Joint Health

Cod Liver Oil is a traditional health supplement that has been taken for hundreds of years for the relief of joint pain and stiffness. Only in the past thirty years has research shown that it is omega-3 fatty acids in cod liver oil and fish oils that have such a beneficial effect on joint inflammation and cartilage degeneration. Glucosamine is a relative newcomer to the list of health supplements that people may choose for joint health protection and relief of joint problems. Joint problems affect a large proportion of the population. By far the most prevalent is osteo- or “wear and tear” arthritis. Arthritis is a serious national health problem affecting nearly three quarters of a million men and women, even affecting up to 1,000 children in Ireland. Over 1 in 6 people have some form of arthritis in Ireland (Source: Arthritis Ireland). Given our aging population, this is set to continue.

Types of Arthritis

1. Osteoarthritis (OA)
A significant majority of people suffering from arthritis have osteoarthritis, also known as “wear and tear” arthritis. It can affect any joint, but the knees, hips and lower spine are most commonly affected. Symptoms include joint pain, stiffness, inflammation, loss of mobility and quality of life. The majority of Irish people over 55 years of age have X-Ray evidence of OA at some joint in their body.

2. Rheumatoid Arthritis (RA)
Rheumatoid Arthritis is a chronic, progressive and disabling auto-immune disease. Instead of fighting off disease, the immune system turns against parts of the body, particularly the joints. It is a painful condition causing swelling and damage to cartilage and bones around the joints. Any joint can be affected but it is commonly the hands, feet and wrists. In time it can affect a person’s ability to carry out everyday tasks. It is estimated that 1% of the adult Irish population is affected by RA.

Anatomy of a Joint

Joints are the place where two bones meet. Most joints are designed to protect the ends of bones, they also hold your bones together and they allow the rigid skeleton to move. Movable joints are described as ‘synovial’ joints e.g. ball and socket joints, like your hip and shoulder joints and hinge joints, like those in your knee and elbow. Synovial joints are made up of bone, connective tissue (cartilage, tendons and ligaments) and synovial fluid.

The ageing Joint

Doctors used to think of osteoarthritis as a disease of old age, but they now believe that it begins in our 30’s, 20’s or even younger, although the first tell-tale twinges may not be felt until our 40’s and 50’s. Professional sports players and people involved in frequent, intensive sports participation and some occupations requiring repetitive use of certain joints may be more at risk of early joint changes than the general population. Those that smoke or are overweight are also associated with an increased risk. Bones, muscles, tendons and ligaments are all involved in the maintenance of joint function, but the health of cartilage is paramount. Connective tissues are continuously being remodelled as they are worn away during activity and then reformed afterwards. As we age we become less efficient at renewing these tissues, especially cartilage. Cartilage is a translucent, tough, flexible and elastic connective tissue that acts as a cushion or shock absorber when weight is placed on the joints. Its smooth, slippery surface also allows the bone ends to move freely.


A Healthy Knee Joint

Healthy cartilage requires four things:
1) fluid for lubrication and nourishment
2) proteoglycans and glycosaminoglycans (GAGs) to attract and hold fluid
3) collagen to hold proteoglycans in place
4) chondrocytes to clean away old and produce new proteoglycans and collagen
When any of these elements are missing, cartilage can deteriorate and osteoarthritis will begin to develop. Sometimes between the ages of 40 and 55, cartilage takes longer to replenish itself. As the cushion of cartilage thins and the bones start to grind together, inflammation of the joints results.
 

A Damaged Knee Joint

Who’s at Risk?

What makes you more susceptible to suffering from arthritis?
• Family – some forms of osteoarthritis run in families
• Age – osteoarthritis is common in older people
• Overweight – being overweight will put more pressure on the joints
• Injury / Operation – a major injury or an operation can increase the risk of OA in later life
• Professional sports players – may be at more risk of early joint changes due to repetitive use of certain joints

Background to Cod Liver Oil and Glucosamine

Early in the 1900’s, it was discovered that cod liver oil was a good natural source of vitamins A & D and its free distribution during World War II was credited with practically eradicating the bone crippling disease, rickets. Since more recent fatty acid research identified that cod liver oil is also a rich source of the important omega-3 fatty acids, its health reputation has risen significantly. There is now an accumulation of robust scientific evidence to support glucosamine supplementation for osteoarthritis relief.

Glucosamine

Glucosamine is a form of amino sugar found naturally in the body where it has a vital role in cartilage formation and repair. Glucosamine supplements are derived from the shells of shellfish like crab, lobster or shrimp, so they may not be suitable for vegetarians.

How glucosamine works?
• Glucosamine is the major building block of proteoglycans and is needed to make glycosaminoglycans (GAGs) proteins that bind water in the cartilage matrix. Each person produces a certain amount of glucosamine but age affects the body’s ability to produce enough. An insufficient supply of glucosamine restricts the efficiency of cartilage rebuilding and can delay repair of cartilage and other connective tissues.

Types of glucosamine
• Glucosamine is available as glucosamine sulphate and glucosamine hydrochloride. The suffix ‘sulphate’ or ‘hydrochloride’ indicates which of the two salts are used.

Recommended dose of glucosamine
• No RDA for glucosamine has been set as yet by the EU, however the maximum recommended dose is 1500mg per day.

Who should not take glucosamine?
• There are no contraindications to glucosamine supplementation, although the following customersshould first consult with their GP:
- Pregnant women.
- Vegetarians and vegans may choose not to take glucosamine because it is derived from shellfish.
- Anyone on prescription medicines should speak to their doctor before taking any health supplements.

Glucosamine helps rebuild the connective tissue around the joints, including tendons, ligaments and cartilage.

Cod Liver Oils and Fish Oils

As the name implies, cod liver oil is extracted from the liver of cod and refined to pharmaceutical standards. Fish oils are obtained from the flesh of oily fish like herring, mackerel and sardines. Both are a rich source of vitamin D and omega-3. Cod liver oil also supplies vitamin A.

How do Cod Liver Oil and Fish Oils work?
• Cod liver oil and fish oils have been identified as an important source of omega-3 fatty acids, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). Research has found that these valuable nutrients have the ability to halt and even reverse cartilage destruction. Research has shown that, by switching off the enzymes that break down joint cartilage, omega-3 can slow the progress of cartilage degradation, reduce inflammation and lessen pain.

Recommended Dose of Cod Liver Oil and Fish Oils
• No RDA for cod liver oil and fish oils has been set.

Who should not take cod liver oil or fish oils?
• Anyone on prescription medicines should speak to their doctor before taking any health supplements.
• Pregnant women because it contains vitamin A.
• Vegetarians and vegans may choose not to take cod liver oil or fish oils. Flaxseed oil is an acceptable alternative omega-3 supplement for these groups but it is important to note that it is not considered equally effective.
Flaxseed oil supplies omega-3 alphalinolenic acid (ALA), which has to undergo metabolic processes in the body to be converted to omega-3 fatty acids EPA & DHA. This conversion is inefficient at best. In order to maximise the conversion process, cutting down use of vegetable margarines and oils should reduce the amount of omega-6 in the diet.

Glucosamine and Cod Liver Oil
• It can be seen from the evidence that glucosamine and the omega-3 found in cod liver oils and fish oils may help maintain joint health. But as they work in different ways, together they are more effective than separately. And as both add to what the body needs to function efficiently, they help rather than interfere with the body’s own repair mechanism.

Glucosamine & Omega-3 work in synergy

Chondroitin

Chondroitin is an amino sugar that occurs naturally in the body. It is a major component of cartilage and connective tissue, which cushion the joint. It is responsible for attracting synovial fluid, which lubricates the joints. Connective tissues are continuously being remodelled as they wear away during activity and are then reformed afterwards. As we age we become less efficient at renewing these tissues, especially cartilage. Like glucosamine, chondroitin is a building block of proteoglycans (one of the main structural components of cartilage). Whilst chondroitin is a natural amino sugar already present in the body, it cannot be easily obtained from diet as it is found in only a small number of foods.

Omega-3 can slow the progress of cartilage degradation, reduce inflammation and lessen pain