Osteoarthritis is a Metabolic Disease Related to Leptin

December 18, 2017 | Linda J. Dobberstein, Chiropractor, Board Certified in Clinical Nutrition

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Osteoarthritis is a Metabolic Disease Related to Leptin
Osteoarthritis, or degenerative joint disease, occurs when the cartilage between joints breaks down and causes pain and stiffness. It used to be thought that osteoarthritis was simply due to wear and tear, trauma, or old age. It isn’t that simple. Osteoarthritis can happen even in non-weight bearing joints without overuse or injury. Increasing amounts of evidence shows that non-traumatic induced osteoarthritis is a metabolic disease related to elevated levels of the hormone leptin, disordered metabolism and mitochondrial breakdown. Science considers leptin as the link between obesity and osteoarthritis. This change in understanding has shifted the direction of treatment towards leptin management

What is Leptin?

Leptin is the king of hormones, the commander and chief of virtually everything that takes place in your body. Understanding how leptin works and applying that information to your day to day life can totally change your health. This is especially true regarding issues of weight management, thyroid function, stress, mental capability, inflammation, immunity, reproduction, and cardiovascular health.

Learn more about leptin:

What is Leptin?

What is the Leptin Diet?

Leptin and Osteoarthritis

Several studies show us that elevated leptin levels are found in osteoarthritis joints. In one study, nearly half of the individuals with elevated body mass index (BMI > 25) had degenerative knee joint disease caused by high levels of leptin Another study showed patients who were undergoing knee replacement surgery or arthroscopic knee surgery had high levels of leptin. High BMIs, elevated leptin, and obesity directly correlated with the severity of the osteoarthritis. In healthy people with normal cartilage, there were very few cartilage cells that produced leptin.

Other recent information shows that women who had an “apple” shaped body or had the predominance of adipose tissue in the trunk and around the internal organs had more severe knee osteoarthritis. This is the same body type that is high risk for cardiovascular disease. High leptin levels are linked with both cardiovascular disease and osteoarthritis.

Things That Worsen Osteoarthritis and Increase Leptin Levels

This consensus amongst researchers that osteoarthritis is a metabolic disease linked with elevate levels of leptin has opened the door to explore factors that specifically impact osteoarthritis and leptin. Some factors include vitamin D, steroids, high fat diets, excess plant-based omega-6 oils. A strong link between leptin and osteoarthritis relates to inflammatory damage affecting cholesterol and mitochondria.

Research published December 2017 showed that elevated leptin levels correlated with low vitamin D levels and significant knee arthritis. In addition, there was loss of muscle strength or sarcopenia, worsening physical performance and obesity.

Steroid drugs/glucocorticoids, oral or injection, are commonly used by the medical profession to manage the pain related to degenerative joint disease, osteoarthritis and other rheumatology disorders. These drugs have many adverse effects and cause osteoporosis and diabetes. These drugs also lead to increased cartilage breakdown and interfere with cartilage cells.

Recent research demonstrates that glucocorticoids/steroids and another steroid, mineralcorticoids induce leptin secretion in cartilage cells with osteoarthritis. Other information shows that steroids and local anesthetics can damage mitochondria found inside cartilage. Mitochondrial damage precedes cartilage cell death that leads to osteoarthritis. The bottom line is that while steroids may relieve pain, it comes with a detrimental price. Steroids cause cartilage damage by increasing leptin and damaging mitochondria which destroys cartilage cells. Its use should be judiciously chosen.

High fat diets due to excessive intake of omega-6 and saturated fats also upregulate leptin levels, and worsen osteoarthritis and obesity. Diets that have a heavy emphasis on saturated fats and omega-6 vegetable oils like canola, safflower, sunflower, corn, soy, and peanut, etc. promote increased levels of arachidonic acid. Elevated arachidonic acid intake promotes inflammation and can damage synovial fluid and cartilage cells which then leads to joint destruction.

Cholesterol and Mitochondria

Viewing osteoarthritis as a metabolic disease has provoked scientists to evaluate if dysfunctional cholesterol metabolism is a risk factor for degenerative joint disease. A study published in February 2017 sought to answer that question. The full answer is still pending, however, there is good evidence to suggest a relationship. Some of the findings pertain to the chronic low-grade inflammation found with obesity and metabolic syndrome. They identified that elevated LDL cholesterol can trigger inflammation not only in the blood vessels, but also in cartilage cells.

In addition, elevated IL-6 and CRP or C-reactive protein occurs in osteoarthritis, obesity, and metabolic syndrome (elevated blood sugar and cholesterol). IL-6 is a proinflammatory cytokine. CRP reflects inflammation levels. This milieu of inflammation and elevated cholesterol provokes a stress response in mitochondria, causes a release of free radicals. Mitochondria dysfunction and breakdown ensues which triggers progressive inflammation, cartilage cell death, and ultimately osteoarthritis if the inflammatory cycle is not broken. Keeping inflammation down, cholesterol metabolism healthy and protecting mitochondria will help protect cartilage cells.

Ask anyone who has severe osteoarthritis. They will tell you that the joint deterioration and pain affects their entire life. The consequences of the elevated leptin, CRP, and other cytokines take a toll on the whole health and age of the body. In fact, osteoarthritis is linked with shortened telomeres. Shortened telomeres reflects biological aging. A healthy diet and several nutrients help keep telomeres healthy.

Joint replacement is the last resort for those with osteoarthritis asthe replacements are never as good as the original parts. Understanding the bigger picture with degenerative joint disease can help guide one towards more personalized choices and can help reduce the risk and effects of osteoarthritis.

Focused Support for Cartilage and Mitochondria

Hyaluronic acid, glucosamine, chondroitin, MSM sulfur, ginger, boswellia, and omega-3 DHA provide direct support for cartilage cellsMitochondrial damage precedes cartilage cell breakdown and loss. Support for mitochondria includes PQQ, coenzyme Q10, grape seed extract, resveratrol, NAC, lipoic acid, B vitamins, acetyl-l-carnitine, magnesium, and curcumin.

Focused Support for Cartilage and Leptin

Nutritional support for elevated leptin and osteoarthritis includes some key elements like omega-3 fish oils EPA and DHA, resveratrol, and vitamin D. Studies have found omega-3 DHA/EPA fish oils essential to management as EPA and DHA inhibit cartilage damage caused by elevated leptin. These fish oils also inhibit NF-kappaB and other inflammatory compounds while balancing the effects of too much arachidonic acid and omega-6 from processed vegetable oils. These omega-3 essential fatty acids are essential, i.e. they must be obtained daily in the diet or in supplement form.

The antioxidant resveratrol is very helpful for elevated leptin and osteoarthritis. Recent research shows that resveratrol inhibited leptin in cartilage cells while protecting these cells from damage. Animal studies show that resveratrol intake prevented the progression of osteoarthritis that was caused by a high-fat diet. Resveratrol also helped improve weight management and prevented breakdown of collagen in the joints.

Vitamin D supplementation is also highly valuable for osteoarthritis, inflammation, leptin, and metabolic syndrome. When patients with knee osteoarthritis supplemented with vitamin D for six months or more, several factors improved. Vitamin D supplementation improved leptin levels, lowered LDL and leptin, improved quality of life, muscle strength and physical performance.

Obesity in children will certainly contribute to earlier onset of osteoarthritis. Overweight children face the same elevated leptin, blood sugar, and inflammation as adults.

There are many more known nutrients that help balance leptin in the body. These nutrients have been studied in the context of obesity, metabolic syndrome and diabetes. Modulating leptin levels systemically will help take the burden off the cartilage cells and inflammation. Helpful nutrients for leptin management include green tea extract, cinnamon extract, quercetin, pantethine, acetyl-l-carnitine, carnosine, gymnema sylvestre, pomegranate extract and more. Don’t forget about exercise and osteoarthritis. Physical activity helps both leptin and osteoarthritis

Additional information about leptin:

Five Rules of The Leptin Diet

Insulin, Leptin, and Blood Sugar – Why Diabetic Medication Fails

Omega 3 Oils Help Correct Leptin Gene Problems

Curcumin: Linking Letpin, Obesity, Joint Problems, Inflammation 

Vitamin K, Leptin, AGEs, and Arthritis

Nighttime Artificial Light Exposure Linked with Obesity and Hormone Changes

Snacking and Skipping Breakfast Linked to Type 2 Diabetes

Is Resveratrol the Fountain of Youth?

Weight Loss Plateaus, Leptin Resistance, and Brain Inflammation

Exercise Tips to Improve Leptin & Fat Burning

Western medicine likes to view and treat disease as individual pieces. The reality is though, everything is connected in the body. Non-trauma induced osteoarthritis reflects that osteoarthritis is more than simple cartilage cell loss. It is the result of systemic metabolic dysregulation involving elevated leptin, metabolic syndrome/blood sugar dysregulation, dysfunctional cholesterol, mitochondria damage, and chronic inflammation.

IbuprofenTylenol, or steroids won’t fix the underlying causes and disease expression. Too much plant-based omega-6 oils and high intake of arachidonic acid provoke more inflammation. Insufficient antioxidants and low vitamin D weaken the needed protection against metabolic inflammation and cartilage stress. Help your body reduce osteoarthritis development by managing leptin and inflammation levels. Osteoarthritis is a leading cause of disability. There are many things that we can do to help reduce the onset of this metabolic disease.

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