Bone Density and Cartilage Loss

For the natural practitioner, skeletal conditions are often challenging, with many remedies offering palliative support but not eliminating the prevailing ailment. Whilst the passing years can take their toll on most people’s articular joints there are factors, too, that can precipitate a condition. So it can pay dividends to have an overall understanding of joint articulation, the formation of bone and why cartilage may deteriorate.

The density of compact bone is surprisingly constant throughout life, The normal, average bone mineral density is around 3.88 g/cm² in males and 2.90 g/cm² in females. But in later years this may start to decline. Bone is made of a hard layer and a mineral layer. One of the structures which makes up the mineral layer of the bone that resembles tubes, is called the Haversian canal. This structure carries organic nourishment required by the bone system. Calcium is an integral part of this process. Thin plates called lamellae that contain the marrow of the bone surround the Haversian canal. The yellow marrow is fat and the red marrow is made of tissue that includes the blood cells. The hard layer of the bone is made of collagen. This layer makes up 70% of the density of bone in adults. There are three types of cell that comprise the functioning aspect of bone. They are Osteoblasts, Osteocytes, and Osteoclasts. The Osteoblasts create collagen and strengthen the bone. The Osteocytes control the mineral balance within the body. Osteoclasts destroy bone mineral tissue in the process called bone turnover.

Primary in all these processes is the mineral Calcium. As well as using Calcium as its own building block, the body’s bones also act as a storage for this mineral and dispense it for other bodily functions when hormonal activity demands it.

The Calcium level in all parts of our bodies is regulated by the parathyroid glands. Through the secretion of parathyroid hormone (PTH), these four small parathyroid glands regulate how much Calcium is absorbed from diet, how much is released into the urine by our kidneys and most other key functions requiring Calcium.

In some circles now there is growing interest in the relationship between the adrenal glands and the parathyroid. Various studies with regard to this were commissioned during the 1930’s and 1940’s but conclusions were not very enlightening. However, the adrenals’ influence on energy levels and demands might point to synergistic activity between these two areas. The principal hormone from these glands, Cortisol, is normally associated  with anti-inflammatory properties but if overproduced (a condition called Cushing’s syndrome ) inhibits the cells that form bone and can cause loss of bone density and bone strength. So it can be extrapolated from this fact ( and minerals’ role in fight or flight biochemical reactions ) there can, indeed, be some relationship between these two glands, when diagnosing some of the conditions involving Calcium loss.

Practitioners favouring glandular extracts in treatment may, after consultation and testing, consider this factor and possibly utilise appropriate adrenal products alongside parathyroid support, monitoring response. Several have reported success with this approach but, as always, patients’ underlying causes vary greatly. The functionality of the thyroid hormone, Calcitonin, that tends to lower the level of calcium in the blood plasma and inhibits resorption of bone, should, additionally, often be checked for.

If the parathyroid glands become overactive, hyperparathyroidism results and excessive calcium is released into the blood stream. As a consequence bones begin to lose their density and hardness

Because of Calcium’s alkaline make-up practitioners can often be thrown a curve when screening a patient. Calcium may circulate in the blood for long periods of time in an attempt to become acidic enough for use. This explains why those who are calcium deficient often show high levels of calcium in their initial blood test or screening.

The blood, the heart, the muscular system, the nervous system, the hormonal system, the kidneys and the gastrointestinal system are all dependent on adequate bio-available serum Calcium, so seemingly unrelated conditions can often occur as a consequence.

Estrogen

Estrogen inhibits excessive turnover of Calcium in the bones, primarily by inhibiting excessive deportation of Calcium from the bones. The act of cell destruction in this skeletal area, known generally as apoptosis, is slowed by Estrogen. From this it easy to see that there is an interplay between Estrogen and the hormones of the parathyroid gland. Thus as these levels start to vary during menopause, women, in particular, become susceptible to osteoporosis as the deportation of Calcium often increase from the bones.

The 2002 study ‘ The effect of estrogens and dietary calcium deficiency on the extracellular matrix of articular cartilage.’ published by Horst Claassen and colleagues, confirmed previous studies in this field.

 Osteoporosis

Faced with the condition of osteoporosis, the natural practitioner has the dilemma of trying to match supplements and therapies with the prevailing status of the patient’s metabolism, homeostasis and skeletal structure. Magnesium should always be a part of any regime, as should Pantothenic acid, but the balance of treatment and supplements normally has to be adjusted as regular screenings and tests indicate progress or lack of it.

There are several systems of establishing bone density but they generally employ two methods of scoring:

A T-score compares your bone density to the optimal peak bone density for your gender. It is reported as number of standard deviations below the average. A T-score of greater than minus-1 is considered normal. A T-score of minus-1 to minus-2.5 is considered osteopenia ( mild thinning of the bone ), and a risk for developing osteoporosis. A T-score of less than minus-2.5 is diagnostic of osteoporosis.

A Z-score is used to compare your results to others of your same age, weight, ethnicity, and gender. This is useful to determine if there is something unusual contributing to your bone loss. A Z-score of less than minus-1.5 raises concern of factors other than aging as contributing to osteoporosis.

Cartilage

Cartilage loss is normally associated with the area of the knee joint but can also affect other joints. There are two types of cartilage in this area… Articular Cartilage, which caps the end of the bone and The Meniscus ( or Menisci, in plural ) which are discs of cartilage that serves as a cushion between the ends of bones that meet at a joint. There are two Menisci in each knee. Both are between the tibia, also called the shinbone, and the femur or thighbone. The Meniscus is nourished by small blood vessels, but the Meniscus also has a large area in the center of that has no direct blood supply (avascular).

The term cartilage tear normally refers to a Meniscus tear. Generally arthritis and wear of cartilage refers to the Articular cartilage.

Researchers have analyzed cartilage loss in the knee joint and found that the main factors that will predict an eventual onset of the condition are medial meniscal damage, lateral meniscal damage, varus malalignment (bow-leggedness) of the knee joint, inflammation and fluid build-up.

Most practitioners are aware of the fact that cartilage does not normally replace itself. So any manifestations of problems in the area of the joints should be treated with a view  to handling the acute condition and avoiding  a chronic one occurring. As well as the usual glucosamine and chondroitin supplements, treatment with hyaluronic acid will support the cartilage. These supplements are best augmented with nutrients or natural remedies that have anti-inflammatory properties ( Omega’s etc ) plus ionic minerals.

There is also a new technology that allows cartilage cells, know as chondrocytes, to be harvested from a knee and cultured and multiplied. The fresh chondrocytes are then re-implanted in the knee and cause hyaline cartilage to regenerate. This biological repair is known as ACI (  Autologous Chondrocyte Implantation ) and current anecdotal evidence points to a reasonable level of success in this approach.

The natural practitioner is just as well equipped, perhaps more so, to deal with the problems of bone and cartilage loss. Use of supportive nutrition, therapeutic exercise, massage and other therapies can often reap dividends. Whilst skeletal deterioration is a consequence of ageing it does not have to be the painful rite of passage that many experience.

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Bilberry and Eye Conditions

Bilberry, Vaccinium myrtillus, is a European berry shrub that is related to the blueberry, huckleberry, and bearberry plants that grow in the United States. The shrub yields large amounts of small, darkish blue berries. Besides their medicinal use, they are often eaten fresh or made into jams and preserves. In addition to the berries, the shrub’s leaves are sometimes used in remedies too.

Bilberry has been used by European herbalists for centuries. In Elizabethan times, bilberries were mixed with honey and made into a syrup called Rob that was prescribed for diarrhea and stomach problems. But Bilberry is most famous, though, for its long use as a medicine for eye and vision problems. During World War II, British and American pilots discovered that eating bilberry jam before night missions greatly improved their night vision. Bilberries then became a staple for Air Force pilots. Since then, extensive research in Europe has shown that bilberries contain specific compounds that have beneficial effects on the eyes and circulatory system.

Bilberries are high in flavonoids, a type of polyphenol. The flavonoids found in bilberry provide the berry’s blue colour and are called anthocyanosides, These help strengthen capillaries and stabilize collagen and are Bilberry’s main active ingredients.

Bilberry flavonoids also increase the presence of important enzymes and substances. More importantly they increase circulation in the blood vessels in the eyes, and help these blood vessels repair and protect themselves. Specifically, research has shown that anthocyanosides help stabilize and protect collagen, a basic building block of veins, arteries, capillaries, and connective tissue.

The anthocyanosides of Bilberry appear to target the tissues found in the retina, the back of the eye where major functions of vision take place. As such, Bilberry can be used to treat many varieties of retinopathy, a disorder in which the intricate blood and nerve vessels in the retina are damaged. Retinopathy particularly affects people with diabetes, high blood pressure, and sickle cell anemia.

Many studies have validated bilberry’s usefulness as a medicinal herb. One study demonstrated that bilberry extract used with Vitamin E prevented the progression of cataracts in 48 of 50 patients with cataract formations. But it is for vision and eye disorders, including glaucoma, cataracts, and macular degeneration that Bilberry is primarily prescribed. In the initial stages of glaucoma Bilberry has proven extremely effective. A daily dose of between 350mg to 400mg has been observed to restore normal macular function in many cases. Bilberry offers the practitioner an effective and relatively inexpensive option in treating many eye complaints.