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Tendon health

Mudge

Mudge

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Tendon Health

While injecting test increases protein synthesis by roughly 50 times, depending on dose and time, most bodybuilders forget that it will reduce collagen synthesis by more than 50% -- more like 80%, giving you the collagen synthesis rate of a senior citizen. Since collagen makes up tendons, bros are very prone to injury if they continue to lift very heavy, unless they cycle off T and let their collagen synthesis get back to normal. It's like having the skeletal muscle of a gorilla with the tendons of a very old man.

Winstrol increases collagen synthesis. It will give you bigger tendons. However, your body compensates for this by making them more brittle, weaker, and more prone to injury. I can't tell you how many bros work out anaerobically and become injured while on winstrol. Guys who lift in the 1-5 rep range while on winstrol, to baseball players who sprint all out from a stationary position -- winstrol should be the LAST drug they choose. Most of them like winstrol because they don't get the weight gain from it but it is very detrimental to bros who train for any sport anaerobically. Tendons tear easily on it.

Also, the drugs I mention increase collagen synthesis while also increasing collagen cross-linking integrity, making for a much stronger tendon.

Winstrol, on the other hand, will dramatically increase collagen syn, but ironically it decreases collagen cross-linking integrity, thus making a much weaker tendon.

You can plan a cycle of AAS which will increase collagen synthesis and skeletal muscle growth at the same time. The key is the drug(s) you choose.

Deca, Equipoise, Anavar, and Primobolan will ALL increase skeletal muscle while at the same time dramatically increase collagen syn and bone mass and density, leaving you with a substantially reduced chance of becoming injured than if you choose to use AAS like sus, cyp, or enth.

While testosterone will increase bone mass and density, even at supra-physiological levels, the result is weaker tendons due to inhibition of collagen syn.

To plan a cycle where the goal is to increase skeletal muscle mass/strength while at the same time increase joint/tendon/ligament strength, enough to keep up with the dramatic increase in skeletal muscle, you must choose drugs like Eq, Deca, Anavar, or Primo as the base of your cycle. Testosterone and its esters can be added to your cycle to keep levels within a 'normal' physiological range (ie, 100-200 mg/wk) but must not go above this. Since drugs like eq, deca, anavar and primo will reduce endogenous, natural levels of test, these levels may be maintained with exogenous test in the 100-200 mg/wk range. Test at this dose will not inhibit collagen syn, but paradoxically, will help increase it. It is when exogenous testosterone is used > 200 mg/wk that collagen syn is inhibited.

Deca @ 3 mg/kg a week(about 270 mg/wk for a 200 lb male) will increase procollagen III levels by 270% by week 2. Procollagen III is a primary indicator used to determine the rate of collagen syn. As you can see, deca is a very good drug at giving you everything you want -- an increase in collagen syn, an increase in skeletal muscle, and increases in bone mass and density. The one thing it does not give you is wood

Primobolan, @ 5 mg/kg, will increase collagen synthesis by roughly 180% -- less than deca and equipoise but still substantial.

Equipoise @ 3 mg/kg will increase procollagen III by approximately 340% -- slightly better than deca.

Oxandrolone has over a hundred studies documenting its effectiveness at treating patients needing rapid increases in collagen syn to enhance healing.

These drugs have longer half-lives than most other AAS, so this should be considered when timing your post cycle clomid use. Here they are:

Deca: 15 days Equipoise: 14 days Primobolan: 10.5 days

Anavar has a half-life of only 8 hours so it should not pose a problem.

GH is probably the most remarkable drug at increasing collagen synthesis. It increases collagen syn in a dose dependant manner -- the more you use, the more you will increase collagen syn. It has also demonstrated this ability in short and long term studies. From what I've read, hGH at 6 iu/day increased the collagen deposition rate by around 250% in damaged collagen structures. This result indicates that the increased biomechanical strength of wounds to collagen structures treated with biosynthetic human growth hormone was produced by an increased deposition of collagen in the collagen structures.

Eq, primo, anavar, and deca are all good -- they increase several biomakers of collagen syn -- ie, type III, II, I, procollagen markers. GH just seems to do so most dramatically.

Use of any of these drugs @ supra-physiological levels with a maintenance dose of test will increase collagen syn while at the same time increase skeletal muscle mass. Skeletal muscle mass gains will not be as dramatic as with large testosterone doses but you have to weigh the risk/reward basis for yourself. Also, these drugs do not satisfy the libido like testosterone, but that is not the point of this thread. It is only to demonstrate that you can increase skeletal muscle and collagen syn at the same time with certain AAS -- the decision is up to you.
 
Excuse my ignorance, but this sounds very interesting since I think I have a real problem with joint and tendon health. Are these drugs legal or not?
 
For prescription, otherwise it would be in the supplements section.

Drugs are regulated, supplements much less.
 
So I would need to get a Rx for those things. Go to an Ortho Dr to get it?
 
Some kind of doctor yep.
 
Do you think that would help with tendonitis? I feel I get tendonitis because my muscles handle more weight than do my tendons.
 
Possibly, I have forced myself to simply drop the weight a bit and slow the reps down on most lifts, back day kills my bicep tendons.

Since I am not taking HRT levels of test though, supposedly I am inhibiting collagen synthesis.

While testosterone will increase bone mass and density, even at supra-physiological levels, the result is weaker tendons due to inhibition of collagen syn.
Click to expand...
 
Thanks Mudge!
 
Would adequan, be of any aid to the tendon problem?
 
Muscle Gelz Transdermals
IronMag Labs Prohormones
Someone on another board brought it up, I dont remember how much he is using though.
 
Perhaps this may be of help to someone on this issue FAST ACCESS TO THE JOINTS: Beneficial levels of Adequan are already at work in all major joints within two hours after intramuscular injection, with even greater uptake (up to 73% higher) in joint tissues that are inflamed or diseased. LONG-TERM EFFECTS: Adequan relieves the pain and disability of joint damage, and the relief has been shown to last up to 6 months or longer. BREAKS THE DESTRUCTIVE CYCLE: Adequan binds to damaged cartilage and boosts cartilage metabolism, facilitating repair processes. At the same time, it blocks the action of destructive enzymes that promote joint inflammation, break down the synovial fluid, and attack the cartilage. RENEWS THE JOINT FLUID: Adequan stimulates the synovial membrane to manufacture new synovial fluid to replace the thin, degraded fluid of joint disease. By doing so, Adequan helps lubricate, nourish, and clean the cartilage.

Administration: An initial 8-dose series is recommended: 2 mg/lb intramuscularly twice a week for four weeks. Adequan Canine is packaged in 5 mL (100 mg/mL) multidose vials.
 
Here's a little more info for those that may be interested
First, Adequan has important antiinflammatory effects, so it is able to provide relief from the symptoms of joint damage: heat, swelling, pain and lameness. And Adequan can be found in synovial fluid at full therapeutic levels within only two hours of an intramuscular injection. Also, Adequan is a product with potent ability to block the action of the destructive enzymes that threaten to perpetuate the joint inflammation, attack the cartilage and break down synovial fluid.

Second, Adequan also stimulates the synovial membrane to manufacture new, viscous synovial fluid to replace the thin fluid that was produced when the joint became injured. By improving this fluid, Adequan helps the joint regain its ability to lubricate and guard itself against further inflammation, and helps reestablish nutrition to the cartilage.

And, Adequan attaches itself to damaged cartilage where it has a positive effect on cartilage metabolism. This should favor the cartilage repair process.

Adequan is the only joint treatment proven to reduce the inflammation and pain of degenerative joint disease, but also to help stop the degenerative process while stimulating the production of new joint fluid and new cartilage components. You are no longer just treating symptoms: you're doing something to help stop the degenerative process.

DOSAGE AND ADMINISTRATION: The recommended dose of Adequan IM in horses is 500mg every 4 days for 28 days intramuscularly. The injection site must be thoroughly cleansed prior to injection. Do not mix Adequan IM with other drugs or solvents.

Comes in 500mg/5ml glass vials.
 
I actually met someone recently that has been using adequan,according to the information I got it's the "goods". He also claimed that it worked as a sort of pain reliever? Maybe because it reduced the swelling? Don't know. But thats what was relayed to me. PEACE
 
I did arms yesterday, and today I did legs (SLDL also) and my bicep tendons were not happy. I may have to give this stuff a shot.

I'll have to order up some glucosamine chondroitin too.
 
I talked to some of the ER Doc's about this stuff and getting a RX and they just laughed at me. They didn't know what these names were until I explained to them.
 
Adequan is not FDA approved for human use.
 
But Dr's can still prescribe it?
 
Its for vet use dewd :) I am not sure if it is easy to get like fina pellets, heck I may try it though, I know a single person using it so I will see if he will give some info.
 
A friend of mine has used and many others this ver product and claim it heals joints permantly in animals and in humans but not yet FDA approved.
Anyone use this here is info I found in a quick search on it.


If you are searching for a product that treats both the symptoms and the underlying degenerative disease process of horses' joint problems, Adequan ® may be a good choice.

First, Adequan has important antiinflammatory effects, so it is able to provide relief from the symptoms of joint damage: heat, swelling, pain and lameness. And Adequan can be found in synovial fluid at full therapeutic levels within only two hours of an intramuscular injection. Also, Adequan is a product with potent ability to block the action of the destructive enzymes that threaten to perpetuate the joint inflammation, attack the cartilage and break down synovial fluid.

Second, Adequan also stimulates the synovial membrane to manufacture new, viscous synovial fluid to replace the thin fluid that was produced when the joint became injured. By improving this fluid, Adequan helps the joint regain its ability to lubricate and guard itself against further inflammation, and helps reestablish nutrition to the cartilage.

And, Adequan attaches itself to damaged cartilage where it has a positive effect on cartilage metabolism. This should favor the cartilage repair process.

Adequan is the only joint treatment proven to reduce the inflammation and pain of degenerative joint disease, but also to help stop the degenerative process while stimulating the production of new joint fluid and new cartilage components. You are no longer just treating symptoms: you're doing something to help stop the degenerative process.

DOSAGE AND ADMINISTRATION: The recommended dose of Adequan IM in horses is 500mg every 4 days for 28 days intramuscularly. The injection site must be thoroughly cleansed prior to injection. Do not mix Adequan IM with other drugs or solvents.

Comes in 500mg/5ml glass vials.
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my friend has a bottle he swears they heal joint problems like quick and permanently build and repair em back.

He is going to school to study chemistry and him and several of his friends have taken it with great results.
No need to do on-sites with either, I don't recall how he doses it he said if I recall correct took a few injections and that was it he no longer had to keep taking it..

try a goggle search I found a few places that I think will ship it
without a script from a veterinarian.

He knows his shit he went off all scientific on me on how ligaments and joints heal very slowly and how this is a catalyst and sends lots of relief fast and permanently ends long joint pains.
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FAST ACCESS TO THE JOINTS: Beneficial levels of Adequan are already at work in all major joints within two hours after intramuscular injection, with even greater uptake (up to 73% higher) in joint tissues that are inflamed or diseased. LONG-TERM EFFECTS: Adequan relieves the pain and disability of joint damage, and the relief has been shown to last up to 6 months or longer. BREAKS THE DESTRUCTIVE CYCLE: Adequan binds to damaged cartilage and boosts cartilage metabolism, facilitating repair processes. At the same time, it blocks the action of destructive enzymes that promote joint inflammation, break down the synovial fluid, and attack the cartilage. RENEWS THE JOINT FLUID: Adequan stimulates the synovial membrane to manufacture new synovial fluid to replace the thin, degraded fluid of joint disease. By doing so, Adequan helps lubricate, nourish, and clean the cartilage.



First, Adequan has important antiinflammatory effects, so it is able to provide relief from the symptoms of joint damage: heat, swelling, pain and lameness. And Adequan can be found in synovial fluid at full therapeutic levels within only two hours of an intramuscular injection. Also, Adequan is a product with potent ability to block the action of the destructive enzymes that threaten to perpetuate the joint inflammation, attack the cartilage and break down synovial fluid.

Second, Adequan also stimulates the synovial membrane to manufacture new, viscous synovial fluid to replace the thin fluid that was produced when the joint became injured. By improving this fluid, Adequan helps the joint regain its ability to lubricate and guard itself against further inflammation, and helps reestablish nutrition to the cartilage.

And, Adequan attaches itself to damaged cartilage where it has a positive effect on cartilage metabolism. This should favor the cartilage repair process.

Adequan is the only joint treatment proven to reduce the inflammation and pain of degenerative joint disease, but also to help stop the degenerative process while stimulating the production of new joint fluid and new cartilage components. You are no longer just treating symptoms: you're doing something to help stop the degenerative process.

DOSAGE AND ADMINISTRATION: The recommended dose of Adequan® in horses is 250 mg (1 vial) once a week for five weeks, intra-articularly. The joint area must be shaved, cleansed and sterilized as in a surgical procedure prior to injection. Do not mix Adequan® with other drugs or solvents.

http://discountpetdrugs.com/adeqin5mlinb.html
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my friend says took all his joint pains in elbows away I am not sure there is a human versions out yet bro, all I find is vet for dog and horses.
Defiantly a product of great interest to many.
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Indications
ADEQUAN® Canine is recommended for intramuscular injection for the control of signs associated with non-infectious degenerative and/or traumatic arthritis of canine synovial joints.

Pharmacology
The active ingredient in ADEQUAN® Canine is polysulfated glycosaminoglycan (PSGAG). Polysulfated glycosaminoglycan is a semi-synthetic glycosaminoglycan prepared by extracting glycosaminoglycans (GAGs) from bovine tracheal cartilage. GAGs are polysaccharides composed of repeating disaccharide units. The GAG present in PSGAG is principally chondroitin sulfate containing 3 to 4 sulfate esters per disaccharide unit. The molecular weight for PSGAG used in the manufacture of ADEQUAN® is 3,000 to 15,000 Daltons.
The specific mechanism of action of ADEQUAN® in canine joints is not known. PSGAG is characterized as a "disease modifying osteoarthritis drug". Experiments conducted in vitro have shown PSGAG to inhibit certain catabolic enzymes which have increased activity in inflamed joints, and to enhance the activity of some anabolic enzymes. For example, PSGAG has been shown to significantly inhibit serine proteinases. Serine proteinases have been demonstrated to play a role in the Interleukin-1 mediated degradation of cartilage proteoglycans and collagen. PSGAG is reported to be an inhibitor of Prostaglandin E2 (PGE2) synthesis. PGE2 has been shown to increase the loss of proteoglycan from cartilage. PSGAG has been reported to inhibit some catabolic enzymes such as elastase, stromelysin, metalloproteases, cathepsin B1, and hyaluronidases, which degrade collagen, proteoglycans, and Hyaluronic acid in degenerative joint disease. Anabolic effects studied include ability to stimulate the synthesis of protein, collagen, proteoglycans, and Hyaluronic acid in various cells and tissues in vitro. Cultured human and rabbit chondrocytes have shown increased synthesis of proteoglycan and Hyaluronic acid in the presence of PSGAG. PSGAGs have shown a specific potentiating effect on Hyaluronic acid synthesis by synovial membrane cells in vitro.
Absorption, distribution, metabolism, and excretion of PSGAG following intramuscular injection have been studied in several species, including rats, rabbits, humans, horses and dogs.
Studies in rabbits showed maximum blood concentrations of PSGAG following IM injection were reached between 20 to 40 minutes following injection, and that the drug was distributed to all tissues studied, including Articular cartilage, synovial fluid, adrenals, thyroid, peritoneal fluid, lungs, eyes, spinal cord, kidneys, brain, liver, spleen, bone marrow, skin, and heart.
Following intramuscular injection of PSGAG in humans, the drug was found to be bound to serum proteins. PSGAG binds to both albumin and chi- and beta-globulins and the extent of the binding is suggested to be 30 to 40%. Therefore, the drug may be present in both bound and free form in the bloodstream. Because of its relatively low molecular weight, the synovial membrane is not a significant barrier to distribution of PSGAG from the bloodstream to the synovial fluid. Distribution from the synovial fluid to the cartilage takes place by diffusion. In the Articular cartilage the drug is deposited into the cartilage matrix.
Serum and synovial fluid distribution curves of PSGAG have been studied in dogs and appear similar to those found in humans and rabbits.
In rabbits, metabolism of PSGAG is reported to take place in the liver, spleen, and bone marrow. Metabolism may also occur in the kidneys. PSGAG administered intramuscularly and not protein bound or bound to other tissues is excreted primarily via the kidneys, with a small proportion excreted in the feces.

Dosage and Administration
The recommended dose of ADEQUAN® Canine is 2 mg/lb body weight (.02 mL/lb, or 1 mL per 50 lb), by intramuscular injection only, twice weekly for up to 4 weeks (maximum of 8 injections). Do not exceed the recommended dose or therapeutic regimen. Do not mix ADEQUAN® Canine with other drugs or solvents.

Contraindications
Do not use in dogs showing hypersensitivity to PSGAG. PSGAG is a synthetic heparinoid; do not use in dogs with known or suspected bleeding disorders.

Precautions
Store at room temperature 18°-25°C (64°-77°F).
Use with caution in dogs with renal or hepatic impairment.

Caution
Federal law restricts this drug to use by or on the order of a licensed veterinarian.

Warning
Keep this and all medications out of reach of children.

Side Effects
In the clinical efficacy trial, 24 dogs were treated with ADEQUAN® Canine twice weekly for 4 weeks. Possible adverse reactions were reported after 2.1% of the injections. These included transient pain at the injection site (1 incident), transient diarrhea (1 incident each in 2 dogs), and abnormal bleeding (1 incident). These effects were mild and self-limiting and did not require interruption of therapy. To report suspected adverse reactions or for a copy of the Material Safety Data Sheet for this product, contact Luitpold Pharmaceuticals, Inc. at 1-800-458-0163.

Toxicology
In a subacute toxicity study, 32 adult beagle dogs (4 males and 4 females per treatment group) received either 0.9% saline solution or PSGAG at a dose of 5 mg, 15 mg, or 50 mg per kg of body weight (approximately 2.3, 6.8, or 22.7 mg/lb), via intramuscular injection twice weekly for 13 weeks. PSGAG doses represent approximately 1X, 3X, and 10X the recommended dosage of 2 mg/lb, and more than 3 times the recommended 4-week duration of treatment. Necropsies were performed 24 hours after the final treatment. During week 12, one dog in the 50 mg/kg dosage group developed a large hematoma at the injection site which necessitated euthanasia. No other mortalities occurred during the treatment period. Statistically significant changes in the 50 mg/kg group included increased prothrombin time, reduced platelet count, an increase in ALT and cholesterol, and increased liver and kidney weights. Increased cholesterol and kidney weights were also noted in the 15 mg/kg group. Microscopic lesions were noted in the liver (Kupffer cells containing eosinophilic foamy cytoplasm), kidneys (swollen, foamy cells in the proximal convoluted tubules), and lymph nodes (macrophages with eosinophilic foamy cytoplasm) in the 15 mg/kg and 50 mg/kg groups. Intramuscular inflammation, hemorrhage, and degeneration were seen in all 3 PSGAG treated groups; the incidence and severity appeared dose related.

Trial Data
Efficacy of ADEQUAN® Canine was demonstrated in two studies. A laboratory study using radio labeled PSGAG established distribution of PSGAG into canine serum and synovial fluid following a single intramuscular injection of 2 mg/lb. A clinical field trial was conducted in dogs diagnosed with radio graphically-confirmed traumatic and/or degenerative joint disease of 1 or 2 joints. Joints evaluated included hips, stifles, shoulders, hocks and elbows. Fifty-one dogs were randomly assigned to receive either ADEQUAN® Canine at 2 mg/lb of body weight or 0.9% saline. Both treatments were administered by intramuscular injection twice weekly for 4 weeks (8 injections total). Investigators administering treatment and evaluating the dogs were unaware of the treatment assignment. A total of 71 limbs in 51 dogs were evaluated. Of these, 35 limbs in 24 dogs were in the ADEQUAN® Canine treated group. Each lame limb was scored for lameness at a walk, lameness at a trot, pain, range of motion, and functional disability. The scores for the individual parameters were combined to determine a total orthopedic score. At the end of the treatment period, dogs treated with ADEQUAN® Canine showed a statistically significant improvement in range of motion and total orthopedic score over placebo treated control dogs.
Studies to establish the safety of ADEQUAN® Canine in breeding, pregnant, or lactating dogs have not been conducted.

Presentation
ADEQUAN® Canine Solution 100 mg/mL in a 5 mL preserved multiple dose vial.
Click to expand...
 
I found this bros (CHECK BOLD PARAGRAPH):


Reversal of Osteoarthritis by Nutritional Intervention
This section is maintained by Frank M. Painter, D.C.
Send all comments or additions to: Frankp@chiro.org




ACA Journal of Chiropractic/November 1990
Reprinted with permission. ?? 1990, all rights reserved.



Luke R. Bucci, Ph.D.



Research from rheumatology and orthopedic clinics from Europe on the ability to reverse osteoarthritis has been accumulating for the last 25 years. Based on these results, this article will describe a nutritional program, that in conjunction with standard therapies used for osteoarthritis, can actually reverse the course of osteoarthritis.

Osteoarthritis is a collection of ill-defined joint diseases with cartilage degeneration being a central feature.1-3 Usually, deficient cartilage repair, joint bone remodeling, and later, synovial inflammatory processes promote extensive de-generation and erosion.1-3 Osteoarthritis has the highest morbidity (incidence) of all diseases, with almost universal occurrence after 50 years of age, although not all cases are severe. However, 5 million Americans per year are disabled by osteoarthritis, which is still the primary cause of lost time from work.


Osteoarthritis Myths

Even now, osteoarthritis is thought to be a normal consequence of aging, caused by routine "wear and tear" on joints. Also, it is thought that cartilage cannot heal itself, which is not completely true.1-6 Of foremost importance is the notion that osteoarthritis is associated with an inevitable progression to disability, and nothing can stop or reverse the process. These concepts have been overturned by recent research findings.


Evidence for Reversibility of Osteoarthritis

There is substantial evidence that osteoarthritis can be reversible.4-7 Spontaneous remissions in humans have been recorded and reported. Juvenile chronic arthritis can be halted by long-term, intense physical therapy and drugs. Chronic passive joint mobilization in animals has reversed osteoarthritis. Redistribution of joint loads by surgical techniques, polio, paralysis, and strokes has led to cessation of osteoarthritic progression. The proper types of electrical and mechanical stimulation of chondrocytes (the cells responsible for cartilage upkeep and repair) are currently being investigated. Thus, cartilage has the innate ability to repair itself if given the correct conditions.


Chondroprotective Nutrients

A new term introduced from Europe describes the actions of two categories of nutrients found to aid in reversal of osteoarthritis. Chondroprotective agents promote repair of cartilage by stimulating anabolic metabolism of chondrocytes and/or inhibiting catabolic processes found in osteoarthritis.7 This concept of helping chondrocytes to heal cartilage, rather than reliance on palliative analgesics, is a relatively new concept that gets more to the actual causes of osteoarthritis, as well as treating the symptoms.

The two major categories of chondroprotective nutrients are: glycosaminoglycans and antioxidants. Glycosaminoglycans (GAGs) were formerly named mucopolysaccharides, and are major structural components of cartilage and connective tissues.8 GAGs are long polymers of repeating two-sugar units, usually with sulfate groups on one type of sugar. The most common GAG is chondroitin sulfate, composed of glucuronic acid and N-acetyl galactosamine sulfate.

Chondroitin sulfate forms the bulk of GAG products previously tested and currently available. In Europe, purified chondroitin sulfate is available as both nutrient and drug. Two pharmaceutical products contain mostly chondroitin sulfates: Arteparon is synthetically sulfated purified chodroitin sulfate; Rumalon is semipurified GAGs from bovine cartilage sources. Glucosamine sulfate is another nutrient/pharmaceutical in European use, and is a single sugar precursor for chondroitin sulfate.


All GAG supplements share these common features:

· provide precursors for GAG synthesis;

· direct inhibition of degradative enzymes (elastase, collagenase, chondroitinases);

· direct stimulation of anabolic metabolism of chondrocytes; and

· counteraction of corticosteroid and NSAID side effects.

Antioxidants with known chondroprotective abilities are ascorbate (vitamin C), tocopherol (vitamin E), superoxide dismutase (SOD), and catalase, and other antioxidant nutritents have shown in vitro protection. Antioxidants share common properties of inhibition of free radical damage to cartilage, modulation of immune functions to resist auto-immunity, decrease of pro-inflammatory prostaglandins, inhibition of degradative enzymes, and for vitamin C, direct anabolic stimulation of chondrocytes.


Clinical Results of Chondroprotective Nutrients

For over 30 years, these chondroitin sulfate forms have been used in animal and human trials against osteoarthritis.9 In fact, over 40 million dose units per year of Rumalon are given. Most of these trials have been summarized in two recent English-language reviews.9,10 However, most of the original articles are in foreign languages in journals not readily accessible in the United States.

From the medical schools of Kumamoto, Matsumoto, Nagoya, Aichi, Tohuku, and Inatsuki, 26 orthopedic clinics participated in a double-blind study of 120 patients with osteoarthritis of the knee given intra-articular injections of either 1 mg arteparon (control group), or 50 mg Arteparon.?? Five total injections were given at weekly intervals for five weeks. Assessment of treatment found that 71 percent of high-dose patients showed improvement, and that 41 percent of controls also showed improvement, a significant difference. Thus, short-term observations suggested that a form of chondroitin sulfate can improve osteoarthritic conditions.

Investigators from the Internal Medicine/Rheumatology Polyclinic of Charles University in Prague, Czechoslovakia conducted independent com-parisons of arteparon and rumalon in osteoarthritis of the knee in long-term studies lasting five and ten years.10 Fifty patients with osteoarthritis of the knee in each of three groups were given either intra-muscuiar injections of vitamin B12 (controls), arteparon (ten courses of injections at six month intervals for a total dose of 7.5 grams), or rumalon (ten courses of injections at six month intervals for a total dose of 250 ml).10 All patients were also given standard analgesics and NSAIDS.

Knee pain was decreased for two years in the control group, but afterwards, became progressively worse, even with higher NSAID doses. This is typical of standard therapy. However, knee pain was decreased quickly (within four months) and to a much greater degree with arteparon and rumalon, along with a decrease in analgesics, and continued to decrease even after five years. Likewise, measures of joint function (time to ascend and descend a 15-step staircase) were maintained for two years in each group, but thereafter, clear divergence was seen. The control group became progressively worse, while the GAG groups became progressively better. Similarly, the ability to work became worse with the control group until, after five years, all controls were unfit for work. Conversely, after five years, between 50 and 80 percent of GAG subjects were fit for work.

Another measure of response was needed for tibial osteotomy operations. For controls, 13/50 received this operation, while only 2/ 50 for each GAG group received osteotomies. Radiologic parameters showed that GAG subjects had only 1/2 to 1/3 of the adverse changes seen in the control group. The grade of osteoarthritis did not worsen in only 1/50 control subjects, but 1/3 to 1/2 of GAG subjects did not worsen. Subjective evaluations by doctors and patients also showed significant benefits for GAG subjects. Thus, by both sub-jective and objective criteria, GAG treatment significantly prevented the inevitable progression to disability, and even slowed the physical findings of osteoarthritis.

This study was preceded by a ten-year study of rumalon on hip arthritis on 112 matched pairs of subjects, which also showed remarkable prevention of progression of radiologic changes, decreases in analgesic use, and an actual decrease in lost working days for the rumalon group, compared to a steady progression to almost complete disability in the control group.10 All differences were statistically significant.

A series of investigations on the effects of glucosamine sulfate supplementation by oral route showed even more promising results. Several short-term studies found significant reductions in joint pain, analgesic use and improvements of joint function with 0.75 or 1.5 grams of daily glucosamine sulfate.12-15 One study actually took cartilage biopsies before and after four weeks of glucosamine sulfate oral supplementation in a few treated subjects.12 Electron microscopy initially showed a typical picture of established osteoarthritis. However, those given glucosamine sulfate "....showed a picture more similar to healthy cartilage." 12 The results of this article strongly suggest that reversal of osteoarthritis was being accomplished after oral GAG supplementation.


The results of short-term oral GAG supplementation are even more dramatic than long-term injectable GAG treatment for several reasons:

· consistently high blood and cartilage levels of GAGs are possible with oral administration, rather than cyclic injectable administration;

· side effects are nonexistent with oral GAG administration;

· higher doses of GAGs can be maintained orally. Thus it is no surprise to find that oral GAG supplementation achieved results much faster than injectable GAG treatment.


Antioxidants as Chondroprotectors

One recent theory of osteoarthritis causation is based on free radical formation in joints as the trigger for disease progression.16 Several scenarios associated with osteoarthritis are now known to cause release of free radicals in joints. 16 Local ischemia in cartilage (already a hypoxic tissue) induced by chronic joint loading, abnormal joint forces, poor circulation, overexercise, trauma, auto-immune attack and even excess iron elevates levels of free radicals in joints.16 Free radicals directly attack and degrade cartilage components,17-19 triggering a synovial and immune response that promotes further cartilage damage. Because of the slow metabolism of chondrocytes, both injury and repair take months or years to become fully evident. This free radical mechanism of arthritis indicates quite logically that antioxidants may prevent or reverse formation of arthritic symptoms.

At Tufts University in Boston, guinea pigs were fed a normal or high intake of vitamin C before, during and after surgery to induce knee osteoarthritis.20 The guinea pigs fed a standard RDA amount of vitamin C (2.4 mg daily) developed osteoarthritis, but the guinea pigs fed 150 mg of vitamin C daily developed only very minor changes.20 This in vivo work is supported by in vitro studies that showed vitamin C is chondroprotective by stimulating anabolism in cartilage cultures, and by inhibiting degradative enzymes in cartilage.20,21

Researchers in Israel gave 32 subjects with osteoarthritis 600 mg daily of vitamine E (d-alpha tocopherol acetate) for only 10 days.22 Even with this very short experimental period, significant improvements in functional assessment, pain and analgesic use were seen with vitamin E, but not with a placebo.

At Konstanz University in Hannover, West Germany, 50 subjects were given either a placebo or 400 IU of d-alpha tocopherol acetate daily for six weeks in a double-blind study.23 Significant decreases in pain and analgesic use were seen for the vitamin E group. Functional improvements were noted, but had not reached significance when the study ended.

In vitro investigations have also shown that vitamin E can inhibit effects of degradative enzymes in cartilage.20 Thus, simple studies have shown that even a single antioxidant can improve osteoarthritis symptoms without side effects. Combinations of antioxidants have yet to be investigated, and longer experimental periods are needed to confirm the effectiveness of antioxidants as chondroprotective agents, but the hypothetical and preliminary evidence is strongly suggestive that antioxidants are potent chondroprotective agents.


Nutrient Combination and Low Back Pain

One recent report examined the effects of several nutritional supplements on chronic low back pain in a chiropractic setting.24 Objective assessment of low back function was accomplished by a computerized testing device. Groups of six patients each were given no supplements (controls), manganese sulfate (900 mg daily), purified chondroitin sulfates (600 mg daily), or purified chondroitin sulfates with a comprehensive multiple vitamin/mineral without iron, including vitamin C and vitamin E. Improvements in strength, range of motion and pain were greatest in the combination group, and moderate in the chondroitin sulfate group, but minimal in the control and manganese sulfate groups.24 This pilot study is the first to suggest that use of chondroprotective nutrients may benefit chronic low back pain patients.




Summary


Osteoarthritis can be reversible by chondroprotective agents if the following conditions are met:

· cartilage remains intact over joint surfaces;

· subchondral bone is intact;

· lifestyle changes to reduce pressure on affected joint are followed;

· analgesic use is kept to a minimum or ideally, not used;

· enough time is given to properly evaluate effects, and;

· consistent, daily supplementation of chondroprotective nutrients is accompanied by a diet providing all essential nutrients.

One important variable not considered here is the use of analgesics, most of which impair synthesis of cartilage components.25,26 While chondroprotective nutrients can counteract analgesic side effects, it is likely that reversal would be more apparent without analgesic use.

Thus, a growing body of clinical evidence, along with a vast literature on hypothetical mechanisms, supports the long-term use of chondroprotective nutrients (GAGs and antioxidants) for cessation or reversal of osteoarthritis, and possibly other degenerative joint diseases. Although results may or may not be noticeable within a month, lack of side effects and ability to attack the cause of arthritis are prime reasons to consider their use in routine clinical settings.




References
1. Hamerman, D. The biology of osteoarthritis. N Engl J Med 1989;320(20):1322-1329.

2. Mankin, H.J. Biochemical and metabolic aspects of osteoarthritis. Orthop Clin N Am 1971;2(1):19-31.

3. Brandt, K.D. Pathogenesis of osteoarthritis. In:00,1417-1432.

4. Reimann, I., Christensen, S.B., Diemer, N.H. Observations of reversibility of glycosaminoglycan depletion in articular cartilage. Clin Orthop 1982;168:258-261.

5. Radin, E.L., Burr, D.B. Hypothesis: joints can heal. Sem Arth Rheum 1984;13(3):293-302.

6. Bland, J.H., Cooper, S.M. Osteoarthritis: a review of the cell biology involved and evidence for reversibility. Management rationally related to known genesis and pathophysiology. Sem Arth Rheum 1984; 14(2):106-133.

7. Altman, R.D., Howell, D.S., Gottlieb, N.L. New directions in therapy of osteoarthritis. Sem Arth Rheum 1987;17(2, Suppl 1):1-2.

8. Varma, R.S., Varma, R. eds. Glycosaminoglycans and proteoglycans in physiological and pathological processes of body systems. Basel: Karger, 1982.

9. Burkhardt, D., Ghosh, P. Laboratory evaluation of antiarthritic drugs as potential chondroprotective agents. Sem Arth Rheum 1987;17(2)Suppl.l:3-34.

10. Rejholec, V. Long-term studies of antiosteoarthritic drugs: an assessment. Sem Arth Rheum 1987;17(2)Suppl.l:35-53.

11. Ishikawa, K., Kitagawa, T., Tanaka, T., Teravama, K., Kuriya, N., Iwata, H., Niwa, S., Sakurai, M. Clinical evaluation of the intra-articular injection of glycosaminoglycan polysulphate for osteoarthritis of the knee joint: a multicentric double blind controlled study. Z Orthop 1982;120:708-716.

12. Drovanti, A., Bignamini, A.A., Rovati, A.L. Therapeutic activity of oral glucosamine sulfate in osteoarthritis: a placebo-controlled double-blind investigation. Clin Ther 1980;3(4):260-272.

13. Vaz, A.L. Double-blind clinical evaluation of the relative efficacy of ibuprofen and glucosamine sulphate in the management of osteoarthritis of the knee in out-patients. Curr Med Res Opin 1982;8(3):145-149.

14. D'Ambrosio, E., Casa, B., Bompani, P., Scali, G., Scali, M. Glucosamine sulphate: a controlled clinical investigation in arthrosis. Pharmatherapeutica 1981;2(8):504-508.

15. Pujalte, J.M., Llavore, E., Ylescupidez, F.R. Double-blind clinical evaluation of oral glucosamine sulphate in the basic treatment of osteoarthrosis. Curr Med Res Opin 1980;7(2):110-114.

16. Swaak, A.J.G., Koster, J.F. Free radicals and arthritic diseases. Rijswijk:Eurage, 1986.

17. Greenwald, R.A. Effect of oxygen-derived free radicals on connective tissue macromolecules. In: Bannister, W.H., Bannister, J.V., eds. Biological and Clinical Aspects of Superoxide and Superoxide Dismutase. New York: Elsevier, 1980, 160-171.

18. Wong, S.F., Halliwell, B., Richmond, P., Skowroneck, W.R. The role of superoxide and hydroxyl radicals in the degradation of hyaluronic acid induced by metal ions and by ascorbic acid. J Inorg Biochem 1981;14:127-134.

19. Burkhardt, H., Schwingel, M., Menninger, H., Macarmey, H.W., Tschesche H. Oxygen radicals as effecters of cartilage destruction. Arth Rheum 1986;29(3):379-387.

20. Schwartz, E.R. The modulation of osteoarthritic development by vitamins C and E. Int J Vit Nutr Res 1984; Suppl 26:141-146.

21. Krystal, G., Morris, G.M., Sokoloff, L. Stimulation of DNA synthesis by ascorbate in cultures of articular chondrocytes. Arth Rheum 1982;25(3):318-325.

22. Machtey, I., Ouaknine, L. Tocopherol in osteoarthritis: a controlled pilot study. J Am Ger Soc 1978;26(7):328-330.

23. Blankenhorn, G. Clinical efficacy of Spondyvit (Vitamin E) in activated arthroses. A multicenter, placebo-controlled, double-blind study. Z Orthop Ihre Grenzgeb 1986; 124:340-343.

24. Christensen, K.D., Bucci, L.R. Comparison of nutritional supplement effects on functional assessments of lower back patients measured by an objective computer-assisted tester. In: Second Symposium on Nutrition and Chiropractic. Davenport: Palmer College of Chiropractic, 1989, 19-22.

25. Palmoski, M.J., Brandt, K.D. Effect of salicylate on proteoglycan metabolism in normal canine atticular cartilage in vitro. Arth Rheum 1979;22(7):746-754,

26. Palmoski, M.J., Brandt, K.D. Effects of some nonsteroidal antiinflammatory drugs on proteoglycan metabolism and organization in canine articular cartilage. Arth Rheum 1980;23(9):1010-1020.
Click to expand...
 
I've also been informed,that site injections are'nt needed !
 
I know of a site that this may be doable, I will have to take a peek. The place I got my fina pellets from, no go.

Did bench today and my tendons are not happy, I put about 10 pounds on my bench every 5 days.
 
Looks like this stuff is site injected into the tendon in some cases with a 3 inch needle, fun fun fun! Probably not for the home dude.
 
I work in a hospital. If I get the stuff, i have plenty of people to inject it. :)
 
I must be readin something different, I actually met someone who uses this stuff, and he says that he's never site injected it. I can't remember what size needle he spiked with or even if I asked him to be Honest.I'm no doc ,just kickin it like I get it, But I will get more info on it "from the horse's mouth" if you can dig it PEACE
 
Thanks Mikhal, appreciate it! :)
 
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