As an orthopedic surgeon, I see and treat arthritis patients daily. I am frequently asked what alternatives there are to NSAIDs (Vioxx, Celebrex, ibuprofen, etc.).
Doctors frequently prescribe NSAIDs to control the symptoms of arthritis. If you are one of the millions of arthritis sufferers in the U.S. who has sought treatment of arthritis, you undoubtedly have had one or more of these prescribed for you.
Some of you are probably familiar with, and may even have experienced some of the side effects which can include simple stomach upset to ulcers, kidney failure or death. It has been estimated that there are approximately 16,000 deaths each year in the U.S. resulting from bleeding ulcers as a direct result of NSAIDs. At a medical conference this week, research presented from the Harvard University-affiliated Brigham & Women’s Hospital suggests that Vioxx may increase the risk of heart attacks.
As an alternative, there are nutrients such as glucosamine sulfate, chrondroitin sulfate, fish oil, Ester-C, antioxidants, curcumin (turmeric), quercetin, etc. that are safe and effective for promoting joint health. Side effects are rare (studies have not shown any serious side effects and the rare indigestion is the only side effect I have seen in my own practice).
These not only control inflammation like the NSAIDs, but some nutrients like glucosamine sulfate, chondroitin sulfate, and green tea have been shown to retard the disease progression of arthritis by slowing down the breakdown of the joint surface. Glucosamine and chondroitin sulfates have been shown to work by inhibiting enzymes that break down the joint surface, improving the microcirculation of the joint, and stimulating the joint cells to increase production of those components such as proteoglycans and collagen which are needed for the structure of the joint surface.
Look for a supplement that contains glucosamine, chondroitin, curcumin, antioxidants, quercetin, and Ester-C. Early on, this was based on studies primarily from Europe. Orthopedists in the U.S. were slow to accept these until more and more studies, especially over the last five years in the U.S., confirmed these previous European studies. These studies have been reported in prestigious medical journals such as Lancet and Archives of Internal Medicine and also in much of the mainstream orthopedic literature. In the last few years the use of these agents, such as glucosamine sulfate and chondroitin sulfate, have become accepted in the U.S. as standard practice for alternatives in treating arthritis. They are considered as disease modifying agents as well as symptom modifying. These important supplements are no longer in the realm of “alternative medicine” and have become widely accepted.
Glucosamine sulfate and chondroitin sulfate products are widespread and produced by many companies. Quality is important and does vary company to company. Glucosamine and chondroitin sulfate have been effective in treating mild to moderate arthritis.
Supplements that combine all the nutrients into one product at the doses shown to be effective in studies are what you should look for. In my own practice, supplementation has been effective in hundreds of my patients.
Some of the more advanced arthritics combine supplements with prescription NSAIDs, and many times in doing so, can lower the dose of the NSAIDs and thereby lower the risk of side effects. In most NSAIDs, side effects and risks are dose dependent. I have many end-stage arthritics who have been able to avoid or put off doing joint replacements by using this product.
I have some patients who medically do not qualify for joint replacement, or for one reason or another do not want to undertake the risks of surgery. These patients have experienced significant benefits with use of a supplement. Another great option to add is highly potent and purified fish oil containing essential Omega-3 fatty acids. These fatty acids can block pain and inflammation. They are also excellent for cardiovascular and brain health.
An additional compound of interest which has been shown to have chondroprotective effects is green tea extract. In a previous blog post we explored the health benefits of green tea when he reviewed articles out of the United Kingdom which show the catechins contained in green tea inhibit the breakdown of the joint surface construct.
Even more exciting are the studies indicating green tea may reduce the risk of Alzheimer’s, cancer and heart disease. Supplementing with products which contain green tea extract and fish oil is recommended. These nutrients give you a wide variety of options to optimize your joint and overall health.
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