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Baby, It’s Cold OUCH-Side

Bone, Joint and Muscle Health Bone, Joint and Muscle Health
Longevity By Nature

Cold weather kicks up the joint pain and often muscle discomfort. Be ready!

Nobody wants their mobility impaired. There’s way too much to do, especially around the holiday season. So much merriment to be had!

However, pain, discomfort, inflammation and soreness can slow people down—and those who enjoy being active and fit will experience less-than-sufficient workouts, which sours mood on top of everything else.

According to Lexi Loch, ND, medical educator for Wisconsin-based EuroMedica USA, there is a relationship between descending mood in the autumn and winter months and reduced mobility from increased aches and pains. She explained, “One common, but often overlooked factor, is the connection between seasonal changes in mood and increases in pain. People with seasonal affective disorder can be more likely to experience chronic pain and vice-versa, those with chronic pain may be more likely to experience seasonal affective disorder or major depressive disorder. Because mood disorders and pain can both increase sedentary behavior, this puts further stress on joints and muscles as they become deconditioned over time.”

Dayna Dye, education content writer, Life Extension, Florida pointed to a study that investigated seasonal patterns in type and frequency of phone calls to an outpatient chronic pain clinic found that winter call volume across pain conditions was more than double that of summer. Another study of men engaged in manual labor found a significantly greater prevalence of stiffness, numbness, pain in the wrist and knee joint, and pain and numbness in the foot in winter months compared to summer months.

She added, “Cold weather can reduce circulation, which causes the muscles and tendons to contract, leading to stiffness. The reduction in physical activity that often occurs when people are restricted to being indoors can also be associated with joint stiffness, since cartilage receives its nourishment through movement rather than blood circulation.”

However, Christophe Merville, D Pharm, Boiron USA, Pennsylvania noted that research about how cold weather affects joint and muscle function “is inconclusive or mixed at best, yet many people say that the pain in their joints or ache in their bones can predict [a] rainy or cold spell.”

He believes that changes in air pressure appear to be the source, and the low pressure resulting from cold air causes joints, tendons and other tissues to expand, resulting in discomfort such as cramping and spasms.

Colder months drive people inside, and thus they become more sedentary, according to Philip Wong, director of acquisition for AlgaeCal (Canada). This more easily leads to muscle stiffness. Additionally, the cold weather itself can cause muscles to contract and tighten, potentially increasing the risk of strains and discomfort.

Furthermore, reduced exposure to natural sunlight during the winter tends to result in significantly reduced levels of vitamin D, which plays a crucial role in bone health and muscle function. Inadequate vitamin D levels may contribute to muscle weakness and joint pain.

“Some experts suggest that drops in barometric pressure cause tendons, muscles and surrounding tissues to expand, putting pressure on joints,” commented Hank Cheatham, vice president, California-based Daiwa Health Development. “Others believe lower temperatures may increase the thickness of the synovial fluid that cushions the joints, slowing it down and preventing it from doing its job.”

He elaborated that as the temperatures drop, chances are many people can feel upcoming rain or snow in their joints, a common phenomenon. Although there is no commonly accepted scientific reason why cold weather makes joints feel a certain way, there are some factors that may be able to provide an explanation for why joints change when the temperature drops, and these include thickening of synovial fluid, barometric changes, heightened nerve sensitivity and lack of activity.

Creating the Conversation

It isn’t that frequently when a client/patient makes an appointment to discuss bone health, a key component of mobility. Stacey Smith, DC, marketing and communications, NORAM at Gnosis by Lesaffre (France), asserted, “Maintaining one’s mobility is paramount for those seeking to age healthily. Yet compromised bone health impacts most middle-aged adults worldwide, with osteoporosis causing millions of fractures annually.”

She added, “Bone health can and should absolutely be brought into patient conversations. In fact, if a patient is concerned about compromised cardiovascular health, especially due to intense calcification, there is a very good chance that he or she is also in the early stages of compromised bone health, which impairs mobility.”

Wong concurred that it’s true that bone health discussions are not usually at the forefront of many appointments. But it is essential for clients/patients to recognize the integral connection between bone health and mobility. Practitioners can begin this conversation by integrating bone health into broader discussions about overall well-being. He believes that one effective approach is to emphasize the preventive aspect of bone health, and that maintaining healthy bone mineral density supports an active, mobile lifestyle in later years. “Additionally, practitioners can encourage patients to ask questions about bone health during routine check-ups,” he suggested.

In Dye’s viewpoint, although osteoporosis prevention is a topic usually discussed with peri-menopausal women, bone health should be a topic with all patients, especially parents of children and teenagers as their needs for bone health nutrition are high. “Children and teenagers should be encouraged to consume foods that are high in calcium and/or vitamin D (along with vitamin K2), and to engage in regular weight-bearing and resistance exercise,” she stated.

Calcium is the top-of-mind bone supplement and still reigns as such. According to Ohad Cohen, CEO of Gadot Biochemical Industries, Israel, in 2022, calcium dominated the market and accounted for a revenue share of more than 27.7 percent. This is attributed to the growing incidence rate of osteoporosis throughout the world, especially among the female and geriatric population. As per the statistics released by the International Osteoporosis Foundation, about 8.9 million bones are fractured annually due to osteoporosis. Furthermore, the launch of new innovative products contributed to market growth.

Besides vitamin D and calcium, the two “go-to” supplements for preserving bone health, Dr. Smith emphasized a discussion about the critical role played by vitamin K2 menaquinone-7. Vitamin K2 ensures peak calcium utilization for the skeleton. It achieves this by activating the K-dependent protein osteocalcin. Research has shown that K2 may also slow bone resorption by reducing prostaglandin E2 synthesis in osteoclasts.

Dr. Smith added, “It is also worth noting that low vitamin K status has been associated with joint problems. More evidence is demonstrating that K2 has excellent potential for impacting joint health through its bone support mechanism and anti-inflammatory action.”

Vitamin K2 also increases collagen synthesis and accumulation and production by osteoblasts, she pointed out. Collagen is essential for bone flexibility and elasticity, occupying more than half the volume of bones. It is responsible for matrix production, the material on which calcium and other minerals accumulate. Therefore, collagen accumulation and bone minerals are critical for high-quality bone formation.

“Often, conversations around bone health are reserved for older populations. However, with more people becoming interested in longevity and healthy aging, discussing the role of maintaining muscle mass and bone density is imperative to people of all ages,” stated Dr. Loch.

In her practice, Dr. Loch likes to ask about current and future goals around mobility. For example, if someone is in their 20s or 30s, what kind of activities do they want to continue doing for the next several decades? She explains to patients that after age 30, we begin to lose about 3 to 8 percent of our muscle mass every decade, along with reaching peak bone mass in mid-20s.

She also inquires if her clients/patients have impediments to current activities, if so, what are they? What kind of support do patients need to increase movement? Surveys continually show that a priority goal for seniors is to maintain mobility to live independently. “These goals are strongly aligned with the need to maintain muscle mass, bone density and overall mobility,” Dr. Loch commented.

Begin by discussing exercise, suggested Céline Torres-Moon, senior scientist, Protocol For Life Balance (Illinois). Exercise is an important contributor to healthy bones and joints, even more so for older patients who might not be as active as they were when they were younger and during the winter months. “For aging individuals, a decrease in physical activity can result in muscle mass loss, bone density loss and a decrease in joint range of motion, which may trigger a loss in overall mobility and increase the risk of falls and bone fractures. Maintaining the same level of exercise year-round is important to maintain joint, bone and muscle health,” she emphasized.

Another critical factor to discuss in this area is the need for painkillers, Merville advised. Suggest a range of solutions, such as physical activity, hot or cold applications, weight loss, meditation and other lifestyle modifications to delay or reduce the need for painkillers that can induce side effects. “When the patient is able to manage their pain by other means than taking anti-inflammatory or analgesics, their perception of pain improves,” he commented. “They should use these medicines as a last resort rather than a first choice.”

During your consultation, said Brian Keenan ND, DOM, Lac, education manager for Washington-based Ayush Herbs Inc., mobility can be addressed by emphasizing the interconnectedness of the body’s systems, bones, joints and muscles as they are not isolated systems as most people tend to think.

Practitioner Edward Griffin, ND, Natural Immunogenics, Florida, related, “Bone and joint health, although rarely specifically the initial reason for a patient or client coming to see a practitioner, are an important aspect of overall health and can be an underlying cause of a deeper issue. I believe that opening up a conversation about any health-related topic starts with being prepared. As a practitioner you have spent many years studying and learning about general and specific health concerns, and you already know more information than most of your patients.”

Product Considerations

Daiwa Joint Health is a new product that Cheatham said is designed to be effective with traditional treatments or to be used as an alternative therapy. Univestin, the active ingredient in Daiwa Joint Health, relieves joint discomfort and stiffness through a multi-pronged mechanism of action (MOA), he reported. “Daiwa Joint Health modulates multiple reactions at once, helping to prevent joint problems from escalating. As a result, processes that cause joint discomfort are neutralized more rapidly, and some are prevented all together.”

Univestin is a proprietary complex derived from Scutellaris baicalensis, an herb used in traditional Chinese medicine and shown to maintain healthy joints; and Acacia catechu, from ayurvedic medicine, demonstrated to manage inflammation.

According to Cheatham, studies have been conducted evaluating the efficacy of Univestin compared to Celebrex and Naproxen. The results revealed that Univestin is more effective than Celebrex in providing relief of stiffness and impaired function. Use of Univestin and Naproxen improved all WOMAC parameters. Results showed reduction in joint pain within five days for both Univestin and Naproxen, joint stiffness within three days for Univestin (five days for Naproxen), joint function within seven days for each, and range of motion improvement in seven days for Univestin but not for Naproxen. There was also greater improvement in the six-minute walk test with Univestin than with Naproxen.

Homeopathy provides numerous single medicines to address joint or muscle pain. According to Merville, the most popular is Arnica montana, which has been used extensively for years in all types of traumas, from minor bruises to muscle aches and sprains. He explained, for muscle or joint pain that is improved by rest, bryonia is ideal. However, Rhus tox can be used instead when pain and stiffness are improved by motion. Hypericum perforatum, the homeopathic preparation of St. John’s wort, can provide relief of sharp pain that follows the nerve’s path. Dulcamara is essential for joint pain triggered or worsened by dampness. For bone pain (bone trauma or bone pain associated with the flu), Eupatorium perfoliatum 6C is the medicine of choice.

“All of these active ingredients are combined, with several others, in Boiron Arnicare Arthritis Tablets,” he said. The sublingual tablets work best when taken at the onset of pain flares or when the weather changes unfavorably.

New for arthritis relief is Boiron’s Arnicare Arthritis Cream, a topical treatment offering relief for minor joint pain, muscle pain and stiffness. Merville pointed out that it is one of the first arthritis topical medicines containing harpagophytum available in the U.S. Harpagophytum (also called devil’s claw), relieves joint discomfort and stiffness associated with arthritis pain. It can be recommended as a complement to Arnicare Arthritis Tablets.

Protocol for Life Balance’s flagship product in the mobility support category is Ache Action a blend of three standardized botanical extracts—willow bark, ginger root and AprèsFlex, a clinically evaluated Boswellia serrata extract. AprèsFlex has been shown to alleviate temporary minor knee pain as early as five days and for up to 90 days when taken at the daily dose of 100 mg, according to Torres-Moon.

Protocol For Life’s D-Flame was also designed to relieve occasional minor aches and pains due to overexertion, and contains a blend of holy basil, turmeric, ginger, green tea, boswellia, Baikal skullcap, resveratrol from Polygonum cuspidatum and berberine from Berberis aristata.

Protocol For Life’s Bone Support Formula provides 1 g protein per serving, including microcrystalline hydroxyapatite and a balanced blend of vitamins such as D and K2, and minerals recognized for their bone health supporting properties. She noted, “We have a dozen products with vitamin D alone or in combination with vitamin K2 as menaquinone-4 or menaquinone-7.”

Ayush’s Boswelya Plus features the herb boswellia, which Dr. Keenan noted has been studied repeatedly for supporting healthy joints as well as promoting overall comfort, combined with glucosamine and chondroitin along with ginger, ashwagandha and turmeric extracts.

For topical relief, Ayush offers narayan oil, a traditional ayurvedic oil preparation designed specifically to warm and ease tired joints and muscles. “It is a perfect addition for topical support of aging joints as well as for athletes and those just getting back into the world of exercise,” he commented.

“One of my favorite combinations for pain and inflammation is curcumin with turmeric essential oil, boswellia, DLPA and nattokinase,” Dr. Loch related. “These ingredients support acute and chronic pain conditions, plus have a much better safety profile than over-the-counter pain relievers.”

Life Extension’s Fast Acting Relief provides noticeable relief for discomfort in bones, joints and muscles. It features Rhuleave-K, a combination of turmeric, boswellia and black sesame extracts was shown in clinical trials to help relieve the kind of minor discomforts everyone occasionally experiences, according to Dye. “Effective by themselves, when combined these extracts provide even more impressive results,” she said. “The combination quickly promotes comfort in muscle tissue, bones, joints and ligaments by helping to support a healthy inflammatory response and muscle and joint health.”

Mobilizing Minerals

Minerals should be a key part of the mobility conversation as, according to Cohen, there are reasons why Americans don’t obtain enough—mineral-depleted soils, lack of awareness and poor diet choices. “Calcium and magnesium are two main minerals in the human body that are essential for preventing osteoporosis,” he stated. “When combined in the right ratio with magnesium, the body can absorb calcium without causing adverse side effects.”

Gadot’s Cal2Mg is a composition of calcium citrate and magnesium citrate, which is produced with a unique granulation process. There are various calcium and magnesium mineral sources, but citrates have an added value and is highly absorbable. Citrates are the only form of mineral salts that support the reduction of kidney stones and absorption is independent of the timing (before/after meal.) Each 1 gram of Cal2Mg contains 100 mg calcium and 50 mg magnesium citrates (10 percent RDA of calcium and 14 percent of the RDA of magnesium.)

Ayush’s newest supplement revolves around calcium. Calcium + CoFactors, is a mineral blend of algae-derived calcium with bone matrix-supporting zinc, boron and strontium, plus vitamin D. “What makes Calcium + Cofactors particularly unique is the inclusion of the herb Winged Treebine extract (Cissus quadrangularis) which has been used traditionally in ayurveda for bone health,” Dr. Keenan said. “Today, there are human trials looking at this herb for supporting post-menopausal women as well as promoting healthy weight maintenance.”

Life Extension’s Bone Restore Elite has four forms of calcium and other minerals needed by the bones. It also provides significant doses of vitamins D and K2 (1,000 IU and 45 mg), which are needed for calcium absorption. Bone Restore Elite is in a vegetable cellulose capsule.

Another key mineral for the connective tissues is silica, pointed out Dr. Loch. Silica is necessary to produce collagen, a major component of all connective tissues. “Silica also helps deliver calcium to the bones and assists the osteoblasts in helping to mineralize bone,” she explained. “One of the richest plant-sources of silica is from the aerial portions of horsetail (Equisetum arvense). In one type of extraction process, the silica remains attached to the bioflavonoids, while the thiaminase and large crystals are filtered out. This yields a plant-based silica that is easy to absorb and very effective.”

According to Dr. Loch, clinical research has found that this unique form of silica increased the growth of collagen by more than 50 percent, which helps provide the structural support for bone mineralization. A double-blind, placebo-controlled study involving 65 postmenopausal women investigated the use of silica for bone mineralization. This 12-month study looked at silica’s impacts on the biomarker C-terminal telopeptide of type 1 collagen (CTX). The results demonstrated that silica supplementation decreased CTX activity, indicating a reduction in bone resorption.

Another mineral that Dr. Loch said is a critical part of a bone-building protocol is strontium, necessary for bone density. She cited a 2017 double-blind, randomized, controlled trial evaluated the effects of melatonin, strontium citrate, vitamins D3 and K2 on bone mineral density in postmenopausal women with osteopenia. The supplement group experienced increases in their bone mineral density in lumbar spine and femoral neck.

“Other research has found that strontium citrate (680 mg per day) in combination with DHA, vitamins D3 and K2, plus magnesium have been found to be as effective as bisphosphonates and strontium ranelate for osteoporosis,” she reported.

AlgaeCal’s AlgaeCal Plus and Strontium Boost are the result of a human study involving more than 200 adult participants and published in Nutrition Journal, according to Wong. The study found that AlgaeCal increased bone density by more than 2 percent on average. “To put this into perspective, it’s an unusual and noteworthy finding, considering that humans typically experience a gradual decline in bone density of approximately 1 percent per year after the age of 40,” he remarked.

In this open-label study, participants’ bone density was measured at the beginning, and again after six months of taking AlgaeCal formulations, which included strontium for comprehensive bone support, he reported. The primary outcome measure was bone mineral density (BMD), and a secondary measure involved an extensive panel of 43 blood tests to assess safety, along with a quality-of-life questionnaire.

“What sets this study apart is that it demonstrates a genuine increase in BMD, rather than the more common reporting of ‘increased bone density’ seen in many calcium studies,” commented Wong. “In those cases, the increase is relative to a placebo group that is experiencing bone loss. However, with AlgaeCal, the participants not only stopped bone loss but experienced a remarkable increase in BMD.”

Copper is a lesser-known mineral to discuss with clients/patients about mobility maintenance and support, according to Dr. Griffin, who noted that copper supports strong cartilage and flexible connective tissue. Without copper, the body cannot absorb iron – and both iron and copper are needed for the formation of healthy red blood cells, which supports bone structure by optimizing oxygen utilization and transport.

When movement doesn’t cause any pain or discomfort, clients/patients aren’t aware that they may need to support their joints, bones and muscles so that they can keep moving without saying “ouch.”

Healthy Take Aways

• Cold weather can reduce circulation, which causes the muscles and tendons to contract, leading to stiffness.
• Some experts suggest that drops in barometric pressure cause tendons, muscles and surrounding tissues to expand, putting pressure on joints.
• More evidence is demonstrating that K2 has excellent potential for impacting joint health through its bone support mechanism and anti-inflammatory action.
• After age 30, we begin to lose about 3 to 8 percent of our muscle mass every decade, along with reaching peak bone mass in mid-20s.
• When combined in the right ratio with magnesium, the body can absorb calcium without causing adverse side effects.
• Silica also helps deliver calcium to the bones and assists the osteoblasts in helping to mineralize bone.
• Both iron and copper are needed for the formation of healthy red blood cells, which supports bone structure by optimizing oxygen utilization and transport.

For More Information:

AlgaeCal, www.algaecal.com
Ayush Herbs Inc., https://ayush.com
Boiron USA, www.boironusa.com
Daiwa Health Development, www.dhdmed.com
Gadot Biochemical Industries, www.gadotbio.com
Gnosis by Lesaffre, www.menaq7.com
EuroMedica USA, www.euromedicausa.com
Life Extension, www.lifeextension.com
Natural Immunogenics, www.argentyn23.com/soveriegn-copper
Protocol For Life Balance, www.protocolforlife.com