A simple 10-step arthritis treatment plan

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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Vitamin C is not vitamin C

Several years ago now, when I read The Calcium Lie, I found out that vitamin C and whole food vitamin C complex were not the same thing. I wasn’t surprised in the least because obviously this is surely the case for most supplements: an extract is not the whole food. But a few days ago, I saw a short video presentation that forced upon me the realisation that there is a huge functional difference between what is sold as vitamin C and the complex vitamin C molecule we find in whole foods.

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The distinction may seem trivial at first—it has on the whole clearly been missed—but it is rather important: ascorbic acid, that has been equated to and sold as vitamin C, is the substance from which is made the thin antioxidant shell that protects the many constituents of the vitamin C complex as it is found in food. Since ascorbic acid can be produced in a lab, whereas whole vitamin C complex can only be found and extracted from real food and therefore cannot, this is naturally what has been done: manufacture ascorbic acid and sell it as vitamin C.

This makes sense, of course, because none of the supplement manufacturers would be inclined to emphasise this point. It would be kind of like shooting themselves in the foot. But also because, given the proven biochemical and physiological value of antioxidants, it’s not a far stretch to convince oneself that the usefulness of vitamin C is, in fact, derived from the effects of the ascorbic acid shell. For this reason, when I read Dr Thompson’s comments on vitamin C, I made a point to pile on the red peppers, brocoli and lemons in our diet at home, but nonetheless kept on taking ascorbic acid supplements and do to this day. This is about to change.

Dr. Darren Schmidt is an American chiropractor who works at the Nutritional Healing Center of Ann Arbour and, as most chiropractors, practices natural medicine, treating thousands of patients each year, most of them suffering from the same kinds of complaints, aches, pains and disorders, as is the case everywhere else. The talk was about heart disease: number one killer in the US and very prominent in all industrialised countries. To make it as clear and simple as possible and get the message across, he described that heart disease arises from the gradual filling up of the coronary arteries supplying blood to the heart with arterial plaques that with time grow to block the way completely or almost, and that this leads to a heart attack. We covered this topic in detail in the article At the heart of heart disease.

The main point he wanted to get across is that plaques in the arteries and blood vessels develop because of an injury to the tissues lining the vessels, just like a scab does on the surface of the skin when we accidentally scratch, scrape or cut it, and that a well-functioning organism will fix that injury in the same way as it does the surface of the skin: the scab forms, the skin repairs itself underneath, and when it is healed, the scab falls off. Plaques are like scabs.

He explained that, fresh out of university in the early 90’s, he had heard at a conference someone speak of the work of a great pioneer in nutritional medicine of the first half of the twentieth century, Dr Royal Lee, a friend and colleague of the other great pioneer Dr Weston Price. Dr Lee was the man who made the first food supplement, and the first concentrated whole food vitamin C supplement. He founded in 1929 the Vitamin Products Company, which later became Standard Process, Inc. Lee taught that this concentrated food in tablet form was like a pipe cleaner for arteries. Hearing this, the young chiropractor thought to himself, if it worked then it should work now, and he began to prescribe vitamin C to all his heart disease patients. For a decade he prescribed vitamin C, and for a decade he failed to see significant improvements or any sign of reversal of atherosclerosis in his heart disease patients. But he had missed something.

Frustrated and disappointed, he looked again at the original research and writings of Drs Lee and Price about nutrition and disease, and in particular about vitamin C, and began prescribing only Standard Process vitamin C. What he found, invariably, was a quick improvement in his patients whose chest pains and complains would disappear, and who would gradually feel better and better. Since then, he has repeated this on thousands of people with such success that he now teaches, he now repeats what Dr Royal Lee taught almost a century ago, that the cure for heart disease, for disease of the arteries and atherosclerosis, is vitamin C. And that vitamin C is not ascorbic acid, but it is whole food vitamin C complex.

Schmidt is not handsome nor charismatic. He does not speak eloquently. He is far from refined in his choice of words and speaking style. He doesn’t come across as a brilliant doctor or scientist, and not even as a bright guy, really. But the clinical experience and observations on which his statements and claims are based are undeniably impressive and clearly unambiguous in the information they convey: ascorbic acid has no effect on healing injured tissues and in allowing for the body to clean up and remove the plaques from the arteries and blood vessels; whole food vitamin C complex does, and it does so remarkably well and efficiently in everyone who takes it.

The implication is that other than providing antioxidant effects, ascorbic acid is useless for aiding and promoting healing of tissues. In this case, the concern is the health of the arteries, but it’s not a far stretch to conclude that this applies to all injured tissues in general. What is needed is whole food complex vitamin C, which we eat in whole foods or take in supplements that are made from whole foods. Therefore, it’s a no brainer: if you are interested in keeping your arteries clean and your heart and brain healthy and well-functioning for as long as possible, take a whole food vitamin C complex supplement, and pile on the vitamin C rich foods in your diet (superfoods highest in vitamin C include Camu Camu, Acerola and Goji ; regular foods highest in C include bell peppers, broccoli, brussels sprouts, strawberries and kiwi).

There is one last crucial point to this story, and I was happily surprised to hear it mentioned during the presentation. It is something that is explained by Gary Taubes in Good Calories, Bad Calories, but that is very rarely heard or mentioned anywhere. Vitamin C enters cells through the same channel as sugar does. But for evolutionary reasons, glucose always takes precedence over it (and all other nutrients). Therefore, as long as there is sugar to be shuttled into the cell, vitamin C stays out and waits: it does not enter the cell. So, what does he suggest for the diet? Can you guess? No sugars (simple carbohydrates), no starches (starchy carbohydrates) because they become sugars, lots of fat, adequate protein from healthy animal sources, and lots of green veggies, Sounds familiar? And, of course, whole food vitamin C concentrated in supplement form.

Finally, I promise to write about these and other great pioneers of nutritional medicine. I feel that these people who were greatly ahead of their times and usually greatly suffered from it deserve more recognition than they get. They deserve more recognition than they ever will get. But still, I would like to do my part. I don’t know when, but I will.

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