Your online resource for objective Arthritis information

Introduction

Whether you have only recently learned that you have arthritis or you have lived with it for years, you’ll find information on here to keep you updated with developments in the treatment field, including medical research and health news. Our ongoing dialogue with our customers enables us to keep providing you with information and support. Look out for our monthly enews (sign up here) and articles from leading experts in the field. You can find general health information on our blog where you’ll find our articles from our in-house nutritionists as well as guest practitioners, events and webinar information and our media cuttings archive.

Symptoms/causes

Arthritis is a painful condition affecting the joints and bones.

Osteoarthritis is the most common form and occurs when the cartilage that lies between the bones gradually wears away. As the function of cartilage is to protect the surface of the bone, its absence allows the bones to rub against each other, resulting in damage and pain. The most frequently affected joints are in the hands, spine, knees and hips. Osteoarthritis, sometimes called degenerative joint disease, tends to be uncommon in people under 40. Risk factors include being overweight and having an injury, operation or repeated strain on a joint.

Rheumatoid arthritis is less common, but more severe. Unlike osteoarthritis, the body’s immune system actually attacks and destroys the joint, causing inflammation, pain and swelling. This can lead to a reduction of movement, and the breakdown of bone and cartilage. Rheumatoid arthritis usually develops between the age of 30 and 50. Whilst osteoarthritis and rheumatoid arthritis are relatively well known, there are approximately 200 types of arthritis which are classified into three categories: Inflammatory Arthritis, Non-Inflammatory Arthritis and Connective Tissue Disease.

Treatment

It is thought that arthritis affects around 1 in 5 people in the UK, with common treatments including use of non-steroidal anti-inflammatory drugs (NSAIDs), physiotherapy and surgery. NSAIDs work by inhibiting the action of an enzyme cyclooxygenase (COX) and prevent the production of inflammatory and pain-producing products called prostaglandins, which are derived from an omega-6 fatty acid called AA. Whilst these drugs are very effective in reducing inflammation they also have detrimental side effects including serious gastrointestinal and cardiovascular complications, making long-term use risky.

Many independent tests have shown that adding concentrated fish oils rich in omega-3 fatty acids to the diet can result in a significant lessening of chronic pain and joint pain in arthritis sufferers. EPA is a long-chain omega-3 fatty acid which actually works in several ways. Firstly it is converted to its own series of prostaglandins but, unlike those derived from AA, these are anti-inflammatory and provide pain relief. Secondly, if EPA levels in the diet are increased it can lower the amount of AA in the body. Thirdly, it actually competes with AA for the COX enzyme, working in a very similar way to NSAIDs by preventing the formation of inflammatory products – except without the associated side effects. It appears, however, that if another fatty acid called GLA (gamma linolenic acid – an anti-inflammatory omega-6) is present with EPA, then all these factors are intensified – in other words, there is a synergistic effect between these two substances such that, when taken in combination, they work even better in the fight against inflammation.

Glucosamine, made naturally in the body (by combining glucose and glutamine – an amino acid), is involved in the production of compounds called proteoglycans and glycosaminoglycans (GAGs). It is these compounds which make up the cartilage that covers and protects the ends of the bones in the joints. These amino sugars absorb water and provide lubrication (synovial fluid) and shock absorption for the cartilage, as well as inhibiting the production of enzymes that degrade cartilage. Cartilage and other related structures like discs, tendons and ligaments are continuously being remodelled, being worn away during activity and then reformed again afterwards. As we get older we are unable to produce enough glucosamine to meet the body’s needs. Also, if demands are increased by activity (such as with active individuals or athletes) and glucosamine needs not met, then damage may occur. Supplementing with glucosamine not only helps rebuild cartilage and decrease joint deterioration without side-effects, but also provides pain relief, equivalent in effect to some NSAIDs. Research suggests that combining EPA with glucosamine may offer benefits to those who suffer with arthritis that are superior to supplementing with glucosamine alone (Gruenwald et al, 2009).

Omegaflex DUO contains glucosamine  hydrochloride (HCL) derived from the fungus aspergillus niger, which is hypoallergenic. Most glucosamine supplements are derived from shellfish, which are more commonly associated with allergies. Significantly purer and more bioavailable than glucosamine sulphate, studies show that glucosamine hydrochloride inhibits bone breakdown (known as ‘resorption’), relieves pain, improves function of affected joints and may reduce the necessity of commonly used pain killers such as NSAIDs and is as effective and safe as glucosamine sulphate (Svetlova & Ignat’ev 2005; Ivanovska et al, 2011).

Calcium is an essential nutrient of the body and low dietary intake can increase the chances of developing osteoporosis.  As vitamin D is required for the body to absorb calcium and evidence suggests that arthritis progresses faster in individuals with a vitamin D deficiency, we combine our vitamin D3 with a unique highly bioavailable source of calcium derived from algae which is also rich in over 70 other mineral and trace minerals known to play a role in bone and joint health.

Recommendation

Omegaflex DUOWe recommend Omegaflex DUO, taken daily at the following doses:

  • For general wellbeing: adults and children aged twelve years and over should take 2 glucosamine & calcium capsules (blue blister) and 1 E-EPA 70 capsule daily (silver blister).
  • For individuals who are especially active or those who require additional joint & bone support in later life: take 4 glucosamine & calcium capsules and 2 E-EPA 70 capsules daily

Please note: Omegaflex DUO is not suitable for children below the age of 12, nor pregnant and breastfeeding women. Diabetics should consult their doctor before taking Omegaflex DUO. It may also be beneficial to take 1 additional Pharmepa STEP 1: RESTORE  capsule daily if injury has been sustained, to increase the intake of EPA for anti-inflammatory benefits.

References

Brzeski M, Madhok R & Capell HA. (1991) Evening primrose oil in patients with rheumatoid arthritis and side-effects of non-steroidal anti-inflammatory drugs. British Journal of Rheumatology 30:370-372.

Calder PC. (1996) Immunomodulatory and anti-inflammatory effects of n-3 polyunsaturated fatty acids. Proceedings of the Nutrition Society 55:737-774.

Gaullier JM, Halse J, Hoye K, Kristiansen K, Fagertun H, Vik H & Gudmundsen O. (2004) Conjugated linoleic acid supplementation for 1 y reduces body fat mass in healthy overweight humans. American Journal of Clinical Nutrition 79:1118-25.

Gruenwald J, Graubaum HJ, Hansen K & Grube B. (2004) Efficacy and tolerability of a combination of Lyprinol and high concentrations of EPA and DHA in inflammatory rheumatoid disorders. Advances in Therapy 21:197-201.

Gruenwald J, Petzold E, Busch R, Petzold HP & Graubaum HJ. (2009) Effect of glucosamine sulfate with or without omega-3 fatty acids in patients with osteoarthritis.  Advances in Therapy 26:858-71.

Hankenson KDWatkins BASchoenlein IAAllen KGTurek JJ. Omega-3 fatty acids enhance ligament fibroblast collagen formation in association with changes in interleukin-6 production. Proceedings of the Society for Experimental Biology and Medicine 223:88-95.

Ivanovska N & Dimitrova, P. (2011) Bone resorption and remodeling in murine collagenase induced osteoarthritis after administration of glucosamine. Arthritis Research & Therapy 13:R44

James MJ, Gibson RA & Cleland LG. (2000) Dietary polyunsaturated fatty acids and inflammatory mediator production. American Journal of Clinical Nutrition 71:343S-348s.

Leventhal LJ, Boyce EG & Zurier RB. (1993) Treatment of Rheumatoid Arthritis with Gamma linolenic Acid. Annals of Internal Medicine 119:867-873.

Murck H & Manku M.  (2007) Ethyl-EPA in Huntington disease: potentially relevant mechanism of action. Brain Research Bulletin 72:159-64.

Puri BK, Bydder GM, Counsell SJ, Corridan BJ, Richardson AJ, Hajnal JV, Appel C, Mckee HM, Vaddadi KS & Horrobin DF. (2002) MRI and neuropsychological improvement in Huntington disease following ethyl-EPA treatment. Neuroreport  13:123-6.

Puri BK, Bydder GM, Manku MS, Clarke A, Waldman AD & Beckmann CF. (2008) Reduction in cerebral atrophy associated with ethyl-eicosapentaenoic acid treatment in patients with Huntington’s disease. Journal of International Medicine and Research  36:896-905.

Qiu GX, Weng XS, Zhang K, Zhou YX, Lou SQ, Wang YP, Li W, Zhang H & Liu Y. (2005) A multi-central, randomized, controlled clinical trial of glucosamine hydrochloride/sulfate in the treatment of knee osteoarthritis. Zhonghua Yi Xue Za Zhi  85:3067-70.

Svetlova MS & Ignat’ev VK. (2005) Experience with glucosamine hydrochloride in the treatment of patients with osteoarthrosis. Terapevticheskii arkhiv 77:64-7.

Volker DH, FitzGerald PE & Garg ML. (2000) The eicosapentaenoic to docosahexaenoic acid ratio of diets affects the pathogenesis of arthritis in Lew/SSN rats. Journal of Nutrition 130:559-65.

Volker D, Fitzgerald P, Major G & Garg M. (2000) Efficacy of fish oil concentrate in the treatment of rheumatoid arthritis. Rheumatology 27:2343-6.

Wall RRoss RPFitzgerald GFStanton C (2010) Fatty acids from fish: the anti-inflammatory potential of long-chain omega-3 fatty acids. Nutrition Reviews.  68:280-9.

Zhang WB, Zhuang CY, Li JM, Yang ZP, Chen XL. (2007) Efficacy and safety evaluation of glucosamine hydrochloride in the treatment of osteoarthritis Zhonghua Wai Ke Za Zhi  45:998-1001.