Case Study: Solutions For Joint Pain

Stacy is a 32 year old lady who came to my clinic recently seeking help for joint pain. The pain wasn’t present all the time; it tended to come and go. Stacy wasn’t able to make any connection with what made her joint pain better and what made it worse, which she found frustrating.

The pain was mostly in her knees, elbows and the joint in her right index finger. Some days the pain in her knees was so bad that she couldn’t walk up or down hills. There are a lot of hills in her neighbourhood where she walks her dog and Stacy gets quite depressed when she is in too much pain to walk her dog.

Stacy’s doctor ordered some blood tests but didn’t find anything significant. She tested negative for rheumatoid factor, therefore she didn’t have rheumatoid arthritis. Everything else was normal except a slightly raised ESR (erythrocyte sedimentation rate) which is a marker of inflammation in the body. This was an expected result, but it didn’t tell us what was generating the inflammation.

I ordered some more tests for Stacy and they revealed an interesting clue to what may be causing her arthritis.

Other symptoms Stacy was experiencing

Before ordering any more tests I questioned Stacy about her health in general and any other symptoms she suffered, even if she didn’t think they were related to the arthritis. I discovered that Stacy felt tired and run down most of the time despite sleeping well and not having a great deal of stress in her life.

Her bowel habits were not healthy, although she didn’t consider them a problem, as that is the way they have always been. As soon as she woke, she experienced mild abdominal cramps and had to have a bowel movement as soon as she got out of bed. Fifteen minutes after breakfast she had to urgently rush to the bathroom again. Stacy usually had one or two more bowel movements later in the day and they were always loose and urgent. This indicated to me that something was irritating and inflaming her digestive tract and she was not digesting and absorbing her food properly. Food was rushing through her digestive tract and that left inadequate time to absorb precious vitamins, minerals and other nutrients from her food.

Blood tests I ordered for Stacy

I ordered an iron blood test for Stacy and noticed her ferritin level was low. Ferritin is the stored iron in the liver; low levels usually indicate that the patient has been iron deficient for quite some time and there is very little iron in reserve. Stacy didn’t have heavy menstrual bleeding and she was not a vegetarian, so I assumed the low iron was the result of poor digestion and malabsorption.

I also checked the level of vitamin D in Stacy’s blood and as I suspected, her level was quite insufficient at 22 ng/mL. The optimal level of vitamin D in the blood is between 40 and 60 ng/mL. This was not a surprising finding as Stacy had an indoor job and she avoided spending time in the sun because her very fair skin burnt easily. Vitamin D has hormone-like effects in the body and it has strong anti-inflammatory properties. For these reasons it is brilliant for people with autoimmune disease and any condition that is associated with pain. Vitamin D deficiency also typically causes fatigue and I regularly notice how delighted my patients are with their increased energy since commencing a vitamin D supplement.

Gluten is a highly inflammatory food that causes joint pain for a large number of people, so I ordered a blood test to check for the presence of the genes associated with gluten intolerance. Stacy has one of the genes, therefore gluten is likely to be responsible for some of her ill health.

My recommended treatment plan for Stacy

• A gluten and dairy free diet. These foods commonly cause inflammation, pain and allergies, therefore they are the first foods to get rid of in anyone with joint pain.
• Avoidance of vegetables in the nightshade family. This includes potatoes, tomatoes, capsicum and eggplant. Some people experience worse joint pain when they eat these foods so I asked Stacy to do a one month trial without them.
• A vitamin D3 supplement in a dose of 5000 IU per day, taken with breakfast.
• A Serrapeptase supplement. Serrapeptase is an anti-inflammatory enzyme that helps to reduce pain and swelling. I asked Stacy to take 3 tablets before breakfast each morning.
• An iron supplement, to help build up her stores of iron in her liver. I asked Stacy to take 2 capsules with dinner.
• Our joints have a high requirement for sulfur. It is needed for the health of ligaments and tendons. Sulfur is found in foods such as eggs, kale, broccoli and onion. I gave Stacy a supplement of MSM which is a type of sulfur. I asked her to include sulfur rich foods in her diet, but this would not be enough to alleviate the joint pain.
• A glutamine supplement to heal and soothe the irritated and inflamed lining of her digestive tract. Stacy found it helped to normalise her bowel motions and she no longer felt the urgency to have a bowel motion.

The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease.