Arimidex/joint prob update

[TSund]

What is the "standard" response to women suffering with AI pain? Seems like there are some who try switching AI's, and others that just continue to live with the discomfort. Is there a standard amount of time that they say to try one before trying a different one?

[Soccermom]

Terri,
I think if one complains regularly to their Onc over siccessive visits a switch will be suggested...thats the only time frame I can think of.
Marcia

[harrie]

Mary, I was on Tamoxifen for 5 yrs and had absolutely no joint pain. In fact I had hardly any if any side effects.
Marcia, it sounds like the joint pain is from the Arimadex, is that correct? What were your side effects like from the Aromasin and how did they differ from the side effects from the Arimadex?
Just curious because in the future I may switch to Aromasin.

[Soccermom]

Aloha Harrie,
Yep, I think its from the Arimidex. Interestingly when I take my monthly Boniva (for bones) I have a 24 period that is very flu like. It seems everything I take now to prevent Cancer and or the side effects of TX causes bone related fatigue and pain. (I had severe pain w/ Taxol but on Herceptin it wasnt quite so pronounced).Just my 2 cents,Marcia

[Jeanette]

I can relate to the pain from Boniva. I ended up going to bed for the day. Also on Arimidex, so thats a double whammy . But it can be tolerated. Hugs and blessings, Jeanette

[TSund]

Seems like so little is known. Why do some women have pain and others not? (rhetorical question, I don't think there is an answer) Sort of like asking why some women recur and other do not.

Given that exercize is proven to help survival stats and to help control estrogen, etc. it's alarming that it might be prohibitive if these side affects get severe enough. But it sounds like some are getting benefit from yoga and the like.

TRS

[harrie]

I have been on Fosomax for osteopenia for at least 3 yrs now. I have never had any kind of bone discomfort from that medication.

Marcia, we sure do have a lot in common, don't you think? Esp now that we both had the DIEP so recently.

[Soccermom]

Hi Harrie!
We sure are similar!
You know before DX I weighed in at 130 (5 5 1/2) now I tip the scales at 155. I eat better now, dont smoke,take vitamins regularly ,exercize when I can ,and since 1/2 oophectomy chemop
ause I
cannot lose any weight. Its the darndest thing. I think if I do lose 15 lbs or so my joint pain will improve.

Marcia

[R.B.]

Fish oil eg long chain Omega 3s are reported as assisting with arthritis.

http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum


A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain.
Goldberg RJ, Katz J.

Department of Psychology, York University, Toronto, ON, Canada.

Between 40% and 60% of Americans use complementary and alternative medicine to manage medical conditions, prevent disease, and promote health and well-being. Omega-3 polyunsaturated fatty acids (omega-3 PUFAs) have been used to treat joint pain associated with several inflammatory conditions. We conducted a meta-analysis of 17 randomized, controlled trials assessing the pain relieving effects of omega-3 PUFAs in patients with rheumatoid arthritis or joint pain secondary to inflammatory bowel disease and dysmenorrhea. Meta-analysis was conducted with Cochrane Review Manager 4.2.8. for six separate outcomes using standardized mean differences (SMDs) as a measure of effect size: (1) patient assessed pain, (2) physician assessed pain, (3) duration of morning stiffness, (4) number of painful and/or tender joints, (5) Ritchie articular index, and (6) nonselective nonsteroidal anti-inflammatory drug consumption. Supplementation with omega-3 PUFAs for 3-4 months reduces patient reported joint pain intensity (SMD: -0.26; 95% CI: -0.49 to -0.03, p=0.03), minutes of morning stiffness (SMD: -0.43; 95% CI: -0.72 to -0.15, p=0.003), number of painful and/or tender joints (SMD: -0.29; 95% CI: -0.48 to -0.10, p=0.003), and NSAID consumption (SMD: -0.40; 95% CI: -0.72 to -0.08, p=0.01). Significant effects were not detected for physician assessed pain (SMD: -0.14; 95% CI: -0.49 to 0.22, p=0.45) or Ritchie articular index (SMD: 0.15; 95% CI: -0.19 to 0.49, p=0.40) at 3-4 months. The results suggest that omega-3 PUFAs are an attractive adjunctive treatment for joint pain associated with rheumatoid arthritis, inflammatory bowel disease, and dysmenorrhea.

[TSund]

RB,

If used as an adjunctive treatment are the dosages significantly higher than supplementation?

TRS

[R.B.]

This is a useful link that might help. It is a paper by a doctor on dosages.

Fish oil: what the prescriber needs to know

Leslie G Cleland email, Michael J James email and Susanna M Proudman email

Rheumatology Unit, Royal Adelaide Hospital, North Terrace, Adelaide, Australia

"Investigations across a variety of inflammatory diseases have used doses of fish oil that provide daily intakes of LC n3 PUFAs that range from less than 1 g to more than 6 g [8]. Collectively, these studies indicate that the anti-inflammatory dose of fish oil requires delivery of 2.7 g or more of LC n3 PUFAs daily, and that higher doses are also safe and effective. A daily intake of 2.7 g EPA plus docosahexaenoic acid (DHA) is provided by a daily dose of nine or more standard fish oil capsules, which typically contain 30% LC n3 PUFAs w/w. People who self medicate with fish oil generally take one or two capsules daily. This is insufficient for an anti-inflammatory effect but it may provide cardiovascular benefit."

http://arthritis-research.com/content/8/1/202

There are no definitive answers, and I am not an expert and cannot give specific advice. I can only point you to research.

Intake recommendations range from 300mg to about 2.7 grams of EPA and DHA Eg 1.4 each.

A trial suggested uptake drops of in women at about 2grams of DHA a day.

For me quality bottled is cheaper and a better option for higher dosages. Check the label for amounts of DHA and EPA. A mix of Cod liver and fish is prudent due to the A and D levels in cod liver.

The body stores the mother Omega 6 but not 3 so historic stores have to be factored in.

As illustrated by the above it is as much about too much Omega 6 as too little 3.

Long chain omega threes in fish oil can thin blood and cause problems for small number of people so please talk to your doctor about dietary change.

RB