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Vitamin D Reduces Severity Of Knee Osteoarthritis Print email this page

Many people develop arthritic joints as they age. This arthritis is sometimes just an annoyance, but for many, degenerative joint disease causes major pain and disability. The conventional treatments-anti-inflammatory medicines such as aspirin or ibuprofen-relieve acute symptoms but don't heal the disease or even slow its progression. In fact, with the exception of glucosamine sulfate supplements, there are no drugs or natural medicines that have demonstrated favorable long-term effects on osteoarthritis (arthritis marked by degeneration of the cartilage and bone of joints).

Now, researchers at Tufts University Medical School in Medford, Mass., present a revolutionary finding: Diets that include vitamin D and vitamin C seem to retard osteoarthritis of the knee (McAlindon, 1996).

More than 500 men and women who participated in the Framingham Heart Study in Framingham, Mass.-with participants from as far north as Canada-had knee x-rays checked for arthritis in the early 1980s and then again eight years later. Vitamin D blood levels and a diet history were taken midway through this period.

The results suggest a powerful role for nutrition in predicting the progress of osteoarthritis. People in the top third for vitamin D intake experienced the least amount of disease progression after eight years. Those in the middle third were three times more likely, and those in the bottom third four times more likely to have worsening arthritis. In a separate study, the same research group found that high vitamin C intake also predicted less disease progression. In both cases, vitamin intake was assessed by tracking the patients' diets.

This study is important for three reasons. First, it emphasizes that people in the northern United States and Canada-where gray winter skies are common-are vulnerable to vitamin D deficiency. The body needs exposure to sunshine to make vitamin D. Second, for this same reason, vitamin D deficiency is especially common among homebound elderly people who can spend an entire winter without encountering sunlight. In both these circumstances, adequate dietary vitamin D or a vitamin D supplement is essential.

Third and even more important is the broader implication. Unlike current medicines, vitamin D and vitamin C don't just mask osteoarthritis symptoms-they appear to restrain the disease process itself. If vitamin D and vitamin C are effective, what about other nutrients known to be involved in bone and cartilage metabolism such as vitamin E, boron, niacinamide, magnesium and zinc? Preliminary research suggests that these also might have a role in blocking arthritis.

How much good might a multi-nutrient cocktail provide? Certainly no less than current anti-inflammatory medicines, and perhaps a lot more. It should be a high priority to find out.

Supplementing vitamin D is easy since there's rarely a need to go beyond the 400 I.U. of vitamin D in most standard multivitamin and mineral supplements. Higher doses of vitamin D can cause toxic side effects and should rarely be used, and then only if someone is working closely with a physician.

People with arthritis should discuss the Tufts research with their doctors. Even if physicians don't "believe" in nutrition, their patients can help them learn about good nutrition research. Knowing that patients care may motivate a doctor to take a second look. Health professionals can obtain copies of the following articles at any hospital medical library affiliated with the National Library of Medicine.

 


Richard Podell, M.D., is clinical professor, Department of Family Medicine at New Jersey's UMDNJ-Robert Wood Johnson Medical School.

 

REFERENCES

D'Ambrosio, E. "Glucosamine sulfate: A controlled clinical investigation in osteoarthrosis," Pharmatherapeutica, 2: 504-8, 1991.

Drovanti, A. "Therapeutic activity of oral glucosamine sulfate in osteoarthritis: A placebo-controlled double-blind investigation," Clin Therap, 3: 260-72, 1980.

Gloth, F. "Vitamin D deficiency in home-bound elderly persons," JAMA, 274: 1683-6, 1995.

Kaufman, W. "The use of vitamin therapy to reverse certain concomitants of aging," J Amer Geriatr Soc, 3: 927, 1955.

Lopes, V. "Double-blind clinical evaluation of the relative efficacy of ibuprofen and glucosamine sulfate in the management of osteoarthrosis of the knee in out-patients," Current Med Research Opin, 8: 245-49, 1982.

Machtey, I. "Tocopherol in osteoarthritis: A controlled pilot study," J Amer Geriatr Soc, 26: 328, 1978.

McAlindon, T. "Do antioxidant micronutrients protect against the development and progression of knee osteoarthritis?" Arthr and Rheumatism, 39: 648-56, 1996a.

McAlindon, T. "Relation of dietary intake and serum levels of vitamin D to progression of osteoarthritis of the knee among participants in the Framingham study," Annals of Internal Medicine, 125: 353-9, 1996b.

Pujalte, J. "Double-blind clinical evaluation of oral glucosamine sulfate in the basic treatment of osteoarthrosis," Current Med Research Opin, 7: 110-24, 1980.

Travers, R. "Boron and arthritis: The results of a double-blind pilot study," J Nutr Med, 1: 127-32, 1990.

 
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