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Osteoporosis & Osteoarthritis in TCM Therapy

Chun Yi, Lu O.M.D., LAc.

There are quite different between osteoporosis and osteoarthritism, but


in traditional Chinese theory, they definite relate to each other.

Osteoporosis is an invisible killer, and more horrible than cancer”.


Due to changing lifestyles and dietary habits, Due to osteoporosis being a “Silent” disease that
as well as the aging population, the so-called shows no advanced symptoms, many people can
“diseases of modern civilization” have emerged only be aware of the problem once fracture occurs.
early. Osteoporosis is the most popularly known, If people do not take this problem seriously and
yet most overlooked disease. According to WHO, effectively prevent it, the disease would take its toll
“osteoporosis-induced fractures cause a great burden in one’s life and finances.
to society. Hip fractures are the most serious, as they
During adolescence, the bones can accumulate
nearly always result in hospitalization, are fatal about
a large quantity of calcium rapidly through exercise
20%, and produce permanent disability about and diet to strengthen the skeletal system, a
half the time. Fracture rates increase rapidly with process called “ the accumulation of bone mass”.
age and the lifetime risk of fracture in 50 year-old At the age of 35, bone mass reaches a peak, after
women is about 40%, similar to that for coronary which the ability to regenerate bone mass starts to
heart disease. In 1990, there were 1.7 million hip decline, leading to osteoporosis if calcium is not
fractures worldwide; with changes in population immediately replenished. As far as the loss of bone
demographics, this figure is expected to rise to 6 mass is concerned men may lose up to 40-50% after
million by 2050.” menopause. It is scar, if 1/2 of the calcium is lost of
the bone mass of the entire body.
Osteoporosis is a disease characterized by
lowered bone density, more and enlarged pores of Many people believe that osteoporosis only
the bones, porous bones with increased brittleness, happens to the elderly. However, many young
and inability to resist pressure and torsion resulting people have such poor life style habits as lack of
in an increased likelihood of bone fractures exercise, smoking, drinking alcohol, coffee and
when one is not careful. “Osteoporosis soda, that can all cause weakening of bone mass.
 SUN TEN QUARTERLY NEWSLETTER WINTER 2007

Calcium is gradually vessels. The symptoms include emaciation,


lost during intake of weakness, diminished visual acuity, aching and
a large quantity of weakness of the lower back and knees. This formula
nicotine or caffeine. reaches beyond the qi and blood to the yin and
To storage and the loss of yang, and still further to the essence and marrow,
calcium in the bone mass is just like in order to replenish the deepest sources of energy
the balanced relationship between the in the body. It is therefore most appropriate in
deposit and the withdrawal of a bank cases of severe depletion due to prolonged illness
account. When calcium is supplied in or long-term, general debility. Depend on the
large quantity, excess calcium will be patients’ situations, the following modifications are
stored in the bones. On the other hand, recommended:
a shortage of calcium over a long period
a. For pain in the arm or upper body, add Gui Zhi
of time will lead to the withdrawal of
(Cinnamomum cassia).
calcium from the bones, leading to
b. For foot pain or pain in the lower body, add Mu
their weakening.
Gua (Chaenomeles speciosa) or Yi Yi Ren (Semen
Although using calcium to increase Coix).
bone density has received most of the media c. For qi deficiency, add Ren Shen (Radix Ginseng) or
attention, it is actually a rather small player when Ci Wu Jia (Siberian Ginseng)
it comes to improving bone strength. The most
important thing is the body absorption rate, and Zuo Gui Wan (Restore the Left Decoction):
in traditional Chinese medicine theory, emphasis This formula is a variation of Rehmannia
the absorption rate is laid on various physiological Six Formula (Liu Wei Di Huang Wan) with the
functions of an organ. The organ system referred three draining herbs, which are Cortex paeonia
to as the kidney incorporate the genitourinary suffruticosa (Mu Dan Pi), Sclerotium Wolfiporia cocos
system, the basis of fluid metabolism, the ability to (Fu Ling), and Rhizoma Alisma orientalis (Ze Xie)
reproduce, and the development and maintenance omitted and five tonics Fructus Lycium barbarum
of the bones. In traditional Chinese medicine (Gou Qi Zi), Gelatinum Plastri Testudinis (Gui Ban
theory, the osteoporosis belongs deficiency category. Jiao), Gelatinum Cornu Cervi (Lu Jiao Jiao), and
There is Kidney / Blood deficiency or Qi deficiency Radix Achyranthes bidentat (Niu Xi) added. It can
and following formulas are helpful to treat the nourish the yin, tonifies the kidney, supplements
osteoporosis: the essence, and benefits the marrow. For deficiency
Gui Lu Er Xian Jiao (Tortoise Shell & Deer of the kidney (especially the marrow and essence)
Antler Syrup):
with soreness and weakness in the lower back and
legs, night sweats, dry mouth. This is a stronger
Nourishes and replenishes the yin, tonifies version of the principal formula that is used in more
the essence, augments the qi, and tonifies and severe cases. Depend on the patients’ situations, the
strengthens the yang. Fire deficiency of the kidney following modifications are recommended:
yin and yang accompanied by insufficiency of
essence and blood in the conception and governing a. For the low body energy, add Ren Shen (Radix
WINTER 2007 SUN TEN QUARTERLY NEWSLETTER 

Ginseng) Liu Wei Di Hunag Wan (Rehmannia Six


b. For the slow body circulation, add San Qi (Radix Formula):
Notoginseng)
The characteristic of this formula is the
c. For the weak immune system, add Xi Yang Shen
combination of three tonics with three draining
(Radix Panacis quinquefolii)
herbs. The three tonic herbs, which are Radix
You Gui Wan (Restore the Right Pill): Rehmannia preparata (Shu Di Huang), Fructus
This formula is a variation of Ba Wei Di Huang Cornus officinalis (Shan Zhu Yu), and Rhizoma
Wan (Rehmannia Eight Formula). The modifications Dioscorea opposita (Shan Yao). The three draining
include an increase in the dosage of the yang tonics. herbs , which are Rhizoma Alisma orientalis (Ze
Cortex Cinnamomum cassia (Rou Gui), omission Xie), Cortex Paeonia suffruticosa (Mu Dan Pi), and
of the three draining herbs which are Sclerotium Sclerotium Wolfiporia cocos (Fu Ling). This formula
Wolfiporia cocos (Fu Ling), Rhizoma Alisma orientalis reinforces the yin; tonifies the liver and kidney.
(Ze Xie) and Cortex Paeonia suffruticosa (Mu Dan Related symptoms are: soreness and weakness of
Pi), and the addition of blood and essence-tonics, the lower back and knee joints; steaming bone
which are Fructus Lycium barbarum (Gou Qi Zi), sensation and heat sensation in the palms and soles.
Cornu Cervi gelatin (Lu Jiao Jiao), Semen Cuscuta Depend on the patients’ situations, the following
chinensis (Tu Si Zi), Cortex Eucommia ulmoides (Du modifications are recommended:
Zhong), and Radix Angelica sinensis (Dang Gui). a. For the lower back and knee sore, add He Shou
This formula can warms and tonifies the kidney Wu (Radix Polygoni multiflori)
yang, replenishes the essence, and tonifies the blood. b. For reduce inflammation and increase immunity,
This formula is use in exhaustion from long-term add Jiao Gu Lan (Herba Gynostemmae pentaphylli)
illness, and aching and weakness of the lower back c. For boost energy and raise the energy levels, add
and knees. This is kidney yang deficiency with Ren Seng (Radix Ginseng)
waning of the fire at the gate of vitality. The root
aspect of this condition, kidney yang deficiency, Even though this formula is regularly taken middle-
causes such symptoms as aversion to cold, coolness aged and older people, but it can help prevent
of the aching and weakness of the lower back and aging, promote health and prolong life if taken by
knees, of the lower extremities. Depend on the younger population.
patients’ situations, the following modifications are If you display any of the following symptoms,
recommended: you may already have osteoporosis: constant
a. For loss body fluids and dry mouth, add Xi sore waist and back pain, difficulty
Yang Shen (Radix Panacis quinquefolii) in walking, occasional acute
b. For sleep disorders, add Suan Zao Ren pain, hunch back, slow curling
(Semen Ziziphi spinosae) or Bo Zi Ren of the back during walking or
(Semen Platycladi) even becoming shorter, and
c. Fo r i n c r e a s e b o d y d e f e n s i v e osteoporosis-induced fractures
mechanism, add Huang Qi (Radix to vertebra, wrists, hip joints,
Astragali) and shoulders. The treatment of
 SUN TEN QUARTERLY NEWSLETTER WINTER 2007

bone fractures is risky and associated with terrible ancient adage said: “Stagnation will cause pain.”
concomitant disease resulting in heavy psychological The blood carries nutrients to all parts of the body,
and financial burdens. Therefore, early prevention while the blood quantity and quality disorder the
and self-protection against osteoporosis becomes problems will be occur.
significantly important.
Osteoarthritis is typically illustrated by stiff
Many studies indicate that proper outdoor and painful joints, often worse in the morning,
exercise, especially adequate weight training, can after exercise or after resting. Moving the joints may
increase the strength of the skeletal and muscle reduce the pain but often sufferers find it difficult
systems. Jogging, mountain climbing or sports are to get full range of motion in the joints and notice
very good choices for younger adults, while walking, a creaking or grinding sound. As osteoarthritis
hiking or other mild exercises are good for seniors. advances, joints may appear swollen and muscles
As a TCM practitioner, we strongly suggest that may become weaker.
people use some herbal supplement to maintain the
Interestingly, most people with early
body. While body function is improved, it can help
osteoarthritis don’t have noticeable symptoms,
formation of nutrition into the body to promote
but x-rays are the best early evidence. Studies
the absorption of calcium.
have shown that fewer than 10% of patients with
Osteoporosis is fearsome only because many moderate or severe osteoarthritis in finger joints also
people do not understand or have an incorrect reported pain or stiffness. Since there are no nerve
understanding of it. As osteoporosis quietly structures in cartilage, the pain associated with
erodes the bone mass of everybody without their osteoarthritis is likely the result of irritation of other
knowledge, everyone should take this problem tissues in and around the affected joints.
seriously and effectively prevent osteoporosis and its
In western medical theory, recent evidence
complications.
suggests that certain enzymes are involved in the
destruction of cartilage and bone. The loss of
Osteoarthritis glycosaminoglycans (molecules that
A growing number of people help hold water) by cartilage
are suffering from degenerative may also plays a role in
joint issues as osteoarthritis. causing osteoarthritis.
In western medical theory, Although osteoarthritis
osteoarthritis is a disorder can occur by itself, it
leading to the structural may also be the result
or functional failure of of other conditions
the joints, and involves such as joint injury or
the advancing loss of repetitive joint stress,
cartilage. In traditional meniscus injury and its
Chinese medical theory, surgical repair, and joint
osteoarthritis is cause by blood inflammation.
stagnation and blood stasis. An
WINTER 2007 SUN TEN QUARTERLY NEWSLETTER 

There are many natural ways to treat Coix).


degenerative joint problems. These natural c. For qi deficiency, add Ren Shen (Radix Ginseng) or
ways include weight loss, low impact exercise, Ci Wu Jia (Siberian Ginseng)
a diet high in antioxidants, heat therapy and
The other recommended formula for
nutritional supplement and the traditional Chinese
osteoarthritis is Shen Tong Zhu Yu Tang (Cnidium
supplementation, which relate to improve the
and Chiang Huo Combination). The ingredients
circulation and energy.
of this formula included the following herbs:
Furthermore, we agree that traditional Chinese Tao Ren (Semen Prunus persica), Hong Hua (Flos
medicines and other natural ways are significantly Carthamus tinctorius), Wu Ling Zhi (Excrementum
safer than NSAID’s (e.g. ibuprofen, piroxicam). Trogopteri seu Pteromi), Niu Xi (Radix Achyranthes
Often traditional Chinese medicine prescribed for bidentata) and Dang Gui (Radix Angelica sinensis),
osteoarthritis: Shu Jing Huo Xue Tang (Clematis and this group of herbs can activate the blood, dispel
Stephania Combination), Shen Tong Zhu Yu Tang blood stasis, and alleviate pain; Chuan Xiong
(Cnidium & Chiang Huo Combination) and Yi Yi (Rhizome Ligusticum chuanxiong) and Mo Yao
Ren Tang (Coix Combination) typically works in (Gummi Commiphora molmol) can activeate the
about eight weeks, and reduces pain at least 50 %, blood and promote the flow of qi to alleviate pain;
but often leaves patients pain free. Di Long (Lumbricus) use to unblocks the meridians
and alleviates pain; Qiang Huo (Herba Artemisia
Shu Jing Huo Xue Tang (Clematis and Stephania
annua), Qin Jiao (Radix Gentiana macrophylla) can
Combination) contains Niu Xi (Achyranthes), Dang
dispel wind-dampness and alleviate pain; Xiang Fu
Gui (Angelica sinensis) and Tao Ren (Prunus persica)
(Rhizoma Cyperus rotundus) is help to promotes
in very specific ratio intended to activate the
the flow of qi to alleviate pain; and Gan Cao
blood and dispels blood stasis, induce downward
(Radix Glycyrrhiza uralensis) use to harmonizes the
movement of the blood, and strengthen the tendons
action of all ingredients and minimizes pain. This
and bones. Shu Jing Huo Xue Tang (Clematis and
specific formula of traditional Chinese medicine
Stephania Combination) also contains Chuan Xiong
has proven in dozens of human clinical trials to
(Rhizoma Chuanxiong). The clinical experiences
improve joints function in most people with mild to
found in Chuan Xiong helps reduce pain and
moderate osteoarthritis. This formula can activates
improve joint function. Shu Jing Huo Xue Tang
the blood, promotes the flow of qi, dispels blood
(Clematis and Stephania Combination) also contains
stasis, unblocks the meridians, disperses wind-
other compounds, which contribute to reduce
dampness, and alleviates pain. Depend on the
joint pain, and believed to reduce inflammation
patients’ situations, the following modifications are
and swollen of the joint lining. Depend on the
recommended:
patients’ situations, the following modifications are
recommended: a. For slight fever, add Cang Zhu (Atractylodes lancea)
or Hunag Bo (Cortex Phellodendron amurense).
a. For pain in the arm or upper body, add Gui Zhi
b. For Weakness, add Huang Qi (Radix astragalus).
(Cinnamomum cassia).
b. For foot pain or pain in the lower body, add Mu A n o t h e r re c o m m e n d e d f o r m u l a f o r
Gua (Chaenomeles speciosa) or Yi Yi Ren (Semen osteoarthritis is Yi Yi Ren Tang (Coix Combination).
 SUN TEN QUARTERLY NEWSLETTER WINTER 2007

The main function of this formula is affliction of Data suggest that an increasing number of
wind-cold-dampness marked by painful joints people will suffer osteoporosis or degenerative joint
and accompanied by numbness also difficulty in problems, so it is very important that sufferers
stretching and swelling in the joints. The ingredients understand the various treatment choices available
of this formula include the following herbs, which to them. As more clinical data is published
are Ma Huang (Herba Ephedra sinica), Yi Yi Ren regarding the health benefits of natural treatment,
(Semen Coix lacryma-jobi), Gui Zhi (Ramulus such as, Chinese herbal medicine, more people are
Cinnarmomum Cassia), Cang Zhu (Rhizoma using the natural treatments to instead the surgery
Atractylodes lance), Dang Gui (Radix Angelica or NSAIDs.
sinensis), Shao Yao (Radix Paeonia lactiflora) and Zhi
Osteoporosis and osteoarthritis are categorized
Gan Cao (Radix Glycyrrhiza uralaensis preparata).
in traditional Chinese medical theory as kidney
This formula contains blood-activating herbs. Ma
deficiency. The kidney stores the reproductive
Huang (Herba Ephedra sinic) can dispels wind-
essence. Furthermore, the kidney supplies the bone
cold and promotes urination to relieve edema; Yi
with marrow, while the bone is filled and nourished
Yi Ren (Semen Coix lacryma-jobi) has the functions
with marrow that will be derived from the vital
to promote urination to eliminate dampness and
essence of the kidney. There are a number of factors
relaxes the muscles to relieve spasms; Gui Zhi
that can lead to osteoporosis and osteoarthritis, most
(Ramulus Cinnarmomum Cassia) and Cang Zhu
of main reason of bone loss will occur naturally
(Rhizoma Atractylodes lance) can dispels wind-cold-
as you get older. Therefore, maintain the body to
dampness, and unblocks the meridians, also can
keep young and get the right thing (food, medicine,
strengthens the spleen; Dang Gui (Radix Angelica
supplement and so on) to eat is an important part
sinensis) and Shao Yao (Radix Paeonia lactiflora)
of traditional Chinese medical theory.
can nourishes the blood and promotes blood
circulation and alleviates pain; finally add the Zhi
Gan Cao (Radix Glycyrrhiza uralaensis preparata) to Reference
harmonizes the action of all ingredients. Depend on
• Hong-Yen H, Chau-Shin H. Commonly Used
the patients’ situations, the following modifications
Chinese Herb Formulas. 4th ed. Taiwan: Oriental
are recommended:
Healing Arts Institute, 1990.
a. For upper joints pain, add Ge Gen (Radix • Dan B, Randall B. Chinese Herbal Medicine
Puerariae lonatae) Formulas & Strategies. USA: Eastland Press, Inc.
b. For lower joints pain, add Chuan Niu Xi (Radix 1990.
Cyathulae) • American Pharmaceutical Association. Handbook
c. For serious whole joints pain, add of Nonprescription Drugs. 11th ed. Washington,
Yan Hu Suo (Rhizome D.C.: American Pharmaceutical Association,
Corydalis) 1996.
• Peng HR and Xiang P. ed. The Dictionary of
Chinese Herbal Formulas. Vol. X. Beijing, The
People’s Medical Publishing House, 1997.
Herbal Garden
Natto New Ally in Anti-Cardiovascular Disease?
Natto is a popular traditional Japanese food for more than
Changes in total cholesterol and triglycerides levels
1000 years. It is made from soybeans fermented by a healthy
bacterium called natto bacillus, and appears sticky with strong
smell and taste. Nutritional wise, Natto is very healthy food
low in cholesterol and sodium. It also contains a good source
of protein, vitamin K, magnesium and copper, and a very good
source of iron and manganese.
In 1980, Dr. Hiroyuki Sumi of Chicago University Medical
School discovered a potent enzyme with strong fibrinolytic
(blood clot clearing) activity in natto, which is later known as
the nattokinase. Nattokinase not only directly clears blood clots
(thrombi) but also breaks down accumulation of fibrin that has
been associated with heart disease.
Average decrease in total cholesterol level: -7.7% in the high cholesterol
Researchers from National Cardiovascular Center group, -1.5% in the normal group.) Average decrease in triglyceride level:
-12.9% in the high triglyceride group, -3.5% in the normal group.
of Japan tested natto on 61 senior citizens, average
ages of 65. Results confirmed that there were a 10% or greater decrease in total cholesterol, in the blood; In
addition, there were also 10% or greater decrease in body mass index (BMI), waist/hip ratio, abdominal
girth, percentage of body fat, and blood pressure (sitting, at rest). National Cardiovascular Center (Osaka, Japan)

Turmeric Protection Against Liver Damage


Turmeric, also known as yellow ginger, is a flowering plant in the ginger family, commonly
used as a food coloring. It is one of the basic ingredients in curry & yellow mustard in India.
Turmeric also has long been used as an anti-inflammatory. In the Ayurvedic medicine, turmeric is applied after a cut
or bruise. Nowadays, curcumin is identified as the active ingredient in turmeric root extracts which has been shown to
exert wide scope of health supporting effects, particularly liver protective activity due to its antioxidant mechanisms.
Research has shown that curcumin can offer protection against alcohol or chemical induced liver toxicity in vivo
studies. The curcumin treated data showed a significant prevention in fatty liver and liver damage in ethanol or methane
tetrachloride induced model, revealing that curcumin has protective effects against alcohol or chemical induced liver toxicity.
Curcumin prevents chemical induced liver damage via Curcumin prevents alcohol induced liver fatty liver &
anti-inflammatory & anti-oxidation mechanism liver injury via anti-inflammatory & anti-oxidation
Control CCI4-Induced Alcohol + Fish Oil Alcohol + Fish Oil + Curcumin

→Fatty

Curcumin CCI4-Induced+Curcumin Fish Oil + Dextrose Fish Oil + Dextrose + Curcumin

Hematoxylin and eosin staining of liver section from (A) control data (vehicle); (B) methane Hematoxylin and eosin staining of liver section from (A) alcohol and fish oil
tetrachloride (CCl4) treated data; (C) CCl4-treated with curcumin; and (D) data administered administered data; (B) alcohol, fish oil administered and curcumin treated
with curcumin alone. Curcumin (200 mg/Kg P.O.) was given before and 2 hr after CCl4 data; (C) fish oil and dextrin administered data; and (D) fish oil, dextrose
administration & protects against acute liver injury; extended necrotic areas & distortive liver administered and curcumin treated data. Curcumin (75 mg/Kg P.O.) was given
around portal triads. with fish oil and ethanol diet to induce fatty liver. Note the absence of necrosis,
Biochimica et Biophysica Acta v1770, p989 inflammation, and reduction of fatty liver (D) compared to lack of curcumin (A)
Biochimica et Biophysica Acta v1770, p989