Nutrition - Don't ignore it!!

[AlexaL]

After convincing myself that NSAIDs were not providing a benefit I stopped taking them a week ago. That turned out to be a wrong decision. Within a few days pains appeared around and under the knee, and I couldn't help starting to limp again. The symptoms were similar to those I experienced about six weeks ago. I then restarted NSAIDs supplemented by fish oil (9g/day), which is a strong anti-inflammatory. Less than 24 hours later the new pains went away, and have stayed away for the past four days!

The pharmacist also suggested that calcium and vitamin D (to improve calcium absorption) supplements might aid in improving bone strength, but then changed his mind because I probably wouldn’t need them – milk with cereal for breakfast and relatively high exposure to sunlight probably suffices. On reading about the relationship between calcium and vitamin D in the diet, it appears that high protein intake might also be associated with calcium leaching from bones, and too low associated with increased fracture risk because of reduced mass. It seems that moderate and balanced diets, and no excesses, are important to a quick recovery.

The comments of morgana are very relevant here. I am now willing to put up with slower bone healing because of the relief the NSAIDs give from the pains and discomfort around the knee. Without the pains and discomfort I feel more capable of doing the quad and VMO strengthening exercises, which are so important to an early and full recovery.

I had similar issue when I immediately stop taking NSAIDs I start to limp with the pain around the knee. Right now I am also taking NSAIDs and Omega 3 supplement, I was advised by my doctor that Omega 3 supplement can also be an alternative anti-inflammatory. But the recommended dose that I was given was 3g daily for this Omega 3 supplement that I am taking... So far the combination of NSAIDs and this Omega 3 supplement worked. I have post-traumatic arthritis on the right knee and we cannot just rely on NSAIDs for the recurring pain as it may also have side effects in taking these NSAIDs for so long.  I was planning in reducing the intake of NSAIDs, I see that you are taking 9g/day of Omega 3 supplement is it possible to increase the dose that I can take of this Omega 3 supplement more than what’s currently recommended by my doctor? Thanks in advance.

[mjeffrey]

Hi AlexaL

You're lucky to have a doctor who is prepared to consider things beyond something produced by a drug company. There are quite a few studies showing that Omega-3 can work for some people, you seem to be one of them.

From what I have read, good quality Omega-3's seem to be fairly safe even at quite high doses see here http://www.mayoclinic.org/drugs-supplements/omega-3-fatty-acids-fish-oil-alpha-linolenic-acid/dosing/hrb-20059372 but 9 grams does seem like a lot. The ones you are taking seem to be good quality (molecularly distilled).

Personally I'd try experimenting with modifying the dose gradually along with reducing the NSAID, but remember more doesn't necessarily mean more effect.
What NSAID are you taking and how much per day?

[AlexaL]

Hi AlexaL

You're lucky to have a doctor who is prepared to consider things beyond something produced by a drug company. There are quite a few studies showing that Omega-3 can work for some people, you seem to be one of them.

From what I have read, good quality Omega-3's seem to be fairly safe even at quite high doses see here http://www.mayoclinic.org/drugs-supplements/omega-3-fatty-acids-fish-oil-alpha-linolenic-acid/dosing/hrb-20059372 but 9 grams does seem like a lot. The ones you are taking seem to be good quality (molecularly distilled).

Personally I'd try experimenting with modifying the dose gradually along with reducing the NSAID, but remember more doesn't necessarily mean more effect.
What NSAID are you taking and how much per day?

Hi Jeff,

Thanks for the response, Advil and lodine is what what I'm commonly taking(that is 2-3 300mg pill/day). This Omega 3 supplement that we are taking worked for me, it had that lemon flavor compared to the previous ones that we've tried(for this 2 gel caps/day). My doctor agreed for me to take Omega 3 supplement so long as it is from a good source and quality.

I'll check with my doctor further to see if its possible for us to modify the dose, depending on its effect. The are loads of information on this forum that are very helpful and hopefully I can also find a thread similar to this that would tackle moderate exercise that would be suitable for my condition.

Thanks again!

[beefrank]

With reference to earlier posts, the recommendation of 9g a day was made by the pharmacist, and also appears on the fish oil container as an anti-inflammatory dose for arthritis and other joint-related problems. I've gone back to 5g a day. Not sure how effective it is, but at the relatively low cost of treatment and with continued discomfort at the fracture site I will carry on taking the capsules. Nothing ventured nothing gained.

[morgana]

just bumping this one to keep the thread active.  So many good points in it!

[mjeffrey]

Nothing conclusive but Leucine supplementation might be something worth trying (downside is the small cost).
Leucine is an amino acid (a BCAA) and is a component of whey protein.

http://link.springer.com/article/10.1007/s00726-010-0636-x
http://aminoacidstudies.org/leucine-reduces-muscular-atrophy/#fnref-1395-1
http://www.omicsonline.org/2161-0673/2161-0673-2-e108.php

p.s. I'd recommend whey protein over BCAAs since a good whey tastes delicious and BCAAs taste disgusting

[mjeffrey]

Some more evidence for supplementing protein to reduce muscle atrophy

http://www.jci.org/articles/view/70160

Conclusion. EAA treatment attenuated muscle atrophy and accelerated the return of functional mobility in older adults following TKA.

In this case for older adults with knee replacement but no reason to believe similar results wouldn't be achieved in other age groups for other interventions.