Arthritis and Osteoporosis

At first, you may wonder why arthritis and osteoporosis have been put in the same section.  Once you understand the true underlying causes of arthritis and osteoporosis, it will become clear why we address them together.

There are simple action steps you can take right now to reduce the severity, pain, and disability of these conditions.

The most common form of Arthritis is OSTEOarthritis, the “wear-and-tear” form of arthritis.  “Osteo” means bone.  Rheumatoid arthritis is also somewhat common.  (For rheumatoid overview and solutions, see the immune and autoimmune section of our website (as they become
available).  Osteoporosis is a condition of the bones that makes them weaken and more likely to fracture.

First, let’s consider who has these conditions and what the standard recommendations are for this condition:

About Osteoarthritis, the American College of Rheumatology states that:

  • At least 70% of people over 70 yrs old have osteoarthritis, making it the most common form of joint disease in humans, and it is a leading cause of disability among the elderly.  But many people start showing sings of arthritis much younger.
  • It typically occurs in the hand joints, spine, hips and knees.
  • It is caused by cartilage breakdown and subsequent bony changes of the joints.
  • Although the joint changes are irreversible, only a small number of patients will progress to the point that requires joint replacement

The standard arthritis risk factors include:
* Older age
* Family members with osteoarthritis
* Obesity
* Joint trauma

Standard Treatment for osteoarthritis include a combination of:

  • physical measures (heat, exercise, other things like chiropractic, acupuncture, and chiropractic),
  • drug therapy
  • and, sometimes, surgery.

Those recommendations are fine, but they are incomplete.  

  • Did you see anything about how what your eat and drink affects how your joints grow, heal, and prevent breakdown.  What if you
    were a tree and your limbs started to get weak where they connected to the main trunk.  Can you imagine the plant expert telling
    you that what you fed the plant was not really that important?  Of course not.

Also, they are wrongly emphasized.  

  • Having arthritis DOES NOT cause pain!  MANY patients come into my office with the diagnosis of arthritis as the cause of their
    pain.  Arthritis is almost never the CAUSE of their pain.  Arthritis is a RESULT of the dysfunction and deficiencies.  As the arthritis
    WORSENS, it does hurt.  It is a little like a callous on your hand or foot.  It may hurt to GET it, but it doesn’t hurt to HAVE it.  
  • Drugs have significant side-effects and new ones are found yearly.  If the side-effects were a just the headache or fatigue, that may
    be worth it, but pain-relief often comes at a very high price.  Most of us have heard of the increased risks with anti-inflammatory
    medications.  The FDA sent out a warning about these medications:  “increased risk of cardiovascular (CV) events and the well
    described, serious, potential life-threatening gastrointestinal (GI) bleeding”.  They warned that people need to pay particular
    attention to the duration and dosage they take.

Medications can be life-saving, but pursue the cause and get off the meds, if possible.  

About Osteoporosis, the American College of Rheumatology states that:

  • By their mid-30s, most people begin to gradually lose bone strength as the balance between bone resorption and bone formation shifts,
    so that more bone is lost than can be replaced.
  • Those over the age of 50 are at greatest risk of developing osteoporosis and suffering related fractures. In this age group, one in two
    women and one in six men will suffer an osteoporosis-related fracture at some point in their life.
  • In addition, 54% of postmenopausal white women in the United States are believed to have osteopenia, a lesser degree of bone loss.

The standard osteoporosis risk factors include:
* ex hormone deficiency, particularly estrogen deficiency, both in women (e.g. menopause) and men
* Cigarette smoking or  Alcohol abuse
* Low dietary intake or absorption of calcium and vitamin D
* Sedentary lifestyle or immobility
* Medications: medications such as prednisone

They fail to mention proton pump inhibitors (PPIs) prescribed for Heartburn, GERD, peptic ulcers, and h pylori. Examples of PPIs
include Prilosec and Prevacid.  These medications inhibit proper mineral absorption.  To learn more about how to prevent the need
for these medications, see the Digestive Problems.
They also missed celiac disease as a cause of osteoporosis in 3-4% of patients.  See the Digestive Problems for proper treatment.

Standard Treatment for osteoarthritis include a combination of:

  • Get enough Vit D (400-800 IU /d if under 50 y.o. & 800-1000 if over 50 y.o.) & Calcium (1000mg if under 50 y.o. & 1200 if over 50 y.o.)
  • Get regular weight-bearing exercise
  • Take medications,
  • typically Bisphosphonates, which include: Fosamax, Actonel, Boniva, or Reclast, but show an increased risk for jaw
    osteonecrosis (permanent bone damage of the bones of the jaw)
  • Estrogen or Hormone Replacement Therapy: Estrogen therapy alone or in combination with another hormone,
    progestin, has been shown to decrease the risk of osteoporosis and osteoporotic fractures in women. However, the
    combination of estrogen with a progestin has been shown to increase the risk for breast cancer, strokes, heart attacks and
    blood clots. Estrogens alone may increase the risk of strokes.
  • Selective Estrogen Receptor Modulators (SERMs): These medications mimic estrogen’s good effects on bones without
    some of the serious side effects such as breast cancer. However, there is still a risk of blood clots and stroke.

Here there is the good news, the bad news, and more bad news.

  • Good News:  Reduced fracture in women.  But, is this just in the short-term?  
  • Bad News:  increase the risk for breast cancer, strokes, heart attacks and blood clots with combination medication therapy and blood clots
    and stroke with Estrogen alone.  
  • Bad news:  The medication(SERMs) that avoids the “serious side effects” still has the increased risk of blood clots and stroke  I guess
    those aren’t so serious, hmmm.   
  • WORSE News: What could be worse than cancer, stroke, blood clot…?  Well, if the drug you were taking did NOT actually prevent
    fractures!  If it only postponed the fracture that would still be good, but what if it postponed it only to result in a worse type of fracture?
    The FDA has put medication companies on notice that they must label their biphosphonate osteoporosis medications to
    say:  “Possible increased risk of thigh bone fracture with bisphosphonates“.  See the Oct 2010 FDA report.

So, you say “Great!  So, now that I know all that horrible information, what am I supposed to do?”

Of course, I would not recommend you go off your medication solely based on this information.  You & your MD can decide if you truly need it.

There are MANY medications with horrendous side effects.  Sometimes the are necessary…

Here are the key questions: