Doctor Q&A: Can supplements help my arthritis? Dr Renee Hoenderkamp answers all your burning questions

The arthritis in my hands is particularly bad at the moment. Can diet and supplements help? 

As a fellow sufferer this question was a fantastic chance to share not only my research but also experience.

Osteoarthrtitis (OA) is the most common form of arthritis that affects all the tissues of the affected joint, leading to the breakdown of the smooth, protective cartilage on the ends of bones over time, meaning that eventually bones rub together and grow extra protective bone, causing pain and sometimes deformity.

There is much written about diet and arthritis but sadly not much in the way of good research. That doesn’t mean diet can’t help though and more likely means that food doesn’t bring profit for pharmaceutical companies and therefore funding research has no interest. However, the theory behind eating for OA is to reduce overall inflammation in the body and this will reduce inflammation causing the joint pain.

So let's start with foods that might be making it worse:

Sugar

Processed sugars can prompt pro-inflammatory cytokine release.

Saturated fat

Saturated fat can cause inflammation in fat tissue and is found in fatty meats/meat products, butter, cheese, cream, chocolate, cakes/pastries, palm oil, coconut oil.

Refined carbohydrates

Refined carbohydrates increase the production of advanced glycation end (AGE) oxidants. Which stimulates inflammation in the body. These include white bread and rice, fried potato. It is possible that if you have a high-glucose high-fat diet this could be making your arthritis worse.

Processed foods

With pro-inflammatory additives such as monosodium glutamate (MSG) and aspartame to name a few, not only could they worsen your arthritis but have links to cancer, so where you can avoid.

What to eat

The best advice is to eat cleanly and where possible home cook from raw ingredients, low or no sugar and non-processed.

Try and include the following foods which are suggested as anti-inflammatory:

• Olive Oil
• Nuts
• Leafy Green veggies; Kale, spinach, broccoli
• Fatty fish; mackerel, sardines, salmon, tuna – but make sure its line caught and not farmed
• Tomatoes
• Berries; blueberries, strawberries, cherries, oranges

There are also supplements which may help. Try to include:

Turmeric to reduce pain and inflammation
Glucosamine and chondroitin to reduce pain, support cartilage preservation, reduce inflammation
SAM-e for pain relief (as effective as NSAIDs for those who can’t tolerate them)

Fish oils are a potent anti-inflammatory with the added benefit of protecting against heart disease and dementia.

I keep getting cramp in my toes. What's causing this? 

The exact cause of cramp is unknown but risk factors include ageing, pregnancy; liver disease; poor physical condition; muscle fatigue; poor diet; over-exercising; mineral and electrolyte imbalances; dehydration; reduced blood flow, and tight, inflexible muscles.

When we sleep we slowly become more dehydrated and this can exacerbate cramp as the sleep period progresses.

Deficiencies can also contribute. Mineral salts such as magnesium, calcium, potassium, sodium, play an important role in muscle contraction and relaxation. If the balance of these is upset by an inadequate diet, dehydration, vomiting and diarrhoea muscles can be more susceptible to cramping.

Certain diseases or conditions may increase the risk of muscle cramp, including:

• Medications: Some medications can interfere with the body’s mineral balance and contribute to cramping. For example; statins, birth control pills, diuretics, NSAIDS
• Atherosclerosis: The formation of fatty plaques in arteries that cause them to become narrowed. This reduces blood flow to muscles which makes cramp more likely
• Sciatica: Pressure on nerves as they leave the spinal in the lower back can cause buttock and leg pain. In some cases, the irritated nerve that runs all the way to the toes can cause muscle contraction/cramp

My grandmother is suffering from early onset dementia - is there anything we can do to slow the pace of decline? 

I am sorry to hear this. Dementia is a devastating condition for the sufferer and family. If dementia is diagnosed under the age of 65, this is early onset, after this age, it is dementia with clear stages; early, middle and late.

Regardless of age, some things can be done to improve symptoms, but sadly not yet slow progress.

When someone is diagnosed with dementia, they and their family often want to know how it will progress. However, it is impossible to say how long each stage will last and the symptoms and development are unique to each person.

For many people, the early stage will last for months or years, but it may progress rapidly, although this is rare. So whilst I can’t give you treatments that will slow the pace for your Grandmother, I have outlined below the available medications and the things that you can do to help with the symptoms so that you can enjoy the present with your grandmother.

Whilst there is currently no cure for dementia, there are medications that can help with symptoms. These include:

• Rivastigmine
  
• Galantamine
  
• Donepezil
  
• Memantine

The medication prescribed will depend on the type of dementia diagnosed and your doctor will offer the appropriate treatment for you.

These medications are only effective for people with Alzheimer’s disease, dementia with Lewy bodies, Parkinson’s disease dementia, and mixed dementia of any of these types. There aren’t yet medications for vascular dementia or frontotemporal dementia.

Patients may also benefit from treatment options that don't involve medication.

Helping someone in the early stages of dementia

This again will need to be an individually tailored approach taken in consultation with what the person themselves wants, and different people will be more or less responsive to help. That must be respected.

It is a good idea if possible to have an honest and open discussion in the early stages of dementia about the diagnosis, what it means and what help they want to support them. This may include:

• Practical help to give reminders or prompts to daily activities.
• Suggesting that they prepare a lasting power of attorney for the future
• Agreeing family help, seeking spiritual support if appropriate, joining new activity/support groups
• Focusing on short-term pleasure or living for the moment, focusing on positive aspects and doing things that can be done today
• Exercising more, enjoying a healthier diet