GEROVITAL-H3 ® TREATMENT IN RHEUMATOLOGY By Mircea Dumitru M.D. Ph.D.
Comparative studies present certain peculiarities of the human osteoarticular with aging: osteopeny, degenerative modifications of the intervertebral discs, the reduction of the osseous capital. The decline of the muscle force, (more evident in men,) represents a primordial sign of aging and begins to manifest after the age of 30. The capacity of muscular and osteoarticular effort requires a longer adaptation period and falls may happen during the effort.
The normal aging of the osteo-articular system may be appreciated with the aid of quantitative and qualitative indicators. The bone involution after the growing period shows that the bone volume diminishes progressively with the advance in age, with some peculiarities in women. The psychological osteopenia and the involutive modifications of the other elements of the osteo-articular system may be accentuated in old people by proteic, calcic and D vitamin deficiency, in various digestive and endocrine diseases, or due to iatrogenic causes. Age related changes in the joint can be found in almost all people over 65. Joints become increasingly misshapen. Aging of cartilage is associated with biochemical modifications. The content of water decreases, but proteoglycan content remains unchanged, thus undergoing changes. Metabolical changes in cartilage or changes in joint biomechanics make easier the development of the osteoarthritis process. By its frequency and medico-social implications, arthritis and rheumatoid arthritis have an important place in rheumatology.
Osteoarthritis is the most common form of arthritis in the elderly. Millions of people suffer from pain, limitation of motion and disability because of osteoarthritis. There is an exponential increase in arthritis with advancing age. In the last decades more adult people are suffering degenerative alterations of joints because of obesity and lack of physical movement. Is there a relationship between aging and osteoarthritis?
As I mentioned, aging is facilitating the development of arthritis, but the normal changes of the bone and joint are not those of osteoarthritis. The earliest events in osteoarthritis occur in the cartilage: decreased total proteoglycan content and shortening of the glucosaminoglycan branches. The continuity of the surface of cartilage is disrupted. The most important change in arthritis is the fibrillation of the cartilage with the focal erosions. In the meantime changes in subchondral are occurring, leading to a decrease in the density of bone with a consequent reduction in the mobility of the joint. We do not know the exact nature of the events that initiate arthritis. Trauma, aging, occupations, metabolic diseases, lifestyle and genetic factors cause alterations into the structure of cartilage that facilitate osteoarthritis. The most common joints that are affected are the hip, knee, carpometacarpal, and the spine.
The clinical use of Gerovital-H3 ®
Many studies prove the positive effect of Gerovital-H3 ® in arthritis (1,2,3,4,5,6,7,8). I studied 100 subjects suffering from moderate to severe arthritis admitted to the prophylactic treatment center at the Nat. Inst. of Gerontology & Geriatrics- Bucharest, 1985 (7). From the beginning in 1946, Professor Ana Aslan tried to discover explanations to the complex biological phenomena with special attention to arthritis. In 1947, Aslan started administering procaine in cases of trophic troubles of the extremities, sometimes with spectacular results. This is what she declared;
"After one injection in the femoral artery, given to a patient with embolism at the level of the inferior extremity, I noticed the almost instantaneous disappearance of pain. Then, for the first time, I had the idea to apply the same method in certain diseases with pain, like rheumatism-specially at the level of knee articulations- which produces immobilization and thus long-lasting incapacity".
Later on, Professor Aslan used that method of treatment with procaine arterially administered to patient with arthritis, and she presented the results obtained with the first 50 cases at a scientific session of the Romanian Academy back in 1950. Starting in 1949, Aslan started applying procaine treatment in an old people's home (based on the fact that such patients present frequent cases of arthritis). Besides an improvement of the local movement, she noticed an obvious improvement of the physical and psychological state of the elderly.
She then initiated experimental arthritis research which evinced particularly favorable effects on animals treated with procaine. Gerovital-H3 ® has a positive effect on cell metabolism and on the cell membrane. There are studies where the emphasis was placed on Gerovital-H3 ® intervention on the collagen metabolism in arthritis. Aslan demonstrated the positive effect of her treatment on experimental arthritis studies (3). In my career, I've treated thousands people with arthritis all over the world. I studied one group of elderly people under treatment with Gerovital-H3 ® suffering from moderate to severe arthritis involving spine, peripheral joints, hips and knees (7).
Gerovital-H3 ® was administered one injection daily for 18 days followed by 12 days of Gerovital-H3 ® pills daily. I assessed the efficacy of the treatment comparing pain, joint mobility, functional capacity of the joints and muscular tone before and after the observation. In parallel, I noted the psychic mood and the circadian rhythm of blood pressure. Clinical symptoms like pain and joint mobility have had a remarkable alleviation in 34%, respectively in 56% and the muscular tone of the patients was improved in 41%.
I want to emphasize that during the Gerovital-H3 ® treatment no side effects were noted. The beneficial effect of Gerovital-H3 ® treatment is due to its antalgo action, an improvement of capillary permeability and the favorable intervention in the bioenzymatic disorders at the level of the joint cartilage. Gerovital-H3 ® can be the drug of choice in the management of mild clinical arthritis forms and can be administered with non-sterodial anti-inflammatory drugs (NSAIDs) in severe arthritis.
From the age of 40, we can start an arthritis' Preventive Treatment with Gerovital-H3 ®: one course of 25 pills over 12 days (one pill twice daily between the meals) and then a 2 week break. The cycle is then resumed. It is possible to do a milder prophylactic treatment only with pills in a series of 25 pills during 12 days with an interval of 45 days in between.
At the beginning of arthritis or in a clinically advanced form, I recommended Curative Treatment: a course of 1 injection daily for 12-days followed by a 2 week break and then one course of 25 pills over 2 weeks - in total 6 courses of 12 injections and 5 courses of 25 pills-yearly. Gerovital-H3 ® treatment can be individualized; we can shorten or extend the breaks depending on the results, arthritis gravity and the accompanying diseases. Taking into consideration cost-results and side effects, with incipient and mild clinical form of arthritis, Gerovital-H3 ® treatment is superior compared to NSAIDs.
Rheumatoid arthritis (RA) is a chronic inflammatory arthritis. The clinical features vary widely ranging from a mild disease to a progressive one. The pattern is influenced by sex, age, endocrine and genetic factors. RA may begin in the aged, or may be encountered in an already "old" form, whose symptoms begin in the adult age. The clinical picture is more faded, often oligosymptomatical. In many old people, RA is no longer active and a sick patient presents symptoms and a better prognosis for seronegative elderly onset. Symptoms such as morning stiffness, fatigue, weight and appetite loss precede the onset of RA. Usually, the onset of RA afflict metacarpophalangeal joints and later on may involve hips, knees and shoulders. Extraarticular symptoms are rare in old people. At this age we have to differentiate RA from polymialgia rheumatica, amyloid arthropathy and arthritis.
Gerovital-H3 ® treatment is indicated in the incipient stage of RA. Its anti-inflammatory effect is exerted through the AMPc stimulated by the moderate rise in circulating catecholamine levels in synovia (5,6). Because RA is a very distressing and an invalidating disease, Gerovital-H3 ® with its affects of less fatigue, less stiffness and its antidepressive effect is beneficial.
Low back pain
Low back pain afflicts one out of every four adults and old people. Many of them can not get out of the bed because of Low Back Pain and they are using anti-inflammatory and pain killing drugs with many side effects. After surgery within one year 50% to 60% of the patients will have the same low back and leg pain. The best care of back pain is the multidisciplinary approach. The loss of disc height is called disc degeneration and sometimes arthritis. Conservative treatment should be used before surgery and can be helpful to relieve pains following back surgery. Gerovital-H3 ® has a strong indication in low back pain because of its anti-degenerative effect and to relieve muscle spasm. Gerovital-H3 ® is administered locally and I.M. After a couple of days, the patient is more relaxed and is sleeping better. To help relieve the pain it is possible to apply Gerovital-H3 ® into certain points. For maximum results, the patient has to be treated daily for the first two weeks. Depending on their condition (arthritis, degenerative disc, spondylolisthesis, sacroiliac treatment etc.) physical therapy should also be applied to help take away the swelling that accompanies the ailments.