osteoarthritis Archives

Mar

2024

Living with the Aging Process

By Ray Schilling | Alzheimer’s disease, andropause, Arthritis, Cancer, Cardiovascular disease, cholesterol, Diabetes, diet, erectile dysfunction, exercise, heart attack, Hormones, lifestyle, Menopause, osteoarthritis, telomeres

The following article describes living with the aging process. Older adults undergo the process of aging between the ages of 50 and 80. This is a complex process affecting various systems parallel. There are hormone factors that are particularly prominent in women during menopause. Joints are affected by degenerative changes, which can lead to total knee and hip replacements. The aging process was described in an article by Monica Jimenez at Tufts University.

What is aging?

Aging is the loss of function over time. The body is much more complex than a car, so there are more possible points of failure. Christopher Wiley is a scientist on the Basic Biology of Aging Team who studies the role of nutrition and metabolism in aging at a cellular level at Tufts University. He said:” The fact that life works is amazing”. He went on to say: “The body tries to maintain itself and restore homeostasis(self-healing) even in the face of all this stress and all this damage. We have these really sophisticated programs for dealing with these points of failure.”

Aging goes on relentlessly

He explains the aging process this way: “It can start with something as simple as a broken molecule, one little thing that goes wrong in one cell, and then it’s like the butterfly effect,” Wiley said. “The tissue starts struggling, and then the organ, and then your entire body.”

Dr. Wiley warns about those who say physicians could make people “immortal”. “There’s definitely a misconception out there that we’re trying to make people immortal. But there is never going to be an immortality vaccine,” Wiley said. “There’s never going to be one thing that defeats all of aging. There’s always going to be another point of failure.”

Slowing down biological aging

The emphasis of research about aging is not to add chronological years. It is on biological aging and on how well our cells and tissues are functioning. Dr. Sarah Booth is the director of the Human Nutrition Research Center on Aging (HNRCA) at Tufts. She said: “Lengthening the time in which we can continue to move around, care for ourselves, and participate in social life and activities, is a worthier goal than extending years of suffering.” Many people become disabled in their last years of life, then they die. “Healthspan” is a new term for our years of freedom from disability, Booth noted.

Factors that prolong healthy aging

Telomere length: One of the factors of longevity is our telomere length. Telomeres are the protective caps at the end of each chromosome. When they wear down, it leads to mistakes in the DNA copies of genetic information. There are supplements and herbs that can elongate telomeres. Exercise and the fasting mimicking diet also make telomeres longer. Older adults in good shape have longer telomeres, which stabilizes the DNA in their cells.
Healthy diet: Researchers have determined that several diets are healthier than others. The Mediterranean diet is anti-inflammatory, so is the DASH diet, which was developed for people with high blood pressure. The HNRCA of Tufts is one of six organizations that got research grants recently to investigate life-prolonging diets. The amount was for $8.5 million.

Exercise and lifestyle factors

Regular exercise: Over the years a lot of research accumulated data that shows regular exercise makes people biologically younger. Heart vessels have less atheromatous deposits and the brain stays younger as well. One study reported that 30 minutes of exercise daily prevents dementia.
Other lifestyle factors: other factors are whether or not you are smoking (it goes without saying that you must quit). In addition, genetics (longevity gene), the environment (polluted or not), stress levels and socioeconomic class all play a factor in how fast we age. These latter points are difficult to tease apart, but they influence us globally. Target organs for aging are: the brain, heart, eyes, and bones, along with cancer, obesity, and more.

Hormone replacement

Bioidentical hormone replacement: One factor about delaying aging significantly was not mentioned in the review article by Monica Jimenez. But I am including it, because bioidentical hormone replacement is important for women who undergo menopause in their 50’s. I also mention it because men enter andropause in their 60’s. BiEst estrogen and progesterone cream make a big difference for the symptoms of menopausal women. Similarly, men experience a lot of relief with testosterone injections twice a week, when blood testosterone levels are low. If they have a lack of erections (erectile dysfunction) they may in addition need to take the “happy pill”. Sildenafil or tadalafil can treat erectile dysfunction by giving a good erection to a menopausal male. Hormone replacement can add as much as 10 healthy years to your life.

Discussion

Dr. Booth said: “We’re looking at the same question through different lenses with different tools, technologies, and perspectives. Progress in aging research is only going to be achieved by bringing together different disciplines addressing the same problem.”

Christopher Wiley added: “The biggest change I’ve seen in the past ten years is that we really are finding new, different ways of actually intervening somewhere that could potentially extend the healthy years of life, and prevent people from getting age-related diseases.” He mentioned that scientists are gradually reducing the suffering associated with aging: “What aging research is really trying to do is compress the morbidity and make it as small as possible – to alleviate suffering,” Wiley said. “I think that’s a much more humanitarian goal, and I think we’re having a lot of success with those efforts.”

Living with the Aging Process

Conclusion

Aging is a slow process that starts the moment we are born. But between the age of 50 and 80 we age faster. I mentioned 5 specific areas that can slow down the aging process. If somebody smokes, he/she must stop smoking. Cigarette and tobacco smoking the biggest aging factor. The protective caps at the end of each chromosome go by the name of telomeres. When they shorten prematurely, mistakes occur in the DNA copies of genetic information. This leads to premature aging.

What keeps you younger for longer

The good news is that exercise, the fasting mimicking diet and several supplements can elongate telomeres. A healthy diet like the Mediterranean diet and regular exercise keeps the arteries open preventing heart attacks and strokes. Bioidentical hormone replacement helps to rebalance your hormones, which is important for normal cell function. In anti-aging circles they talk about life prolongation of about 10 years for hormone replacement alone. It comes down to not simply extend your lifespan, but to extend your years of healthy living without disability.

Jul

2022

Stem Cell Therapy Is a New Way to Treat Osteoarthritis

By Ray Schilling | Arthritis, back pain, chronic pain, osteoarthritis, Pain, regenerative medicine, stem cells

Traditional treatment for osteoarthritis is not very successful, but stem cell therapy is a new way to treat osteoarthritis.

Traditional treatment of osteoarthritis

Osteoarthritis is a common degenerative type of arthritis. Wear and tear are diminishing the hyaline cartilage that coats joint bones. The lubrication of synovial fluid is diminishing as well. The end result is that the patient suffers pain from bone rubbing on bone in affected joints with swelling of the synovial membranes. The physician usually prescribes diclofenac topical solution for the affected joints and also gives anti-inflammatory drugs by mouth (diclofenac or ibuprofen). Unfortunately, the patient may develop side effects of the anti-inflammatory medication, such as kidney damage and gastritis. The end result after years of suffering is that the joints turn stiff and the joint pain becomes unbearable.

Joint replacement surgery

This is when the doctor refers the patient to an orthopedic surgeon, and an artificial hip or a knee joint replacement is the next suggestion. These surgical procedures are not without dangers. Postsurgically blood clots can develop and cause pulmonary emboli. Infection and sepsis can also develop. Often the surgery does not solve all of the problems and leaves the patient with a permanent limp.

Stem cell therapy to treat osteoarthritis

Regenerative medicine has developed an alternative to the conventional treatment of osteoarthritis. I described this new approach to osteoarthritis before here.

Stem cells are harvested from fatty tissue of the patient and injected into the affected joint. Stem cell stimulators like platelet rich plasma and low-dose laser therapy activate the stem cells that were lying dormant in the fatty tissue. These type of stem cells are mesenchymal in origin, so they go by the name of mesenchymal stem cells. When injected into a joint with osteoarthritis they can transform into any tissue that is needed to repair the damage of the joint. A defect of the hyaline cartilage is covered by stem cells transforming into cartilage cells and fixing the hyaline cartilage defect.

What stem cells do

Stem cells fix any meniscal degeneration in the knee joint by mending what is degenerated. They can form new tissue that over-bridged mini tears in the meniscus. If the synovial membranes that produce joint lubrication are damaged, the stem cells rejuvenate the old tissue and joint lubrication normalizes. The end result following stem cell treatment is that the osteoarthritic joint becomes regenerated with normal function. Stem cell treatment normalizes the osteoarthritic process in the joint, and down the road no joint replacements are necessary. This is a huge advantage in comparison to the conventional treatment of osteoarthritis.

My own experience with stem cell therapy for osteoarthritis of my left knee

I have experienced mild left knee arthritis for 5 years. It was not severe enough to treat with anti-inflammatory pills. I used higher amounts of fish oil capsules, which helped somewhat. I heard that Dr. Michael Weber from Lauenförde, Germany treats osteoarthritis with stem cell therapy.

He had treated my back successfully on several occasions in the past. I had previous stem cell treatment 4 years earlier as summarized here. Part of this was stem cell therapy for my left knee. During the Covid time I could not go to the gym for a period of time. Instead, I went for long walks on a nature trail that was bumpy and had many roots. This flared up my previous problem with my left knee. But in early June 2022 I made my way back to Dr. Weber’s clinic for more stem cell therapy.

The following summarizes how he treated my left knee with stem cells.

Liposuction to harvest stem cells for treatment

The doctor used a local anesthetic to freeze the skin and subcutaneous tissue on the right flank. Subsequently a solution of normal saline that contained adrenaline and bicarbonate was injected. This allowed Dr. Weber to withdraw fatty tissue easier 20 minutes after the normal saline injection. The generous portion of fatty tissue harvested was brought to a cell separator, which separated stem cells, fat cells and connective tissue. The stem cells were counted by a technician. They were found to be 100% viable and there was a total of 980 million stem cells.

Intravenous stem cells

Dr. Weber administered one portion of the total stem cell harvest intravenously. I was told that this ensured that stem cells would be delivered to tissues that needed renewal through stem cell therapy. There are several methods to stimulate stem cells. One of these methods is to give oxygen intravenously with a device with the name Oxyven (from Swiss Medica) . This procedure took 20 minutes. A second method to stimulate stem cells is with low-dose laser therapy. Dr. Weber used intravenous red, green, blue and yellow lasers, for 20 minutes each.

The laboratory kept the rest of the stem cells overnight at room temperature. Dr. Weber told me that it would have been a mistake to keep the stem cells in the refrigerator overnight as the cold temperature kills all of the stem cells!

Targeted stem cell therapy

The following day I received treatments with my stem cells harvested the day before. The doctor drew blood up first, which underwent centrifugation. The interface between the red blood cell portion and the plasma contains PRP (platelet rich plasma). Dr. Weber mixed PRP in with the stem cells. PRP is a powerful stimulator of stem cells.

Dr. Weber inserted a needle into my left knee and injected stem cells (and PRP) into the left knee. Following this he inserted a thin sterile fiberglass applicator. This served to introduce four laser lights into the knee, namely red, green, blue and yellow low-dose laser beams. Dr. Weber connected each for 20 minutes. He explained that the laser light activates the stem cells, similar to PRP and to oxygen (Oxyven, Swiss Media).

Lower cervical spine, upper thoracic spine and lower lumbar spine also treated

I get monthly chiropractic manipulations to my spine to stabilize it. My chiropractor told me that it would help to have stem cell therapy in the C4 to T4 area of the upper spine and in the L4 to S1 region in the lower spine. Dr. Weber concentrated his treatments on exactly these levels of my spine. He placed interstitial needles over the facet joints bilaterally in the lower cervical spine, upper thoracic spine and lower lumbar spine. Subsequently he injected the stem cell/PRP mix and followed this up with the four laser lights for 20 minutes each.

Follow up after the stem cell treatments

There was a lot of swelling in my left knee during the first two days after the stem cell treatment. I also experienced pain with walking. But on the third day the swelling disappeared completely. After 1 week the previous mild left knee pain improved significantly. After 1 month the left knee no longer ached with stairs or uneven ground. Presently I am still completely pain-free. My back pain also disappeared within 2 to 3 weeks.

Stem Cell Therapy Is a New Way to Treat Osteoarthritis

Conclusion

When it comes to the treatment for osteoarthritis, conventional medicine offers topical and oral anti-inflammatory medicine. Usually, the physician also recommends active exercises and heat applications by a physiotherapist. When anti-inflammatories no longer work and bone rubs on bone in a hip or knee joint, total hip or total knee replacement by an orthopedic surgeon is usually the next step. Unfortunately, these surgical procedures have a certain complication rate. They often do not lead to perfect end results with residual pain and possibly a limp

Stem cell therapy is usually not what a family practitioner recommends. But when the physician does stem cell therapy at an early stage, the success rate is good and as in my case you can always do another stem cell therapy to improve the knee or hip joint further. There are three procedures that help to stimulate stem cells: platelet rich plasma (PRP), intravenous oxygen (Oxyven, Swiss Media) and low-dose laser activation. In my case Dr. Weber applied all of these methods together with stem cell therapy. Improvement in my case was very rapid, and it was a delight to witness the result of stem cell therapy as a patient.

Jun

2020

Chronic Inflammation Can Cause Many Diseases

By Ray Schilling | Alzheimer’s disease, Asthma, Cardiovascular disease, Diabetes, fish oil, heart attack, Inflammation, kidney disease, Obesity, omega-3 fatty acids, osteoarthritis, Pain, polyunsaturated oil, Vitamins and supplements

We knew since the mid 1990’s that chronic inflammation can cause many diseases. Among these are cancer, hardening of the arteries (atherosclerosis), arthritis, dementia (Alzheimer’s disease), frailty and other degenerative disorders. LifeExtension reviewed this topic in 2019.

Older people often accumulate chronic inflammation, which associates with the aging process. Persistent pain is one of the symptoms that chronic inflammation can cause.

Doctors use tests like the C-reactive protein, hemoglobin A1C, homocysteine and the erythrocyte sedimentation rate to measure chronic inflammation.

When the doctor diagnoses chronic inflammation, it is important to find ways to inhibit it and finally resolve it. Curcumin, ginger and non-steroidal anti-inflammatories are examples of measures that help inhibit inflammation. But it is only lately that scientists have found specialized pro-resolving mediators (SPM) that help to resolve chronic inflammation. They are polyunsaturated fatty acids, which health food stores offer as supplements.

Specialized pro-resolving mediators (SPM)

Researchers isolated several pro-resolving mediators that are metabolites of omega-3 fatty acids. This link discusses an experiment where researchers obtained synovial fluid from arthritis patients who took omega-3 fatty acids. They compared this to synovial fluid from volunteers who also took omega-3 fatty acid supplements. Within 4 weeks there was a big difference for the arthritis patients with higher levels of E- and D-series SPMs in synovial fluid and plasma. Dr. Silverman reviewed the action of SPMs here. He points out that they can be taken as supplements and that they are safe, because they do not have any side effects. Conditions such as asthma, irritable bowel syndrome and various musculoskeletal conditions with chronic inflammation respond very well to SPM supplements. Omega-3 fatty acid supplements (EPA) metabolize into the E-series resolvins. On the other hand, Krill oil with Docosahexaenoic acid (DHA) metabolizes into protectins, maresins and the D-series resolvins.

Three vital tasks of pro-resolving mediators

SPMs fulfill three vital tasks, called remove, restore and renew. First, they activate macrophages, which remove dead cells and cellular debris as a result of chronic inflammation. Second, they restore the healthy balance of inflammatory compounds and anti-inflammatory substances. Third, SPMs help renew tissues that were damaged by chronic inflammation.

Some examples where SPM’s were helpful resolving inflammation in health conditions

Alzheimer’s disease patients had reduced SPMs in cerebrospinal fluid of living patients and in the hippocampus of corpses who had Alzheimer’s disease.
A research group showed that defective SPM resolution can be responsible for missing resolution of atheromatous plaques in arteries. This leads to more and more hardening of arteries until a heart attack or stroke occurs.
With obesity or metabolic syndrome insulin resistance develops. Researchers found that certain SPM’s are missing in obesity, which causes chronic inflammation. However, they also found that precursors of SPMs such as 17-hydroxydocosahexaenoic acid (17-HDHA) can serve as a novel treatment agent to treat obesity-related complications.

Newer studies about SPMs

62 patients with knee osteoarthritis had the precursor of resolvins, 17-HDHA tested in the blood. Compared to controls with no arthritis the 17-HDHA level in the arthritis patients was low. When levels of 17-HDHA were high, there was no pain in osteoarthritis patients.
Chronic periodontitis is a chronic inflammatory condition in the mouth. In a rabbit model this condition was cured with resolvin E1 derived from omega-3 fatty acids.
Delayed wound healing is typical for type 2 diabetes. In a mouse model with diabetic mice researchers inflicted skin wounds on mice. Subsequently they showed that with resolvins mice wounds healed much faster than in control mice.
Chronic kidney failure, liver impairment, diabetes, obesity and coronary heart disease showed abnormalities in the SPM system in humans. Potentially they will be healed with the help of resolvins or their precursors, which includes the omega-3 fatty acids EPA and DHA.

Chronic Inflammation Can Cause Many Diseases

Conclusion

New compounds have been detected that derive from the omega-3 fatty acids EPA and DHA. They have the name specialized pro-resolving mediators (SPM). Included are the resolvins D1 and D2, the resolvins E1, E2 and E3 as well as the precursors 18-hydroxyeicosapentaenoic acid (18-HEPE) and 17-hydroxydocosahexaenoic acid (17-HDHA). The function of these compounds is to stimulate macrophages to clean up areas of chronic inflammation and remove cell debris and injured cells that cannot survive. While anti-inflammatories like ginger and curcumin only tone down the inflammation, SPMs help to resolve chronic inflammation. Various chronic clinical conditions were identified as being due to chronic inflammation. Chronic kidney failure, liver impairment, diabetes, obesity and coronary heart disease showed abnormalities in the SPM system. We may soon see alternative approaches treating these conditions with specialized pro-resolving mediators.

May

2020

The Quality of Food is Important

By Ray Schilling | diet, fish oil, food, Health, heart attack, Nutrition, Obesity, omega-3 fatty acids, organic food, osteoarthritis, polyunsaturated oil, Prevention, Processed food, sugar

Many authors wrote books about food; the quality of food is important. Recently I came across a book review regarding the book “The Way We Eat Now” by Bee Wilson. In the March 2020 edition of the health magazine “LifeExtension” Laurie Mathena interviewed Bee Wilson about her book.

Bee Wilson explained that there is a distinct history about the production of food throughout the centuries. She described 5 phases.

During the hunter/gatherer time people were eating a low-fat diet with berries, wild greens and wild animals.
Stage two began around 20,000 BC. It was the agricultural age with a switch to cereals. At that time the population experienced rapid growth.

More stages

Only a couple of centuries ago, agriculture made progress with crop rotation and by adding fertilizers. This led to a more varied diet. People ate more vegetables, less starchy food and animal protein.
After the Second World War there was a major food transition. Processed food was introduced. People started eating more fat, meat, sugar and a lot less fiber. We are now experiencing a phenomenon that we are simultaneously overfed, but undernourished. We get too many calories, but our diet is poor in nutrients. This type of diet causes obesity and degenerative type illnesses.
Stage 5 involves people abandoning junk food and eating more vegetables and fruit again. The more knowledgeable people are about the link between a good diet and health, the healthier people eat. This stage requires governments and other organizations to do their part in assisting people to make that food transition.

Food labeling changes in Chile

Here is one example of how governments can make a difference. This happened in Chile. Chile used to have the highest consumption of sugary beverages in the world. Prior to 2016 the average consumer in Chile bought more than 50% of the food as ultra-processed. This resulted in Chile having the second highest obesity rate after Mexico. The government of Chile decided in 2014 to introduce very simple labels for every food item. The government of Chile demanded that all the foods with too much sugar, high saturated fat, food high in salt and high in calories had proper labels. These labels are simple, hexagonal warning labels.

Warning labels

For instance, if a food product had too much salt in it, it would say in the hexagonal label: “Warning: high in salt”. As the labels had the effect of lowering sales, the food companies reformulated their products very quickly to stay under the threshold triggering the food warning. In 2016 Chile also decided to tax unhealthy foods higher. The government taxed sugar-sweetened colas with an 18% extra tax. Schools had to abandon junk foods sales.

Quality of food

When you start cutting out junk food and other processed foods, the quality of your food intake is improving. Eat more vegetables, and fruit. Eat wild salmon, which provides omega-3 fatty acids. Do not consume vegetable oils like soybean oil, canola oil, safflower oil, corn oil and grape-seed oil. They all contain omega-6 fatty acids. Omega-6 fatty acids are essential fatty acids and they convert mainly into energy. But the problem is that our western diet contains too many omega-6 fatty acids. Omega-6 fatty acids can convert into arachidonic acid, which causes inflammation. This in turn can cause heart attacks and strokes on the one hand and arthritis on the other hand.

The omega-6 to omega-3 ratio is important

In the past a healthy ratio between omega-6 and omega-3 was 4:1 or less. The average American now eats food with 16-times the amount of omega-6 fatty acids than omega-3’s. This is an omega-6 to omega-3 ratio of 16:1. No wonder people get sick with degenerative diseases.

Brain health maintained by eating enough omega-3 fatty acids

Here is a study that looked at brain structure using MRI scans. 3660 participants aged 65 received MRI brain scans. The researchers recorded their food intake with questionnaires. They rescanned 2313 of these individuals 5 years later. The group highest in omega-3 consumption was compared to the group with the lowest omega-3 consumption. Blood tests were also done both initially and 5 years later to verify the omega-3 intake. The researchers found that the higher omega-3 group had less subclinical infarcts and the white matter of the brain was of a better grade. They concluded that fish consumption, the major source of omega-3 fatty acids, had a beneficial effect on brain health later in life, preventing Alzheimer’s disease.

Cook your own food, do not eat out frequently

When you cook your own food, you can choose the right foods as you shop. Stay away from the “dirty dozen”, which is poisoned with insecticides, herbicides or pesticides. Instead you can buy organic foods that have not been sprayed with toxic substances. When you eat out, you have no choice about what you eat. Food in restaurants also contains food preservatives that are not labeled in North America, but that would be labeled in restaurant menus in Europe. In addition, food in restaurants often contains too much salt, too much sugar and the wrong oils. Omega-6 fatty acids are much cheaper than olive oil, and as a result this is what the chef uses.

Transition from stage 4 to stage 5

When you want to transition from stage 4 to stage 5 regarding your food composition you are swimming against the stream of establishment. At this point you are more or less alone when you want to abandon French fries, processed food bars, hamburgers and sugary soft drinks. But the more you eat at home, the more you take out your lunch box with food prepared at home, the more you are winning the war against convenience foods. It is what you put into your mouth, which is the fuel for your body. Don’t compromise regarding the quality of your food!

The Quality of Food is Important

Conclusion

The quality of food is important. We have been inundated by ads from the food industry that we should eat fast foods (hamburgers, French fries), processed foods like power bars and drink sugary drinks. We have met the entire lineup on television! But it is best to buy basic foods and prepare all your food from scratch. Be careful that you avoid the “dirty dozen” foods. If you want to eat these, buy the organic food versions. This way you avoid pesticides and other poisons. Stick to extra virgin olive oil as a fat source and avoid vegetable oils. Soybean oil, canola oil, safflower oil, corn oil and grape-seed oil contain a lot of omega-6 fatty oils.

Inflammation caused by vegetable oils

These cause inflammation in your blood vessels and joints. The end result are heart attacks, strokes and arthritis. I also eat a lot of wild salmon and other seafoods, a great source of omega-3 fatty acids. In addition, I take two capsules of molecularly distilled fish oil in the morning and at night. Eat more vegetables and fruit. You are now paying attention to the fact that the quality of food is important.

Here is a link to the book by Bee Wilson; “The Way We Eat Now”.

Oct

2019

Steroid Injections Are Doing Harm, But Stem Cells Help

By Ray Schilling | Arthritis, osteoarthritis, Pain

When a person has osteoarthritis, steroid injections are doing harm, but stem cells help. A new study published in the journal “Radiology” came to the conclusion that steroid injections are doing harm.

The article was published on October 15, 2019. 459 patients with osteoarthritis of knees or hips received injections with intraarticular corticosteroids or placebo to conduct this study. As a matter of fact steroid injections are a standard treatment for moderate to severe osteoarthritis. The injections consisted of triamcinolone 40 mg mixed with a local anesthetic. 36 of these patients (8%) had adverse events in their joints.

Here is the break down of these negative events following intraarticular corticosteroid injections.

Accelerated osteoarthritis progression (6%)
Subchondral insufficiency fracture (0.9%)
Osteonecrosis (0.7%)
Rapid joint destruction with bone loss (0.7%)

Critical analysis of effects of intraarticular corticosteroid injections

The authors reviewed the literature and came across an evidence-based review by the Cochrane Musculoskeletal Group involving 1767 participants. The review showed an overall low evidence for all outcomes. Intraarticular corticosteroid injections were inconsistent and variations between trials were high. Certainly, there was a moderate improvement of joint pain, and physical joint function improved as well.

But then again more severe osteoarthritis in knee or hip joints showed a lack of improvement and in many cases even joint deterioration. With this in mind, these cases often ended up with total hip or total knee replacements. Overall the Cochrane review showed a lack of objective evidence of symptom improvement after intraarticular corticosteroid injections in people with osteoarthritis.

Mesenchymal stem cell injections for osteoarthritis

A fairly recent alternative approach to treating osteoarthritis is by mesenchymal stem cell injection with platelet-rich plasma activation. Researchers conducted a meta-analysis of 35 studies regarding knee osteoarthritis and mesenchymal stem cell injections in 2018. There were minor adverse events like knee pain and swelling. No serious side effects of the stem cell treatments were noted. The outcome of the treatment was classified as “very low” to “low”. The reason for this were poor study designs, large heterogeneity among the studies and wide variation among the 95% confidence intervals regarding study outcomes.

Australian study of mesenchymal stem cell injections into symptomatic knees

A short-term study from Australia examined 30 patients with mesenchymal stem cell therapy for knee osteoarthritis. There were two treatment groups. One group received 100 million adipose tissue derived mesenchymal stem cells into symptomatic osteoarthritis knee joints. Another treatment group received 100 million mesenchymal stem cells twice, namely at baseline and at 6 months after the first injection. The third group served as a control with continued conservative management. All of the groups had baseline MRI scans (magnetic resonance imaging) to assess the knee conditions. Both treatment groups had pain and inflammation at baseline. After 1 year following the initial treatment the patients had repeat MRI scans. They showed modification of the disease process in the treatment arm, while the controls had deteriorating osteoarthritis. The researchers concluded that adipose derived mesenchymal stem cell treatment of knee osteoarthritis has the potential of preventing disease progression.

Why stem cells help with osteoarthritis of the knees and the hips

Here is a research project between researchers from Palm Harbor, Florida and researchers from Serbia. The Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences University of Kragujevac, Serbia reviewed the literature on treatment of osteoarthritis.

The researchers explain that the physician can easily harvest mesenchymal stem cells by doing a liposuction of fat cells. These stem cells maintain their differentiation potential and there is only minor immunological rejection because of low histocompatibility antigen expression. As a result mesenchymal stem cells stay in the joint where they are injected.

Two processes that occur with injected stem cells

Two main advantages of mesenchymal stem cells stand out. Mesenchymal stem cells are capable of building up hyaline cartilage and in addition they have immunosuppressive characteristics. In comparison with controls patients who receive intraarticular injections of mesenteric stem cells have less pain and less swelling.

This review paper cites all the major animal and human studies regarding mesenchymal stem cell therapy for osteoarthritis. It concludes that stem cell therapy is most effective in mild to moderate osteoarthritis cases. It stresses the point that stem cells can regenerate joint tissues and that the inflammatory process of osteoarthritis is interrupted by the stem cells. This stabilized the osteoarthritic condition.

Steroid Injections Are Doing Harm, But Stem Cells Help

Conclusion

Mesenchymal stem cells derived from fatty tissue will repair tissue defects in joints afflicted by osteoarthritis. The stem cells also take care of the inflammation, which takes care of pain and swelling. Range of motion of the joint increases following stem cell treatment. Other studies have shown that intraarticular steroid injections do not interrupt the degenerative process. MRI scan studies have shown deterioration of the joint tissues following steroid injections. All in all, stem cell treatments of joints with osteoarthritis are superior to a treatment with steroid injections.

Dec

2018

Biological Age Is Different From The Chronological Age

By Ray Schilling | alcohol, Alzheimer’s disease, andropause, blood test, cholesterol, diet, exercise, food, Health, heart attack, lifestyle, osteoarthritis, stress, Stroke, telomeres

Biological age is different from the chronological age said professor Morgan Levine from Yale Medical School. She is working in the department of pathology. She has found in her research that people of the same chronological age have very different biological ages. From a biological standpoint they may be much younger or older than their chronological age. When people are younger than their chronological age, they have less disease and less mortality. This article has reviewed the facts.

Measuring biological age

Dr. Levine also has developed tools how to determine the biological age. And when the biological age is higher than the chronological age, she recommends lifestyle changes that will set back the biological clock. We age differently according to what we eat, how our genetic make-up is, which we cannot change, whether we are physically active and what environmental toxins we are exposed to. So, the biological age determines our health status and what our final life expectancy will be.

Biomarkers for biological age

A simple blood test that your family doctor can order consists of the following. A fasting blood sugar, kidney and liver tests, immune tests and inflammatory tests. In addition the doctor will want to know whether you are smoking or not, how much alcohol you consume and how much red meat and processed meat you eat. A computer program processes these results, which determines your biological age.

Lifestyle improvements can lower biological age

Biological age testing has a strength built in. By changing your lifestyle you can lower it. When you exercise more regularly and switch to eating a Mediterranean diet you can lower your biological age. Other studies have shown that the Mediterranean diet is anti-inflammatory. A telomere test, which also determines the biological age, is fixed. It is not easily changed by dietary measures and increasing your exercise.

Dr. Levine said: “I think the most exciting thing about this research is that these things aren’t set in stone.”

Putting the biological age to the test

Dr. Levine was curious what her own biological age was. She entered her blood test data and lifestyle facts into the computer. She was surprised that her biological age was not as good as her first assumption. Now she is trying to get more sleep, has increased her exercise level and improved her diet.

Her research team is working on getting the algorithm online so that everyone will be able to put one’s blood tests and other data into the computer program and calculate the biological age. The program will also recommend what steps are likely most helpful to increase one’s health and decrease the biological age.

Lower your biological age

No one wants to live a long life, if they are in pain and have various illnesses like arthritis or Alzheimer’s. But things are different, if they can change lifestyle factors and maintain a low biological age for a long time. Now they can stay active, have no pains and are able to contribute to society.

“By delaying the onset of diseases and cognitive and physical functioning problems people can still be engaged in society,” Dr. Levine said. “I think that is the ideal we should be striving for.”

Other literature about biological age

Inflammation increases the biological age

In this publication the authors stressed that inflammation is the common denominator for developing disease and premature aging. The authors stress further that it is mandatory to change one’s lifestyle to lower the biological age and live longer.

Diastolic blood pressure predicts mortality

In an older study the diastolic blood pressure was related to mortality. The higher the diastolic blood pressure was, the higher the mortality. The authors also noted that it was the persons with the higher biological age who were at the highest risk of dying.

Scientific study about the predictors for the biological age

Here is a scientific study that examines predictors for the biological age. This is not easy reading, but I placed it here for completeness sake.

Link to a site that can calculate your biological age

Here is a link to a site that calculates your biological age. It is probably not as good as Dr. Levine’s computer analysis will be when it is available. However, it is a good approximation to what it will be like.

Biological Age Is Different From The Chronological Age

Conclusion

The dream of staying younger for longer is not new. Research has shown that we actually can do something about it. If we look after our lifestyle, don’t smoke, don’t drink excessively, eat a sensible Mediterranean-type diet and exercise regularly, our biological age will be less than our chronological age. It is the biological age that determines how old we get and whether or not we will suffer from age-related illnesses. Researchers also found out that when your biological age is younger than your actual age mortality will occur later. The math is simple. Let’s assume that your biological age is 15 to 20 years younger than your chronological age. As the average life expectancy presently is 80 years, your life expectancy can increase to 95 or 100 years.

Aug

2018

The Downside Of Living To 100

By Ray Schilling | Alzheimer’s disease, Arthritis, back pain, Cancer, Cardiovascular disease, chronic pain, Dementia, depression, Diabetes, diet, Drugs, exercise, Fitness, fractures, heart attack, High Blood Pressure, Infectious Disease, mitochondria, Mortality, Obesity, osteoarthritis, Osteoporosis

A review article has examined longevity and reviewed the downside of living to 100. In their 80’s about 10% of the population live in nursing homes, but among centenarians 55% are residing in nursing homes. They are often very lonely, as their social circles have shrunk as they aged.

Common diseases of older people

Osteoarthritis makes it difficult for people to get around, it causes chronic pain and it can also be the reason for falls. In 1990 there were 213.4 cases of osteoarthritis per 100,000. 26 years later, in 2016 there were 232.1 cases of osteoarthritis per 100,000 people.

Chronic obstructive pulmonary disease (COPD) has been falling, because less people smoke cigarettes now. Statistics show 1667 cases of COPD per 100,000 in 1990, but only 945 cases of COPD per 100,000 in 2016.

Diarrhea and common infections have dropped sharply from 8951 per 100,000 in 1990 to 3276 per 100,000 in 2016.

What other common diseases do older people get?

There are a number of common diseases that affect the elderly.

Osteoarthritis

Osteoarthritis of the hips and the knees are common, but it can affect every joint in the body. In the end stage knee replacements or hip replacements may be necessary. But before a total knee replacement or total hip replacement can even come into consideration, the person’s heart needs a thorough checkup to ensure that it is safe for the patient to undergo surgery under a general anesthetic.

Heart disease

Older people often have heart disease.

When coronary arteries are narrowed, heart attacks occur. Cardiologists can place stents, so that previously narrowed coronary arteries receive normal blood flow. Following such a procedure the patient may live for another 10 to 15 years.

There are also heart valve calcifications. The aortic valve is particularly endangered. A heart surgeon may be able to replace a diseased aortic valve by a porcine valve.

The nervous system of the heart transmits electrical signals from the sinus node to the muscle fibers, which can get diseased. Heart rhythm problems may necessitate the insertion of a pacemaker.

Finally, the heart may enlarge, but pump less blood than before. This condition is congestive heart failure. The 5-year survival for this condition is only 50.4%. Unfortunately there is very little the doctor can do for patients like this.

Cancer

The older we get, the more DNA mutations we accumulate. At one point cancer develops. If the diagnosis happens at an early stage there is a good chance that surgery can remove a cancerous growth, and the patient survives. But there are cancers that are notoriously difficult to recognize in the early stages. These are: cancer of the pancreas, kidney cancer, stomach cancer and certain types of leukemias.

Respiratory diseases

Those who smoked earlier in life may develop chronic obstructive pulmonary disease (COPD). It is a chronically disabling lung disorder. Often these individuals have to carry an oxygen tank with them wherever they go. The 5-year survival rate for people with COPD is 40 to 70%.

Osteoporosis

Osteoporosis is a disease where the bone is brittle. Spontaneous bone fractures can occur at the wrists, the upper thigh bone (femoral fractures) or in the vertebral bones. Women in menopause are hormone deficient and this contributes to calcium depletion of the bones. Lately research has shown that vitamin K2 and vitamin D3 are necessary for a normal calcium metabolism. Briefly, 200 micrograms of vitamin K2 and 5000 IU of vitamin D3 every day are the necessary dosage that the body can absorb calcium from the gut, eliminate it from the blood vessels and deposit it into the bone. Calcium is present in milk products and milk. If a person does not consume enough milk products a supplement of 1000 mg of calcium daily does make sense.

Alzheimer’s

The older we get, the more likely it is an onset of Alzheimer’s or dementia. Between the ages of 90 to 94 there is a yearly increase of Alzheimer’s of 12.7% per year. The group from age 95 to 99 years has a yearly increase of Alzheimer’s of 21.2% per year. Persons aged 100 years and older have an increase of Alzheimer’s by 40.7% per year. What this means is that essentially there is a doubling of Alzheimer’s every 5.5 years. We do not have all of the answers why this is happening and why Alzheimer’s develops. But we do know that diabetics are more likely to develop Alzheimer’s. High blood sugar levels and high insulin levels seem to lead to the precipitation of the tau protein in the brain, which causes Alzheimer’s.

Diabetes

When diabetes is not well controlled, there is accelerated hardening of the arteries. This can cause heart attacks and strokes. Longstanding diabetes can affect the kidneys (diabetic nephropathy, kidney damage) and can lead to hardening of the leg arteries. Often the only treatment left is a below knee amputation. Blindness from uncontrolled diabetes is common and pain from diabetic neuropathy as well.

Diabetics have an average life expectancy of 77 to 81 years. However, if they pay attention to their blood sugars and manage their diabetes closely they can live past the age of 85.

Falls and balance problems

As people age, their balance organ is not functioning as well. Also, people with high blood pressure medication may have postural hypotensive episodes that can lead to falls.

There may be a lack of cognitive functioning and misjudging of steps, ledges and irregularities in the floor. When a person has brittle bones from osteoporosis and they fall, a hip fracture is very common. At a higher age surgery for a hip fracture is dangerous. It can have a mortality of 50%.

Obesity

A person with obesity has a life expectancy that is 10 years less than a person without obesity. The reason for this is that with obesity This is so, because the risk of heart attacks, strokes, cancer, arthritis and diabetes is increased.

Depression

Older people often get depressed. It even has its own name: involutional depression. People can get into a state of mind, where they think negatively. Depressed people feel that they have nothing to live for. They lost friends; they are shut in because they can’t drive a car any more. This type of depression needs treatment by a psychologist or psychiatrist. The danger of leaving depression untreated is that the person may get suicidal. In older people depression is often precipitated by physical health problems.

Oral health

When teeth are not looked after, gingivitis and periodontitis can develop. Infected gums can shed bacteria into the blood and this can affect the heart valves. Endocarditis, the infection of heart valves, is a cardiological emergency. Prolonged antibiotic therapy is necessary to overcome this condition.

Poverty

Poverty has real consequences. The aging person may not have access to the optimal medical care facility because of a lack of funds. But even at a younger age there is evidence that people are healthier when they are wealthier.

Shingles

Older people often get shingles, even if they had chickenpox or shingles as a child. This is evidence that the immune system is getting weaker. Shingles in an older person should alarm the treating physician that there could be an underlying cancer. Due to that knowledge a cancer-screening tests should be part of the medical exam. In addition, a varicella vaccine should be offered to the patient to build up immunity.

The Downside Of Living To 100

Conclusion

Living to 100 is often glorified in the press. Maybe you have seen a 90-year old jogger completing a marathon, or you saw an 85-year old couple ballroom dancing. But what they don’t show you is what I summarized here, the less glamorous things about living to 100. You may get a heart attack or a stroke. Osteoarthritis may affect you how you walk. Congestive heart failure may make you get short of breath when you walk upstairs. Then there are various cancer types that are difficult to diagnose early.

If you have smoked in the past, you may suffer from chronic obstructive pulmonary disease (COPD), which leaves you breathless.

Other illnesses

Osteoporosis can lead to spontaneous fractures. Because the bone has a lack of calcium, this is difficult to treat and takes a long time to heal.

Alzheimer’s is ever so much more common when you approach the year 100. There are other medical conditions you can get: obesity, diabetes and depression. When you get shingles for the second time, it may mean that your immune system is getting weak and a cancer-screening test should be done.

There are some downsides when you approach the age of 100.

Know your risks and be vigilant

You may keep your physician busy checking out various age-related illnesses, but more importantly, get regular check-ups and tests. Any condition is easier to treat with an earlier diagnosis! The message for anybody reading this is very simple. Prevention through healthy living is something you can actively pursue. Keep your body and your mind busy. Enjoy time with friends and family instead of living a solitary existence. See the glass that is half full instead of viewing it as half empty. Stick to a healthy diet. Knowing all the risks is not a scare but a call to being vigilant. Knowledge is powerful and will help you to enjoy your golden years feeling well and happy.

Feb

2018

Causes Of Back Pain And Their Treatment

By Ray Schilling | Arthritis, back pain, laser therapy, low back pain, osteoarthritis, Pain, strain

There are many possible causes of back pain and their treatment is described in this blog. I have listed the 10 most common causes of back pain below. I also added brief therapeutic suggestions.

Facet joint disease (lower back strain)

When there is a misalignment of the facet joints, the joint capsules of these small joints are pulled, which can cause severe back pain. Chiropractic or physiotherapy treatments initially followed by active exercises will help (facet joint pain).

Degenerative disc and facet joint disease

Degenerative changes of the disc material between vertebral bodies and osteoarthritis of the facet joints can cause back pain. This is due to irritation of the nerve roots. Anti-inflammatory medication and physiotherapy treatments often help; swimming will be beneficial as well. End stage intractable disease, if confined to one or two levels, may respond to fusion surgery by a spinal surgeon. While you research the surgical option, I suggest you investigate about the possibility of stem cell therapy with PRP (platelet rich plasma). This is less invasive and will likely heal better than conventional surgery.

Spondyloarthropathies

This is a family of chronic inflammatory joint diseases of the spine . The physician treats the underlying disease and uses anti-inflammatories to control inflammation. Most of all, a person with this condition needs a referral to a rheumatologist for more specific therapy.

Osteoporosis

Osteoporosis is a bone condition that can lead to compression fractures of the spine. These in turn can irritate one of the nerve roots to lea to radiating pain into one or both legs. The physician will treat the underlying hormone disbalance, if present. Regular walking and swimming are used to remobilize. Avoid alcohol, caffeine and stop smoking. Supplements like calcium, bisphosphonates, vitamin D in higher doses and vitamin K2 can help re-calcify the bone.

Scoliosis

Scoliosis is often congenital. This spinal curvature leads to back pain and hurts more the more the spine is curved. Treatment: bracing during growth spurts; good posture; strengthening exercises; in severe cases corrective surgery by a spinal surgeon through the use of Harrington rods.

Spinal stenosis

Spinal stenosis is often the end condition of severe degenerative arthritis of the spine. It is more common in the older generation. As this link explains, there is a narrowing of the channel through which the spinal cord travels. In the past decompression surgery for severe cases was the only means to free spinal cord and nerve roots. In the last few years stem cell therapy is a new addition as an alternative to orthopedic surgery. The advantage of stem cell therapy is that there is no scarring following the procedure and the stem cells function like a biological knife from inside.

Posttraumatic fibromyalgia

Some people develop lower back pain following traumatic injuries. Instead of resolving their muscle sprain, they end up with chronic pain. Often low dose antidepressants and cognitive therapy will help. Mild physical exercises may help to rehabilitate the patient and return to normal muscle mobility. Unconventional therapy like prolotherapy, dry-needling and low-dose laser therapy (Dr. Weber) may be useful.

Disc herniation with or without sciatica

With disc herniation the back pain is intense, which often prompts the orthopedic surgeon to do an early discectomy (back surgery). But long term studies have shown that only in 3% of all acute back pain cases surgery is necessary; many cases heal on their own. In this case the new regenerative medicine approach of stem cell therapy with PRP will give superb clinical results. Stem cells will rebuild the disc and also take care of any arthritis in the small joint along the spine.

Spondylolisthesis and other congenital malformations

There are 4 grades of slipped vertebral body diseases (spondylolisthesis), where grade IV is the most severe case. Grade I to IIIA do not need surgery, stage IIIB and IV need fusion with instrumentation by a spinal surgeon.

Bone metastases

In stage 4 of many cancers metastases travel through the whole body including the skeleton. The underlying cancer needs treatment, often chemotherapy is required. Unfortunately cancers with bone metastases have a very poor prognosis. Here is a link how to manage symptoms of bone metastases.

Causes Of Back Pain And Their Treatment

Conclusion

I have listed the ten most common ones of back pain. For muscle spasms, simple physiotherapy or chiropractic treatment are often very helpful. Early degenerative changes in joints and discs will often respond to anti-inflammatory medication. But anti inflammatory drugs can be hard on your liver and your kidneys. If your back pain is getting more chronic, your doctor may want to arrange for an MRI scan of the area that causes pain. If this shows degenerative change in the discs and facet joints it is time to contact a regenerative medicine clinic. They specialize in stem cell and platelet rich plasma (PRP) treatments. This may be what you need to restore your back to normal. Conventional surgical methods are often the choice, but they are not always successful. Surgery can leave scarring behind, which by itself can give you chronic back pain.

Dec

2017

Stem Cells Cure Back Pain

By Ray Schilling | Arthritis, osteoarthritis, Pain

A person with chronic back pain has several treatment options, but only stem cells cure back pain. Stem cell treatment has been available in the US and Canada and many other countries for approximately 10 years.

I come from a family with a strong history of back pain (mother, maternal grandmother and maternal grandfather). They all got their back pain in their mid to late 40’s. From my growing up years I remember that they complained about chronic back pain on and off. Sometimes they had to cancel events they wanted to attend because they could not tolerate sitting. In those times there were no CAT scans or MRI scans. If you had back pain, you just had to put up with it.

My personal experience

Given my family history of back pain I was surprised that my back pain was only a more persistent problem in the last 1.5 years, but not earlier. Normally a monthly chiropractic adjustment would keep my back symptoms under control. But in the last 1.5 years I needed to see a chiropractor more often than that. I took omega-3 fatty acid supplements for the past several years (two capsules twice per day) thinking that this should halt the development of degenerative arthritis in the lower back joints. When I turned 71, it was clear to me that I was now at the point where my immediate relatives were when they were in their late 40’s. Therefore, diet, exercise, weight loss, good nutrition and supplements can only do that much for you. If there is a familiar disposition, it will eventually catch up with you.

Conventional medicine’s approach to lower back pain

I have practiced as a general practitioner for 16 years in the past. In addition I joined Workers’ Compensation for another 16 years as a medical advisor. From this clinical activity I knew of hundreds of cases first hand what the steps were in the treatment of chronic back pain. First of all, physiotherapy treatments or chiropractic treatments were the treatment protocol. In minor back pain cases this would often help the pain symptoms. Furthermore, if residual pain persisted, the patients received anti-inflammatory medication (non-steroidal anti-inflammatory drugs or NSAID’s). Finally, if symptoms continued to persist, a CT scan or MRI scan was necessary for assessment. If it showed moderate changes like my findings, the patient received intermittent physical therapy, chiropractic therapy or acupuncture therapy.

Surgical procedures for chronic lower back pain

If there were more severe degenerative changes or spinal stenosis with severe degenerative changes, a referral to an orthopedic surgeon or neurosurgeon would be necessary. But this was often the point of no return. If the surgeon felt that the condition was severe enough to do back surgery, various procedures could follow. For disc herniations irritating one of the nerve roots, laparoscopic discectomy was the treatment of choice. For severe spinal stenosis or intractable pain from end stage facet joint disease instrumentation was an option.

Fusion surgery

Under a general anesthetic the surgeon makes an incision in the patient’s back over the lumbar spine. The surgeon identifies the diseased disc level and places stabilizing stainless steel plates over the affected facet joints or the narrowed disc space. Many people think that fusion surgery would be the end of their trouble. In many cases this can actually be the beginning of chronic back trouble. The problem is that the body is designed to move. If the surgeon takes movement away in one area of the spine, the levels above and below have to work harder. It often takes only a few months or a couple of years, and the patient is back with excruciating pain from degenerative changes in the levels above and below the previous surgery. What does the surgeon usually do? He does more fusion surgery above and/or below the previous area of surgery.

Alternatives to back surgeries

New treatment options have opened up new possibilities. On the one hand there is prolotherapy treatment that I have described under this link. On the other hand stem cell therapy is another popular regenerative technique. Prolotherapy strengthens tissues, relieves pain and increases the range of motion in joints. There is 80 to 85% full pain relief and more than 80% improvement in range of motion. Prolotherapy promotes the healing of torn ligaments and tendons. There are many suitable conditions that lend themselves to the treatment with prolotherapy like the hip, knee, shoulder, ankle, neck, lower back and elbow. With prolotherapy the physician uses hyperosmolar dextrose injections into the affected area. Current thinking is that this irritates the tissues, which mobilizes local stem cells to heal the area.

In my case I had two prolotherapy treatments of my lower back, but it did not change my lower back pain.

MRI scans of my lumbar spine

We needed to find out what was happening in my lower back. My general practitioner ordered MRI scans of my lower back in summer of 2017. There are 5 levels of the lumbar spine from L1 to S1. In my case one level of 5 was normal. The other levels showed bulging of the discs. The scans also showed signs of arthritis in the small joints adjacent to the spine. Lucky for me, there was no sign of spinal stenosis. It was not good news: overall 4 levels of my lumbar spine showed signs of degenerative disc changes. At the same levels I also had arthritic changes in the facet joints. This was enough to consider some intervention, or I would be headed for trouble in the future.

Stem cell treatment for chronic back pain

Following the failed prolotherapy for my lower back pain I needed to figure out what to do next. The MRI scans had shown degenerative changes in the discs of the lower 4 levels of the lumbar spine. There also was arthritis in eight facet joints (two on each side of each of the four L2 to S1 levels). Conventional medicine would have offered corticosteroid injections into the facet joint areas. My experience with many patients who had this procedure was that the effect of the corticosteroid injections wore off after 3 to 6 months. If a patient had more than 3 injections, there usually was a point of no return, and fusion surgery would be next.

Best therapy for my own chronic lower back condition

For me there was no question that stem cell therapy would be the best fit for treating my back condition. In addition platelet -rich plasma and low-level laser therapy could activate the stem cells. This would be the ideal non-invasive treatment option to treat my chronic lower back pain. I had met Dr. H. Michael Weber before. He is a well-known laser expert from Germany who has a double certification as an engineer and as an internist treating various clinical conditions with laser and stem cell therapy. In addition he is an expert of regenerative medicine methods. Also, he invented and designed the laser machines himself. I set up an appointment in the fall of 2017 at his clinic in Lauenförde, Germany.

First day of stem cell treatment

On the first day fat tissue was removed under a local anesthetic from my lower left buttock area. Next a cell separator divides the tissue into connective tissue, fat cells and mesenchymal stem cells. Two blood samples were also taken from me for processing platelet rich plasma (PRP). PRP is a natural stem cell activator. Growth factors and anti-inflammatory cytokines were also part of the mix together with the stem cells.

The very same afternoon I received the stem cell mix by injection. Eight needles, four on each side, were necessary to administer the stem cell combination. I also had a treatment on a light therapy bed with red light to activate stem cells in general. The stem cell injection was a pain free procedure, as I received a shot of a local anesthetic in the area before. After that the physician inserted laser applicators through the interstitial needles.

Laser activation of injected stem cells

The next step was to use laser treatments with 5 different colors (infrared, blue, red, yellow and green) for 10 minutes for each of the 8 interstitial needles. The laser activation and the PRP mixed with the mesenchymal stem cells were the two main stem cell activators. They are crucial for activating the stem cells. But growth factors and anti-inflammatory cytokines also aided stem cell activation.

Second day of stem cell treatment

On the second day I received an infrared light treatment over my back for 20 minutes. Following that I received light therapy bed treatment for 20 minutes. The physician told me that all of this was to activate the stem cells further. The next step was a bone marrow low-dose laser therapy.

Bone marrow stem cell activation by low-dose laser therapy

Often stem cell therapists mix mesenchymal stem cells from fat tissue with bone marrow stem cells which they harvest before from pelvic bone marrow. Dr. Weber told me that he would do a direct bone marrow laser activation of the pelvic bone marrow instead. He anesthetized the tissue above the pelvic bone. Following this he made a small hole into the pelvic bone through which he inserted a laser applicator into the bone marrow cavity. 5 different colored lasers were again applied for 10 minutes each to activate the bone marrow stem cells. Studies have shown, as Dr. Weber stated, that low-dose laser activates bone marrow stem cells. They can be found in the blood circulation within 1 hour. This is similar to mixing stem cells in a Petri dish and then injecting it as a mix, except it is a less invasive approach.

Further activation of stem cells

Following these procedures Dr. Weber felt that another light bed therapy was necessary for 20 minutes. He also gave me a Weber medical laser watch called “Regenerate+”. This device fits on the wrist. It is programmed to generate a number of different lasers to shine against the underside of the wrist. This is the area where the ulnar and radial arteries run close to the surface. This device will shine the laser lights for 30 minutes, and the laser light reaches the arterial blood. The circulating stem cells from the stem cell therapy are receiving a further boost this way. Dr. Weber told me to use this device twice a day on an ongoing basis. The Weber medical laser watch stimulates the immune system. Jet lag also responds to, and it can stimulate stem cells as they circulate in the blood.

Stem Cells Cure Back Pain

Conclusion

Medical tourism is flourishing. I have become a medical tourist myself because I did not want to get crippled by conventional medicine regarding my lower back pain. Two days after my stem cell treatment my back pain was significantly improved. There was mild pain in the area of the fat liposuction site. Four days after the treatment the lumbar spine pain was gone. Innumerable chiropractic treatments and two prolotherapy treatments had not given me relief. Now stem cell therapy in Germany has taken my chronic back pain away in only a few days. I realize that the healing process will take 3 to 6 months to complete, but as a patient what counts most is pain relief.

What, if someone criticizes me for choosing stem cell treatment?

It is difficult to argue with success. Whether somebody criticizes me for having followed a non-conventional treatment protocol does not matter to me. My question back would be: what do you do when conventional methods fail? Are you willing to suffer chronic pain and swallow pain pills that could either get you addicted or have serious side effects? I would try stem cell therapy again, if I had a problem that does not respond to conventional therapy.

Jul

2017

Stem Cells For Osteoarthritis

By Ray Schilling | Arthritis, low back pain, osteoarthritis, Pain, stem cells

Many clinicians have used stem cells for osteoarthritis of the knee or other joints for some time. However, objective publications about the effectiveness of stem cells are only coming out now. Both stem cell types, derived from fat or stem cells from the bone marrow, are effective. Most doctors are using stem cells from fat (mesenchymal stem cells), because they are so much easier to harvest.

CNN reported about a man, Bill Marlette who had lost one of his arms in the past. He ended up overusing the other arm and as a result developed end-stage osteoarthritis in his wrist. He could not find relief with conventional methods of anti-inflammatories and pain pills. Next he went to a stem cell expert in Munich, Germany who treated him with mesenchymal stem cells from his fatty tissue. Only one treatment took away his chronic pain and helped him regain his wrist mobility.

Approval of stem cell therapy in Germany

Prof. Dr. Eckhard Alt, an expert in regenerative medicine has previously treated patients with end stage osteoarthritis and had good clinical outcomes with it. As a result the German regulatory agency has approved his treatment protocol.

Dr. David Pearce, executive vice president for research at Sanford Health in South Dakota said that Prof. Dr. Eckhard Alt was the first one to use fat cells as a source of mesenchymal stem cells to treat osteoarthritis. He went on to say: ”Those stem cells don’t have to be programmed in any way, but if you put them in the right environment, they will naturally turn into what the cell type around them is.” The physician harvests the stem cells through liposuction. An enzyme mixture is necessary to separate the stem cells from fat cells, oil and connective tissue. A cell separator can also help separating the stem cells from the rest of the cells and tissue.

A case of wrist osteoarthritis

As I mentioned before only one injection was necessary to relieve the chronic pain of Bill Marlette’s wrist. Since his return the doctors in the US have followed Bill closely. They took MRI scans and noted that the bony cysts associated with the severe arthritis have disappeared. His wrist and hand strength have returned to normal. The pain almost disappeared. There were no side effects whatsoever. Because the stem cells are of the same tissue type as all his other cells of his body, one would not expect any tissue rejection by the immune system. Bill Marlette did not need any pain pills following the procedure in August 2016. And he says: “I have more range of motion with my wrist, shaking hands didn’t hurt anymore,” he said. “My wrist seems to continue to improve, and there’s less and less pain all the time.”

Past experiences treating osteoarthritis with mesenchymal stem cells

A 2014 clinical trial from Korea involved 18 patients with osteoarthritis of the knee where adipose mesenchymal stem cells were injected. The high dose group did best. After 6 months there was significant improvement, also confirmed by arthroscopy. The previous cartilage defect in the femoral and tibial condyles had decreased in size. Range of motion in the knee joints and pain had also improved. There were no adverse effects from the treatment.

Chinese study

Mesenchymal progenitor cells have the propensity to develop into cartilage. At the Shanghai Medical College, Fudan University Shanghai, China the following experiment took place in 2015. The researchers grew human adipose mesenchymal cells in vitro. Later they injected these mesenchymal progenitor cells into the knees of rabbits with experimentally produced osteoarthritis. Despite doing xenotransplants (human cartilage to rabbits) with known HLA differences the cartilage grew and cured the osteoarthritis of the rabbits. The new cartilage had human HLA markers while the rabbit cartilage underneath had rabbit HLA markers. At 16 weeks the researchers examined the tissues under the microscope and another exam involved the HLA marker testing.

Tehran study

A study from Tehran, Iran was carried out on 18 patients with ankle, knee and hip osteoarthritis in 2015. Physicians injected stem cells from the bone marrow into the osteoarthritic joint. The doctors followed the patients and ordered occasional MRI scans for 30 months. All of the patients had improved significantly with regard to their joint function and pain. The MRI scans also showed thickening of the joint surfaces from new cartilage production.

French/German study

In a 2016 joint French/German study 18 patients with end stage knee osteoarthritis were treated with stem cells. The stem cells came from adipose tissue that went through a cell separator. Physicians injected the mesenchymal stem cell fraction into the osteoarthritic knees. This was a phase I study to rule out any adverse reactions, but none were evident. It also established that there were significant positive improvements in pain and mobility with regard to the affected knees.

General remarks about how stem cells heal osteoarthritis

The example above with end stage osteoarthritis of the wrist was just one example of where osteoarthritis can strike. Perhaps the more common other locations are hips, knees and the facet joints of the lower lumbar spine (causing chronic lower back pain).

The same treatment procedure, which Bill Marlette’s wrist benefitted from is useful for all these other locations. The common factor in osteoarthritis is that the cartilage is getting thinner and thinner until bone rubs on bone causing excruciating pain. It is here where mesenchymal cells can come to the rescue. The stem cells will assess what requires a repair after injection into an affected joint. They recognize that there is a lack of cartilage. Then they transform themselves into chondrocytes, which are cartilage-forming cells. How can stem cells do that? They come with a program to replace missing cells, particularly cartilage and bone cells. But if they are within fatty tissue, they cannot act within a joint that has osteoarthritis. The doctor has to transport the mesenchymal cells into the joint where they can then begin their healing function.

Other methods to treat osteoarthritis

Stem cells are only one of several regenerative treatment modalities for osteoarthritis. Another method are platelet-rich plasma (PRP) injections. Platelets have a lot of anti-inflammatory substances in them and also growth factors that can stimulate stem cells contained in the synovial membrane, the lining of any joint. To get PRP plasma, it is necessary to spin down blood and harvest the PRP fraction with a syringe. After three PRP injections were given into the knees of 90 patients with end stage osteoarthritis these patients were followed for two years.

In the beginning before treatment 100% of the patients had symptoms. After one year following the treatment with PRP their knee functions were normal in 67% of them. After two years only 59% had normal knee function. The investigators pointed out that this treatment modality initially helped to a certain point, but then the effects were slowly fading away.

Stem cell treatment of osteoarthritis of the knee

The literature on either bone stem cells or fat stem cell use for osteoarthritis of the knee in man is still sparse. Nobody has done larger clinical trials. Part of the reasons could be that total knee and total hip replacement in orthopedics is very lucrative. We are still in a symptomatic treatment mode. Physicians treat osteoarthritis conservatively with anti-inflammatories and pain pills. When bone rubs on bone, there can be excruciating pain. The physician refers the patient to an orthopedic surgeon who likely will do invasive surgical procedures. My own impression in general practice in the past is that these procedures do not always turn out the way they are supposed to work. Following total hip or knee replacement joint swelling often remains; pain issues are still there. There can be unequal height issues, balancing problems and so on.

Here is a review of mesenchymal stem cell therapy for osteoarthritis. This publication is very conventional medicine. An attitude change by conventional medicine would be useful to catch up with what is happening in real life. Some patients will travel abroad to Munich as Bill Marlette did. But others may travel to other places like India, Mexico or wherever medical tourism takes you. Regenerative medicine is there to stay.

Stem Cells For Osteoarthritis

Conclusion

We have learnt about a case of severe osteoarthritis of the wrist that has been cured in Germany with one injection of mesenchymal stem cells. More common than wrist osteoarthritis is osteoarthritis of the hips, knees and the facet joints of the lower lumbar spine. The same stem cell therapy can be given for osteoarthritis in these locations. I find it very strange that progress in stem cell treatments is so slow in the US. The FDA has decided to be open to clinical trials with stem cell treatments, but progress seems to be much slower than in other countries. Why? We may never know. In the meantime, patients may seek treatments in other countries where such treatments are offered. In real estate sales there is a saying: “Buyer beware”.

Be cautious, if you get treated abroad

The same goes for stem cell treatments in another country. Should you contemplate doing this, do your homework; ask about the qualification of the treating physician, about safety records and whether the local authorities have approved this procedure. In the case of Bill Marlette’s osteoarthritis of the wrist the procedure in Munich, Germany had been accepted by the European equivalent of the FDA, the European Medicines Agency. Safety is top priority, effectiveness is next.