Ask Dr. H: Findings about the cause of arthritis

Posted: February 13, 2012

Question: What causes osteoarthritis?

Answer: Osteoarthritis, the progressive wearing down of the cartilage in joints, is generally thought to occur because of wear and tear of the joint - especially the joints in the knees, hips, and low back.

Excess body weight and repetitive injury to certain joints are known risk factors for developing osteoarthritis, but it's actually not as simple as that.

It's not known, for example, why some joints are affected by arthritis if they have not suffered any previous injury or disease. Osteoarthritis of the fingers is more likely to be seen in women than in men. Osteoarthritis definitely has a genetic factor, as it is more likely to develop in folks whose mother or father suffered with it.

New research suggests that there may be a link between our chromosomes and osteoarthritis. Every time a cell divides, the protective tips of the chromosomes called "telomeres" become shorter.

Think of them as the protective tips of your shoelaces. When cells divide, they duplicate their DNA genetic information contained on chromosomes. Eventually, cells can't divide any longer to replace old worn-out cells because the telomeres become too short and won't allow it. That spells death for that cell and represents what it is to age.

That process in joints means that new cartilage can no longer be produced. As we age, the process of telomere shortening contributes to the eventual death of cartilage cells and osteoarthritis. But what is also observed is that telomeres can suddenly shorten as a result of sudden cell damage from various stressors like compression stress and oxidative stress (e.g., smoking). That may lead to the development of early osteoarthritis.

A neat corollary to this is that daily fish oil supplementation, cardiovascular exercise, and Vitamin D supplementation can actually reverse the process of telomere shortening and possibly slow down the development of osteoarthritis. Smoking causes oxidative stress to cells by causing telomeres to prematurely shorten.

Latex not in flu vaccine, but may be in syringe

Q: I avoid getting flu shots because I have a latex allergy. Why is there latex in a flu shot? It doesn't make any sense to me.

A: It's not the vaccine itself that may contain latex; it's the prefilled syringes that are the potential problem.

I say "potential" because there are several manufacturers that do not use latex in the manufacturing of their flu vaccine.

Here's a flu vaccine list from the American Latex Allergy Association that should help clarify the situation:

Afluria: The rubber tip cap and plunger used for both the single-dose syringes and the rubber stoppers used for the multi-dose vial contain no latex. Fluarix: The tip caps of the prefilled syringes may contain natural rubber latex which may cause an allergic reaction in folks with a latex allergy. FluLaval: The multi-dose vials do not contain latex. Fluvirin: The tip caps of the single-dose syringes may contain natural rubber latex; the multi-dose vials do not contain latex. Fluzone: The tip caps of the single-dose syringes may contain natural rubber latex; the multi-dose vials do not. FluMist live-attenuated single-use nasal sprayers do not contain latex.

It's not too late for you to get one of those latex-free flu vaccinations. The peak of flu season is right now.


Mitchell Hecht specializes in internal medicine. Send questions to him at: "Ask Dr. H.," Box 767787, Atlanta, Ga. 30076. Due to the large volume of mail received, personal replies are not possible.

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