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Nutraceuticals and nootropics for anti-aging |
DIRECTORY
Ask Dr. Zarkov
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Perthes Disease (aka ‘Legg-Calve-Perthes’) is a childhood disease with symptoms that continue into adulthood. Since it is defined by its symptoms rather than by its causes, it may actually encompass several different diseases with similar symptoms but entirely different causes. The main feature of most Perthes cases is damage to the head of the femur — the leg bone that forms the ‘ball’ of the hip’s ball-and-socket joint. In Perthes, the blood supply to the femoral head is interrupted during childhood, and the bone tissue dies. The damaged bone is removed by the body’s scavenging mechanisms, and the femur then tries to replace it. The trouble is, the regrown ‘ball’ is usually too small and non-spherical to perform its proper function. The adult Perthes patient therefore ends up with a hip joint that works poorly, causes pain, and eventually fails and must be surgically replaced. Ideally, one would like to halt the original damage to the bone before it becomes serious. In a child, the body can usually repair such a small amount of damage, leaving no long-term disability. To achieve this, various schemes have been proposed and tried over many decades — traction, leg braces, range-of-motion exercises, and surgical interventions. But the latest word on the benefits of these treatments is that none of them work well, and most of them don’t work at all. Most Perthes patients therefore suffer severe damage to the hip and require hip replacement later in life. The causes of PerthesIt is fairly well accepted that Perthes disease is usually caused by the blockage of blood flow to the femoral head by chronic blood clots in the blood vessels that serve it. But why these blood clots should occur in children with Perthes is not understood. There is abundant evidence that the condition can be hereditary, and it is known that many Perthes patients have a defective gene for a blood clotting factor (the ‘Factor V Leiden’ mutation). Other suggested explanations are: other problems with blood clotting; inflammation in the femur due to chronic infections; defects in the growth hormone system; or traumatic injuries to the femur. Supplements for inhibiting blood clottingSince the prevailing view is that most Perthes cases are the result of excessive blood clotting in the femur, we will look first at supplements that may regulate this process. This discussion adopts a rather naïve view of the subject — we make the assumption that consuming substances that lower the blood’s clotting tendency will reduce the number of blood clots that form. This strategy works for some well-known conditions like deep-vein thrombosis, but it has not been tested for Perthes Disease. While there are a number of very powerful anticoagulant drugs available, such as heparin and warfarin, these would be poor choices for self-experimentation by Perthes patients — they are risky to use because they often thin the blood excessively and lead to bruising and hemorrhaging. Certain nutritional supplements offer a more promising approach because they only mildly inhibit blood clotting. These anti-clotting supplements include:
Supplements for removing blood clotsThe term ‘fibrinolysis’ means the breaking up of blood clots by dissolving the ‘fibrin’ that holds them together. Agents that encourage fibrinolysis might be useful in preventing Perthes-related bone damage:
Supplements for reducing inflammationAntioxidants offer another approach to prevention, based on the inflammation theory of Perthes. This theory holds that inflammation causes vascular injury in the femur and results in loss of blood supply to the femoral head. It is generally accepted that inflammation can be caused by free radicals, and it is widely believed that antioxidant supplementation can reduce inflammation. Therefore, it seems plausible that antioxidant supplements might reduce the progression of Perthes. Since antioxidant research is still in its infancy, one can only guess at which antioxidants might be the most effective in suppressing Perthes development — it would make sense to use a variety of antioxidants, such as the following:
Supplements for preventing bone damageBone and joint enhancers might also be useful in preventing Perthes symptoms, since they supply raw materials for bone and cartilage formation and for producing the ‘synovial fluid’ that cushions joints. Perthes patients are known to be deficient in some of these substances (namely, the glycosaminoglycans). Two bone and joint enhancers are especially worth considering as supplements:
A major component of the synovial fluid, hyaluronan, can be synthesized by the body from glucosamine and chondroitin, and is not required as a separate supplement. Why haven’t these ideas been tested?The suggestions I’ve made here are speculative, since they have not been subjected to clinical testing in a controlled manner. But they are obvious candidate treatments if one accepts the prevailing theories about what causes Perthes Disease. So, why hasn’t their obviousness caused them to be tested by bone disease specialists? Most likely the reasons include: a lack of interest in nutritional supplements by the medical industry and by government, and the outrageous costs of conducting clinical trials — costs that have been run through the roof by government regulations. Don’t look for much official progress in Perthes or many other medical conditions anytime soon unless it comes from China or other technologically advanced Asian countries. Medical progress in western societies is slowing to a crawl because we have allowed our governments to stifle innovation and medical advances under the pretense of ‘protecting the public’. Nowadays we are more likely to find treatments for some of these medical conditions by self-experimentation than we are by waiting for mainstream medicine to find them. ConclusionPerthes Disease is a degeneration of the head of the femur, thought to be caused by a disruption of the blood supply to that part of the bone. Blood clots are thought to be involved. Standard medical treatments do not prevent or slow this disease. On the other hand, the regular use of nutritional supplements that mildly inhibit blood clotting, or that encourage the breakup of such clots, might inhibit the progression of Perthes. Antioxidants could also be useful, if the inflammation theory of Perthes turns out to be valid. — Dr. Alexis Zarkov, Ph.D. You can contact Dr. Zarkov at AskDrZarkov@yahoo.com. Last modified 2005.Mar.24 ReferencesAlpha-linolenic acid and cardiovascular diseases. J Nutr Health Aging. 2001;5(3):179-83. Glucosamine Sulfate (monograph) Arginine Nutrition and Cardiovascular Function J Nutr. 2000 Nov;130(11):2626-9. L-arginine and atherothrombosis. J Nutr. 2004 Oct;134(10 Suppl):2798S-2800S; discussion 2818S-2819S. Legg-Calve-Perthes disease and thrombophilia. J Bone Joint Surg Am. 2004 Dec;86-A(12):2642-7. Resistance to activated protein C and Legg-Perthes disease. Clin Orthop. 1997 May;(338):139-52. Disclaimer: The information provided in this “Ask Dr. Zarkov” article contains no medical advice whatsoever — it contains ‘biological information’. Nothing in the article constitutes an effort to persuade readers to use, or not to use, this biological information as a basis for action. |
My young son has been diagnosed with Perthes Disease. Standard medical treatments have little to offer except surgical correction
after the hips become damaged. Are there supplements that might help to prevent Perthes symptoms from developing?
Maybe. Before discussing them, let’s take an overview of the ailment.
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