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Joint & Bone Health

What is the difference between glucosamine potassium sulphate and glucosamine sodium sulphate?
Sulphate functioning as the delivery vehicle for us to absorb the active ingredient which is glucosamine. Glucosamine sulphate needs to be stabilized with sodium chloride or potassium chloride. Both glucosamine potassium sulphate and glucosamine sodium sulphate are effective and safe for treatment of mild and moderate degree of osteoarthritis. However, glucosamine sodium sulphate is containing sodium which might not suitable for those who need to control their daily salt intake.
I am a 28-year-old female with mild osteoarthritis on my left knee. Every month, during the week before my period, the joint pain will usually be getting worse. After the period is over, the joint pain will suddenly diminish. Why does this happen?
Many women with osteoarthritis report an increase in joint pain just before or during their period. This is likely due to the hormonal fluctuation. Before menstruation, the estrogen level will drop, causing you to be more sensitive to pain. Either way, you will perceive it as your joint pain is getting worse. After menstruation, the estrogen level will rise again, thus diminishing the pain.
How magnesium support bone health?
Magnesium (Mg) is the fourth most abundant mineral in the body and is essential to good health. About 60% of total magnesium is stored in the bone. When talking about bone health, most of the people will think of calcium or vitamin D. However, magnesium is also associate with osteoporosis.

Calcium cannot be optimally utilized without proper balance of magnesium. A high calcium intake without adequate magnesium intake can further drain any reserves of magnesium in the body. Magnesium stimulates hormone calcitonin that helps preserve bone structure by drawing calcium from the blood and soft tissues back into the bones. Sufficient magnesium can help to suppress parathyroid, another hormone that breaks down bone.

Magnesium is also necessary to convert vitamin D into its active form so that it can stimulate calcium absorption. The enzymes metabolizing vitamin D require magnesium as a necessary co-factor. If our body lack of magnesium but we still taking high doses of vitamin D, the increased amount of metabolic activity will drain magnesium from the storage sites.

Why we need collagen for joint health?
Collagen plays an important role in the building of joint cartilage and it may have anti-inflammatory effects. Thus, optimizing collagen level in body is essential to maintain joint health especially in OA patients.
What causes Osteoarthritis?
  • Aged 50years old and above
  • Body weight
  • Family history
  • Women are more prone to be affected
  • Previous joint injury or joint deformity
What is Osteoarthritis (OA)?
Arthritis refers to disorder that affect the joints. Most common arthritis includes osteoarthritis (OA), rheumatoid arthritis and gout. OA is characterized by degeneration of cartilage which protect the ends of each bone in joint. It is a medical condition where bones become brittle and fragile. Rheumatoid arthritis is an autoimmune disorder where the body defence system attack the joints. Gout refers to inflammation at joints due to building up of uric acid crystals.
How type II collagen and glycosaminoglycans (GAGs) affects joint health?

Cartilage is made up of specialized cells called chondrocytes, and it does not have any blood  vessels, nerves or lymphatic. These chondrocytes produce large amounts of extracellular matrix composed of collagen fibers, proteoglycan, and elastin fibers. In normal cartilage, it is highly hydrated, being 70% – 75% water. Collagen and proteoglycans account for the remaining dry weight.

Type II collagen represents the largest group of collagen in the cartilage, which account for 90% to 95%. It helps to maintain the tensile strength of the cartilage or resist stretching force on the cartilage.

Glycosaminoglycans (GAGs), which are usually found covalently linked to protein in the form of proteoglycans. The functions of proteoglycan include maintaining the hydration of the matrix, stabilizing the collagen network, and resisting the compressive forces. The main groups of GAGs which covalently attached to proteoglycan includes chondroitin sulphate, keratin sulphate, dermatan sulphate, heparan sulphate and hyaluronan.

In order to have a healthy cartilage, it is very important to maintain the correct composition of water, collagen, and proteoglycan in the cartilage. We can get sufficient of collagen and GAGs through various food and nutritional supplement intake.

Can soft drinks, coffee or tea cause a problem to my bones?
Many of us enjoy the caffeine boost that they get from drinking a cup or more coffee or tea daily. Others like the taste of the soft drinks or sodas. Certain soft drinks and sodas contain phosphorus (phosphoric acid) and caffeine that may bring some effect to the bones. Those soft drinks may even have other additives, besides phosphoric acid and caffeine that can interfere the calcium absorption in the body. Thus, people with low bone mass and osteoporosis are highly recommended to consume them with cautious, not more than 5 soft drinks/caffeinated beverages weekly.
How to stay active and healthy against osteoarthritis?
Glucosamine and chondroitin are two clinically proven nutritional compounds that help to relieve joint pain, promote cartilage formation and improve joint flexibility.
My mother has rheumatoid arthritis and she experiences pain in her finger and ankles when she eats certain foods. What is rheumatoid arthritis? Currently, she only uses cold packs to relieve the pain. Please advise.
Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects synovium, the lining of the joints. It is an autoimmune disease, in which the body’s immune system produces antibodies that attack its own tissues. Some individuals with RA do experience flare-ups after eating certain foods especially dairy products, tomatoes, eggs and nuts. Hence, it is advisable that she keeps a food diary and if her condition worsens after eating a particular food, it is best to avoid it.

The same goes for foods that improve RA such as fiber and fish. Try to eat them more regularly. Oily fish and fish oil contain omega-3 fatty acid derivatives specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) that inhibit the formation of inflammatory compounds. Evening primrose oil is another valuable supplement as it contains gamma-linolenic acid (GLA), an omega-6 fatty acid derivative which is associated with beneficial anti-inflammatory prostaglandins.
Clinical studies revealed that a combination of fish oil and evening primrose oil significantly reduced morning stiffness and swollen joints which led to improvements in RA. It is important to understand that although home remedies such as cold packs, rest and elevation may make your mother feel somewhat better, these will not prevent the progressive destruction of her joints. Thus, apart from prescribed medications, it is advisable to supplement her diet with fish oil and evening primrose oil. A 4:1 ratio of fish oil and evening primrose oil is the optimum ratio that our bodies can use.
I am in my mid 50s. I went for blood test and full body check up at a hospital recently. I was shocked when the doctor told me that I have osteoporosis. What will happen in long term?
Osteoporosis has no symptoms or discomfort, and one might not know about it until a fracture occurs. This disease simply indicates that your bones are becoming fragile and more likely to break. If left untreated, osteoporosis can progress painlessly until a bone (especially hip, spine and wrist) breaks, which often occurs as a result of a fall.

Aging is the prime reason responsible for osteoporosis. Bones gradually lose their density as a natural part of aging which simply means that the older we are, the lower our total bone mass. Poor nutrition, sedentary lifestyle, smoking and excessive alcohol use have been linked to osteoporosis. A low calcium diet and too much caffeine-containing beverages (coffee, tea and some sodas) can cause bone loss. Besides that, those having a small frame and bone structure are at a disadvantage because it increases the chance of getting osteoporosis.
As for your condition, you should include higher amounts of calcium and vitamin D in your diet. The body needs calcium to build strong bones and to create a supply of calcium reserves. For those with osteoporosis, increasing intake of calcium and vitamin D can decrease the risk of fracture. Dairy products including milk, yogurt and cheese are excellent sources of calcium. Vitamin D, magnesium and zinc are equally important as they enhance calcium absorption. If you are not exercising regularly, you might want to start from now because exercise can help minimize bone loss while providing many additional benefits.
My father who is 53 years old has no major health problems except for gout. He has flare-ups every now and then. What foods should he avoid?
Gout is a common type of arthritis that occurs when too much uric acid builds in the blood, tissue and urine.
Uric acid is a by-product formed from the breakdown of purine. When the level of uric acid becomes high, needle-like crystals may form and accumulate, causing irritation in the joint lining and severe joint inflammation. Affected joints usually swell and may look red and inflamed. Individuals suffering from gout are advised to avoid purine-rich foods such as organ meats, shellfish, peas and lentils as well as alcohol. These foods may increase uric acid levels and precipitate an attack in those with existing gout.
Opt for complex carbohydrates such as bread, cereals, pasta, rice as well as all vegetables and fruits. Drink 2 to 3 liter of fluids (8-12 cups) daily. Adequate fluid intake promotes the solubility and excretion of uric acid. Traditional herb such as celery seeds may help relieve gout. Celery seeds exert a diuretic effect that helps flush out uric acids from the body.
On the other hand, omega-3 and omega-6 essential fatty acids found in fish oil and evening primrose oil (in 4:1 ratio) may also help to reduce stiffness and tenderness of the joints.
My father has frequent knee pain. He experiences stiffness when he gets up from his seat and pain when walking. What would you suggest to reduce the pain?

Your father may be suffering from osteoarthritis.

Osteoarthritis is known as a “wear & tear” problem, mostly affects the cartilage where the surface layer of cartilage breakdown and wears away. This allows bones under the cartilage to rub together, causing pain, swelling, and loss of motion of the joint. For this condition, glucosamine supplementation is highly recommended.
Glucosamine stimulates the production of both proteoglycans and collagen, normalizes cartilage metabolism which helps keep cartilage from breaking down, helps the body to repair damaged cartilage and slows the progression of joint deterioration. A 500mg glucosamine sulfate formula that is sodium-free is suitable for individuals with high blood pressure.
Apart from that, omega-3 and omega-6 essential fatty acids are also beneficial. Besides suppressing inflammation, it can also help lower high blood pressure. Consider one that provides a 4:1 ratio of evening primrose oil (omega-6) to marine fish oil (omega-3) as it is the optimum ratio that our bodies can use.
Most osteoarthritis sufferers benefit from exercise especially when their pain is least severe. Always start with adequate warming up and begin exercising slowly. Dietary wise, reduce the consumption of meat, fast food and soft drinks. A high consumption of these foods may lead to spur formation around the joints and cause inflammation.

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