Arthritis action plan page

[_bigfoot_]

hi - I'm a 35 year old male. Have been active all my life, including triathlons. 193 cm tall and fluctuated between 93-98 KG over last 5 years. Recently discovered I have osteoarthritis in my right ankle which I understand is rare at my age given I have no family history and no previous injuries to the ankle.

Condition is complicated due to a suspected tib post tendon injury. Wearing orthotics I get arthritic pain, without I get no arthritic pain but my tib post injury causes retinaculum pain and lateral subtalar joint pain. Currently still trying to get ankle comfortable via physio and podiatrist - not making much progress which is frustrating and worrying. Plus since off loading weight onto other foot, now have pain in lateral subtalar joint on that one. Not sleeping well at the moment due to constant worry and limited options available to me in the long term (fusion or amputation).

On finding results out last month - I had my first flare up as I overprotected ankle and seized up. Hip seized and ankle. Currently awaiting blood test results as also getting pain in wrists. (RA tests). I was on Naproxen for a week but off it now - not sure it actually did anything. At present if I am in flip flops or bare feet I am ok.... but wearing socks and shoes I am in pain. (swimming but not doing much else as cant walk far currently).

Currently taking combination of 1000mg of M.S.M (Methylsulfonylmethane) 1 tablet a day. + 3 tablets of Glucosamine Sulphate 500mg with Chondroitin 400mg. And 1 capsule of Cod liver oil tablets (1000mg). Appreciate these might not do anything but worth a shot.

I used to be a complete cereal and bread fiend (my staple diet). Over last 3 weeks I have cut out all cereal (porridge, weetabix, muesli). I used to eat 5 slices of seeded batch brown bread a day but have cut this back to just 1 slice. Currently eating the following.

breakfast : fat free plain yoghurt + banana. Glass of milk
lunch : egg on toast or salad
evening meal : veg + chicken or fish. OR a salad (lettuce, tomato, radish,red onion, garlic, carrot, pepper, cress, celery + chicken or tuna).
snacks: oranges, apples, nectarins, walnuts, bananas and cherries.

I've lost 6 lbs quite quickly. I've never really had a food allergy before except maybe a bloated stomach if too much pasta was consumed without exercise. Have always had good health up until now. (ear infection + fungal nail infection on toe and athletes foot probably the worst I've had - put those down to athletic activities).

From what I have read here, I need to investigate cutting out bread completely . Look at the nightshades and by the sounds of it fruit (too much sugar)! I love my fruit and always thought it was needed for a healthy diet. Also what would I have for snacks?

Very tiered all the time at the moment which I believe is a common symptom of removing lots of carbs from diet. Plus not getting much more than 5.5 hrs a sleep through worry.

Any advice greatly appreciated.

thanks


edit : meant to say, I wanted to lose weight to take load off joints which seems one of best things I can do to prolong what cartilage I currently have. But also cut down on inflammatory foods and take natural anti inflam foods.

[prncsssmartass]

I have been doing a lot of research on auto immune disorders gluten sensitivity is the number one (and your tummy after eating pasta seems to support that), dairy is another....going primal is the right start. I have also read a lot about night shades. You might also look at THE LECTIN STORY ....( if the link goes away it is krispin dot com / lectin) it talks about night shades.

Replace your fruit with veggies....helps the transition....good luck.

[Lewis]

hi - I'm a 35 year old male. Have been active all my life, including triathlons. 193 cm tall and fluctuated between 93-98 KG over last 5 years. Recently discovered I have osteoarthritis in my right ankle which I understand is rare at my age given I have no family history and no previous injuries to the ankle.

Condition is complicated due to a suspected tib post tendon injury. Wearing orthotics I get arthritic pain, without I get no arthritic pain but my tib post injury causes retinaculum pain and lateral subtalar joint pain. Currently still trying to get ankle comfortable via physio and podiatrist - not making much progress which is frustrating and worrying. Plus since off loading weight onto other foot, now have pain in lateral subtalar joint on that one. Not sleeping well at the moment due to constant worry and limited options available to me in the long term (fusion or amputation).

Diet in a minute. Insofar as the mechanics of movement go, I'd recommend Alexander Technique lessons, if you can afford them. I've taken quite a few, although none for some time, and they really do make a difference to a lot of conditions. A recent NHS survey of over 500 people with chronic back pain found it was the most effective (and actually the cheapest) treatment. Better than physio or drugs. I'd take two or three lessons just to give it a try, if I were you:

Back pain and Alexander technique - Health news - NHS Choices

Here's STAT, if you'd be interested in finding a teacher near you:

The Definitive Guide to The Alexander Technique provided by STAT - The Society of Teachers of The Alexander Technique

On finding results out last month - I had my first flare up as I overprotected ankle and seized up. Hip seized and ankle. Currently awaiting blood test results as also getting pain in wrists. (RA tests). I was on Naproxen for a week but off it now - not sure it actually did anything. At present if I am in flip flops or bare feet I am ok.... but wearing socks and shoes I am in pain. (swimming but not doing much else as cant walk far currently).

Currently taking combination of 1000mg of M.S.M (Methylsulfonylmethane) 1 tablet a day. + 3 tablets of Glucosamine Sulphate 500mg with Chondroitin 400mg. And 1 capsule of Cod liver oil tablets (1000mg). Appreciate these might not do anything but worth a shot.

Fish oil is an anti-inflammatory, and fish liver oil is also quite high in vitamins A and D. You want both those to be at quite a high level. The best cod liver oil is naturally-fermented, which is much higher in D—important for immune function apart from anything else.

The only company in the world still making a naturally fermented cod liver oil is Green Pastures in the U.S. However, the oil, going under the name Blue Ice is imported to the UK. These people, for example, have it:

Organic Food UK

You could take half a teaspoon in the morning and the same in the evening—or perhaps half that if you get out in the sun a lot (since you make D in your skin from cholesterol and sunlight).

Ideally you should have your vitamin D level checked to see what it is. If your GP won't do it, the Path lab at City Hospital in Birmingham will do it for twenty quid, which is pretty cheap. You probably want a value of something like 100 nmol/L. Many people are shockingly low.

Clinical Biochemistry, City Hospital, Birmingham

I used to be a complete cereal and bread fiend (my staple diet). Over last 3 weeks I have cut out all cereal (porridge, weetabix, muesli). I used to eat 5 slices of seeded batch brown bread a day but have cut this back to just 1 slice.

Yes, that's bad. From the point of view of low-carb for weight-loss, then a slice of bread may be OK; from the POV of auto-immunity problems, such as arthritis, it's probably not. Try the following Google search:

"osteoarthritis gluten"

Currently eating the following.

breakfast : fat free plain yoghurt + banana. Glass of milk
lunch : egg on toast or salad
evening meal : veg + chicken or fish. OR a salad (lettuce, tomato, radish,red onion, garlic, carrot, pepper, cress, celery + chicken or tuna).
snacks: oranges, apples, nectarins, walnuts, bananas and cherries.

I'd drop bread and anything with any wheat in it. If gluten really is the problem, this may also mean searching out personal care products that are gluten-free—sounds strange, but really. Wheat or gluten are often added to shampoo, for example, and that's enough to hurt some people. There was a nun whose gut didn't begin to recover from gluten-damage, even though she'd removed all gluten-containing products from her diet, until her doctors realized that she was still talking the wafer at Holy Communion. A tiny little bit like that can be enough.

You'd likely be best off dropping all dairy products for awhile. You could re-introduce well-fermented dairy (such as homemade 24-hour-fermented yoghurt or kefir) later if your symptoms abate and see if you get a negative reaction to it or not. But for now ... it seems that with many people if gluten (wheat protein) is a problem, then so often is casein (milk protein), too. It can be that once gluten has done damage to the gut, dairy products, which otherwise would have been OK, then becomes hard to digest and can end up firing off your immune system.

I've lost 6 lbs quite quickly. I've never really had a food allergy before except maybe a bloated stomach if too much pasta was consumed without exercise. Have always had good health up until now. (ear infection + fungal nail infection on toe and athletes foot probably the worst I've had - put those down to athletic activities).

Yeah, but infections like that can actually be systemic rather than local. I'd take a good multi-strain probiotic to make sure your gut is populated with the right bacteria. Antibiotic use, the use of antacids, the excessive consumption of carbohydrates, and many other things, can impact on gut-flora, and then pathogens can move in.

Bio-kult is a good multi-strain probiotic. You should be able to find a distributor on Amazon UK. Or find a good health food store (one that keeps the probiotics in the fridge) and look for one that has many strains in it.

From what I have read here, I need to investigate cutting out bread completely .

Yes, you probably do need to. You could have tests to try to determine whether gluten is the problem, but honestly you might just as well save your money, take it out, and see what happens. I've heard that it can be two or three months before you notice a difference with arthritis; so you may not get results very quickly.

Look at the nightshades

Possibly.

and by the sounds of it fruit (too much sugar)! I love my fruit and always thought it was needed for a healthy diet.

I wouldn't worry too much about that. As long as you don't overdo the quantity of fruit and tend to prefer the low-sugar options (like berries) there's no real problem.

Also what would I have for snacks?

Nuts. But don't overdo them, because that would throw your omega-3/omega-6 balance off. Maybe an ounce or so a day, or every other day. Hardboiled eggs. Sugar-free jerky/biltong. Sure, fruit. An avocado (actually is a fruit).

Very tiered all the time at the moment which I believe is a common symptom of removing lots of carbs from diet. Plus not getting much more than 5.5 hrs a sleep through worry.

Sleep? Try some magnesium. it's very much lower in the food we eat than it was for our ancestors because of soil-depletion. It's probably the one supplement everyone should take. The most readily absorbable form is magnesium glycinate, but try what you can get. Lots of people here, including me, use Naturalcalm, which is a citrate. There's some good advice on sleep in this short piece in the Guardian:

Can't sleep? Hold the coffee | Life and style | The Observer

Any advice greatly appreciated.

Well, I hope that's some use. All the best.

[_bigfoot_]

thanks very much for the reply and information.

Are there any threads on this site suggesting weekly meal plans that people tend to stick to? I'm struggling for inspiration at the moment. Let's say I took dairy products out, what the heck do you eat for breakfast if no yoghurt and no cereal?

Is rice ok for meals or is that part of the grains?

If bread is out what about lunch?

I see quite a lot of contradicting advice. Some say no nuts, some say no eggs, but other people say these are fine. Think I need to experiment by removing certain items from my diet to see if they make any difference.

[Adrianag]

You need to add animal fats to your diet, full fat yogurt, bacon, fatty meats, chicken with skin, coconut oil! There are lots of carbs in the fruit you are eating.


EAT THIS, NOT THAT

In a nutshell....

PRIMAL DIET – EAT THIS, NOT THAT

EAT THIS*
YOU CAN AND SHOULD EAT IT. In fact, it should be the backbone of your diet.*
- Meat (preferably grass-fed)
- Poultry (preferably free-range)
- Fish (preferably wild-caught)
- Eggs (preferably cage-free)
- Non-starchy and/or green vegetables (preferably organic)
- Avocado
- Butter (preferably from grass-fed cows)
- Lard
- Ghee
- Coconut oil
- Coconut milk
- Olive oil (but not for cooking)
- A berry (up to a handful)

NOT THAT
YOU SHOULD NOT EAT IT. Throw it away (unless it's a cleaning or stationery product, in which case use it for its appropriate purpose).
- A legume (bean, pea, peanut)
- A grain (wheat, corn, rice) or made of a grain (cereal, oatmeal, bread, cake, tortilla, pasta)
- A processed food product
- A "low-fat" manufactured food product
- A "low-carb" manufactured food product
- A "diet" manufactured food product
- Anything with an ingredient that ends in "ose" (sucrose, glucose, fructose) or that contains sugar, agave nectar, honey, or maple syrup
- Anything from the center aisles of the grocery store...

EAT IN MODERATION
- Dairy products (milk, yogurt, cream, sour cream, half & half) – whole milk (not low-fat)
- Nuts (peanuts are not nuts)
- A seed
- A fruit other than a berry
- A starchy or sugary vegetable (carrot, beet, winter squash)
- A tuber (potato, sweet potato, yam)
- A nightshade (tomato, bell pepper)
- Coffee

UNLESS:
- You are trying to lose weight (for dairy, nuts, fruits, starchy vegetables, and tubers)
- You are lactose intolerant (for dairy)
- You are significantly inactive/sedentary
- You are insulin resistant (for dairy, nuts, fruits, starchy vegetables, tubers, and coffee)
- You want to go 100% evolutionary diet and avoid anything we aren't sure paleo man ate

[Lewis]

... what the heck do you eat for breakfast if no yoghurt and no cereal?

What our grandparents used to. Eggs in all forms, bacon, poached haddock, smoked fish, liver, kidneys, cold beef. All the kinds of things you'd find people eating in Victorian or Edwardian novels. Firms like Kellogs have sold modern people on "breakfast cereal" for convenience' sake and with the lie that it's "healthy". Go back to what people used to eat.

Is rice ok for meals or is that part of the grains?

People on low-carb reducing diets do tend to miss it out, because it is very starchy. But probably some now and then isn't going to derail anyone's weight-loss.

So far as autoimmune reactions go it's probably not a problem for most people: white rice is safer than brown from the point of view of reactions of that sort. However, people whose gut flora are seriously disrupted seem to need to drop out all hard-to-digest starches, because those (and hard-to-digest sugars, the principal one of which is table-sugar, sucrose) provide food for the bad bacteria in the gut. If you can't digest them, something else will. The GAPS protocol does that. That's what one would be best to do, if one had reason to believe one's gut flora were seriously disrupted. Yours might be, judging from the arthritis and the fungal infections. Up to you how far you want to go.

If bread is out what about lunch?

Salad and cold meat or fish. Take a large soup plate or a small mixing bowl and fill it with all manner of salad vegetables. Drizzle a 15ml tablespoon of olive oil over and some lemon juice or cider vinegar. That much salad—and you've got the good fats in the form of the olive oil—is quite filling.

I see quite a lot of contradicting advice. Some say no nuts, some say no eggs, but other people say these are fine.

Well, no nuts if you have a reaction to them. Again, some people seem to have reactions to chicken eggs—duck eggs are usually OK. That may be because people eat them very frequently: you can get sensitized to what you eat too frequently—particularly if you have a damaged gut, since then unbroken-down bits of proteins can get into the bloodstream and trigger your immune system. Wheat may be a particular problem for many people partly because our society eats so damn much of it—cereal and toast for breakfast, sandwiches for lunch, pasta for dinner, 3 times a day or more, every day. You can drop anything suspect out for awhile (three weeks at least) and then cautiously re-introduce foods one at a time.

[Littlesigh]

Just a small input here.... I would not think 35 is too young for Osteo... especially considering you said you damaged you ankle and were active in tiathlons. I was heavy into Martail Arts and damged both knees in my late 20's.. started having problems over the next ten years and now I deal with it. I have to admit they have been better since dropping 20-30lbs over the past 4 years but still get pains... I am only 54..... Getting old sucks! But being Primal has taken the edge off! I feel and look as good as I did when I was 30! (my prime MA time)

[Adrianag]

Are you taking vitamins K2 and D3? Together they are critical for bone formation. This is the only K2 that comes in high enough dosages.
Ultra K2, 90 caps

[Sudenveri]

I've had arthritis since I was 23 (26 now). I've found that taking glucosamine/chondroitin and pantothenic acid (vitamin B5) helps. Dietary changes have done precisely dick, but have helped other conditions (as well as improving my skin, hair and nails).