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From the Townsend Letter
February/March 2014

The Integrated Treatment of Postmenopausal Osteoarthritis
by Alena Guggenheim, ND, and Carla Guggenheim, DO, FACP, with thanks to Nicholas Morgan, ND
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24.  Marchand WR. Mindfulness-based stress reduction, mindfulness-based cognitive therapy, and Zen meditation for depression, anxiety, pain, and psychological distress. J Psychiatr Pract. 2012 Jul;18(4):233–252. doi:10.1097/01.pra.0000416014.53215.86.
25.  Carlson LE. Mindfulness-based interventions for physical conditions: a narrative review evaluating levels of evidence. ISRN Psychiatry. 2012 Nov 14;2012:651583. doi:10.5402/2012/651583. Print 2012.
26.  Copland C, Nicolaou A, Cargill A, Amini-Tabrizi N, McCracken LM. Immediate effects of a brief mindfulness-based body scan on patients with chronic pain. J Behav Med. Epub 2012 Nov 6.
27.  Ussher M, Copland C, Nicolaou A, Cargill A, Amini-Tabrizi N, McCracken LM. Immediate effects of a brief mindfulness-based body scan on patients with chronic pain. J Behav Med. Epub 2012 Nov 6.
28.  Rosenzweig S, Greeson JM, Reibel DK, Green JS, Jasser SA, Beasley D. Mindfulness-based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice. J Psychosom Res. 2010 Jan;68(1):29–36. doi:10.1016/j.jpsychores.2009.03.010.
29.  Mak, JC. Potential role of green tea catechins in various disease therapies: progress and promise. Clin Exp Pharmacol Physiol. 2012;39:265–273.
30.  Oliviero F, Sfriso P, Scanu A, Fiocco U, Spinella P, Punzi L. Epigallocatechin-3-gallate reduces inflammation induced by calcium pyrophosphate crystals in vitro. Front Pharmacol. 2013 Apr 17;4:51. doi:10.3389/fphar.2013.00051. eCollection 2013.
31.  Akhtar N, Haqqi TM. Epigallocatechin-3-gallate suppresses the global interleukin-1beta-induced inflammatory response in human chondrocytes. Arthritis Res Ther. 2011 Jun 17;13(3):R93. doi:10.1186/ar3368.
32.  Ahmed S. Green tea polyphenol epigallocatechin 3-gallate in arthritis: progress and promise. Arthritis Res Ther. 2010;12(2):208. doi:10.1186/ar2982. Epub 2010 Apr 28.
33.  Huang GS, Tseng CY, Lee CH, Su SL, Lee HS. Effects of (-)-epigallocatechin-3-gallate on cyclooxygenase 2, PGE(2), and IL-8 expression induced by IL-1beta in human synovial fibroblasts. Rheumatol Int. 2010 Jul;30(9):1197–203. doi:10.1007/s00296-009-1128-8. Epub 2009 Sep 24.
34.  Rasheed Z, Anbazhagan AN, Akhtar N, Ramamurthy S, Voss FR, Haqqi TM. Green tea polyphenol epigallocatechin-3-gallate inhibits advanced glycation end product-induced expression of tumor necrosis factor-alpha and matrix metalloproteinase-13 in human chondrocytes. Arthritis Res Ther. 2009;11(3):R71. doi:10.1186/ar2700. Epub 2009 May 15.
35.  Buhrmann C, Mobasheri A, Matis U, Shakibaei M. Curcumin mediated suppression of nuclear factor-kB promotes chondrogenic differentiation of mesenchymal stem cells in a high-density co-culture microenvironment. Arthritis Res Ther. 2010;12(4):R127. doi:10.1186/ar3065. Epub 2010 Jul 1.
36.  Yang Q, Wu S, Mao X, Wang W, Tai H. Inhibition effect of curcumin on TNF-a and MMP-13 expression induced by advanced glycation end products in chondrocytes. Pharmacology. 2013;91(1–2):77–85. doi:10.1159/000345345. Epub 2012 Nov 26.
37.  Aggarwal BB, Gupta SC, Sung B. Curcumin: an orally bioavailable blocker of TNF and other pro-inflammatory biomarkers. Br J Pharmacol. 2013 Aug;169(8):1672–1692. doi:10.1111/bph.12131.
38.  Mobasheri A, Henrotin Y, Biesalski HK, Shakibaei M. Scientific evidence and rationale for the development of curcumin and resveratrol as nutraceutricals for joint health. Int J Mol Sci. 2012;13(4):4202–4232. doi:10.3390/ijms13044202. Epub 2012 Mar 30.
39.  Mathy-Hartert M, Jacquemond-Collet I, Priem F, Sanchez C, Lambert C, Henrotin Y. Curcumin inhibits pro-inflammatory mediators and metalloproteinase-3 production by chondrocytes. Inflamm Res. 2009 Dec;58(12):899–908. doi:10.1007/s00011-009-0063-1. Epub 2009 Jul 5.
40.  Shakibaei M, John T, Schulze-Tanzil G, Lehmann I, Mobasheri A. Suppression of NF-kappaB activation by curcumin leads to inhibition of expression of cyclo-oxygenase-2 and matrix metalloproteinase-9 in human articular chondrocytes: Implications for the treatment of osteoarthritis. Biochem Pharmacol. 2007 May 1;73(9):1434–1445. Epub 2007 Jan 7.
41.  Henrotin Y, Priem F, Mobasheri A. Curcumin: a new paradigm and therapeutic opportunity for the treatment of osteoarthritis: curcumin for osteoarthritis management. Springerplus. 2013 Dec;2(1):56. Epub 2013 Feb 18.
42.  Shakibaei M, Mobasheri A, Buhrmann C. Curcumin synergizes with resveratrol to stimulate the MAPK signaling pathway in human articular chondrocytes in vitro. Genes Nutr. 2011 May;6(2):171–9. doi:10.1007/s12263-010-0179-5. Epub 2010 May 25.
43.  Csaki C, Mobasheri A, Shakibaei M. Synergistic chondroprotective effects of curcumin and resveratrol in human articular chondrocytes: inhibition of IL-1beta-induced NF-kappaB-mediated inflammation and apoptosis. Arthritis Res Ther. 2009;11(6):R165. doi:10.1186/ar2850. Epub 2009 Nov 4.
44.  Pinsornsak P, Niempoog S. The efficacy of Curcuma Longa L. extract as an adjuvant therapy in primary knee osteoarthritis: a randomized control trial. J Med Assoc Thai. 2012 Jan;95 Suppl 1:S51–S58.
45.  Kizhakkedath R. Clinical evaluation of a formulation containing Curcuma longa and Boswellia serrata extracts in the management of knee osteoarthritis. Mol Med Rep. 2013 Nov;8(5):1542–1548. doi:10.3892/mmr.2013.1661. Epub 2013 Aug 29.
46.  Antony B, Merina B, Iyer VS, Judy N, Lennertz K, Joyal S. A pilot cross-over study to evaluate human oral bioavailability of BCM-95CG (Biocurcumax), a novel bioenhanced preparation of curcumin. Indian J Pharm Sci. 2008 Jul–Aug;70(4):445–449. doi:10.4103/0250-474X.44591.
47.  Sasaki H, Sunagawa Y, Takahashi K, et al. Innovative preparation of curcumin for improved oral bioavailability. Biol Pharm Bull. 2011;34(5):660–665.
48.  Cuomo J, Appendino G, Dern AS, et al. Comparative absorption of a standardized curcuminoid mixture and its lecithin formulation. J Nat Prod. 2011 Apr 25;74(4):664–669. doi:10.1021/np1007262. Epub 2011 Mar 17.
49.  Belcaro G, Cesarone MR, Dugall M, et al. Efficacy and safety of Meriva®, a curcumin-phosphatidylcholine complex, during extended administration in osteoarthritis patients. Altern Med Rev. 2010 Dec;15(4):337–344.
50.  Vishal AA, Mishra A, Raychaudhuri SP. A double blind, randomized, placebo controlled clinical study evaluates the early efficacy of aflapin in subjects with osteoarthritis of knee. Int J Med Sci. 2011;8(7):615–622. Epub 2011 Oct 12.
51.  Sengupta K, Alluri KV, Satish AR, et al. A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin for treatment of osteoarthritis of the knee. Arthritis Res Ther. 2008;10(4):R85. doi:10.1186/ar2461. Epub 2008 Jul 30.
52.  Akhtar N, Miller MJ, Haqqi TM. Effect of a Herbal-Leucine mix on the IL-1b-induced cartilage degradation and inflammatory gene expression in human chondrocytes. BMC Complement Altern Med. 2011 Aug 19;11:66. doi:10.1186/1472-6882-11-66.
53.  Ammon HP. Modulation of the immune system by Boswellia serrata extracts and boswellic acids. Phytomedicine. 2010 Sep;17(11):862–867. doi:10.1016/j.phymed.2010.03.003. Epub 2010 Aug 8.
54.  Ernst E. Frankincense: systematic review. BMJ. 2008 Dec 17;337:a2813. doi:10.1136/bmj.a2813.
55.  Davidson RK, Jupp O, de Ferrars R, et al. Sulforaphane represses matrix-degrading proteases and protects cartilage from destruction in vitro and in vivo. Arthritis Rheum. Epub 2013 Aug 27. doi:10.1002/art.38133.
56.  Facchini A, Stanic I, Cetrullo S, Borzì RM, Filardo G, Flamigni F. Sulforaphane protects human chondrocytes against cell death induced by various stimuli. J Cell Physiol. 2011 Jul;226(7):1771–1779. doi:10.1002/jcp.22506.
57.  Fragoulis A, Laufs J, Müller S, et al. Sulforaphane has opposing effects on TNF-alpha stimulated and unstimulated synoviocytes. Arthritis Res Ther. Epub 2012 Oct 27;14(5):R220.
58.  Vlachojannis J, Roufogalis BD, Chrubasik S. Systematic review on the safety of Harpagophytum preparations for osteoarthritic and low back pain. Phytother Res. 2008 Feb;22(2):149–152. doi:10.1002/ptr.2314.
59.  Fiebich BL, Muñoz E, Rose T, Weiss G, McGregor GP. Molecular targets of the antiinflammatory Harpagophytum procumbens (devil's claw): inhibition of TNFα and COX-2 gene expression by preventing activation of AP-1. Phytother Res. 2012 Jun;26(6):806–811. doi:10.1002/ptr.3636. Epub 2011 Nov 10.
60.  Gagnier JJ, Chrubasik S, Manheimer E. Harpgophytum procumbens for osteoarthritis and low back pain: a systematic review. BMC Complement Altern Med. 2004 Sep 15;4:13.
61.  Huang TH, Tran VH, Duke RK, Tan S, Chrubasik S, Roufogalis BD, Duke CC. Harpagoside suppresses lipopolysaccharide-induced iNOS and COX-2 expression through inhibition of NF-kappa B activation. J Ethnopharmacol. 2006 Mar 8;104(1–2):149–155. Epub 2005 Oct 3.
62.  Chopra A, Saluja M, Tillu G, et al. Ayurvedic medicine offers a good alternative to glucosamine and celecoxib in the treatment of symptomatic knee osteoarthritis: a randomized, double-blind, controlled equivalence drug trial. Rheumatology (Oxford). 2013 Aug;52(8):1408–17. doi:10.1093/rheumatology/kes414. Epub 2013 Jan 30.
63.  Liu H, Zeng C, Gao SG, Yang T, Luo W, Li YS, Xiong YL, Sun JP, Lei GH. The effect of mud therapy on pain relief in patients with knee osteoarthritis: A meta-analysis of randomized controlled trials. J Int Med Res. 2013 Oct;41(5):1418–1425. doi:10.1177/0300060513488509. Epub 2013 Sep 5.
64.  Fraioli A, Serio A, Mennuni G, et al. A study on the efficacy of treatment with mud packs and baths with Sillene mineral water (Chianciano Spa Italy) in patients suffering from knee osteoarthritis. Rheumatol Int. 2011 Oct;31(10):1333–1340. doi:10.1007/s00296-010-1475-5.
65.  Bostan B, Sen U, Güneş T, Sahin SA, Sen C, Erdem M, Erkorkmaz U. Comparison of intra-articular hyaluronic acid injections and mud-pack therapy in the treatment of knee osteoarthritis. Acta Orthop Traumatol Turc. 2010;44(1):42–47. doi:10.3944/AOTT.2010.2238.
66.  Kiliçoğlu O, Dönmez A, Karagülle Z, Erdoğan N, Akalan E, Temelli Y. Effect of balneotherapy on temporospatial gait characteristics of patients with osteoarthritis of the knee. Rheumatol Int. 2010 Apr;30(6):739–747. doi:10.1007/s00296-009-1054-9. Epub 2009 Jul 9.
67.  Evcik D, Kavuncu V, Yeter A, Yigit I. The efficacy of balneotherapy and mud-pack therapy in patients with knee osteoarthritis. Joint Bone Spine. 2007 Jan;74(1):60–65. Epub 2006 Nov 29.
68.  McAlindon TE, Felson DT, Zhang Y, et al. Relation of dietary intake and serum levels of vitamin D to progression of osteoarthritis of the knee among participants in the Framingham Study. Ann Intern Med. 1996 Sep 1;125(5):353–359.
69.  Sanghi D, Mishra A, Sharma AC, et al. Does vitamin D improve osteoarthritis of the knee: a randomized controlled pilot trial. Clin Orthop Relat Res. 2013 Nov;471(11):3556–3562. doi:10.1007/s11999-013-3201-6. Epub 2013 Aug 1.
70.  McAlindon T, LaValley M, Schneider E, et al. Effect of vitamin D supplementation on progression of knee pain and cartilage volume loss in patients with symptomatic osteoarthritis: a randomized controlled trial. JAMA. 2013 Jan 9;309(2):155–162. doi:10.1001/jama.2012.164487.
71.  Wann AK, Mistry J, Blain EJ, Michael-Titus AT, Knight MM. Eicosapentaenoic acid and docosahexaenoic acid reduce interleukin-1b-mediated cartilage degradation. Arthritis Res Ther. 2010;12(6):R207. doi:10.1186/ar3183. Epub 2010 Nov 8.
72.  Knott L, Avery NC, Hollander AP, Tarlton JF. Regulation of osteoarthritis by omega-3 (n-3) polyunsaturated fatty acids in a naturally occurring model of disease. Osteoarthritis Cartilage. 2011 Sep;19(9):1150–1157. doi:10.1016/j.joca.2011.06.005. Epub 2011 Jul 1.
73.  Baker KR, Matthan NR, Lichtenstein AH, et al. Association of plasma n-6 and n-3 polyunsaturated fatty acids with synovitis in the knee: the MOST study. Osteoarthritis Cartilage. 2012 May;20(5):382–7. doi:10.1016/j.joca.2012.01.021. Epub 2012 Feb 4.
74.  Cleland LG, James MJ. Osteoarthritis. Omega-3 fatty acids and synovitis in osteoarthritic knees. Nat Rev Rheumatol. 2012 Apr 17;8(6):314–315. doi:10.1038/nrrheum.2012.60.
75.  Henrotin Y, Lambert C. Chondroitin and glucosamine in the management of osteoarthritis: an update. Curr Rheumatol Rep. 2013 Oct;15(10):361. doi:10.1007/s11926-013-0361-z.
76.  Bertin P, Taieb C. NSAID-sparing effect of glucosamine hydrochloride (Structoflex®) in patients with knee osteoarthritis: an analysis of data from a French database. Curr Med Res Opin. Epub 2013 Oct 16.
77.  Cerda C, Bruguera M, Parés A. Hepatotoxicity associated with glucosamine and chondroitin sulfate in patients with chronic liver disease. World J Gastroenterol. 2013 Aug 28;19(32):5381–5384. doi:10.3748/wjg.v19.i32.5381.
78.  Howard D, Shepherd JH, Kew SJ, et al. Release of growth factors from a reinforced collagen GAG matrix supplemented with platelet rich plasma: Influence on cultured human meniscal cells. J Orthop Res. Epub 2013 Oct 7. doi:10.1002/jor.22495.
79.  Andia I, Maffulli N. Platelet-rich plasma for managing pain and inflammation in osteoarthritis. Nat Rev Rheumatol. Epub 2013 Oct 1. doi:10.1038/nrrheum.2013.141.
80.  Zhu Y, Yuan M, Meng HY, et al. Basic science and clinical application of platelet-rich plasma for cartilage defects and osteoarthritis: a review. Osteoarthritis Cartilage. 2013 Nov;21(11):1627–1637. doi:10.1016/j.joca.2013.07.017. Epub 2013 Aug 7.
81.  Say F, Gurler D, Yener K, Bulbul M, Malkoc M. Platelet-rich plasma injection is more effective than hyaluronic acid in the treatment of knee osteoarthritis. Acta Chir Orthop Traumatol Cech. 2013;80(4):278–283.
82.  Vaquerizo V, Plasencia MÁ, Arribas I, et al. Comparison of intra-articular injections of plasma rich in growth factors (PRGF-Endoret) versus durolane hyaluronic acid in the treatment of patients with symptomatic osteoarthritis: a randomized controlled trial. Arthroscopy. 2013 Oct;29(10):1635–1643. doi:10.1016/j.arthro.2013.07.264.
83.  Qin B, Shi X, Samai PS, Renner JB, Jordan JM, He K. Association of dietary magnesium intake with radiographic knee osteoarthritis: results from a population-based study. Arthritis Care Res (Hoboken). 2012 Sep;64(9):1306–1311. doi:10.1002/acr.21708.
84.  Oka H, Akune T, Muraki S, et al. Association of low dietary vitamin K intake with radiographic knee osteoarthritis in the Japanese elderly population: dietary survey in a population-based cohort of the ROAD study. J Orthop Sci. 2009 Nov;14(6):687–692. doi:10.1007/s00776-009-1395-y. Epub 2009 Dec 8.
85.  Lu B, Ahmad O, Zhang FF, et al. Soft drink intake and progression of radiographic knee osteoarthritis: data from the osteoarthritis initiative. BMJ Open. 2013 Jul 19;3(7). pii: e002993. doi:10.1136/bmjopen-2013-002993. Print 2013.

Alena GuggenheimAlena Guggenheim attended Reed College in Portland, Oregon, and graduated with a BA in biology in 2001. In 2007 she graduated from the National College of Natural Medicine with a doctorate in naturopathic medicine. In 2009 she completed a residency through National College of Natural Medicine and the Center For Natural Medicine mentored by Dr. Martin Milner that focused on cardiopulmonary medicine. During her education she participated in research regarding immune modulation with herbs and personality implications on health. In 2011 she began teaching in the Master of Science in Integrative Medicine Research (MSiMR) and Doctorate of Naturopathic Medicine programs at NCNM. She teaches clinical physical diagnosis, rheumatology, microbiology and an integrative modalities course. She also mentors students completing the MSiMR program. Her research focuses on immune modulation by mushrooms. Dr. Guggenheim maintains a private practice at the Center For Natural Medicine in Portland, the first naturopathic clinic in the country to be a certified Patient Centered Primary Care Home. She provides holistic primary care with a focus on rheumatological diseases such as rheumatoid arthritis and lupus.

Carla Guggenheim, DO, FACP

Carla Guggenheim, DO, FACP, is a board-certified rheumatologist and fellow of the American College of Physicians. Her undergraduate degree is in dance. She completed her DO degree at Des Moines University in 1988, DO rotating internship and internal medicine residency at Michigan State University in 1992, and rheumatology residency at the University of Iowa in 1994. She is clinical faculty at Michigan State University and National College of Natural Medicine. She is director of the first naturopathic rheumatology residency in the US.

Nicholas Morgan, ND


Nicholas Morgan, ND, is a second-year resident at Arthritis Care PC in Lansing, Michigan, where he also founded the Center for Integrative Wellness. He graduated from NUHS in 2011 and is the first naturopathic rheumatology resident in the US. Dr. Morgan's medical interests include arthritis prevention, epigenetics/nutrigenomics, functional medicine, and methylation management. In addition to practicing medicine, he enjoys teaching and public speaking to help increase awareness about the benefits of person-centered health care.

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