Solving The Joint Pain Problem

The first thing I need to do if I’m going to get super fit is solve the joint pain problem. I can’t do any decent exercise until I’ve calmed down the pain in almost every joint in my body.

From my toes, through my knees, my hips, my spine, my elbows, wrists and hands, everything hurts. Everything is a struggle.

I was diagnosed with osteoarthritis in September last year, aged 41. Now I’m 42 and the pain is spreading at what seems like an increasing rate. And I really am SO done with it. I can’t function properly as a mother to my three children because my whole body hurts all the time.

So, I have spent every spare minute researching a trail through medical studies and literature to formulate a hypothesis on how to fix myself.

The traditional medical solution is painkillers and bone fusion. That just isn’t an option I want to look at to be honest.

I simply cannot believe that it is normal to feel the way I do and to have a body deteriorating as rapidly as mine seems to be. How the hell am I going to live to be 100 if at 42 I am already falling apart? I have a genuine fear that if I don’t do something radical to change what’s going on in my body, I could well be in a wheelchair by the time I am 50 (and my daughter will be only 9). Again, NOT an option I want to look at.

So, here in brief note-y form are the huge leaps I have taken through medical science to explain my own condition. I am not a doctor, but I am probably more interested in my own health than any doctor is.

Osteoarthritis

Scientists don’t really know WHY cartilage breaks down.
https://www.urmc.rochester.edu/news/story/2091/researchers-offer-first-direct-proof-of-how-arthritis-destroys-cartilage.aspx

However, joints in patients with OA exhibit a common trait of less viscous synovial fluid (the fluid that lubricates the joints)
http://www.boneandjoint.org.uk/content/jbjsbr/41-B/2/388.full.pdf

My hypothesis 1: Synovial fluid’s primary role is to lubricate and cushion. When faulty it doesn’t do this job properly and cartilage gets damaged through normal joint use, aka, “wear and tear”.

Currently there are no drugs available that can stop or reverse the process of cartilage degradation.
http://www.mdpi.com/2221-3759/3/4/177/pdf

My hypothesis 2: Fix my synovial fluid to prevent new damage.

Synovial fluid contains three things:

  1. Fluid filtered from blood plasma
  2. Lubricin secreted by cartilage chondrocytes
  3. Hyaluronan secreted by the cells of the synovial membrane

https://en.m.wikipedia.org/wiki/Synovial_fluid

Hyaluronic acid (HA) can be injected into the joint, but results are not great.
http://annals.org/aim/article/1305531/viscosupplementation-osteoarthritis-knee-systematic-review-meta-analysis

And oral HA is dubious – HA levels are a tumour marker (though not necessarily causative).

So why would my HA be low, and how can I raise it?

Oestrogen increases hyaluronic acid production (in mice). If my oestrogen is low, my HA would be low.

Evidence: I suffered multiple recurrent miscarriages when trying for a family.

So, if my oestrogen is low, how can I raise it?

Oestrogen is synthesised from androgens, which are synthesised from cholesterol – the primary steroid. Cholesterol is a precursor to several steroid hormones in the body including oestrogen and vitamin D.
http://www.dermalinstitute.com/uk/library/76_article_Hormones_and_Your_Skin.html

The liver, mainly, creates cholesterol (around 20%), but ALL cells make it as it is essential to life.
The body converts cholesterol to pregnenolone which is considered to be the “mother” hormone.
Pregnenolone is then converted to other hormones such as progesterone, DHEA, testosterone, estrogen, cortisol, and dozens of other critical hormones. If your cholesterol is low, these hormones will also be low.

Evidence: my cholesterol is very low : 2.4 mmol/L or 92mg/dL, and so are my triglycerides : 0.49mmol/L or 43mg/dL

I always thought that was a good thing, so I was stunned to discover this is actually quite bad and that it is linked to anxiety, depression, violent behaviour, infertility, suicide, and negative outcomes (ie death) in the critically ill/elderly:

http://articles.mercola.com/sites/articles/archive/2008/01/02/low-cholesterol-linked-to-violence.aspx

http://www.webmd.com/men/features/can-your-cholesterol-be-too-low-feature#1

http://www.telegraph.co.uk/news/health/news/4707834/Too-little-cholesterol-is-harmful-for-elderly.html

https://metabolichealing.com/cholesterol-your-body-is-incapable-of-making-hormones-without-it/

There is very little info on low cholesterol, but it is called hypocholesterolemia.
https://en.wikipedia.org/wiki/Hypocholesterolemia

Why is my cholesterol low and how can I raise it? 

Low cholesterol has me stumped. It can be caused by statins (nope), an inherited genetic disease (nope), a couple of other rare diseases (nope) or an extremely low fat diet (guffaw! Hardly the case for me).

The other general causes seem to be malnutrition and malabsorption. I am fairly slim, but I am certainly not malnourished in the true definition of the word. If I have malabsorption I don’t have the typical symptoms. However, in the absence of any other explanation, a sub-clinical undernourishment problem is what I’m going to go with.

Evidence: I do have a compound MTHFR mutation, which (it turns out), means I am a poor absorber of folate/B9, so perhaps this is not as crazy as it sounds.

The whole MTHFR thing uncovers a host of problems I may have, including low glutathione, and low choline. Choline is also further depleted by pregnancy and breastfeeding, as is cholesterol. I am still breastfeeding my daughter.

http://www.beyondmthfr.com/low-lipids-low-cholesterol-and-choline-deficiency/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2782876/

My hypothesis 3: My compound MTHFR mutation, combined with three pregnancies, breastfeeding and a poor diet, has resulted in a malnourished state, causing low cholesterol and triglycerides, meaning low steroid hormones, which ends up causing low levels of hyaluronic acid and therefore the deterioration of my joints with osteoarthritis.

Now, I know that this is crazily unscientific, but it does make sense.

So this is what I am going to base my “treatment” on:

Reversing my “malnourished” state and then looking at how to best support my cartilage for regrowth (cartilage does regrow, just very very slowly).

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