Coping with arthritis pain

Quality oils are key to naturopathic therapy
By Tori Hudson, ND

In my women's health practice, I frequently see cases of arthritis (both osteo and rheumatoid), especially in women in their mid-to-late forties and older. These diseases have dramatic effects on the quality of the lives of my patients. Joint pain and stiffness can turn normal activities into unpleasant ordeals. Day-to-day activities like gardening, swinging a golf club and other hobbies can become more and more difficult.

Joint inflammation and degeneration are not generally considered "women's conditions". However, arthritis and other joint conditions are far more common in women than in men. In fact, nearly twice as many women (26 million) suffer from arthritis than men (14.2 million).

Rheumatoid arthritis is the most debilitating form of arthritis and is a chronic inflammatory condition that commonly affects the hands, feet, wrists, ankles, and knees. Swollen, stiff, painful joints are the hallmarks of the disease. The joints in rheumatoid arthritis patients tend to be heated, tender and swollen. As the disease progresses, the joints of the hands and feet can become deformed.

When I see a patient with rheumatoid arthritis, I advise a well-rounded natural medicine approach. Fundamental to a naturopathic approach to arthritis problems is the achievement of a normal body weight. Plain and simple, excess body weight causes an increased weight load on the joint. Regular exercise helps to accomplish weight loss and weight control while also improving circulation to the joint and range of motion. Physical activity that does not traumatize the joints is preferential ­ for example, walking, swimming, and cycling.

The quality and quantity of food in the diet also plays an important role in weight management. In general, I recommend a healthy whole foods diet, including complex carbohydrates, fruits, vegetables, legumes, nuts and seeds. The diet should be low in saturated fats and trans fatty acids ("bad" fats), while rich in essential fatty acids ("good" fats) such as fish containing omega 3 oils (salmon, tuna, halibut, sardines, mackerel, herring).

Of additional importance is the detection of food allergies and sensitivities. Eliminating allergic foods will very often offer significant benefit to many individuals with rheumatoid arthritis. Almost any food can aggravate rheumatoid arthritis but common offenders are wheat, corn, dairy products, beef, food additives and nightshade-family foods (tomato, potato, eggplant, peppers, tobacco).

Loosen the joints with good fats
In addition to changes in diet and exercise, I usually prescribe a combination of supplements with therapeu tic effects for the joints. I commonly start with supplements of essential fatty acid oils ­ including borage, evening primrose, and fish oils. I typically receive good feedback from my patients on these oils, and some even say they just feel like their joints are "better lubricated".

Borage and evening primrose oils contain the omega 6 fatty acid gamma linolenic acid (GLA). Many studies on GLA have shown that individuals with rheumatoid arthritis experience significant improvements in their symptoms within the first six months of use. They also continue to improve by as much as 50 percent in the number of tender joints, 54 percent in the reduction of tenderness in joints, 42 percent in the reduction in swollen joints, morning stiffness decreasing by 67 percent, and overall 27 percent reduction in pain.1, 2 I'm especially drawn to the use of borage oil with my patients because it is the richest source of GLA ­ up to 24 percent. Evening primrose oil contains only 8-10 percent GLA on average. With borage oil, an individual can take fewer capsules to achieve the required dosage, which is usually between 1.4 and 2.8 grams of GLA per day. I generally see significant benefits within six months of use.

Fish oil supplementation in the treatment of rheumatoid arthritis may also yield good results in some women. More than a dozen studies have consistently demonstrated positive benefits in relieving morning stiffness and joint tenderness.3 I generally recommend at least 1.8 grams of eicosapentanoic acid (EPA), from fish oil as a supplement.

Combining EFAs with other nutritional supplements
In addition to essential fatty acids, I regularly use many other nutritional supplements and herbs for therapeutic benefit. Some examples include glucosamine sulfate, chondroitin sulfate, and herbs such as devil's claw, yucca, curcumin, ginger and boswelia. Many manufacturers offer formulas for joint health that combine EFAs with some of these nutritional supplements. In conclusion, quality oils and fats are as important as vitamins and minerals in maintaining our health and in the prevention of many chronic diseases, not only arthritic conditions. They are a valuable addition to any diet but are especially important for people with arthritis.

Tori Hudson, ND, is author of The Women's Encyclopedia of Natural Medicine and operates "A Woman's Time" naturopathic women¹s health care clinic in Portland, Oregon.

References:
1. Zurier R, et al. Gamma linolenic acid treatment of Rheumatoid Arthritis. A randomized placebo- controlled trial. Arthritis Rheumatology, 1996; 39(11):1808-1817.
2. Leventhal L, et al. Treatment of Rheumatoid Arthritis with gamma-linolenic acid. Annals of Internal Medicine, 1993; 119:867-873.
3. Fortin P, et al. Validation of a meta-analysis: the effects of fish oil in rheumatoid arthritis. Journal of Clinical Epidemiology, 1995; 31:112-115.

Good to hear from you

Cat skin problems cured by borage oil

"My 8 year old cat has been on a low-fat diet for the last two years. Over time, her weight gain has been controlled, but the low-fat diet has led to problems with her skin and coat. Over the last winter, her condition became especially bad ­ she had dry flakes of dandruff all over her back and her coat was dry and lusterless. I tried brushing her and bathing her but the dandruff would always return. I finally added 1/4 tsp. of borage oil daily to her diet ­ I mixed the oil into her canned food and she ate it quite happily. I have since noticed a 100 percent improvement in her skin and coat. Over the course of about four weeks, the dandruff cleared up and her black fur became shiny once again. Her coat looks more beautiful now than it ever has. I will definitely continue to use this oil!"
H.O., Saskatoon

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Please write c/o:
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Healing skin from the inside out

Relief for winter skin irritation.

As winter approaches and thermometers drop across North America, problems of dry and itchy skin tend to flare up. Chilly winds and low humidity levels certainly don¹t help! If your body lacks proper amounts of essential fatty acids (EFAs), it¹s likely your skin is really suffering.

Although all EFAs have benefits for the skin, the most important one is GLA (gamma linolenic acid). GLA, found in borage and evening primrose oils, is a cousin to the better known EFAs found in fish and flax seed oils. GLA is a powerful agent in healing and soothing dry and damaged skin.

Janice McColl, a pharmacist and master herbalist specializing in the study of essential fatty acids, points out that recurring skin conditions like eczema may be linked to GLA deficiency.

"A healthy body obtains GLA by converting dietary linoleic acid (found in many processed foods) into GLA" says McColl. "In eczema, the conversion of linoleic acid to GLA is often defective. When the body can¹t convert enough GLA to meet its needs, the deficiency contributes directly to skin inflammation and itching."

In a 12-week study of patients with atopic eczema, doctors at the University of Italy reported that patients treated with 548 mg GLA per day realized a 90 percent drop in itching. Blister formation around the irritated areas dropped by 40 percent, and oozing and patchy redness improved significantly (The Journal of International Medical Research, Vol. 25, 1997).

Last year, the British Journal of Dermatology (Vol. 140, 1999) published results from a placebo-controlled, multi-center study of borage oil's effect on eczema. Doctors observed that patients who received 690 mg of GLA daily for 24 weeks showed significant improvement in symptoms compared to patients in the placebo group. "The science shows that GLA supplementation enhances moisture levels and reduces inflammation," says McColl. "I have seen the positive results in my patients time and again."

McColl suggests two to four capsules of borage oil or four to six capsules of evening primrose oil daily to help soothe and heal eczema and dry skin. Borage oil, containing up to 24 percent GLA, is the richest source of this essential fatty acid. Evening primrose oil is less potent, containing 8-10 percent GLA.

"I highly recommend borage oil," says McColl. "I even use it for my own children ­ it really helps their eczema."

Fish oil supplements may help reduce risk of heart disease for post-menopausal women

Post-menopausal women may be able to reduce their risk of developing heart disease by taking fish oil supplements, according to a new study conducted at the University of Guelph, Ontario, Canada. The results were reported in the American Journal of Clinical Nutrition, August, 2000.

The placebo-controlled study included 35 post-menopausal women grouped according to whether or not they were taking hormone replacement therapy (HRT). Researchers found that fish oil supplements lowered blood triglyceride levels by 26 percent. These results were consistent whether the women were undergoing hormone replacement therapy or not.

High triglyceride levels are an important risk factor in the development of heart disease. By reducing triglyceride levels so significantly, researchers concluded that fish oil could potentially reduce the risk of coronary heart disease by 27 percent in post-menopausal women.

View abstract online at:http://www.ajcn.org/ (August 2000 issue) or at FATSforHEALTH.com

Research News

The wave of scientific interest in essential fatty acids continues to grow. In the last year alone, researchers have studied EFAs in dozens of clinical applications with good results. Some highlights:

Arthritis: The first-ever systematic review of the therapeutic value of gamma linolenic acid (GLA) was completed in April 2000. The conclusions point to striking results in the area of rheumatoid arthritis, particularly for morning stiffness. "We found very firm evidence that GLA is useful in reducing morning stiffness in rheumatoid arthritis patients by a substantial amount of time," said lead researcher Marya Zilberberg, MD. "We saw about a 60-65 percent reduction in morning stiffness for patients who participated in the trials. In other words if you have two hours of morning stiffness, that goes down to about half an hour."

Heart Attack: The most prominent news in this area was a two-year trial conducted in Italy that showed reduction of the mortality rate in a group of patients after heart attack who were given concentrated fish oil. In this study fish oil proved to be more beneficial than vitamin E.

Lung Disease: A study from the Mayo Clinic found that borage oil (containing GLA) significantly increased survival odds in patients being treated for acute respiratory distress syndrome (ARDS) in a critical care unit.

Bipolar Disorder: A four month, placebo-controlled study conducted in conjunction with the Harvard Medical School demonstrated that fish oil improves bipolar disorder (manic depression).

Immune System: Several markers of immune response in elderly subjects improved after supplementation with alpha linolenic acid (ALA) found in flax seed and gamma linolenic acid (GLA) found in borage and evening primrose oils, as reported by a Tufts University study.

Diabetes: A review article on diabetic neuropathy has confirmed gamma linolenic acid (GLA) found in borage and evening primrose oils to be one of the best treatments available for this condition.

From the Kitchen

Orange Bran Flax Muffins

Whole oranges give these muffins a wonderful flavour.

• In a large bowl, combine oat bran, flour, flax seed, bran, baking powder and salt. Set aside.
• In a blender or food processor, combine oranges, brown sugar, buttermilk, oil, eggs and baking soda. Blend well.
• Pour orange mixture into dry ingredients. Mix until well blended.
• Stir in raisins.
• Fill paper lined muffin tins almost to the top.
• Bake in 190º C (375º F) oven for 18 to 20 minutes or until wooden toothpick inserted in centre of muffin comes out clean.
• Cool in tins 5 minutes before removing to cooling rack.
  
  ** For chocolate lovers, substitute white chocolate chips for raisins.
  Yield: 18 muffins
  
  Recipe courtesy of the Flax Council of Canada.

Brought to you by: October 2000 Bioriginal Food & Science Corp.
This publication is for informational purposes only. Consult your health care practitioner for any medical advice. The statements made in this publication have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent disease.