Bone and joint health has nothing to do with age or sex, but everything to do with steering patients toward healthy choices and hands-on treatment.
At the heart—or the marrow— of bone and joint health is that it doesn’t discriminate because of age. Practitioners know that. The general populace doesn’t realize that their skeletons are under constant attack, or that they are responsible for the damage.
“Degenerative bone and joint diseases such as osteoporosis and osteoarthritis are on the rise for both men and women, and are striking younger populations,” said Isaac Eliaz, MD, Lac, medical director of Amitabha Clinic in Santa Rosa, CA. “Toxins, immune imbalances, an acid-forming diet, sedentary lifestyle, obesity/metabolic syndrome, pharmaceutical drugs and many other unhealthy assaults are contributing to this emerging epidemic.”
Alberto Galdamez, director of sales for Nevada-based Coral, LLC, isn’t so sure diet can help anymore. “Due to poor unsustainable farming practices and pesticides in our crops and farmland, we now have few minerals in our contaminated soils,” he said. “This poor nutrition coupled with unhealthy lifestyles results in bone and joint issues, among other problems, and seems to be a growing concern.”
People are not eating foods with “bonehealthy” protein and minerals and are also consuming too much sugar, further contributing to deteriorating bone health, said Dave Barton, director of education at Florida-based Enzyme Science. Or they’re eating too much—of pretty much everything. “People carrying excess weight are far more likely to develop joint issues than those with a normal BMI, and two-thirds of Americans are overweight,” observed Gerard McIntee, president of Patient One MediNutritionals in New York.
In short, Americans will pay for their bad choices with their health. According to the Centers for Disease Control and Prevention (CDC) website on arthritis-related statistics, more than 294,000 children under the age of 18 have some form of arthritis or rheumatic condition. By 2030, an estimated 67 million Americans aged 18 years or older are projected to have doctor-diagnosed arthritis. Right now, the CDC revealed that “an estimated 50 million adults in the United States reported being told by a doctor that they have some form of arthritis, rheumatoid arthritis, gout, lupus or fibromyalgia.”1
“The aging demographic and the poor diet consumed by many people in North America is contributing to a rising need for bone health formulas,” said Jolie Root, nutritionist and educator for Illinois-based Carlson Labs. “The target market is really the entire adolescent and adult population of North America.”
Dr. Eliaz pointed out that “like so many other chronic illnesses and conditions, poor joint and bone health can be attributed to an unhealthy diet, lack of exercise and chronic stress.” Practitioners must have their patients take a step back, examine their choices and commit to change.
Taking a supplement is a good start. That is, if practitioner and patient can figure out what to take.
There is No Silver Bullet
Glucosamine may be “an oldie but a goodie,” according to Dr. Adam Killpartrick, DC, but he’s found with his own patients and talking to others in the field that glucosamine/ chondroitin formulas have a 50 to 60 percent success rate with joint issues. The chiropractor has also had mixed results with another classic, hyaluronic acid.
“I think anybody who has treated a patient with joint pain, knows there is no silver bullet,” said Dr. Killpartrick, a Natural Practitioner advisory board member who has a private practice in Pittsfield, NH.
Practitioners and manufacturers still have their favorites, be they old or new. Dr. Killpartrick said he believes people usually don’t get enough magnesium in their diet. “Magnesium works to relax the muscles [and] optimize the calcium/magnesium ratio, which is ideal for better muscle function.” Along with magnesium, he added, calcium (ideally from green leafy vegetables) and vitamins D and K2 supports a healthy bone metabolism.
Dr. Eliaz is a longtime advocate of modified citrus pectin (MCP), which he describes as “a special form of pectin modified for enhanced absorption and activity throughout the body.” MCP’s notable function is that it blocks the protein galectin-3.
“Studies show that blocking galectin-3 halts and reverses the degenerative processes of chronic inflammation and fibrosis throughout the body, helping to relieve joint pain and stiffness,” Dr. Eliaz explained. “I’ve been using MCP in my clinical practice for decades, and early on, I was amazed at how quickly MCP reduced joint pain in patients.” He also suggested the botanical extract honokiol (derived from magnolia tree bark), which controls “chronic and acute inflammation.”
“Recent research shows that honokiol also supports bone health by promoting the actions of osteoblasts, the cells which build bone tissue, and controlling the actions of osteoclasts, the cells which break down bone tissue,” Dr. Eliaz said. “Because of these inflammation-reducing, bone-building effects, honokiol may be very useful against osteoporosis and related conditions.” According to Dr. Eliaz, inflammation is one problem that, if left untreated, is alleviated by the body “leach[ing] essential minerals from bone tissue.”
For patients to reap the aforementioned benefits, a key element must be addressed.
“There also seems to be a very strong connection between digestive integrity, or lack thereof, and joint issues,” said Dr. Killpartrick, who makes sure his patients’ digestion is optimal. “And when it comes to bone metabolism and absorbing the nutrients necessary for optimal bone density, digestion is key, particularly in the upper digestive tract. Adequate Hcl levels are vital to the absorption of key minerals such as calcium, magnesium and zinc.”
Diet can help. “I recommend a lowglycemic, alkalizing diet, which emphasizes fresh vegetables and minimizes acid-forming foods such as sugars, dairy, cooked oils, red meat and alcohol, and any processed foods,” Dr. Eliaz said. “An alkalizing diet emphasizes whole, nutrient-dense, plant-based foods, which help detoxify the body and reduce acid build-up; nourish bones, joints, muscles and tissues; and address chronic inflammation.”
Manufacturers have ingredients they favor as well, but those favorites are increasingly surrounded by other all-stars. Every company interviewed for this article promoted products that featured an ensemble approach.
Star Ingredients Share the Spotlight
A fine example is Patient One’s OsteoOne, described by McIntee as “a multi-faceted bone support formula,” which has eight ingredients, five of them trademarked. Among the highlights: TRAACS manganese, vitamin D3 (as cholecalciferol) and VitaMK7 vitamin K2. “When combined with vitamin D, the menaquinone-7 form of vitamin K2 has been shown to promote bone growth,” McIntee said. “It also inhibits the production of osteoclasts, which break down bone.”
Patient One also offers RheumActive, “a unique, highly researched blend of ingredients known for their anti-inflammatory and joint-supporting properties,” said McIntee. The product doesn’t have quite the ingredient diversity: five trademarked ingredients and two standardized ingredients for optimal absorption. Among those making the cut is NEM (natural eggshell membrane), which shows “properties that control cytokine production and modulate the signaling of leukocyte activation,” he added.
Vitamin K2 is also a main component of Carlson Laboratories’ Nutra-Support Bone, which offers magnesium, zinc, boron and what Root called “a highly absorbable glycinate chelated dose of 1,000 mg of calcium a day.” Nutra-Support Bone’s key ingredient is 2,000 IU of vitamin D3—the most active form of vitamin D, according to Root.
“A recent study found that low vitamin D levels increased the risk of hip fracture in older patients, according to research published in the Journal of Clinical Endocrinology & Metabolism,” Root added. “The study revealed that patients with the lowest vitamin D levels (<17 ng/ml) had a 38 percent increased risk of hip fracture compared to those with the highest levels (>27 ng/ml). The authors noted a preventative effect with levels above 30 ng/ml compared with levels below 20 ng/ml. The study was the largest cohort type study to find an increased risk of hip fracture with low vitamin D levels.”2
Root also cited a study last summer in the New England Journal of Medicine where higher does of vitamin D, in this case 800 to 200 IU, prevented fractures.3
Ateevia PRIME from New Jersey-based Ateevia Botanica is a topical cream containing a blend of organic ingredients with antiinflammatory markers. This includes borage, a major source of gamma linolenic acid, which decreases the secretion of inflammatory markers, and pumpkin, said Ronit Arginteanu, the company’s counsel. The latter is high in betacarotene and omega-3 and omega-6 fatty acids. “Besides being a natural anti-inflammatory, omega-3 also acts as a component of the fluid that lubricates joints from the inside out,” said Arginteanu.
The ingredient profile isn’t the only aspect Ateevia Botanica wants to trumpet.
“The cream is brown, not an overprocessed white lotion, because we do not use heat or alcohol in our production process,” Arginteanu stressed. “Our extractions from any one of our raw sources typically contains novel, structurally diverse chemical compounds, of which the natural environment is a rich source. We take pains to protect these natural compounds so as to preserve them as the powerful biochemical storehouses of vital phytonutrients that they are. If they are processed too much, they will not be compelling in fighting inflammatory activity, because the essential anti-inflammatory nutrients— such as antioxidants, flavonoids, lignans, as well as oleic and linolenic acids—will not work.”
Joint health products are typically formulated with two goals in mind, said Coral LLC’s Galdamez: maintain bone health in people already suffering from joint problems or trigger an immune response to “detrimental situations to bone health.” The company decided to broaden the audience with its Coral Joint & Collagen Support, and that meant offering more than its usual coral minerals.
Galdamez detailed the ingredients. In addition to the above-thesea EcoSafe coral minerals, it also includes vitamins D3, K1 and K2 to support healthy bones. GreenGrow, a vegetable source glucosamine, along with PUREFLEX Chondroitin and MSM, helps support healthy joints and flexibility. Undenatured Bio-Collagen UC-II promotes an immune response when joints are exposed to “extreme conditions” ranging from “athletes during extreme physical workouts” to “those who spend long hours with little body movement” such as the deskor cubicle-bound, Galdamez said. Finally, betaine HCL, calcium ascorbate and malic acid—acids naturally produced by the digestive system—help “maintain proper nutrient absorption.”
Enzyme Science’s Flex-Mend is a “unique blend of concentrated plant and plantbased enzymes [e.g., bromelain, papain, nattokinase, etc.] and the antioxidant properties of rutin,” according to the company. The product sets its sights on fibrin, a protein produced by the blood in response to inflammation.
“The protein is essential to stop excess blood loss in the event of bodily trauma or injury,” according to Flex-Mend’s spec sheet. “Excessive inflammation due to injury may encourage cross-linked fibrin to circulate through the bloodstream and stick to the walls of blood vessels. The nattokinase enzyme blend in Flex-Mend supports healthy circulation by breaking down fibrin and helping to increase antioxidant activity.” In addition, bromelain (from pineapple) and papain (from papaya) boast “an established history for supporting healthy inflammation, circulation and repair.”
Let’s Get Physical
While supplements play a role in bone and join health, it is not the lead role.
Dr. Killpartrick said most patients don’t look at bone or joint health as a physical issue. “People seek out a chemical solution,” he said, referring to pills, over-the-counter medicines and even supplements. “I think people are looking for an easy, chemical solution they can take with a glass of water and be done with it. I think that’s a huge issue because the structural issues are being ignored.”
That, in turn, could worsen the problem. Relying on the “just take something” mentality camouflages the issue or down-regulates the problem, said Dr. Killpartrick. And since “your body works very hard to compensate physically for pain,” he observed, the body can ultimately set itself up for more chronic joint degeneration.
So, what are the options?
“Acupuncture can be helpful for increasing circulation to clear inflammatory blockages and reduce painful nerve impulses,” Dr. Eliaz said. “Cranio-sacral therapy is another system of manual therapy where bones, ligaments, joints and connective tissues are softly manipulated with slow, gentle movements, bringing more circulation to the affected area and releasing points of tension. Micro-current therapy, using tiny electrical pulses that produce a tingling sensation, can also help by stimulating cell growth and regeneration in tissues, joints and bones.”
If practitioners cannot offer these treatments to their patients, who may be apprehensive about what’s involved, they should answer their questions and give a thorough description of services provided by other practices.
“The door swings both ways in this regard as chiropractors should be educating themselves on the health care providers in their community as well,” Dr. Killpartrick said. “And relative to methods of treatment, chiropractic approaches can vary dramatically from office to office. While some chiropractors adjust with high-velocity adjustments to various segments of the spine, others may specialize in gentler, more delicate adjusting techniques that would be more beneficial for someone with a sensitive constitution. It’s important to be able to make that distinction and refer a patient to the most fitting practitioner.
“If a primary health care provider is able to accurately and appropriately recommend the most fitting chiropractor, that goes a long way to putting the patient’s mind at ease,” he added.
Once a patient visits his practice, Dr. Killpartrick employs a simple plan to ensure compliance. He feels an honest approach makes its way to the patient. “If it’s not working, they feel they can come to you,” he said. “That cuts down on miscommunication, wasted effort, wasted energy and wasted treatments.”
Second, Dr. Killpartrick makes treatment realistic from a physical and financial standpoint. “You can’t put a plan in front of anyone that is not achievable,” he said.
Finally, there’s communication and monitoring. People who are limited by a pain or dysfunction can forget they had restrictions, Dr. Killpartrick said. It’s up to the practitioner to remind them of just how big the little accomplishments of daily life are, like the 95-year-old who can finally put a dish away without succumbing to pain.
Like most issues addressed by supplementation, bone and joint health is about changing a lifestyle. As part of his work with patients with bone and join problems, Dr. Eliaz teaches simple meditation and mind-body therapies. It’s about “supporting them on their path to optimal health and wellness.”
1 www.cdc.gov/arthritis/data_statistics/arthritis_ related_stats.htm.
2 Holvik K, et al. Low serum levels of 25-hydroxyvitamin D predict hip fracture in the elderly. A NOREPOS study. Journal of Clinical Endocrinology & Metabolism. 2013.
3 A pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med. 2012;367:40-9.
Healthy Take Aways
■ By 2030, an estimated 67 million Americans ages 18 years or older are projected to have doctor-diagnosed arthritis.
■ A large number of bone and joint health supplements feature a combination of well-researched ingredients, including vitamin K2, enzymes, chondroitin and glucosamine.
■ When treating joint pain, physical treatment (e.g., acupuncture and chiropractic) may be necessary for a patient if improved diet and supplementation don’t work.
■ Practitioners must familiarize themselves with the quality professional peers (and their methods) in their community, so they can confidently make recommendations to their patients.
FOR MORE INFORMATION:
■ Ateevia Botanica, (888) 783-6083, www.ateevia.com
■ Carlson Laboratories, (800) 323-4141, www.carlsonlabs.com
■ Coral, LLC, (800) 882-9577, www.coralcalcium.com
■ Enzyme Science, (855) 281-7246, www.enzymescience.com
■ PatientOne MediNutritionals, (877) 723-0777, www.patientoneformulas.com
Bone and joint health has nothing to do with age or sex, but everything to do with steering patients toward healthy choices and hands-on treatment.