Hallo all,

I'm struggling and i need everyone's wisdom please. Long story short I destroyed my knees in my teens showjumping. At one point i was cheerfully told I had severe rheumatoid arthritis and just prep for a life in a wheelchair. Thankfully a combination of alternative approaches and supplements over the years have returned me to a state of okay knees - high impact excercise is a no no, but i can walk and live pain free and i'm thankful for that.

Up until now...
I take a fair amount of glucosamine daily to keep my rusty old knees happy - but in the last 48 hrs its lost its effect. I am in pain, lots and lots of pain. I have just tightened my atkins diet to ketogenic fat protein ratios, roughly 80% fat, 20% protein and i have a low carb count of about 10grams - Its not hardcore torture - i am simply very resistant. I am in keto flu - adjusting my sodium, magnesium ect, but where has my glucosamine gone - its no where near my knees!

Ive done some research and yes it binds sodium ect to water - so i'm guessing i'm peeing it away, but then i found more info about it being used in the Krebs cycle, or citric acid cycle. and there i got baffled!

I'm not sure if i should stop taking it, ride out the pain for as long as i can bear, and this will be a passing phase

Up the dose to compensate.

Stay at the same dose, and ride out the pain knowing it will be a passing phase.

I can't live with this pain for very long though. Its is severe. I couldn't cope long term.

Does anyone understand or have any experience of what has happened to my glucosamine? what is my body using it for / doing with it instead of letting my knees have it! - and is this a passing phase, part of keto flu?

Any advice / experience would be greatly appreciated - Thank you!

Possibly someone else will give a more direct answer to your question.. but my own attitude to this post is that you should revert to your previous diet, to see if it is the new dietary measures which are causing the issue, or if it is a new development in your condition. If you were losing weight - however slowly - with your previous percentages, stick with those.. It's counter-productive to try to speed up the weightloss if it reduces your quality of life and ability to be active. Otherwise, make the transition to higher fat very, very gradually, since it's the dramatic changes which tend to lead to the loss of salts etc.. I wouldn't mess with a winning formula which makes the difference between a life worth living and constant pain and disability.

Cheers Kirsteen,
I think ive got it, its the glucosamine, it is being utilised, it also has a role in exacerbating insulin resistance. I need to find an alternative to the glucosamine. Apparently Chondroitin sulfate might work. Still interested in hearing from anyone who has already cracked this one though and what to try next.

I never had glucosamine work for me. If you do have RA, then it could be flaring. Autoimmune diseases go through phases like that. Stress, changes to diet, all kinds of things can kick them off.

You should go see a rheumatologist and you should look into a autoimmune paleo diet. Terry Wahls, a doctor, had MS and she put it into remission by eating a ketogenic paleo diet. Many people with other autoimmune diseases also have had that work. RA is an autoimmune disease.

I've apparently got osteoarthritis and it is in my lower spine. So far the only thing that has helped it has been NSAIDs, sometimes heat helps relax the muscles. :\

Thanks Nancy, I'm going to try fish oils and see if i can put this back in its box. Glucosamine is not compatible with low carbing, nor would it seem is Chondroitin from what i can decipher of the chemistry.

I'll try fish oils first before i go fighting with the NHS. I've managed it myself for years as i think the treatment options can be as bad as the symptoms in their own way. You are so right about stress & diet - its easy to forget about my knees when they are behaving. And unbelivable how painful they are when it goes wrong. I have a great osteopath, i'll consult him too.

Nsaids, i struggle with ibuprofen, it relieves the pain but I find it doesn't agree with atkins, yep heat and changing the sensations gives some relief - but its purely fooling the nerves. But i'll definitely look into an autoimmune paleo diet - that sounds very interesting! Ive not been down that road before.

All i wanted to do was lose a bit of weight! - Nothing is ever simple though is it!

I like your "apparently" - sounds as though its little trouble to you - i hope it stays that way for you!

No, my OA is pretty awful at times.

There's a lot that can be done for knees. HA injections, cortisone shots, knee replacement (if it is really bad). There are some good treatments for autoimmune diseases now too... well, better than being left completely crippled and unable to function, I suppose. :\

Probably the best, easiest thing is the HA injections. My sister swears by them. HA comes from collagen and isn't toxic at all.

Arrrggghh - knee injections....im cringing just thinking about it!
My poor neddy ( my show jumper) also had arthritic knees in his old age, and taking care of him after his injections, and avoiding cystalisation... poor boy.

My plan is to get as far as i can without the cortisone ect, and then consider knee replacements hopefully in my very very advanced old age, as you say treatments have come on a long way - hopefully they will be brilliant by then.

My knees have been happy enough for a very long time - i did not see this coming, avoiding all impact & other "shocks" plus glucosamine & osteopathy was working brilliantly. On a day by day basic they've been fine for a long time.

Glucosamine is clearly not compatible with low carb though, but losing weight would really help here too - i'm carrying a whole extra person around on these knees and it can't continue - there are so many reasons i need to get this weight down.

but as you say at what price, agony and immobilisation are not an option either.

I'm sorry your back is so bad, when they act up my knees are agony, there's no pain quite like it as its a constant grinding pain. Hubby seems to remember i had success previously with fish oil but moved to glucosamine when i was pregnant. If i succeed with something i'll let you know, if not i'll put myself back in the hands of the medical establishment. (shudder).

Actually no - i'm going to check out your autoimmune paleo diet first! - do you follow it for your back?

I gave it a shot for a few months, but osteoarthritis isn't an autoimmune disease. Still, I do eat fairly Paleo, but probably not LC enough.

Good point -apologies - i'm stuck in my autoimmune mindset - i hear arthritis and quite selfishly think in terms of what i know, I've just been to this website for me and ordered my fish oil in line with their recommendations...

If its of any help to you this is the page that relates to osteoarthritis:
http://www.arthritisresearchuk.org/...oarthritis.aspx

I have had great experiences with dry gelatin. You can also make bone broth. In either case, best results with grassfed animals.

This might be out in left field, but glucosamine is synthesized from glutamine and a fructose metabolite. Maybe glutamine could help to support in-house production of glucosamine? Glucosamine might have been effective as a supplement to endogenous glucosamine production, but not enough for its replacement. Paul Jaminet would probably accuse you of having a glucose deficiency at this point, I'm usually resistant to that idea, but there's a lot of stuff I don't know.

There's the other possibility that, if glucosamine is being used as an input to the krebs cycle, to cover for glucose's usual role as substrate for oxaloacetate production, then oxaloacetate, malic acid, etc. nutrients that can donate carbon to the krebs cycle at various points might spare glucosamine that role.

Something that worked for me, with ongoing shoulder pain, is niacin--the full flush type. It always took a couple of weeks of taking it faithfully before the shoulder started feeling better. I wasn't even taking it for the shoulder, that was an accidental discovery--so probably not a placebo effect, at least for me.

What my husband & I have found helpful for our mild old-age arthritis is MSM. I take 1000mg/day & my husband twice that.

Neither glucosamine or chondroitin did a thing for us.

Thanks everyone. It's taken roughly a month, but I'm finding success with fish oils.

It's been a while since I tried it but glucosamine and related supplements never worked for me. I tried various formulas.

But I admit that I have a probably unwarranted distrust of supplements because everything depends on the manufacturer and how they determine quality. You could be doing everything right, just not getting a good-quality formula.

I know some people distrust herbal remedies as much as I do supplements, but empirically I can say there are a few remedies that almost always help when I have a flare-up of pain: skullcap, white willow bark, and California poppy. Extracts (or tea) much better than powdered capsules if you can find it. Herb-Pharm is usually a reliable brand and often available at health food stores, or even better you can try to find more local remedies (local harvest is a good site, type in your zip code to see what's near you). Read up on the herbs and make sure they're OK for you.