interesting anecdotal report of treatment of AI induced joint pains with sunlight!!

[Lani]

Med Hypotheses. 2008 Sep 7. [Epub ahead of print]

Aromatase inhibitor-induced joint pain: Melatonin's role.

Burk R.
Burk Labs, 9414 168th Place NE, Redmond, WA 98052, USA.
Aromatase inhibitors (AIs) enjoy increasing use in breast cancer adjuvant therapy. But the joint pain associated with AIs significantly reduces patient adherence despite the clear survival benefits of this class of drugs. Two clues point to a novel hypothesis for this unexplained symptom. First, realizing that joint pain is associated with virtually all estrogen-depleting breast cancer treatments suggests that the cause is broader than this particular class of drugs. Second, the strongly circadian nature of these symptoms suggests circadian hormone involvement. This puts new light on some existing research findings: that estrogen depletion can increase pineal melatonin, that the ability of light to suppress pineal melatonin is more variable than once thought, and that an altered melatonin cycle is associated with rheumatoid arthritis patients, where identical circadian symptoms present. It is hypothesized that when AIs decrease estrogen levels, light-induced melatonin suppression (LIMS) loses efficacy, leading to an abnormal melatonin cycle as seen in rheumatoid arthritis patients, producing (via mechanisms not yet understood) the symptoms of morning stiffness. Not all frequencies of retinal light are equally effective at suppressing pineal melatonin; most artificial lighting has less relevant spectral density than sunlight. This hypothesis predicts that some patients can suppress the circadian joint pain associated with aromatase inhibitors merely by getting sufficient hours of daily retinal sunlight. A single patient history is discussed, in which a series of treatments had no effect on AI joint pain, while extended exposure to sunlight produced a definitive elimination of symptoms the next morning. To conclusively demonstrate the role of melatonin, light-emitting diodes of an appropriate frequency were mounted on a cap for the patient to wear. If worn first thing in the morning, the cap sharply curtailed the duration of morning stiffness. If worn for a sufficient number of hours during the day, the cap suppressed symptoms the next morning, just as sunlight did. Because of evidence for melatonin's oncostatic properties, this hypothesis potentially has implications beyond decreasing the number of patients that discontinue AIs. It may be that some portion of the survival benefit of AIs is due to their indirect effect on melatonin, not just their direct effect on estrogen.
PMID: 18782656 [PubMed - as supplied by publisher]

[Hopeful]

Lani,

This is fascinating - thanks for posting. I wonder if this is also the reason that some AI's provoke the stiffness in a particular patient, while other's don't.

Hopeful

[Patb]

Thanks for posting this. This is very interesting because
I am so stiff in the mornings.
patb

[harrie]

Lani, that is an interesting hypothesis. I live a HI where we get lots of sunshie and yet I still get joint stiffness in my hand and slight locking of the thumb. Maybe it would be worse if I did not get the sunshine. It is also worse at night when it is dark, but I had always presumed it was more due to inactivity of the hand.