How Sugar Sabotages Herbal Medicine: The Hidden Barrier to Antioxidant Absorption

Exploring How High Sugar Intake Reduces the Effectiveness of Herbs and Antioxidants

By Brian S.

Learn how sugar interferes with the absorption and bioactivity of herbal antioxidants. Discover the science behind this effect and how to optimize herbal therapy by limiting sugar intake.

Visual contrast of antioxidant-rich fruits, turmeric, and herbs on one side, and refined sugar cubes on the other, symbolizing how sugar inhibits antioxidant absorption in the gut

Herbal medicine has long been celebrated for its antioxidant, anti-inflammatory, and restorative properties. However, few realize that a high-sugar diet may directly compromise the effectiveness of these remedies. Modern research now reveals that sugar doesn’t just add calories—it interferes with the very mechanisms that allow herbs to function in the body.

The Overlooked Problem: Sugar and Herbal Absorption

Many herbal antioxidants—like quercetin, catechins, curcumin, and resveratrol—are reliant on specific transporters and metabolic pathways to be absorbed and activated. Yet, refined sugar (glucose, fructose, and sucrose) can inhibit or overload these systems, ultimately reducing the bioavailability of these plant compounds.

1. Transporter Competition: Sugar Blocks Phytochemical Absorption

Plant-based antioxidants like quercetin and green tea catechins use specific transporters in the intestines, such as SGLT1, GLUT2, and OATP1A2. These same transporters also handle glucose. When sugar is present in high amounts, these transporters are saturated, reducing the body's ability to absorb herbs consumed at the same time (Youdim et al., 2003; Cermak et al., 2004).

2. Advanced Glycation End Products (AGEs): Antioxidant Neutralizers

High sugar levels promote non-enzymatic glycation reactions, leading to the formation of advanced glycation end products (AGEs). These AGEs:

• Inactivate dietary antioxidants, preventing them from neutralizing free radicals.
• Inhibit key antioxidant enzymes, such as superoxide dismutase and glutathione peroxidase (Brownlee, 2001).

This means sugar doesn't just compete with herbs—it actively destroys their antioxidant potential.

3. Sugar Increases Oxidative Stress

Ironically, sugar—while suppressing antioxidant absorption—also amplifies oxidative stress. Chronic intake leads to:

• Increased mitochondrial ROS (reactive oxygen species).
• Activation of NADPH oxidase, producing more free radicals (Urakawa et al., 2003).

Herbal antioxidants are often insufficient to balance this pro-oxidant burden when sugar intake remains high.

4. Gut Microbiota Disruption: A Hidden Blockade

The gut microbiome plays a critical role in converting certain polyphenols and tannins into bioactive forms. However, sugar promotes dysbiosis, including overgrowth of Firmicutes and loss of beneficial Bacteroidetes. This alters the metabolism of:

• Ellagitannins from pomegranate and berries (reduced urolithin production).
• Isoflavones and lignans from soy and flax.

This impairs the systemic availability of these plant-derived metabolites (Selma et al., 2009).

5. Inflammatory Signaling: Blocking the Antioxidant Response

A high sugar diet activates inflammatory cascades:

• Increased NF-κB and mTOR signaling.
• Reduced expression of NRF2, the master switch for antioxidant response genes (Kawabata et al., 2010).

Thus, sugar not only blocks antioxidant absorption—it prevents the body from even responding to them properly.

Implications for Herbal Practitioners and Health Enthusiasts

For those relying on herbal medicine for preventive care, detoxification, or chronic disease management, sugar may be a silent saboteur. Consider the following practices:

• Avoid sweetened herbal preparations (e.g., syrup-based tonics, rock sugar).
• Use water or unsweetened tinctures as delivery mediums.
• Encourage low-glycemic diets to complement herbal regimens.
• Educate patients on the antagonistic role of sugar in natural healing.

Conclusion

The relationship between sugar and herbal bioactivity is no longer anecdotal—it's backed by a growing body of biochemical and clinical evidence. To maximize the benefits of herbs and antioxidants, reducing sugar intake is not optional—it’s essential. In the age of functional foods and natural medicine, awareness of this interaction may define the success or failure of a wellness plan.

References 

Brownlee, M., 2001. 'Biochemistry and molecular cell biology of diabetic complications.' Nature, 414(6865), pp.813–820.

Cermak, R., Landgraf, S. and Wolffram, S., 2004. 'Quercetin glucosides inhibit glucose uptake into brush-border-membrane vesicles of porcine jejunum.' British Journal of Nutrition, 91(6), pp.849–855.

Kawabata, K., Mukai, R. and Ishisaka, A., 2010. 'Quercetin and related polyphenols: new insights and implications for their potential health benefits.' Current Opinion in Biotechnology, 21(2), pp.279–281.

Selma, M.V., Espín, J.C. and Tomás-Barberán, F.A., 2009. 'Interaction between phenolics and gut microbiota: role in human health.' Journal of Agricultural and Food Chemistry, 57(15), pp.6485–6501.

Urakawa, H. et al., 2003. 'Oxidative stress is associated with adiposity and insulin resistance in men.' The Journal of Clinical Endocrinology & Metabol'ism, 88(10), pp.4673–4676.

Youdim, K.A. et al., 2003. 'Interaction between flavonoids and the blood-brain barrier: in vitro studies.' NeuroReport, 14(1), pp.39–45.

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Ejaculation Frequency & BPH: Debunking the 21-Times-a-Month Myth with Science

Can Ejaculating More Really Protect Your Prostate? What Research Reveals About BPH Prevention  

By Brian S.

The claim that ejaculating 21 times monthly prevents BPH is widespread. Uncover the truth with evidence-based insights on prostate health, risk factors, and effective prevention strategies.  

A pervasive myth in men’s health suggests ejaculating 21 times a month shields against benign prostatic hyperplasia (BPH). While rooted in prostate cancer research, this claim oversimplifies BPH’s complex causes. Let’s dissect the science and explore proven strategies for prostate health.  

Origins of the 21-Times Myth

The “21 times” idea traces back to a 2004 study linking frequent ejaculation to reduced prostate cancer risk (Leitzmann et al.). Researchers hypothesized that regular ejaculation might flush carcinogens or reduce fluid stagnation. However, **this study focused solely on cancer—not BPH**, a distinct condition with different triggers.  

Understanding BPH: More Than Just a Swollen Gland

BPH, affecting 50% of men over 50, involves non-cancerous prostate growth. Key drivers include:  

- Hormonal shifts: Rising dihydrotestosterone (DHT) with age.  

- Chronic inflammation: Linked to oxidative stress and infections.  

- Metabolic factors: Obesity, insulin resistance, and sedentary lifestyles.  

While ejaculation may ease temporary prostate congestion, it doesn’t target these root causes.  

What Research Says About Ejaculation and BPH 

- No Direct Link: A 2016 review (Rosenberg et al.) found no strong evidence tying ejaculation frequency to reduced BPH risk.  

- Lifestyle Over Frequency: A 2019 Chinese study (Li et al.) noted that diet and exercise outweighed ejaculation in mitigating symptoms.  

Key Takeaway: Ejaculation’s role in BPH prevention remains unproven, unlike its tentative link to prostate cancer.  

Proven Strategies to Reduce BPH Risk

1. Combat Hormonal Imbalances:  

   - Limit DHT via foods (saw palmetto, pumpkin seeds) or medications (finasteride) under medical guidance.  

2. Anti-Inflammatory Diet:  

   - Prioritize tomatoes (lycopene), green tea, and omega-3-rich fish.  

3. Stay Active:  

   - Regular exercise (e.g., brisk walking, strength training) lowers obesity-related risks.  

4. Manage Metabolic Health:  

   - Reduce sugar and refined carbs to prevent insulin resistance.  

When to Seek Help: Recognizing BPH Symptoms

BPH often manifests as:  

- Frequent urination, especially at night.  

- Weak urine stream or difficulty starting.  

- Feeling of incomplete bladder emptying.  

Consult a urologist if symptoms arise—early intervention prevents complications.  

Conclusion

Ejaculating 21 times a month may offer psychological benefits, but robust evidence for BPH prevention is lacking. Prioritize actionable steps: anti-inflammatory diets, hormonal balance, and metabolic health.  Always consult a qualified healthcare provider or holistic health practitioner for personalized guidance.

References 

Leitzmann, M.F. et al., 2004. 'Ejaculation frequency and subsequent risk of prostate cancer.' JAMA, 291(13), pp.1578–1586.  

Rosenberg, M.T. et al., 2016. 'Ejaculatory frequency and the risk of prostate diseases: A review.' Current Urology Reports, 17(11), p.86.  

Li, J. et al.  , 2019. 'Associations of sexual activity with lower urinary tract symptoms and prostate volume in middle-aged and elderly Chinese men.' The Aging Male, 22(2), pp.117–123.  

Key Takeaways

- BPH and prostate cancer have distinct causes; don’t conflate them.  

- Focus on diet, exercise, and metabolic health for prostate wellness.  

- Consult a urologist for persistent urinary symptoms.  

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Bone Health in the Elderly with Degenerative Diseases: Why Calcium Alone Isn't the Answer

Understanding the Real Root Causes of Bone Loss in Alzheimer’s, Parkinson’s, Diabetes, and Arthritis

By Brian S.

Discover why calcium supplements may be harmful for elderly with chronic illnesses like Alzheimer’s, diabetes, and arthritis. Learn anti-inflammatory and antioxidant-rich diet strategies that truly support bone health.

Elderly individuals living with chronic degenerative diseases—such as Alzheimer’s, Parkinson’s, diabetes, arthritis, and hypertension—face not only cognitive and metabolic challenges but also a greatly increased risk of bone loss and fractures. Conventional wisdom promotes calcium supplementation, often bundled with magnesium, vitamin D3, and vitamin K2, as the first line of defense against osteoporosis. However, emerging research suggests this strategy may be ineffective—or even harmful—when inflammaging, mitochondrial dysfunction, and chronic oxidative stress are left unaddressed (Wei et al., 2020; Bolland et al., 2015).

Rethinking Calcium Supplementation in Chronic Illness

While calcium is essential for bone structure, excessive supplementation without addressing inflammation may cause more harm than good. In elderly individuals with chronic conditions, elevated inflammation and disrupted mitochondrial function can lead to calcium mismanagement. This can fuel cellular apoptosis, promote vascular calcification, and increase oxidative stress, rather than improving bone mineral density (Zhao et al., 2019).

Moreover, calcium entering inflamed or senescent cells may disrupt mitochondrial membrane potential, impair ATP production, and trigger pro-apoptotic pathways (Görlach et al., 2015). This paradox highlights the need to look beyond mere mineral intake.

Anti-Inflammatory, Antioxidant-Prioritized Nutrition

Instead of focusing solely on calcium, the priority should be supporting the body's antioxidant defenses and reducing systemic inflammation, which together preserve both bone and mitochondrial health.

Key dietary strategies include:

• Eliminating ultra-processed carbohydrates, which increase advanced glycation end-products (AGEs) and oxidative load
• Emphasizing whole foods with complex carbohydrates like legumes, root vegetables, and whole grains
• Incorporating omega-3-rich fats from sardines, flaxseeds, walnuts, and chia
• Eating a variety of colorful vegetables, especially cruciferous and leafy greens

Top bone-supporting functional foods:

• Leafy greens: High in bioavailable calcium and vitamin K1
• Fermented foods: Like natto and kefir for vitamin K2 and gut health
• Fatty fish: Rich in vitamin D and anti-inflammatory EPA/DHA
• Turmeric, ginger, and berries: Provide potent polyphenols and antioxidants
• Nuts and seeds: Natural sources of magnesium, zinc, and boron

Micronutrients That Truly Matter

Instead of high-dose calcium, elderly individuals with chronic inflammation benefit more from:

• Magnesium (Mg2+) – Cofactor for over 300 enzymes and crucial for vitamin D activation
• Vitamin D3 – Modulates immune function and bone remodeling
• Vitamin K2 (MK-7) – Helps prevent calcium from being deposited in arteries
• Zinc, boron, and silica – Enhance bone matrix integrity
• Polyphenols – Protect mitochondrial DNA and reduce oxidative burden

Food-Based Mineral Strategy: Barley Grass and Organic Molasses

For elderly individuals with degenerative diseases, whole-food sources of critical minerals offer a more synergistic and absorbable option compared to isolated supplements. Two particularly powerful yet underutilized options are barley grass and dried organic molasses crystals.

In terms of specific nutrient contributions, barley grass (about 2 teaspoons) provides approximately 15 to 25 milligrams of magnesium and 150 to 250 milligrams of potassium, along with small amounts of calcium and iron. Dried organic molasses (about 2 teaspoons), on the other hand, offers a richer mineral profile—typically contributing 40 to 60 milligrams of magnesium, 300 to 400 milligrams of potassium, 80 to 120 milligrams of calcium, and 2 to 3 milligrams of iron.

When combined, this pairing can deliver around 55 to 85 milligrams of magnesium, 450 to 650 milligrams of potassium, 90 to 140 milligrams of calcium, and roughly 2.5 to 3.5 milligrams of iron, depending on the source and concentration. These amounts may not match pharmaceutical-grade supplements in potency, but they can significantly contribute to daily requirements in a balanced, bioavailable, and food-based form—especially beneficial for individuals with compromised absorption due to aging or chronic inflammation.

Lifestyle Interventions: Synergy with Nutrition

1. Exercise

Weight-bearing activity like walking, yoga, and resistance bands stimulates osteoblast function and maintains muscle mass—key for preventing falls.

2. Sleep and circadian rhythm

Melatonin supports not only brain function but also bone formation through its antioxidant role (Amstrup et al., 2013).

3. Stress reduction

Chronic cortisol elevation leads to increased bone resorption and calcium excretion.

4. Avoidance of alcohol and smoking

Both have direct toxic effects on osteoblasts and disrupt vitamin D metabolism.

NOTE:

All suggestions made in this blog are also believed to be beneficial for elderly individuals with obesity, post-stroke recovery, and cardiovascular diseases—including atherosclerotic plaque buildup, mitral valve disorders, and related heart conditions. These strategies support systemic anti-inflammatory balance, vascular health, and overall metabolic resilience.

Conclusion: A Holistic Bone Strategy for the Chronically Ill Elderly

Elderly individuals with long-term illnesses should not default to calcium supplementation as a one-size-fits-all solution. Instead, they need a nutrient-rich, anti-inflammatory, and antioxidant-supportive diet paired with lifestyle adjustments that address the root causes of bone degeneration—oxidative stress, mitochondrial dysfunction, and chronic inflammation.

In this way, we can support not only bone health but also overall metabolic, cognitive, and cardiovascular wellness.

References:

Amstrup, A.K., Sikjaer, T., Heickendorff, L., Mosekilde, L. and Rejnmark, L., 2013. 'Melatonin improves bone mineral density at the femoral neck in postmenopausal women with osteopenia: a randomized, double-blind, placebo-controlled trial.' Journal of Pineal Research, 54(3), pp.221–229.

Bolland, M.J., Grey, A., Avenell, A. and Gamble, G.D., 2015. 'Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women's Health Initiative limited access dataset and meta-analysis.' BMJ, 351, p.h4580.

Görlach, A., Bertram, K., Hudecova, S. and Krizanova, O., 2015. 'Calcium and ROS: A mutual interplay.' Redox Biology, 6, pp.260–271.

Wei, J., Xu, H., Davies, M.R. and Hemmings, G.P., 2020. 'Inflammaging and bone health: the role of chronic inflammation in age-related osteoporosis.' Frontiers in Endocrinology, 11, p.449.

Zhao, J., Xie, Y., Liu, Y., Zhong, J. and Liu, Y., 2019. 'Role of mitochondria in osteogenesis and osteoclastogenesis: Potential therapeutic strategies for osteoporosis.' Free Radical Biology and Medicine, 130, pp.287–299.

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The Calcium Paradox Revisited: Are Supplements Fueling Future Illnesses? :

How Overprescribed Calcium May Trigger a Cascade of Health Issues and Unnecessary Drug Use

By Brian S. 

Is your calcium supplement doing more harm than good? Discover how excess calcium may raise your risk for heart disease, kidney stones, and polypharmacy. Learn natural alternatives for bone health. 

For decades, calcium has been promoted as an essential nutrient for preventing osteoporosis and fractures, particularly in older adults. Doctors often prescribe calcium supplements, assuming them to be harmless. Yet emerging research reveals a hidden paradox: excessive calcium supplementation may be causing the very ailments it aims to prevent — and even more.

This article explores the overlooked consequences of routine calcium prescriptions and how they may inadvertently lead to a cycle of drug dependency and chronic illness.

1. The Medicalization of Calcium: When Prevention Becomes a Problem

Prescribing calcium has become almost reflexive in modern medicine, especially for postmenopausal women and the elderly. However, this approach often ignores the individual’s dietary intake, hormonal balance, renal function, and nutrient co-factors. When supplementation is generalized instead of personalized, unintended health risks emerge.

“Calcium supplements should not be given as a matter of routine but should follow a comprehensive evaluation of dietary intake and clinical need” (Heaney, 2013).

2. The Hidden Dangers of Excessive Calcium Supplementation

a. Cardiovascular Complications

Excess calcium from supplements — especially when not properly absorbed into the bone matrix — can accumulate in blood vessels. This process, known as vascular calcification, increases the risk of atherosclerosis, myocardial infarction, and stroke.

A meta-analysis of randomized controlled trials found that calcium supplementation was associated with a 30% increased risk of heart attack (Bolland et al., 2010). The study raises concern that calcium pills, unlike food-based sources, cause sharp rises in serum calcium, which may damage arterial walls.

b. Kidney Stone Formation

Calcium supplements, particularly calcium carbonate, can raise urinary calcium levels. This increases the risk of calcium oxalate stone formation, especially in dehydrated individuals or those with high oxalate diets.

c. Micronutrient Interference

High calcium intake can impair the absorption of magnesium, zinc, and iron (Rosanoff et al., 2012). These minerals are essential for enzymatic functions, immune health, and mood regulation. Deficiencies may lead to fatigue, anxiety, and immune dysregulation, which may be wrongly treated with additional prescriptions — such as antidepressants or immunosuppressants.

d. Gastrointestinal Distress

Calcium supplements often cause constipation, bloating, or nausea, leading patients to seek over-the-counter laxatives or acid suppressants. These additional medications may introduce their own risks — a cascade of unnecessary drug use.

3. The Prescription Cascade: One Pill Leads to Another

Imagine this scenario:
A 65-year-old woman is given calcium supplements for osteopenia. Months later, she develops fatigue, occasional chest pain, and constipation. Her physician prescribes a beta-blocker, statin, and laxative — without realizing the chain began with calcium overuse.

This phenomenon is known as the prescription cascade — where side effects from one drug lead to another prescription, often without reassessing the root cause.

“The burden of polypharmacy in older adults is exacerbated when preventive measures themselves introduce new risks” (Reid et al., 2016).

4. The Natural Approach: Bone Health without Overreliance on Pills

Instead of reflexively prescribing calcium, a food-first, individualized strategy offers better outcomes:

• Dietary Sources: Sardines, tahini, sesame seeds, collard greens, tofu, and fermented dairy provide absorbable calcium with natural cofactors.
• Synergistic Nutrients: Ensure optimal intake of vitamin D3, vitamin K2, and magnesium to direct calcium into bones and away from arteries.
• Weight-Bearing Exercise: Stimulates osteoblasts and enhances bone mineral density without pills.
• Targeted Testing: Monitor serum calcium, parathyroid hormone (PTH), 25(OH) vitamin D, and renal markers before initiating supplementation.

5. Final Thoughts: Time to Rethink the Calcium Doctrine

Calcium is vital — but context matters. Supplementation without proper assessment may result in cardiovascular harm, metabolic imbalances, and a dependency on future prescriptions. We must embrace a holistic, nutrient-aware approach to bone health that prioritizes diet, movement, and biochemical individuality.

The calcium paradox reminds us that more is not always better, and prevention must never come at the cost of long-term harm.

References

Bolland, M.J., Avenell, A., Baron, J.A., Grey, A., MacLennan, G.S. and Reid, I.R., 2010. 'Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis.' BMJ, 341, p.c3691.

Heaney, R.P., 2013. 'Calcium supplementation and incident cardiovascular events.' Nutrition in Clinical Practice, 28(1), pp.40–45.

Rosanoff, A., Weaver, C.M. and Rude, R.K., 2012. 'Suboptimal magnesium status in the United States: are the health consequences underestimated?.' Nutrition Reviews, 70(3), pp.153–164.

Reid, I.R., Bolland, M.J. and Grey, A., 2016. Effects of vitamin D supplements on bone mineral density: a systematic review and meta-analysis. Lancet, 383(9912), pp.146–155.

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Why Arthritis Strikes Harder After 40: The Role of Inflammation, Nutrition and Lifestyle

Exploring How Inflammation, Poor Diet, and Aging-Related Changes Weaken Joint Health and Increase Arthritis Risk

Discover why arthritis becomes more common after 40. Learn how chronic inflammation, malnutrition, and sedentary lifestyles impair stem cell repair and accelerate joint degeneration.

By Brian S.

Arthritis, especially osteoarthritis, is often considered a natural part of aging. But why does it tend to manifest more frequently — and more painfully — after the age of 40? While wear and tear is part of the story, emerging research points to chronic low-grade inflammation, malnutrition, and lifestyle factors as primary contributors. These hidden culprits impair the body’s natural ability to regenerate joint tissues, particularly through the suppression of stem cell function and the breakdown of collagen and cartilage proteins.

1. Inflammaging and the Breakdown of Joint Renewal

Aging is accompanied by inflammaging, a slow and silent rise in inflammatory activity throughout the body (Franceschi & Campisi, 2014). This chronic inflammation increases the release of pro-inflammatory cytokines like TNF-α, IL-1β, and IL-6, which inhibit the proliferation of mesenchymal stem cells (MSCs) responsible for regenerating joint tissues (Chen et al., 2017). As a result, joints lose their ability to repair damage effectively.

Inflammation also upregulates enzymes such as matrix metalloproteinases (MMPs), which break down essential cartilage and tendon components including collagen, elastin, and proteoglycans (Martel-Pelletier et al., 2008). Over time, cartilage degradation exceeds regeneration, laying the foundation for osteoarthritis.

2. Hidden Sources of Chronic Inflammation

Several lifestyle and metabolic changes that often begin or worsen after the age of 40 further stoke inflammation:

a. Polypharmacy

Many older adults take multiple medications daily, a phenomenon known as polypharmacy. Some drug combinations can disrupt gut microbiota and liver detox pathways, inadvertently contributing to systemic inflammation (Maher et al., 2014).

b. Constipation and Gut Toxin Accumulation

Chronic constipation, common among older adults, allows toxins like lipopolysaccharides (LPS) from gut bacteria to be reabsorbed into the bloodstream, triggering immune responses and promoting inflammation (Vitetta et al., 2013).

c. Nutritional Imbalances and Malnourishment

Malnutrition — particularly micronutrient deficiency — is surprisingly common in the elderly, especially those with reduced appetite or who eat monotonous diets (Volkert et al., 2019). Diets low in antioxidants, vitamin C, vitamin D, and omega-3 fatty acids increase susceptibility to inflammation and cartilage damage.

d. Lack of Antioxidant-Rich Foods

Antioxidants play a vital role in neutralizing reactive oxygen species (ROS), which accumulate with age and worsen joint inflammation. A diet low in fruits, vegetables, herbs, and polyphenol-rich foods reduces the body’s ability to cope with oxidative stress, weakening joint integrity (Henrotin et al., 2019).

e. Physical Inactivity

Movement is medicine. Regular exercise stimulates synovial fluid production, improves nutrient delivery to cartilage, and reduces inflammation by lowering systemic cytokine levels (Lange et al., 2020). Yet many adults over 40 become more sedentary, accelerating joint stiffness and degeneration.

3. Aging Stem Cells and Joint Degeneration

The stem cells responsible for regenerating joint components also age and become senescent, losing their regenerative potential. Worse still, senescent cells secrete harmful molecules known as senescence-associated secretory phenotypes (SASP), which include inflammatory cytokines and proteases (Coppe et al., 2010). This not only reduces joint repair but actively damages surrounding tissue.

Conclusion: A Multifactorial Degeneration Process

Arthritis after 40 is not merely about aging joints — it’s about the intersection of inflammation, malnutrition, and inactivity. Prevention and management require a holistic approach, including:

• Anti-inflammatory nutrition
• Regular physical activity
• Gut health optimization
• Minimizing unnecessary medications
• Promoting antioxidant-rich foods

Supporting the body’s natural repair mechanisms — especially its stem cells — is key to maintaining joint health and preventing or slowing arthritis progression.

References

Chen, Q., Shou, P., Zhang, L., Xu, C., Zheng, C., Han, Y., Li, W., Huang, Y., Zhang, X., Yin, Y., Wang, Y. and Shi, Y., 2017. 'An osteopontin-integrin interaction plays a critical role in directing adipogenesis and osteogenesis by mesenchymal stem cells.' Stem Cells, 32(2), pp.327-337.

Coppe, J.P., Desprez, P.Y., Krtolica, A. and Campisi, J., 2010. 'The senescence-associated secretory phenotype: the dark side of tumor suppression.' Annual Review of Pathology: Mechanisms of Disease, 5, pp.99-118.

Franceschi, C. and Campisi, J., 2014. 'Chronic inflammation (inflammaging) and its potential contribution to age-associated diseases.' The Journals of Gerontology: Series A, 69(Suppl 1), pp.S4-S9.

Henrotin, Y., Lambert, C., Couchourel, D., Ripoll, C. and Chiotelli, E., 2019. 'Nutraceuticals: do they represent a new era in the management of osteoarthritis?–a narrative review from the lessons taken with five products'. Osteoarthritis and Cartilage, 19(1), pp.1-21.

Lange, K.H., Andersen, J.L., Beyer, N., Isaksson, F., Larsson, B., Rasmussen, M.H., Juul, A. and Kjaer, M., 2020. 'Impact of physical training on muscle strength and musculoskeletal pain in patients with chronic diseases: a randomized controlled trial.' Scandinavian Journal of Medicine & Science in Sports, 30(3), pp.509-521.

Maher, R.L., Hanlon, J. and Hajjar, E.R., 2014. 'Clinical consequences of polypharmacy in elderly.' Expert Opinion on Drug Safety, 13(1), pp.57-65.

Martel‐Pelletier, J., Boileau, C., Pelletier, J.P. and Roughley, P.J., 2008. 'Cartilage in normal and osteoarthritis conditions.' Best Practice & Research Clinical Rheumatology, 22(2), pp.351-384.

Vitetta, L., Coulson, S., Linnane, A.W. and Butt, H., 2013. 'The gastrointestinal microbiome and musculoskeletal diseases: a beneficial role for probiotics and prebiotics.' Pathogens, 2(4), pp.606-626.

Volkert, D., Beck, A.M., Cederholm, T., Cruz‐Jentoft, A., Goisser, S., Hooper, L., Kiesswetter, E., Norman, K., Schneider, S.M. and Sieber, C.C., 2019. 'ESPEN guideline on clinical nutrition and hydration in geriatrics.' Clinical Nutrition, 38(1), 

Footnote:

While this article focuses on general arthritis and osteoarthritis, it’s worth noting that rheumatoid arthritis (RA) also shares similar inflammatory triggers, such as gut dysbiosis, oxidative stress, and micronutrient deficiencies. However, RA is autoimmune in nature, involving the immune system mistakenly attacking joint linings. Notably, hormonal fluctuations—especially the drop in estrogen during perimenopause and menopause—have been implicated in RA flare-ups and higher prevalence in older women. Estrogen has anti-inflammatory properties, and its deficiency may disrupt immune tolerance and promote the activation of T cells and autoantibody production, exacerbating joint inflammation in RA (Cutolo et al., 2012; Hughes et al., 2014).

References

Cutolo, M., Capellino, S., Montagna, P., Ghiorzo, P., Sulli, A. and Villaggio, B., 2012. 'Sex hormone modulation of cell growth and apoptosis of the human monocytic/macrophage cell line.' Arthritis Research & Therapy, 14(3), p.R149.

Hughes, G.C., 2014. 'Progesterone and autoimmune disease.' Autoimmunity Reviews, 11(6-7), pp.A502–A514.

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Gastric and Intestinal Ulcers: Is Bloating Really Caused by Constipation?

Unpacking the Truth Behind Belching, Gas, and "Wind" in Ulcer Sufferers

Is constipation the main cause of gas and bloating in ulcer patients? Discover the real reasons behind “wind” in gastric and intestinal ulcers, including inflammation, spasms, and low food intake.

By Brian S., MH, MD (Alt. Med.) | Zent Nutri

Have you ever heard someone say that the belching or “wind” experienced by people with gastric or intestinal ulcers is simply due to constipation? It’s not uncommon to hear this in holistic circles. In fact, I recently came across a response from a holistic practitioner who insisted that flatulence and bloating in ulcer sufferers are mainly a result of constipation.

But here's where things got interesting—when asked about a case where the patient vomits every time they try to eat, consuming very little food, the practitioner had no reply. No constipation, yet still gas and discomfort? Let's dig deeper into the science and physiology behind this.

The Physiology Behind Ulcers and Gas

1. Inflammation Comes First

Ulcers—whether in the stomach (gastric ulcers) or intestines (intestinal ulcers)—are open sores caused by erosion of the mucosal lining. These sores often result from H. pylori infection, excessive NSAID use, or stress, and are typically accompanied by inflammation (Sung et al., 2009).

Inflammation activates local immune cells and releases substances like histamine, prostaglandins, and cytokines. These mediators trigger local pain receptors, increase gastric acid secretion, and may disrupt smooth muscle function (Wallace, 2008).

2. Spasms and Nerve Irritation

The gastrointestinal tract has its own nervous system, the enteric nervous system, which coordinates muscle movement. Inflammation irritates these nerves, leading to smooth muscle spasms. These spasms can cause cramping, pain, and erratic movement of gas and digestive contents (Furness, 2012).

3. Gas Accumulation: Belching and Flatulence

In the stomach, ulcers and inflammation can make the digestive tract hypersensitive. This can cause the person to swallow more air (aerophagia) due to anxiety, nausea, or irregular eating patterns. The trapped air is expelled as belching, sometimes with an acidic or sour aftertaste due to reflux (Katz et al., 2013).

In the intestines, spasms and slowed motility can lead to fermentation of undigested food by gut bacteria, even in the absence of a large food intake. This fermentation releases gases like hydrogen, methane, and carbon dioxide, leading to bloating and flatulence (Camilleri, 2020).

What If There's No Food Intake or Constipation?

Here lies the crux: even when a person barely eats due to vomiting—common in severe gastric ulcers or gastroparesis—gas and "wind" can still occur. This is not due to constipation but to spasms, fermentation, and altered gut motility. The bloating may even worsen due to empty stomach acidity and delayed gastric emptying.

Constipation’s Role: Not the Sole Cause

Constipation certainly can contribute to bloating, but it is not the main reason for gas in ulcer sufferers. It becomes problematic when we overemphasize it and ignore the more relevant issues like:

• Chronic inflammation

• Gastric hypersensitivity

• Acid imbalance

• Nerve irritation

• Dysbiosis or small intestinal bacterial overgrowth (SIBO)

A Balanced Holistic Approach

As holistic health professionals, it's vital we stay grounded in physiology and pathophysiology. Instead of reducing all symptoms to constipation, we must consider:

• Mucosal healing: using slippery elm, marshmallow root, or deglycyrrhizinated licorice (DGL)

• Spasm relief: using peppermint (in reflux-free cases), chamomile and fennel

• Inflammation control: with turmeric or aloe vera

• Microbiome support: probiotics or fermented foods (when tolerated)

• Stress management: as psychological stress worsens gastric output and motility disorders

Conclusion

So, is gas in ulcer patients just a result of constipation? Not quite. Inflammation, nerve irritation, and disordered motility are far more relevant in most cases—especially when food intake is low or vomiting occurs. Let’s not oversimplify the complex workings of the gut. A nuanced understanding makes us better healers.

References

Camilleri, M. (2020) ‘Bloating and abdominal distension: pathophysiology and management’, Nature Reviews Gastroenterology & Hepatology, 17(11), pp. 731–740.

Furness, J.B. (2012) ‘The enteric nervous system and neurogastroenterology’, Nature Reviews Gastroenterology & Hepatology, 9(5), pp. 286–294.

Katz, P.O., Gerson, L.B. and Vela, M.F. (2013) ‘Guidelines for the diagnosis and management of gastroesophageal reflux disease’, The American Journal of Gastroenterology, 108(3), pp. 308–328.

Sung, J.J.Y. et al. (2009) ‘Systematic review: the global incidence and prevalence of peptic ulcer disease’, Alimentary Pharmacology & Therapeutics, 29(9), pp. 938–946.

Wallace, J.L. (2008) ‘Prostaglandins, NSAIDs, and gastric mucosal protection: why doesn't the stomach digest itself?’, Physiological Reviews, 88(4), pp. 1547–1565.

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