNA that helps the tissue grow and function properly. When it comes to bone health, estrogen fights against osteoporosis by helping bones absorb the calcium they need to stay strong. Research has shown that estrogen blocks a class of inflammatory molecules called cytokines from binding to bone cell surfaces (cytokines stimulate osteoclasts, the cells that break down bone tissue). When the body has enough estrogen, bone cells thwart cytokines by producing decoy receptors that the cytokines can bind to; without estrogen, the decoy receptors diminish and the cytokines are able to initiate the path of bone destruction. Estrogen also helps conserve calcium stored in the bones by encouraging other cells to use dietary calcium more efficiently.
Good nutrition stimulates the hypothalamus and pituitary glands to produce more precursor hormones which then impact all of the endocrine glands - the pineal, the adrenals, ovaries, testes, pancreas, and the thyroid gland.
HORMONE REPLACEMENT THERAPY (HRT)- WHAT YOU NEED TO KNOW, RISKS AND SIDE EFFECTS
Despite the positive effects of hormone replacement therapy (also known as HRT) on osteoporosis, a recent study by the Women's Health Initiative showed that hormone replacement therapy may increase a woman's risk for heart disease, heart attacks, strokes, blood clots, and breast cancer. The FDA now requires all HRT medication labels to list these risks and to advise health care providers to prescribe the product at the lowest dose for the shortest duration of time possible for each individual woman.
There are two main types of hormone replacement therapy: Estrogen Replacement Therapy (ERT) and Progestin-Estrogen Replacement Therapy (PERT), a combination of estrogen and progestin (a synthetic form of progesterone). Although PERT is more potent in fighting against osteoporosis, the progestin in progestin-estrogen replacement therapy products can help reduce the risk of uterine cancer associated with taking estrogen alone.
Hormone replacement therapy is either taken continuously (everyday) or cyclically (for a specified period of time each month). The products come in a variety of forms including pills, skin patches, creams, and vaginal tablets and rings. The type of medication, dosage, and method of delivery depends on individual factors such as a patient's age, health, and lifestyle.
Side effects of ERT drugs may include:
- Leg cramps
- Headaches
- Water retention
Side effects of PERT drugs may include:
- Tender and swollen breasts
- Fatigue
- Irritability
- Monthly bleeding
Is Hormone Replacement Therapy (HRT) Safe?
Although HRT may be relatively safe for most people, it is not usually recommended for women who have:
- Current or past breast cancer
- History of uterine cancer
- Abnormal vaginal bleeding
- Recurrent or recent blood clots
- Liver disease
In addition, HRT may not be advisable for women with:
- Endometriosis
- Fibrocystic breast disease
- Uterine fibroids
- Gallbladder disease
- High risk for blood clots
- Migraine headaches
- Epilepsy
- Recent heart attack
Note: ERT = Estrogen Replacement Therapy and PERT = Progestin-Estrogen Replacement Therapy.
...something to think about
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