Tag Archives: Arthritis

Case study: B12 deficiency, rapid weight loss, protein in the urine, osteoarthritis, elevated vitamin D

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Just last week, a friend of mine wrote me this:

My mom has not been well.  Not eating well, massive head ache, lost a lot of weight.  Blood test results yesterday showed that she’s B12 deficient;  urine, however, has too much protein.  Any idea why?

I suppose, since he asked me, it most likely meant her MD didn’t offer an explanation for the test results.  One this is sure, neither she nor he knew what to do.  My feeling is that he asked just in case I knew anything that could help. And I did. So, I did.

Let’s go through the analysis together:

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Is it normal to have protein in the urine?  What is supposed to be excreted in the urine?  What organ regulates what goes and what doesn’t go into the urine?  Under what circumstances would protein end up in the urine?

From a biological standpoint protein is precious.  From an evolutionary standpoint protein is hard to come by and hence relatively rare.  Therefore, the body has evolved to use and keep as much protein as it can.  The urine is intended to excrete uric acid, which is the main acid produced by metabolic processes.  Urine is excreted through the urethra, it is stored in the bladder, and it is produced by the kidneys, which filter the acids out of the blood.  The kidneys try to prevent large molecules like amino acids and glucose from going through into the urine.  The solids in the blood are separated from the water, the acid is filtered out of it, and depending on the state of hydration, more or less water is used to make urine or returned back to the blood.  The only circumstances under which protein would end up in the urine are 1) that the kidneys are not working properly, and unable to filter the protein out of the blood, 2) that there is a serious excess of protein in the blood, or 3) that there is both kidney dysfunction and excess amino acids in the blood.  We’ve explored kidney function in great detail before in The kidney: evolutionary marvel, and this understanding comes from there.

This means we already know that his mom either has kidney disease, that there is too much protein in the blood, or both.  But he wrote that she had lost a lot of weight.  Losing weight can be due to fat loss, muscle loss, or both.  Usually, very rapid weight loss in the elderly is not voluntary, and almost always means rapid loss of fat and muscle.  Therefore, for sure, the protein in the urine was the result of a the fast weight loss with rapid breakdown of muscle tissue.

But why?  Why would she all of a sudden start losing weight so fast?  What could have happened or triggered this?

Well, he also wrote that she was found to be B12 deficient.  And if this was recognized by the conventional MD who ordered the tests, you can be sure B12 levels were very low: surely below 200 pg/ml.

Do we become B12 deficient all of a sudden?  Or do B12 levels decrease slowly and gradually over the years?  Can we even become B12 deficient all of a sudden?  Why do we become B12 deficient in the first place?  And why is B12 important and relevant in this case?

It is possible to become B12 deficient all of a sudden.  This happens when our levels are marginally acceptable to start, and we receive a large dose of an anesthetic, before a surgery, for example.  Anaesthetic drugs deplete B12; and the larger the dose, the more severe the depletion.  But this is certainly not the majority of cases.

Most of the time, B12 levels decrease slowly and gradually over the years,  either from inadequate intake, or from compromised digestion.  In the younger population, it is usually from inadequate intake—as is the case for vegans and vegetarians.  In older adults, it is usually from compromised digestion—as is the case from the middle aged to the elderly, generally from a damaged gut and stomach cells that do not produce enough hydrochloric acid needed to break down the protein we eat.

As some of you will remember, we’ve also explored the importance and functions of vitamin B12 in B12: your life depends on it and more recently in Case Study: Homocysteine, B12, and folate.  Vitamin B12 is most important for its role in the nervous system: for healthy nerves and proper brain function.  But it is also an important anabolic nutrient essential in building and preserving muscle tissue.  Bodybuilders everywhere have been taking B12 supplements for at least 4 decades, exactly because it’s a potent natural anabolic.

Therefore, here is where our analysis leads us:

The most probable explanation is that his mother has been growing more and more deficient over the years, a B12 deficiency developed over several decades that just recently reached critically low levels. This triggered rapid weight loss that caused both the loss of body fat stores and the breakdown of muscle tissue.  The fat loss released streams of toxins that have been accumulating in the fat cells over years and years, and which caused the massive head aches from which she was complaining.  The muscle loss, the rapid breakdown of muscle tissue due to the extreme B12 deficiency, caused the kidneys to be overwhelmed and become unable to keep all these amino acids in circulation, and the protein therefore spilled into the urine.

My recommendation: B12 shots of 1 mg once a week for 10 weeks, and then of 5 mg once a month for the rest of her life.

 

The story doesn’t end here.  It turns out that she has osteoarthritis and she’s in pain.  Some time ago some friends of hers recommended taking vitamin D supplements, and so she did.  When she got her blood test done, her 25-OH-D was through the roof at 127 ng/ml.  If you’ve read our last post on vitamin K2 you will know that this is possibly the worst thing that someone with arthritis can do: high levels of D without correspondingly high levels of K2 will accelerate soft tissue calcification.  And since osteoarthritis is a disease of calcification, it will make everything much worse than it already is.  Naturally, I immediately recommend she stop taking vitamin D and start taking large doses of vitamin K2 as soon as possible, before something more serious like a stroke or a heart attack happens.

He sent me the blood tests, which I examined to get a better picture.  Interestingly, few markers were out of the reference ranges.  This is probably why nobody said anything other than to point out the obvious abnormalities: low B12, high D, and protein in the urine.

But in addition, what could be seen was that both urea and creatinine were near the top of their range, which is expected from rapid weight (muscle) loss, and the eGFR (the estimated glomerular filtration rate) was at the low end of the reference range, which is expected from compromised kidney function given the protein in the urine.  C-reactive protein was high but not super high.  This signals system inflammation, and is naturally excepted for someone with arthritis, as we also have seen together in the past (https://healthfully.net/category/arthritis/).  Lastly, calcium was also high, but nevertheless within the reference range, something we would expected for someone with high D and not enough K2.

 

I asked if she was taking medications, and she was.  Several different drugs among which were a statin drug to lower cholesterol, a malaria drug used to treat symptoms of arthritis, and a couple of high blood pressure drugs one that is a diuretic and forces the kidneys to excrete more water, and the other that is an angiotensin antagonist that blocks the hormone which tells the kidneys to retain water when hydration is inadequate.  I replayed my view that drugs typically always attempt to block some pathway, and prevent the body from doing something that it naturally does to protect itself.  And in this case, she should wean herself off all of these over a few weeks.

I also explained that one of the most serious side effects of statin drugs is that they cause muscle wasting, promoting muscle tissue breakdown.  Statins do this in everyone, but in the elderly who already have accelerated muscle breakdown, it can be very serious.

My final recommendations, beside coming off the various drugs gradually to avoid a shock to the body, were as simple as possible for an old woman to follow: high dose B12 shots, high dose K2 pills, and high dose Mg as L-threonate, plenty of water and salt each day, a low carb diet rich in animal fats and green veggies, and sodium bicarbonate in water first thing in the morning on an empty stomach.  We’ll see what happens.

 

Blood tests can be used very effectively as a window onto the inner environment of the body.  MDs tend to only pay attention to the markers outside the reference range that appear in bold on the print outs.  But the reference range is derived from the blood tests of the whole population, and the population is far from being optimally healthy, that’s for sure.  What we need are not reference ranges derived from a sickly population, but an understanding of how the body works, what its organs and systems are trying to do, and with that understanding, of what our blood markers should be … ideally. What they should be in the best possible case.

That’s what we have to aim for.  And that’s what we have to learn to do, because we certainly can’t rely on your average MD to help us in this.  If you are an MD, and you are reading this, you already know that you are not your average MD, and I’m pretty confident you also know that your patients are lucky to have you.

 

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Reversing calcification and the miracle of vitamin K2

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Vitamin K2 is the only known substance that can stop and reverse soft tissue calcification.

If you didn’t stop at the end of that sentence to say Wow to yourself, you should keep reading.

Soft tissue calcification is one of the most serious health problems we face as individuals, as modern societies, and, on a global scale, as a species.  Cardiovascular disease—which leads to heart attacks and strokes, and accounts for nearly half of all deaths in industrialised countries—is a disease of soft tissue calcification: the calcification of our arteries.

Arthritis, of which basically everyone past the age of 40 suffers, and increasingly more with time and with age, is a disease of soft tissue calcification.  It is caused by the calcification of the cartilage in the joints:  the joints of the knees, but also of the shoulders; the joints of the hips, but also of the wrists; the joints of the elbows, but also of the feet and the toes; the cartilage between the vertebrae of the neck and the spine all the way down the back, but also of the hands and of the fingers.

Soft tissue calcification also causes kidney stones and kidney disease.  How many people above the age of 60 don’t have kidney problems?  Hardly any.  And how many young men and women in their 20s and 30s already have kidney stones and kidney dysfunction?  More and more every year.

Every one of the processes generally associated with ageing, from heart disease and stroke, to Alzheimer’s and dementia, to arthritis and kidney disease, to stiffness in the joints and muscles, but also to the wrinkling of the skin, is intimately linked to soft tissue calcification.

And now, let me repeat the sentence with which we opened:  Vitamin K2 is the only known substance that can stop and reverse soft tissue calcification.  It is really remarkable.

Maybe you didn’t know about calcification.  And so, maybe you are wondering why it is such a major and widespread problem, why it affects everyone no matter where we are or what we do.  It’s a good question.  But because we know that only vitamin K2 can prevent this from happening, we already have our answer:  soft tissue calcification is a major and widespread problem because our intake of vitamin K2 is inadequate to provide protection from calcification.

Naturally, the next question is why?  Why is our intake of vitamin K2 so inadequate?  If it is such a crucial essential nutrient, we would surely not be here as a species if intake had always been so inadequate.  Looking at things the other way around, if we are so dependent on adequate K2 intake for staying healthy, this must necessarily mean that we evolved having plenty of it in our food supply.  What’s so different now?

To answer this question with some level of detail—meaning with an explanation more extensive than just saying that it’s industrialisation that stripped our food supply of vitamin K2 as it has for all the essential nutrients to a greater or lesser extent—we have to understand what K2 is, how it’s made, and where it’s found in food.

The short answer is that K2 is found in the fat of pastured animals that graze on fresh green grass, and produced from vitamin K1 by certain kinds of bacteria in their gut.

The longer answer is that vitamin K2 is a family of compounds called menaquinones, ranging from MK-4 to MK-13 depending on their molecular structure.  These compounds are derived from the plant analog, the sister compound, vitamin K1, called phylloquinone, and found in chlorophyll-rich plant foods.  Phylloquinone is consumed by the pastured animal, it makes its way into their intestines, and there it is transformed by the bacteria of the animal’s intestinal flora.  The resulting menaquinone is then stored in the fat cells of the animal as well as in the fat of their milk if they are milk-producing.  Consuming these animal fats in which vitamin K2 has been concentrated will provide this precious essential micronutrient.

If the grazing animal does not feed on green grass, they get no vitamin K1.  If they get no vitamin K1, their gut flora is not only compromised and negatively altered with respect to what it should be if they were consuming the grass they have evolved eating, but it produces no vitamin K2.  If their gut flora produces no vitamin K2, their fat and milk will contain no vitamin K2, and neither their offspring nor any person consuming products derived from the animal will get any vitamin K2.  Hence, no grass feeding, no vitamin K2 in the animal’s fat.

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It is most natural that grass-eating animals should be grazing on fresh green grass in open pastures.  And yet, it is rather rare.  But without green grass, there is no vitamin K1.  And without vitamin K1 there can be no vitamin K2.

Maybe you’ve already thought ahead, and wondered since it is bacteria that produces vitamin K2 from vitamin K1 in the guts of grazing animals, can’t we make vitamin K2 without the need for grass-fed animals to do it for us?  Yes, it is possible.  Fermented vegetables and dairy products like cheese can also contain vitamin K2.  In fact, in the case of cheese, there is a lot more in the finished hard cheese than in the milk used to make it.  The amount varies widely because it depends on the kind of bacteria.  For dairy products, hard cheeses like Gouda have the most, and for plant foods, even if fermented veggies have a little, the Japanese fermented soybean snack natto is the ultimate source of K2.

As we all know, pastured meat and dairy is not easy to come by in our modern world.  It’s actually quite hard to find.  Our supermarkets and food stores are flooded with industrially produced meat and dairy from animals that have never seen a blade of grass—grass-grazing animals living their entire lives indoors, in stalls, fed and fattened exclusively on grains, corn, and soybeans.  This is how we have stripped our food supply of vitamin K2, and this is why is this a modern phenomenon—most of our grand-parents were still eating pastured meats and animal foods.

And if this wasn’t enough of a blow to vitamin K2 status, trans-fats, which are formed when vegetable oils are hydrogenated to be made saturated and stable (for long shelf life), and which most of us consume in great quantities, contain a K2 analog called DHP (dihydrophylloquinone) that displaces the little K2 that might has found its way into our diet.

It is for all these reasons that soft tissue calcification is so widespread.  And you have at this point what you need to know in order to first stop the process by which your soft tissues are getting increasingly calcified, and then, in time, to remove the accumulated calcium from these tissues.  It’s simple: healthy grass-fed animals produce yellow butter, yellow yolks, and yellowish fat;  you need to eat plenty of pastured animal foods, making sure you eat the fat in which vitamin K2 is concentrated, and, to be sure you have enough to reverse the already present calcification, take K2 supplements.  And this might be enough for you.

If it is, you can head to your browser to find and order some K2 supplements (I currently get mine, it’s a 500 mcg per tablet, from Phoenix Nutrition).  Also, we need to know that the two main forms of K2 are MK-4 (with four double bonds) and MK-7 (with seven).  The first is the one generally found in animal fats that haven’t been fermented, while the second is the product of bacterial fermentation.  Hence, meat and butter contain mostly MK-4, whereas natto, sauerkraut, and cheese contain mostly MK-7.

There is an important difference between these two forms of K2 in terms of their effects inside the body which has to do with their half-life, not in the sense of radioactivity, but in the sense of duration of biological activity in the body.  MK-4 will be in circulation at therapeutic doses for a number of hours, while MK-7 remains in circulation between 24 and 48 hours.  Therefore, to be safe, we need to eat grass fed meat and butter, and take MK-7 supplements (I take 1000 mcg), always after a meal with plenty of fat to maximize absorption.

If you are curious to find out more, if you want to know how menaquinone does this, how vitamin K2 does its miracles inside the body, then we need to take a closer look at the biochemistry of calcium metabolism.

There are three proteins found in bone matrix that undergo gamma-carboxylation via Vitamin K-dependent enzymes: matrix-gla-protein (MGP) (Price et al., 1983), osteocalcin (bone gla-protein, BGP) (Price et al., 1976), both of which are made by bone cells, and protein S (made primarily in the liver but also made by osteogenic cells) (Maillard et al., 1992) (Table V).  The presence of di-carboxylic glutamyl (gla) residues confers calcium-binding properties to these proteins.

MGP is found in many connective tissues and is highly expressed in cartilage.  It appears that the physiological role of MGP is to act as an inhibitor of mineral deposition.  MGP-deficient mice develop calcification in extraskeletal sites such as in the aorta (Luo et al., 1997).  Interestingly, the vascular calcification proceeds via transition of vascular smooth muscle cells into chondrocytes, which subsequently hypertrophy (El-Maadawy et al., 2003).  In humans, mutations in MGP have been also been associated with excessive cartilage calcification (Keutel syndrome, OMIM 245150).

Whereas MGP is broadly expressed, osteocalcin is somewhat bone specific, although messenger RNA (mRNA) has been found in platelets and megakaryocytes (Thiede et al., 1994).  Osteocalcin-deficient mice are reported to have increased bone mineral density compared with normal (Ducy et al., 1996).  In human bone, it is concentrated in osteocytes, and its release may be a signal in the bone-turnover cascade (Kasai et al., 1994).  Osteocalcin measurements in serum have proved valuable as a marker of bone turnover in metabolic disease states.  Interestingly, it has been recently suggested that osteocalcin also acts as a hormone that influences energy metabolism by regulating insulin secretion, beta-cell proliferation, and serum triglyceride (Lee et al., 2007).

These are the first three paragraphs of the chapter Noncollagenous Bone Matrix Proteins in Principles of Bone Biology (3rd ed.) which I found it on the web when I was searching for more info on the biochemical action of menaquinone.

And now, here is my simple explanation of how things work:

The players are the fat-soluble vitamins A, D, and K2;  three special proteins called osteocalcin, matrix gla protein, and protein S;  and an enzyme called vitamin K-dependent carboxylase.

First, vitamin D makes calcium available by allowing its absorption from the intestines into the bloodstream.  This is vital for life and health.  You know that severe vitamin D deficiency is extremely dangerous and develops into the disease that deforms bones called rickets.  Milder forms of vitamin D deficiency are much harder to detect without a blood test, but can and do lead to a huge spectrum of disorders and health problems.  However, without vitamin K2, ample or even just adequate levels of vitamin D will inevitably lead to increased soft tissue calcification.

Vitamins A and D make bone-building cells (osteoblasts) and teeth-building cells (odontoblasts) produce osteocalcin (also known as bone gla protein or BGP) and matrix gla protein (or MGP).  This is key because it is these proteins that will transport the calcium.

Vitamin K2, through the action of the vitamin K-dependent carboxylase enzyme, activates bone and matrix gla proteins by changing their molecular structure which then allows them to bind and transport calcium.

Once activated, bone gla protein brings calcium (and other minerals) into the bones;  and matrix gla protein takes calcium out of the soft tissues like smooth muscle cells of arteries, but also organs, cartilage, skeletal muscles, and skin.  Without this K2-dependent activation, BGP and MGP remain inactive, and the calcium accumulates in soft tissues all over the body.

What completes the act, is that vitamin K2 activates protein S which oversees and helps the immune system clear out the stuff of arterial plaques that remains once the calcium making the plaques structurally stable has been taken out.  And, amazingly, protein S does this without triggering a large inflammatory response.

Even though it is quite straight forward when explained in this way, this understanding of vitamin K2 and its action in the body is really quite recent: in the last 20 years or so.  For one thing, it was only 10 years ago that Chris Masterjohn solved the 60-year old mystery of Weston A. Price’s X-Factor, correctly identifying it for the first time as vitamin K2. (You can read that for yourself here.)  And although some laboratory studies and experiments on vitamin K were done several decades ago, the majority are from the last 10 years (take a look at the references in Masterjohn’s paper.)

We’ll stop here for now.  But we’ll come back to vitamin K2 because there are so many other amazing things it does for our health.

This article was inspired by Dr. Kate Rheaume-Bleue’s book entitled Vitamin K2 and the Calcium Paradox.

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A simple 10-step arthritis treatment plan

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What are the most important things we can do to stop and reverse the degeneration, and alleviate the stiffness and pain of arthritis? You can be sure that no matter how bad things are, there are many things that will help, and they don’t involve pharmaceuticals.

We looked in some detail at how to treat arthritis in Treating Arthritis I and II, and have at least one of our readers, an artist, Catherine Bath, who has been able to alleviate a great deal of her stiffness and pain, and recover a good amount of mobility and ease of movement by following the various recommendations we made there and throughout this blog.

Here, prompted by a request from a good friend who needs it, we present a simple treatment plan with the most important elements, and just the essential details needed to understand why the interventions are useful, and how to put them into practice right away.

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Illustration of painful, inflamed, arthritic joints. (Image taken from Everyday Health)

1. Hydrate and alkalise

This is the most important point of all. Without it nothing will work, really. Every joint works thanks to the cartilage that allows the bones to move within it without rubbing against one another. Arthritis is always characterised by the degradation of this cartilage and the pain associated with the inflammation caused by the bones not moving properly or rubbing inside the joints. Cartilage is water (85% by weight) held together in a matrix made mostly of collagen, and chronic dehydration is the first cause of cartilage breakdown (details in Your Body’s Many Cries for Water).

Metabolic acids (mostly uric acid) can only be excreted efficiently by the kidneys when there is an excess of both water in which to dilute the acid, and salt to help carry it out in the urine. Without excess water, the kidneys will prioritise retaining as much of it as they can. Without excess salt, the uric acid will be recycled instead of being excreted in order to to maintain the concentration gradient in the medulla of the kidney that ensures its ability to reabsorb as much water as possible. Chronic dehydration and avoidance of salt, coupled with the drinking of acidic liquids and eating of acid-forming foods inevitably leads to chronic acidosis.

To maintain the pH of the blood at 7.365 in spite of the continuous flow of acids into it from the muscles and digestive system, two main coping strategies are available: 1) The body’s main acid buffering mechanism using the reserves of alkalising minerals stored in the bones and teeth to counterbalance the acid load. If you don’t quite understand the implication here, this means erosion of the bones and teeth to put into the blood some of the alkalising calcium, phosphate and magnesium as acid-buffering minerals. 2) The crystallisation of the uric acid to pull it out of circulation, but then storing it into tissues, of which the joints, regrettably for arthritis sufferers, seem to be used preferentially, even though all tissues can be used for this to a certain extent.

The strategy is simple: drink alkaline water (either naturally so, or made to be with pH drops) on an empty stomach, and allow at least 30 minutes before eating. Aim for 3 litres per day. One litre before each meal, drank over a period of one to two hours, is a simple rule of thumb and easy schedule to remember. And aim for 2 full teaspoons of unrefined salt with your meals.

2. Magnesium chloride and sodium bicarbonate baths

Magnesium is at the very top of the list of supplements for anyone in any circumstance. We explored and explained why in Why you should start taking magnesium today.

Transdermal magnesium and bicarbonate therapy is the best way to simultaneously replenish magnesium stores in the cells, while alkalising the tissues directly by transdermal absorption of magnesium and sodium bicarbonate. If you have a bath tub, do this once or twice per week, or more if you can or need it. Add two cups of each magnesium chloride and baking soda, and soak for 45 to 60 minutes.

I also recommend that in addition to this—but crucially if you don’t have a bath—you take magnesium supplements. I take a fat-bound magnesium supplement called L-Threonate. Another alternative is the amino acid-bound supplement called magnesium glycinate (using glycine). Both of these form maximise absorption. Take it with meals.

3. Silicic acid, collagen, hyaluronic acid, and proteolytic enzymes

An essential constituent of hair, skin, and cartilage. Absorption is poor and slow. This means you need to take small amounts every day for long periods of time. Every morning, first thing, with your first glass of water. You will need to do this in cycles of three months on, three month off. I take Silicea, a concentrated water-soluble silicic acid gel by the German brand Huebner.

Collagen and hyaluronic acid will help greatly in rebuilding the damaged cartilage. Look for type II collagen for better absorption. Now Foods has good products at good prices. Also, glucosamine, chondroitin, MSM have all been shown to be useful for joints.

Proteolytic enzymes are responsible for breaking down, building, and repairing tissues. They can be amazing in accelerating a healing process, no matter what it is. Therefore, this is an essential supplement to take in treating arthritis.

4. Vitamin D3 and K2

These are the two vitamins that control and regulate the availability and deposition of calcium. Vitamin D3 makes it available, and vitamin K2 directs it to the bones and teeth.  Lots of vitamin D3 without K2 will lead to calcification with calcium being deposited all over the place in the arteries and soft tissues. Lots of K2 without D3 will lead to a depletion of available calcium in the bloodstream because it will be stored away in the bones and teeth. K2 is also used to decalcify soft tissues by pulling out and redirecting the deposited calcium from the tissues to the bones.

Vitamin D deficiency is universal in the west, and so is vitamin K2 deficiency. Arthritis sufferers need large doses of both for extended periods of time (at least a year). I recommend taking a combo supplement containing both in an optimal ratio, and take as many capsules as needed to bring vitamin D intake to 20 000 – 50 000 IU per day with breakfast and lunch. For years I took DaVinci’s ADK combo, which I think is one of the best. Now I take Life Extension’s D and K combo, without vitamin A, because its presence dampens the activity of vitamin D3. However, vitamin A promotes the healing of tissues. You can take both, alternating between the two.

Another of our readers who had his entire adult life an arthritic wrist that caused him pain and trouble whenever he used his hand for anything at all, followed my suggestion of taking 50 000 IU of vitamin D3 per day, together with the appropriate amount of vitamin K2 to match in the D3 intake, for six months. Within the first month, he found incredible improvement, something he had never been able to achieve using all the methods and drugs that had been proposed to him by MDs. After three months, his wrist was completely healed. He continued for the entire 6 months just to be sure, and now, his painful, debilitating, arthritic wrist that he was living with for more than 20 years, is a thing of past, a bad memory.

5. Vitamin C

Whole food vitamin C is essential for healing and keeping tissues and cells healthy. And there is definitely a difference between whole food C and ascorbic acid. We discussed this in Vitamin C is not vitamin C. This is not specific to arthritis, but everyone with arthritis should be loading up on it. I take The Synergy Company’s Pure Radiance C. You should take at least three capsules, but better 6 capsules per day, split evenly with each meal.

6. Turmeric extract

Turmeric is one of if not the most powerful natural anti-inflammatory. And inflammation is a hallmark of arthritis. You should take an extract that concentrates the curcuminoids, but you should also think of making yourself hot turmeric drinks, adding as much turmeric to your soups and curries as the flavours and combinations of foods will allow. It always needs to be taken with a lot of fat to maximise assimilation.

7. Food

Naturally, you will have guessed that my recommendations for food are the same as always, but even more important in this case when we are trying to bring inflammation as low as possible, and maximise healing:

  • no simple or starchy carbs because they cause inflammation, tissue damage, and metabolic disorder, except for berries once in a while;
  • unlimited unprocessed saturated fats from coconut oil, butter, and animal sources;
  • enough high quality protein from healthy animals including organ meats, especially liver; and
  • as many green veggies as you like, especially leafy like spinach, kale and lettuces, watery like cucumbers, fibrous like celery and broccoli.
  • Avocados are fantastic to eat as often as you want. Walnuts and hazelnuts are excellent health-promoting nuts (either roasted, or raw and soaked, subsequently dehydrated or not).

8. Sunshine, fresh Air, exercise and sauna

Go out in the sun, go for long hike, expose your skin, breath deeply, run up the hills, work your muscles at the gym if you can, go to Pilates and yoga classes, do lots of stretching whenever you can, and go to the sauna when you can. Make sure you stay 15 minutes to get really hot and for the heat to penetrate into the tissues and joints.

9. Iodine

Iodine is the universal medicine. Everyone needs it, and everyone should be supplementing with it. You can read for yourself why in Orthoiodosupplementation. Start at 12.5 mg and work your way up to 50 mg per day. Increment by 12.5 mg each week. Take the supplements on weekdays and give the kidneys a break on weekends. I take Iodoral, and recommend that. Using the generic Lugol’s solution is as good but less convenient.

10. Melatonin and good sleep

Good sleep is absolutely essential for repair and healing. Make sure you get plenty every day. Melatonin has, in addition to its effects in helping you sleep, many other amazingly health-promoting effects that we will explore in another article sometime soon, I hope.

Last words

Are there more supplements you can take? Of course there are. I personally take all of the above and several others. I wanted to stick to the things which I believe most essential. If I were to recommend additional supplements, I would say to take

  • omega-3’s, which are useful for lowering inflammation, as well as tissue healing and repair. I take Life Extension’s Mega EPA/DHA. Don’t take more than the recommended dose. Omega-3’s are very easily oxidised, and should always be taken in very small quantities.
  • Niacin in the form of niacinamide is also a universally useful supplement because it provides molecular building blocks needed by every single cell to produce energy. I take 500-1000 mg/day, but you could take 3000 mg (1000 mg with each meal). Niacin supplements will also do wonders for your mood (see No more bipolar disorder?).
  • Ubiquinol, the active form of Co-enzyme Q10, is also essential in cellular energy. I would recommend at least 50 mg per day, but more (like 100 or even 200 mg) would probably be better.
  • Vitamin B12 is crucially important for health. And the older we get, the more critical it becomes. I get an injection of 5 mg every month, and recommend that for everyone (see B12: your life depends on it).

Keep in mind that the timescale for improvements is long: on the scale of months. If you think that is too slow, ask yourself how old you are, and how long it took to get to the state you’re in. Now, with the answers in mind, remind yourself to be patient. You need to be determined to get better, consistent with your new regimen, and patient. But I assure you that you will get better. And please, keep me posted on your progress.

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Treating arthritis II: cleansing, nourishing and rebuilding

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Preventing arthritis is easy. Unfortunately, everything everyone does, or almost, promotes arthritis. But not just arthritis, all inflammatory degenerative conditions. The amazing thing is that what must be done to prevent any of them is quite well known. We have covered a lot of material relating to this already, and it was made clear at the start of Treating arthritis I, that natural healing, even when motivated by the healing of a particular condition, is done through healing the entire organism—all cells, all tissues, all organs, all parts—all at once. Therefore, we could just as well entitle this article “treating arthritis and all other inflammatory degenerative disease conditions” because the approach is fundamentally always the same.

Treating arthritis after it has already developed is not as easy as preventing it, but the extent to which it can be reversed and cured depends firstly on our own dedication and determination, and secondly on the state of the body and amount of damage it has sustained. The first article on arthritis was posted a while back. Its writing was motivated by my wish to help a friend who suffers from a highly debilitating form of arthritis for which conventional approaches are mostly inadequate—as inadequate as they are for all other degenerative chronic conditions.

It is useful for me to know that even if these efforts of were in vain in the sense that they were not acknowledged and didn’t motivate in them to make the recommended changes in lifestyle and diet, the article must have made some difference to some people because it has at this point been viewed more than 4600 times, and is the most viewed of all the posts on the blog after the Welcome page. If you are among the millions of people who suffer from arthritis, and also happens to be one of those who read Treating arthritis I, I hope you found it useful, and you are most welcome to let me and every other reader know how.

There is an obvious difficulty in overcoming any state of disease, especially one like arthritis. It is that everything about our success depends on our efforts to foster and nurture the conditions under which the organism can heal and repair itself. This is the only way to regain health. I want to emphasise this more explicitly:

It is only by creating, fostering and maintaining the biochemical, hormonal and physiological conditions under which the organism has the ability to clean, repair and rebuild its cells, tissues and organs that disease conditions—no matter what they are—can be prevented, overcome, reversed and recovered from. What we are required to do is provide the organism what it needs to do this.

The fundamental elements we concentrated on in the first part were: hydration, alkalisation, and magnesium. As was underlined, these are essential for everyone, but primordial for arthritis relief. The detailed recommendations were intended to help establish good habits. Their essence should be understood as follows.

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Illustration of painful, inflamed, arthritic joints. (Image taken from Everyday Health)

Every day, from the moment you get out of bed, your primary concern should be to hydrate and alkalise. This is particularly important in the morning and the first part of the day. There is a natural daily cycle governed by the circadian rhythm which controls all processes in the organism by a delicate balance of a vast number of different hormones. A good example relating to the hydration-dehydration cycle, is that the hormone calcitonin whose role is to put calcium from the bloodstream into bones and teeth, is active at night as dehydration sets in: as the water content of the blood decreases, the kidneys release renin and angiotensin, calcitonin is activated, and can thus do its work for fixing calcium where it is needed, subject to adequate amounts of the all-important fat-soluble vitamins D and K2. There are surely many more hormonal processes that depend on the diurnal cycle than those we currently know of. The point to remember is that we have to make hydration and alkalisation a priority in our life, and repeat this every day, while allowing dehydration during the night by typically having our last drink of water between 19 and 20 hours and nothing else until the morning.

Hydration and alkalisation are most effectively done when there is no food in the stomach, and both depend critically on maintaining a balanced intake of water and unrefined salt. An easy way to keep track of both and ensure optimal balance, is to prepare capsules filled with unrefined sea salt, taking one capsule for every half liter of water tea or green juice. This is particularly useful when doing a cleanse. In normal circumstances, it can also easily be achieved by having watery veggies like cucumber, celery or kohlrabi with liberal amounts of salt a couple of times a day. It is ideal to finish drinking about 30-45 minute before eating and not drink for two to three hours after. This leads to a natural rhythm of drinking, waiting, eating, waiting, and repeating this pattern throughout the day.

As this is so, it is easiest to hydrate and alkalise thoroughly each day by adopting a regime based on having only one big meal in the late afternoon or early evening, leaving the rest of the day before that to focus on these crucial aspects of our optimal health without the constraints of the timing surrounding eating. Snacking on raw veggies and salt is perfect and can be done at any time regardless of drinking, because it is also a kind of drinking: watery veggies are basically water with minerals, enzymes, phytonutrients and some fibre. Intermittent fasting, as is called, has many metabolic and physiological benefits not least of which is natural detoxification.

We have looked at some of the key aspects of this practice in The crux of the intermittent fasting, and I plan to deepen this investigation in the future, but maybe the most useful consequence of it, which should also come across as a rather obvious, is that if the body is getting food of any kind that requires processing, then it will immediately engage in doing just that: processing it to extract what it can from it.

Food processing is prioritised and mobilises much of the body’s energy and resources: blood supply (directed to the stomach), secretions from the digestive organs (acid and enzymes from the stomach; insulin, bicarbonate and more digestive enzymes from the pancreas; and bile produced by the liver and stored in the gallbladder), active transport across the intestinal wall into the bloodstream, increased workload on kidneys and liver in filtering metabolic wastes out of the blood, and although you don’t feel it, you can be sure that this does indeed require a lot of energy and bodily resources.

Allowing the body to rest from all this food processing related physiological activity leaves all this energy for other tasks which generally fall in the category of “clean and repair”. This is the natural detoxification that the body desperately needs to engage in as often and regularly as possible but unfortunately cannot because we are, from the time we wake up to the time we go to bed, almost constantly eating. As soon as we take the foot off the gas pedal and give the system a much-needed break from food processing, the organism immediately begins to clean and repair itself. This is why fasting is so good.

Now, if you, in addition to that, provide the organism with a supply of vital nutrients—enzymes, vitamins, minerals—in a form that requires no digestion and is immediately absorbable from the intestines into the bloodstream in the form of vegetable juices, this becomes an amazing way to bring about self-healing in what will indeed look like a most miraculous manner depending on how sick we are at the onset. This is what happens during a juice fast or cleanse, and although fasting has been practiced for centuries, and juice fasting for many decades, both with awe-inspiring results, one recent and vocal advocate of juicing cleanses for healing is the Englishman Jason Vale who runs the Juicy Oasis retreat and healing centre in Portugal (see Superjuice Me on FMTV).

Arthritis sufferers would do extremely well to consider doing such a juice fast as well as adopting intermittent fasting as a long-term daily practice. These measures—in and of themselves—could resolve the problem permanently in a relatively brief period of time.

The importance of magnesium was also emphasised in Treating arthritis I. The best is to have baths with one cup of nigari and one cup of baking soda at least once a week (a couple of times is great, and in some circumstances you may want or need to have them every other day). We should soak the whole body for 45–60 minutes. Magnesium oil, a saturated solution of nigari in water, is also very effective. Putting it on the skin of the arms, upper back and neck, chest and belly, legs and bum, avoiding sensitive skin of the armpits and genital area, and leaving it at least 30 minutes before showering. It can work wonders to loosen tight, achy or cramping muscles, and will often do this quickly from the first application. It doesn’t need to be done every day, but it can for several months without risking overwhelming the system with too much magnesium. Oral supplementation with liposomal (fat-bound) magnesium is also a very good idea.

Once we have understood the importance of these elements of health, healing and recovery that are hydration, alkalisation, magnesium, juicing green vegetables and intermittent fasting, and incorporated them into our life as fundamental pillars of optimal health, then we can and must turn to the question of what to eat when we do eat.

When we consider what to eat from the perspective of eating to most effectively promote health, the considerations can be very different from what they might be were we to take any other point of view as to our primary motivation. For optimal health, the first and foremost important consideration is the old and well-known principle first do no harm. This means what it says, but more explicitly means to not eat anything that has or may have detrimental effects on the organism. Using “has” implies negative effects have been identified and demonstrated to a lesser or greater extent, whereas “may have” means that even though there may be little, inconclusive or no evidence, there are nevertheless reasons to be skeptical or at least cautious about its safety or health benefits. Simple examples include cigarette smoke that is well established to have multiple negative impacts on our health, and industrial pesticides demonstrated to be endocrine disruptors or neurotoxic: a new brand of cigarettes or a new yet untested agricultural pesticide should therefore also be considered as potentially harmful. This is just common sense.

Following this principle encourages us to eliminate industrial chemicals and additives from our food and drink, but also from our cleaning and body care products. This can sound as an obvious and simple first step, but it is not so easy nor so simple without considerable care and attention to detail. Moreover, it also implies, right from the start, no industrially processed products of any kind, and that is a major step for most people given the state of affairs and average dietary regime of the bulk of the population in industrialised countries.

Assuming you are reading this because you are already on the lookout for better ways of doing things, as well as already feeding yourself with real food, this is not such a big deal. And in practice, it means this: buy and eat only whole organically grown or raised food, use only the simplest and most benign organic cleaning and body care products, drink the highest quality filtered or natural spring or mineral water that is certified to be free of known major and minor pollutants, and take only the highest quality supplements. Doing only this ensures an already excellent base for a healthy lifestyle, and it is already enough to avoid and prevent a lot of potential health disorders.

It is, however, not enough if our goal it to be optimally healthy, never have any health disorders at all, and live strong and vibrant to 100, 120 or 140 years of age. It is, also, not enough if we are trying to stop progression, reverse already existing damage, and eventually recover from our own arthritic condition that may have been causing us pain for years or decades. In either case, we need to go further.

The statement in the opening paragraph about the universality of the natural healing approach to treatment and prevention of disease conditions is here both appropriate and necessary to emphasise:

the most fundamental characteristic of but also driver in progressively worsening arthritis symptoms and degeneration is chronic systemic inflammation;

the most fundamental characteristic of but also driver in progressively worsening cardiovascular heart disease symptoms and degeneration is chronic systemic inflammation;

the most fundamental characteristic of but also driver in progressively worsening cardiovascular brain disease symptoms and degeneration is chronic systemic inflammation;

the most fundamental characteristic of but also driver in progressively worsening Alzheimer’s disease symptoms and degeneration is chronic systemic inflammation;

the most fundamental characteristic of but also driver in progressively worsening multiple sclerosis symptoms and degeneration is chronic systemic inflammation;

the most fundamental characteristic of but also driver in progressively worsening Crohn’s disease symptoms and degeneration is chronic systemic inflammation;

and, of course, the most fundamental characteristic of but also driver in progressively worsening type II diabetes symptoms and degeneration is also chronic systemic inflammation,

even if we know that the root cause of this diabetes is chronically elevated glucose and insulin levels, that this leads to systemic inflammation, which in turn leads to the pathological symptoms and degeneration, something that is underlined by the fact that diabetics suffer all other chronic diseases listed above 200-400% more than non-diabetics.

This was a forceful, repetitive, heavy-handed way to express and highlight this fundamental characteristic that is shared by so many disease conditions. But it is, I think objectively, the most important point to have in mind when our intention is to really understand health and to be ourselves, at all levels, an expression and embodiment of health. Because whether it is inflammation in the joints as in arthritis, in the arteries supplying the heart or brain as in cardiovascular disease, in the brain itself as in Alzheimer’s disease, in the nerves throughout the body as in multiple sclerosis, in the lining of the gut as in Crohn’s disease, or basically everywhere in the body as for diabetes, this inflammation—in all cases—is chronic and systemic. Hence, it is this which must be addressed and corrected, and it is addressed and corrected in exactly the same way in every case.

Taking into account differences and thus tuning the treatment, especially in what concerns reversing and repairing existing damage, is important. But it is definitely secondary with respect to the root cause of degeneration that is systemic inflammation. And even these differences whose importance varies depending on the specificity of the condition we aim to address, all of them—when working with natural, nutrition-based medicine—are useful and health-promoting for all conditions: none are detrimental to the treatment of any other specific disease.

For example, supplementing with organic silicic acid, collagen, vitamin C, and vitamin D is essential for repairing and rebuilding cartilage and soft tissues, and thus essential in the treatment of arthritis. It is, however, greatly beneficial for everyone to supplement with these micronutrients because all will benefit from it. It is essential to supplement with and maintain very high levels of vitamin B12 (>1200 pg/ml) when treating multiple sclerosis or Parkinson’s disease, but it is excellent for everyone to do the same. It is essential to supplement with L-Carnosine when treating Crohn’s disease because it is particularly useful for healing the lining of the gut. But it is also very beneficial for everybody to take because it helps to stop and repair the damage caused by glycation, which affects everyone to a greater or lesser extent depending on circulating glucose and insulin concentrations.

And thus, the first principle is to eliminate from our life what causes inflammation: everything that triggers an inflammatory reaction in the body. This obviously includes all allergens which, even if there are some well-known foods that have been recognised as causing allergic reactions, mild or severe, in a large fraction of the population, and could, therefore, be eliminated from our diet directly in order to minimise unnecessary exposure to potentially harmful substances, it is nevertheless ultimately an individual assessment and testing of food intolerance that is needed.

The foods most likely to cause an inflammatory immune system response are gluten-containing grain products and animal milk products. Estimates of intolerance for these two classes of foods—grains and dairy—range between 50 and 75% in most countries, although evolutionary adaptations can have an important effect. Good examples are the indigenous Swiss mountain dwellers and the African nomadic tribe called Masai, who, by consuming most of their daily calories from milk and milk products for thousands of years, have developed the genetic adaptations for the immune system to tolerate the proteins in milk that cause mild to severe allergic reaction in close to 75% of the world’s population, with the most extreme proportions of 90-95\% in the Chinese and other Asian populations that have never, throughout their history, consumed milk products.

The other two classes of foods that are established as inflammatory—highly inflammatory—even if they rarely cause intolerance or allergic reactions, are insulin-stimulating carbohydrates and omega-6 fats. In the case of these substances, it is not inflammation triggered by a reaction to them of the immune system. Rather, they themselves trigger inflammatory biochemical pathways: several hundred inflammatory pathways! These foods should therefore be eliminated from the diet: all simple and starchy carbohydrates, and all vegetable oils. Nuts and seeds, which contain omega-6 oils, can be had whole in small quantities. Olive oil is mono-unsaturated and is the best vegetable oil to use for salads. No omega-6 rich vegetable oil should be used.

I don’t think it’s necessary nor useful to discuss the inflammatory effects of industrial chemicals because we already know that they only cause harm and should be eliminated from our food supply, avoided at all costs in all their other forms by everyone who is even superficially concerned with their health.

This is our first conclusion: to minimise inflammation, it is essential to eliminate inflammatory foods; and the most inflammatory classes of foods are dairy, grains, insulin-stimulating carbohydrates and omega-6 oils. To overcome or prevent inflammatory disease conditions, arthritis but also all others, we have to stop eating these foods. It is as simple as that. And although it is true that we could potentially supplement with adequate types and amounts of enzymes to try to ensure that all types of proteins found in these foods are actually broken down properly during digestion in order to avoid triggering an immune response, it does seem silly to eat or drink something that we know cannot be metabolised correctly and which is, for this reason, harmful to the organism, but still try to mitigate the harm it causes by taking a supplement of those enzymes needed to digest it that do exist even if our body’s genetic and evolutionary makeup doesn’t produce. This reflection applies to dairy and grain proteins to which we are intolerant. It doesn’t apply to insulin-stimulating carbohydrates or omega-6 fats, because these seldom cause allergic reactions in people, but are nevertheless universally inflammatory.

The second principle is to consume anti-inflammatory foods. It should not be a surprise to find out that the most anti-inflammatory foods (think of them as soothing to the body), also tend to be the most alkalising: raw, green, chlorophyl-rich plant foods, and especially green vegetable juices. The most anti-inflammatory and anti-oxidant fat is the miraculously beneficial, highly saturated (96%), and medium chain triglyceride-rich (50%) coconut oil. Hence, without any additional considerations, we already know that an optimally anti-inflammatory and healing diet should be based on mostly raw vegetables and salads, in particular green ones, green juices, and lots of coconut oil from all coconut products.

Also not surprisingly, we can have as much of these nutrient-rich foods as we want, and the more the better. This, it turns out, is an extremely useful selection criterion to determine the level to which something can be good or bad: how much of it we can eat, and what are the consequences, if any, of having increasingly larger quantities; is there an upper limit in the sense that above a certain amount we can expect negative consequences, or is there only a lower limit below which therapeutic value is not noticeable? For what concerns green juices, greens and coconut oil, I would say that there are only lower limits to the minimum we should all intake in order to be perfectly healthy, and no upper limits within what can be considered reasonable through the body’s auto-regulation mechanisms of satiety and digestive function.

For instance, we can drink a 250 or 500 ml of green juice, and that’s great. We can drink 1000 ml and that’s much better. We can drink two or three litres of green juice per day, and that is truly amazingly therapeutic, something that would be done during a juice cleanse. For coconut oil and milk, we can have one or two tablespoons per day, and that’s really good (apparently enough to slow down cerebral degeneration). We can have five to seven tablespoons per day, and that’s far better (apparently enough to reverse early stage dementia and Alzheimer’s). We can have as much as 200 or 300 ml (between 13 and 20 tbsp) of oil per day, and that’s better still. In the case of coconut oil and milk, eating such large quantities amounts to a lot of calories, all from fat which makes us feel really full and not willing to eat anything. This is the body’s natural hormonal messaging system to prevent over-eating and it works perfectly well in this case. It also works well for protein. Only for sugars and starches does it not work so well because we evolved having very few carbohydrates and thus didn’t have to develop the mechanism to avoid overeating them—what pretty much the whole world is doing nowadays.

Most nuts and seeds can be considered as superfoods because of they are very concentrated sources of minerals, antioxidants, unique phytonutrients, vitamins, as well as fat and protein. Because they are seeds, they also have anti-nutrient—phytates and enzyme inhibitors—without which they would not keep for months on end as they do, and would spoil much more quickly. These are not as strong as they are in cereal grains, which have can keep for thousands of years, as they have in some pyramids, and then sprout after soaking in water for a while. This is nature’s very clever way to ensure dry seeds retain the nutrients needed to grow the plant when the conditions are suitable. But it implies that we must do something to them before we can consume them and know that they are wholly beneficial and health-promoting rather than only partially so.

The solution is simple: soak the dry seeds or nuts in water for 24 hours to hydrate them and activate the biological mechanisms responsible for sprouting—to get the seed ready to produce a new plant by making inactive the enzyme inhibitors and phytates—and making all of its nutrients fully available. Soaked nuts and seeds can definitely be eaten hydrated, and are much more filling that way because they hold as much water as their dry weight (they double in weight and volume when fully hydrated), but they can also be dehydrated after having soaked for 24 hours, and be preserved for much longer than the couple of days they can in the fridge before going bad when hydrated. This is what I do at home: 24 hours of soaking with rinsing and changing of the water a couple of times in between, and 24-36 hours of drying in the dehydrator at 45 C to keep all enzymes alive.

Roasting or otherwise heating the nut or seed also neutralises the anti nutrients, but this also destroys the enzymes, making it a dead food that will require the pancreas to produce the necessary enzymes for digestion, as well as cause digestive stress and acidification. Nonetheless, roasted nuts are nutritious and delicious, and thus great to have once in a while. Either way, sprouted or not, nuts and seeds are by their nature nutrient-rich concentrated food and should generally only be had in relatively small quantities (a handful or two). Doing this will also prevent excessive intake of omega-6 fats that make up about 50% of their weight, even if whole nuts and seeds have their own anti-oxidants that give additional protection from free-radicals in the body.

Having a somewhat different status as food, but being naturally most anti-inflammatory, are the trio of ginger, turmeric and garlic. Some may have difficulty digesting garlic (as is the case with onions as well), but ginger and turmeric are generally very easy to digest and actually digestive aids. It is important in the treatment of arthritis to consume them often, even daily, and in liberal amounts. Ginger is very easy to have in relatively large quantity by cold press juicing it in your daily green juice (that’s what we do), which guarantees you a good therapeutic amount on a daily basis. For turmeric, it is also possibly to find it fresh in some places, but it stains everything that it comes in contact with. Mostly for this reason, we take it in capsules, where it can even be concentrated further to be more potent still. The beneficial compounds in turmeric are most effectively absorbed when taken with plenty of fat (coconut fat is perfect).

Animal protein other than from dairy—eggs, meat and fish—is important for the body but also highly acidifying and therefore inflammatory. In addition, the proteins need to be completely broken down first by the acidic gastric juices in the stomach and then by the digestive enzymes in the intestines in order for the amino acids of which they are made to be available to the brain and other organs, but also prevent partially digested proteins from finding their way into the bloodstream and causing additional inflammatory immune responses.

Therefore, we have to eat only small quantities of the highest quality grass-fed or wild caught animal products, give the organism plenty of time to cleanse the metabolic byproducts of their digestion, and, I recommend, supplement with digestive enzymes when eating animal foods. In fact, I recommend taking digestive enzymes whenever you eat cooked foods: we do not want to get anywhere close to exhausting the pancreas’ enzyme-producing potential, because enzymes are far more important for all other molecular repair and rebuild processes than they are for digesting cooked food, and we need to keep them for these purposes if we aim to live healthy for a long time.

This is our second conclusion: to minimise inflammation and maximise repairing and rebuilding of damaged tissues, it is essential to consume the most powerfully anti-inflammatory, nutrient-dense and anti-oxidant foods. The diet should therefore be mostly raw, primarily green vegetables, green juices, special anti-inflammatory foods such as ginger, turmeric and garlic, unlimited amounts of coconut products rich in coconut oil, some sprouted nuts and seeds, and small amounts of clean animal flesh products accompanied with plenty of time for metabolic cleansing on a continual basis. The supplements most important in treating and reversing arthritis are organic silica, collagen complex (Reverse Aging), whole food vitamin C (from The Synergy Company), magnesium (L-Threonate; both from Mercola), B12 (Thorne), the fat soluble vitamins A-D-K (DaVinci), turmeric extract (Organic India and Gaia Herbs), niacinamide (Thorne), and the universally needed but universally deficient iodine (in Lugol’s solution). In addition, it may be really beneficial to take high doses (50000 IU/day) of vitamin D3 for at least three and maybe up to six months or more, in order to set the body on its course to intensive healing and recovery from years of arthritic degeneration. This has been found to be very effective in some people. Supplementing with proteolytic enzymes is also very important to accelerate healing and repair of damaged tissues.

Incorporating these principles and specific recommendations into one’s life, not as a special diet, but as a comprehensive way of taking care of this amazing organism that is the human body mind, will not only treat, reverse and cure arthritis to the greatest extent, and maybe even completely depending on the level of degeneration, but will do the same for all inflammatory conditions, which underlie all degenerative diseases. In addition, the immune system will grow to be so strong that no infectious diseases will be able to take hold or develop within your body: never get a cold, never get a flu, never catch anything at all.

Finally, there are two crucially important factors which are not related to diet, and that in many ways can overshadow all other efforts to heal and remain in optimal health: lack of sleep and psychological/emotional stress. They are more than important: they are foundational. Without good sleep and minimal stress it is impossible to become and remain vibrantly healthy, no matter what else we do or don’t do.

This shouldn’t be understood to mean that if we don’t sleep well or are overstressed there is no point doing anything else. On the contrary! It is all that much more important to do everything else we can. However, it means that if we are already doing everything else, then without correcting the conditions causing us stress and preventing us to get enough restful sleep, we will never reach our optimal health potential.

Having said that, you can be sure that they go hand in hand: optimal nutrition and biochemistry promote less stress and better sleep; better sleep and less stress promote more balanced biochemistry, digestion, cleansing, and cellular rebuilding and repairing. They are the two sides of the same coin, one that is measurelessly priceless: optimal health.

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Treating arthritis I: super-hydration, alkalisation and magnesium

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This is entitled Treating arthritis I, because I want to highlight that it is the first phase of what I think is of the most fundamental importance for people suffering from any form of arthritis. It should really be entitled Treating and preventing any and all disease conditions in everyone I, because these measures are truly fundamental to optimal health in all respects and for everyone throughout life. So even if you don’t have arthritis, you should read on.

This first phase should be viewed as one during which you train yourself to acquire new habits. It is not a treatment per se, but rather a prescription for the basis of a new daily rhythm where hydrating and cleansing the body are of the most fundamental importance. In the end, it is really very easy and very simple. It’s just that we need to get used to it.

Arthritis is a word that means joint (arthro) inflammation (itis). There are tons of different types of arthritis (in the hundreds), but all of them are manifestations of the same thing in different joints and somewhat different ways. And the symptoms: the stiffness, the breakdown of cartilage and other tissues, the ossification or rather calcification, the crippling pain, are all related to the inflammation. But what if there were no inflammation? Would there be no arthritis?

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Illustration of painful, inflamed, arthritic joints. (Image taken from Everyday Health)

Without inflammation there is no tendonitis where a tendon gets inflamed like in the well known tennis elbow. Without inflammation of the lining of the arteries there is no plaque and no atherosclerosis, and thus no heart disease and no stroke. Without inflammation there is no Multiple Sclerosis (MS), the inflammation of the myelin sheath that covers nerves, and no Crohn’s disease either, inflammation in the gut. We could go on and on like this because inflammation is at the heart of almost every single ailment from which we suffer. The reason is simple: inflammation is the body’s way of responding to injury in our tissues.

We sprain an ankle and it swells up by the inflammation that follows the partial tearing of ligament and tendon: this is essential for bringing plenty of blood carrying all the specialised molecules and nutrients necessary to repair the injured tissues. What is the best course of action? Just rest and allow the ankle to heal. The more we use it, the slower the healing will be, the longer the inflammation will last, and the more we will increase the chances of causing some more serious or even permanent damage to these fragile tissues. Without the body’s inflammatory response mechanisms, healing would be impossible.

In fact, repair and growth would also be impossible; muscle growth would be impossible. The process is rather simple: stress and tear (injury) followed by inflammation and repair or growth. This applies to body builders who develop enormous muscle mass over years of intense daily workouts, but it also applies to a baby’s legs kicking and tiny hands squeezing your index finger tightly. It applies to their learning to hold their head up and pulling themselves to their feet with the edge of the sofa to then take those first few steps. It applies to me, to you and to every animal. So, once again: repair and growth of tissue depends on the body’s inflammatory response mechanisms. In a well-functioning metabolism, this process takes place continuously in a daily cycle regulated by activity during the day and rest during the night: stress, tear and injury to tissues during activity; repair, growth and cleaning during the night.

Difficulties arise when inflammation becomes chronic. Either a low-grade inflammation that we can ignore completely and go about our business until it manifests in the form of a serious health concern, or a sustained,  sub-acute state of inflammation that does indeed make it difficult to go about our business, but that we can nonetheless learn to ignore or cope with hoping that it will eventually disappear. Unfortunately, this is how it is for most of us to a greater or lesser extent, whether we are aware of it or not. If it weren’t the case, there wouldn’t be hundreds of millions of people suffering from arthritis the world over, and atherosclerosis-caused heart attacks and strokes would not be claiming the lives of more than one quarter of the population of industrialised countries.

As an aside, for those of you who are interested in measurements and quantifiable effects, among the best markers of chronic inflammation are C-Reactive Protein (hsCRP) and Interleukin-6 (IL-6). The number of white blood cells relate to immune response, and if elevated mean the body is fighting something. Elevated concentrations of Ferritin and Homocysteine (HcY) are also associated with chronic inflammation much elevated risks of heart attack and stroke. You can easily get a blood test to check those numbers among other important ones (see Blood analysis: important numbers).

So what is it that causes a person to develop arthritis at 50 or even 40 years of age, while another person only begins to have mild signs of it at 80? What is it that causes a teenager to develop the crippling Rheumatoid Arthritis (RA) at 16, while none of her friends do? Why does only 1 in 400 develop Ankylosing Spondylitis (AS) or bamboo spine, characterised by the chronic inflammation of the spine, the ossification and gradual fusion of the vertebrae? Who knows?

But, for example, approximately 90% of AS patients express the HLA-B27 genotype and exhibit the HLA-B27 antigen, which is also expressed by Klebsiella bacteria. Could it be the bacteria that causes the damage and injury to spinal tissues and structure, which then follows by inflammation that over time becomes chronic, and since the bacteria remains and continues its damaging activities, the inflammation continues to grow together with all the awful symptoms? Maybe. The debilitating effects of certain bacteria and viruses such as Epstein Barr or HPV for example, that persist in the bloodstream over years and decades, are well known. And the chronic inflammation that results of the activity of infectious agents such as these is also a well established effect, even claimed by some to be among the primary causes of arterial disease (see Fat and Cholesterol are Good for You in the Bibliography page.

But whether it is AS or arterial disease, MS or tendonitis, what is common to all is inflammation, and what needs to be addressed are the causes of the inflammation, not the inflammation itself, which is what we do with anti-inflammatory medication. The inflammation is the body’s response to the injury. What we need to do is find and stop the process causing damage and injury to our tissues, and once the tissues have healed, the inflammation will disappear of itself.

There are many things that cause injury to our tissues, and we will look at all the most important ones in greater detail in subsequent posts, but it is fundamental to address first order issues first. Among the most fundamental issues of all are therefore those with which we concern ourselves in the first phase of treatment:  super-hydration, alkalisation and magnesium. But the truth is that these fundamental elements are what everyone concerned with optimising their health should actually concern themselves with first, before everything else.

Super-hydration

Chronic dehydration is at the root of so many health problems that it is hard to know where to begin. I’ve written a few posts on the importance of water that you can identify by their title. If you’ve read them and want to know more, you should read Your Body’s Many Cries for Water (see Bibliography). In relation to arthritis, however, water is not only the primary means to reduce inflammation of stressed cells and tissues, but it is also what gives our cartilage suppleness and flexibility.

Cartilage a very simple tissue. It is water, 85% in healthy cartilage, down to 70% or less in compromised cartilage and in most older people, held within a matrix of collagen and other proteins that consists of a single type of cell called chondrocyte. These cells have very special electrical properties that give cartilage its amazing resistance to friction and pressure. Without sufficient water, however, the chondrocytes cannot work correctly, cartilage dries out and breaks down, and calcification grows.

What is totally under-appreciated is that because cartilage does not have a blood supply, nerves or lymphatic system, water makes it into the cartilage through the porous end of the bone to which it is stuck, and the only way water can make it into the bone in order to get to that porous end to which the cartilage is attached is through the blood that makes it into the bone.

Since there is, within the body’s functions, a definite hierarchy in water usage in which the digestive system is naturally the first served since it is through it that water enters, even the mildest dehydration can be felt in the function of the most water-sensitive tissues like those of the lungs (90% water) and muscles (85% water), (something any athlete who has drank alcohol the night before a race or even training run or ride will have noticed), it is unfortunately often the cartilage that suffer the most.

Dehydration will make it such that the soft conjunctive tissues at the ends of our bones, in every joint, and that allow us to move will not get the water supply they need to remain well hydrated, supple and flexible. This is really the most important point to remember. What is also highly under-appreciated is the vital importance of silica in the form of silicic acid in the growth, maintenance, repair and regeneration of all connective tissues, including and maybe especially bones and cartilage (here is a good article about it). Silicic acid should therefore be included in all arthritis treatment programmes.

How do we super-hydrate? By drinking more, as much as possible on an empty stomach, and balancing water with salt intake. You should read How much salt, how much water, and our amazing kidneys, and make sure you understand the importance of a plentiful intake of water, an adequate intake of salt, and the crucial balance of these for optimal cellular hydration and function. Detailed recommendations are given below.

Alkalisation

Chronic acidosis, some would argue, is not only at the root of innumerable health complaints and problems, but that it actually is the root of all health disorders. The reading of Sick and Tired, The pH Miracle and Alkalise or Die is, I  believe, enough to convince most readers that that premise is in fact true. Not surprisingly though, it is not possible to alkalise bodily tissues without optimal hydration. And so we immediately understand that chronic dehydration is the primary cause of chronic and ever increasing tissue acidosis. Therefore we address both simultaneously, and in fact, cannot do otherwise.

Briefly, what is essential to understand is that healthy cells thrive in an alkaline environment, and indeed require an alkaline environment to thrive. Conversely, pathogens such as moulds, yeasts, fungi, viruses and bacteria thrive in acidic environments. Healthy cells thrive in well oxygenated aerobic environments, whereas pathogens thrive in anaerobic environments deprived of oxygen. Since this is so, we can say, crudely speaking, that if the tissues and inner environment of the body—its terrain—is alkaline, then pathogens cannot take hold nor develop nor evolve nor survive in it. On the other hand, if the body’s terrain is acidic, then they thrive, proliferate, and overtake it, sometimes slowly and gradually, but sometimes quickly and suddenly, causing sickness and disease.

Everything that we eat and drink has an effect that is either alkalising, acidifying or neutral. This is after digestion, and has little to do with taste. All sweet tasting foods or drinks that contain sugars, for instance, are acidifying. I will write quite a lot more about pH and alkalisation in future posts. For now, we are concerned with alkalising through super-hydration, and this involves drinking alkaline water and green drinks. By the end of phase I, drinking your 2 litres of alkaline water and 2 litres of super-alkalizing green juice should be as second nature to you as brushing the teeth before bed.

Magnesium

As I attempted to express and make evident the importance of magnesium for every cell and cellular process in the body in Why you should start taking magnesium today, and thus show that we all need to take plenty of magnesium daily in order to both attain and maintain optimal health, for someone suffering from arthritis it is extremely important, it is crucial. And the reason is very simple: arthritis is characterised by inflammation, stiffening and calcification. They come together, of course, and it is useless to even wonder if one comes before another. Regardless, the best, most effective, most proven treatment or antidote for inflammation, stiffening and calcification is magnesium.

Magnesium, injected directly into the bloodstream, can almost miraculously stop spasms and convulsions of muscle fibres, and release, practically instantaneously, even the most extreme muscular contraction associated with shock, heart attack and stroke. This is used routinely and very effectively in birthing wards and surgery rooms. Magnesium is the only ion that can prevent calcium from entering and flooding a cell, thereby causing it to die, and magnesium is the best at dissolving non-ionic calcium—the one that deposits throughout the body in tissues and arteries, and over bone, cartilage, tendons and ligaments—and allowing all this excess calcium to be excreted: precisely what we must do in treating arthritis.

In addition, magnesium is very effective at chelating (pulling out) both toxic heavy metals like mercury and persistent chemicals that bio-accumulate in blood, brain and other tissues. For too many unfortunately unsuspecting people, heavy metal toxicity is the cause of a plethora of various symptoms, wide-ranging in nature, hard to understand or associate with some known and easily identifiable condition, but that cause them often immense discomfort up to complete disability.

Putting all of this into practice

When you get up in the morning, you go to the bathroom, undress and spray or spread on your legs, arms chest and belly, neck and shoulders, the 20% magnesium chloride solution (4 teaspoons of nigari with 80 ml of water for a total of 20 g in 100 ml of solution). You wash your hands and face well, put your PJs back on, and head to the kitchen to prepare your water and green drinks for the day.

Line up three wide-mouth 1 litre Nalgene bottles. In each one put: 5 drops of alkalising and purifying concentrate (e.g. Dr. Young’s puripHy) and 10 drops of concentrated liquid trace minerals (e.g. Concentrace).

In the first bottle, add 50 ml of the 2% solution of magnesium chloride (made with 4 teaspoons of nigari dissolved in 1 litre of water), 50 ml of aloe vera juice, 20 ml of liquid silicic acid, fill it up with high quality filtered water, shake well to mix, and take your first glass with 1 capsule of Mercola’s Complete Probiotics. You should drink this first litre over the course of about 30 minutes, taking the third or fourth glass with an added 1-2 teaspoons of psyllium husks. (The aloe vera and psyllium husks are to help cleanse the intestines over time.)

In the second and third bottles, add a heaping teaspoon of green juice powder (e.g., Vitamineral Green by HealthForce), 1/2 to 1 teaspoon of fine, grey, unrefined sea salt, 1/4 teaspoon of finely ground Ceylon cinnamon, a heaping mini-spoonful of stevia extract powder and a single drop of either orange, lemon or grapefruit high quality, organic, food-grade essential oil. Shake well. One of them you will drink between about 10:00 and 12:00, the other between 15:30 and 17:30. Shake every time you serve yourself a glass or drink directly from the bottle to stir up the solutes in the water. You should take these two bottles with you to work and/or keep them in the fridge until needed: the drink is really nice when it’s cool.

Now that the magnesium has been absorbed through the skin—this takes around 30 minutes, you can go have a shower to rinse off the slight salty residue that feels like when you let sea water dry on your skin without rinsing it off. You should wait at least 30 minutes after you have finished your first litre of water before you eat anything.

By about 10 or 10:30, depending on when you finished breakfast, you should start to drink your first litre of green drink and continue until about 12:00 or 12:30. Make sure you finish drinking 30-45 minutes before you eat. Wait at least couple of hours after eating. Then start drinking the second litre of green drink by about 15:30 or 16:00 until about 17:30 or 18:00. Again, make sure you stop drinking always at least 30 minutes before eating. Depending on when you eat dinner, you should drink a half litre of plain water 30 minutes before the meal. The general rules for drinking you should follow are: 1) always drink at least 500 ml up to 30 minutes before eating, and 2) do not drink during or within 2 hours after the meal.

Before going to bed, take a small glass of water with 50 ml of 2% magnesium chloride solution. And that’s it for the day. And tomorrow and the next day and the day after that, keeping to this schedule, until it becomes perfectly natural and customary. After four weeks, you should do another blood test and see how the numbers compare to those before starting. In addition, if you are interested in this from the scientific standpoint, or just curious, or both, you should get Doppler imaging of your coronary and cerebral arteries, as well as an MRI of the joints in your body, including the spine, before you start and at then end of every phase. It will also be extremely informative to test and record the pH of at least your first urine every morning; any additional urine pH readings will be very useful and tracing the progress of the gradual de-acidification of your tissues and the days and the weeks progress. And finally, the transdermal magnesium therapy (putting the 20% solution on your skin), should last 6-8 weeks. By that time, you intracellular magnesium stores should have been replenished. We continue taking the 2% solution indefinitely, and use transdermal magnesium once in a while (once or twice per week).

The great advantage of the transdermal magnesium is that almost all of it is absorbed into your tissues and bloodstream. The oral magnesium is absorbed a level between 25 and 50%, and this depends primarily on the amount of magnesium in the blood when you take it. This is why it is very important to take it first thing in the morning when magnesium is at its lowest, and then in the latter half of the afternoon and before bed, those times when concentrations are lowest. You don’t have to worry about too much magnesium because any excess will be excrete in the urine and faeces.

You should just worry about not enough: that’s the real problem. Incidentally, the fact that almost all the magnesium that you put on your skin is absorbed underlines the importance of carefully choosing what we put on our skin. Because in the same way, anything we put on it will be absorbed into our system. So putting coconut and almond oil is just as good for our skin and our health, as it is bad to put on creams and lotions with synthetic chemicals and compounds that all make their way into our blood. General rule: if you cannot eat it, don’t put it on your skin.

Update: read these Updated recommendations for magnesium supplementation.

That’s it for the first phase: mostly drinking a lot more than you used to, with a few special tweaks to what and when you drink. I haven’t mentioned anything about food even though you can obviously know from the rest of the articles on the blog that this will come in time: in the second phase. We first deal with the first order terms, then the second order terms, and after that with the third and fourth order terms. That’s very important to grasp: what has the most and what has the least impact and thus importance.

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