It is not uncommon for patients to report that their joint pain becomes exacerbated during stressful times. There are many known, and probably many to be discovered, different reasons for this. For now I’ll focus on one aspect of the stress response which may seem like minutia, however, if it’s your missing link you’ll want to continue reading.

I use the word minutia because I’m going to focus on a particular molecule (really its depletion), sulfate. You may have heard of glucosamine sulfate and even chondroitin sulfate. Add keratan and dermatan sulfate to the list as well – the list of compounds involved (and contained) in the cartilage that cushions your joints. As you may know, one reason for musculoskeletal pain is “wear and tear” to this cartilage. This is especially true in the case of osteoarthritis. However, whether or not you are diagnosed with osteoarthritis, joint pain from cartilage damage and loss – or is it really joint pain from lack of repair – occurs frequently.

Now, back to the stress response. One of the major hormones secreted during stressful times is cortisol. And one of the hallmarks of this hormone is to help stimulate the production of glucose by breaking down fat and protein in order to ready the body to respond to the stressful situation. By the way, this “stressful situation” has been found to be anything from lack of sleep, a food sensitivity or allergy, chronic infections, blood sugar imbalances, musculoskeletal imbalances, and certainly mental/emotional stress as well. Regardless of the source, it’s well known that stress of any kind leads to an increase in cortisol. [In cases of severely depleted individuals with chronic stress, cortisol can get eventually become depleted] In this article I’m not concerned much with the production of cortisol, but rather its clearance or breakdown from the body that may have unpleasant side effects.

Cortisol is a steroid hormone (along with DHEA, testosterone, estrogen, progesterone, etc.) that gets detoxified through specific pathways in the liver. These pathways are known as glucuronidation and sulfation. (That’s about as fancy as I’ll get with words, so no worries from here on.) Note the name of the second detox pathway I mentioned. It’s derived from the word sulfate, because it is the sulfate molecule that is used in this type of detoxification. Now recall those substances mentioned earlier that are components of cartilage. They all end with the word “sulfate” as they also require the sulfate molecule for their structure and function. So, if your body is busy burning through its sulfate to detox the excess cortisol that’s running through your bloodstream; where is the sulfate that helps repair cartilage going to come from? That’s certainly the issue, isn’t it?

Fortunately there are several options. Starting with dietary choices, you can consume foods rich in sulfur. These include garlic, onions, eggs, cauliflower, broccoli, and many others. This may be helpful, though sometimes not sufficient. One major reason (aside from quantity) that relying on food alone may not cut it is if high levels of circulating cortisol has compromised your digestive tract, which it typically does. This may lead to malabsorption of any nutrient(s), and not just sulfur. Another option is to supplement with sulfur, typically in the form known as methyl-sulphonyl-methane (MSM). Whether or not research supports the use of MSM in joint pain and cartilage repair/synthesis, you’re still an individual and may experience varying results (certainly related to your sulfate-dependent detox pathways). Lastly, sulfate can be had from the appropriate metabolism of homocysteine. If you’re unfamiliar with homocysteine, click here to learn more. In order to metabolize homocysteine into sulfate, the body requires certain nutrients especially vitamin B6 and molybdenum.

Please be aware that even though sulfate is critical in relation to stress and joint repair, chances are that your sulfur intake is not the only thing that need adjusting. In order to combat the stress response, I find it critical to support the structural (bones, muscles, etc.), chemical (nutrients, toxins, etc.), and mental/emotional components of a person. A “big picture” (well, truly holistic) approach is often preferred, if not necessary, to overcome the problems associated with any stressors, not the least of which is joint damage and repair. As a generally observed, several other (than sulfate) nutritional factors come to mind: proper collagen formation, healthy blood sugar metabolism, and last but certainly not least, stress management.

Hopefully this helped you to understand a bit of how the pathophysiology of the stress response may be affecting your body; and how to help it. Click here to read more on adrenal stress syndrome.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

source – “Degeneration Intervention – Gut, Liver, & Joints” seminar by Walter Schmitt, Jr., DC, DIBAK, DABCN

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