When a joint is in degenerative disease, a multifactorial degrading process is in play that accelerates break down of bone, cartilage, and soft tissue. It all happens simultaneously and spontaneously. This multifactorial breakdown system is so complete that it turns the joint’s protective synovial fluid into a toxic pool of inflammatory factors manifest as the chronic, harmful swelling that most are plagued with.
In its key roles vitamin C may act as an anti-inflammatory and collagen synthesizer.
According to researchers, this is what is happening in your joints during this breakdown process.
- Runaway oxidative stress (free radical and unchecked oxidative damage, antioxidant deficiency leading to breakdown of the entire joint structure).
- Overproduction of reactive oxygen species (ROS) simply the process that creates a toxic inflammation in your joints. ROS regulates intracellular signaling processes (sends signals to create more inflammation), chondrocyte senescence (stops the development and growth of cartilage) and apoptosis (instructs immune system to kill cartilage cells), along with synovial inflammation and dysfunction of the subchondral bone.
Research: Start targeting the complex oxidative stress signaling pathways
- As suggested by a recent study, (1) “disease-modifying drugs for osteoarthritis are rare, targeting the complex oxidative stress signaling pathways would offer a valuable perspective for exploration of potential therapeutic strategies in the treatment of this devastating disease.”
As we will see in the below research, vitamin C may be an answer in targeting excessive oxidant damage in joints where osteoarthritis has taken hold. How? By helping to reverse the damaging signals the oxidants are sending out.
People who took vitamin C were 11% less likely to develop osteoarthritis when compared to those who did not
The suggestion that vitamin C may help prevent the progression of osteoarthritis is controversial. Mixed results from various studies gives an uneven answer as to whether vitamin C supplementation is beneficial or not.
An October 2021 paper (2) outlines some of the challenges the proponents or the opponents of vitamin C supplementation in cases of osteoarthritis face. In this paper, the authors cited a previous 2011 study on the relationship between vitamin C supplementation and its effects on knee osteoarthritis. “The 2011 study included over 1023 patients aged 40 years or older, and with the use of an MRI, the osteoarthritis status of each individual was determined.” (3) After ten years of taking supplemental vitamin C, the study participants had a comparative MRI done to determine the progression of osteoarthritis, as well as a detailed questionnaire aimed at determining daily vitamin C intake. Results showed that participants who engaged in supplementation of the vitamin were 11% less likely to develop osteoarthritis when compared to those who did not supplement. However, results also demonstrated no significant difference in osteoarthritis progression between the two groups. The conclusion was vitamin C had no effect on delaying the progression of osteoarthritis once established.
“There is no denying that vitamin C benefits everybody, whether they have arthritis or not”
This is from a June 2019 paper in the journal Medical archives.(4)
“There is no denying that vitamin C benefits everybody, whether they have arthritis or not. Therefore, it is a good idea to maintain a healthy balance of vitamin C. Without a doubt, vitamin C benefits most people with early osteoarthritis.”
It is unlikely that anyone would question the benefits of vitamin C in supporting immune function, recently however, researchers have looked at what vitamin C can do for inflammatory arthritis and osteoarthritis.
In an August 2019 study from Loma Linda University (5), researchers examined how vitamin C worked on arthritis:
“Vitamin C (ascorbic acid) is a well-known regulator of bone and cartilage metabolism, they write, “However, the mechanisms of Vitamin C’s action in these tissues are only partly understood.” So we know it helps, but how? In this study, the research team confirmed their findings that Vitamin C (ascorbic acid) contributes to bone and cartilage metabolism by (preventing) articular cartilage and trabecular bone (porous bone such as that found in the femur or thigh bone) breakdown by way of helping to create more chondrocyte (cartilage cells) and osteoblasts (bone cells). How, by disrupting gene modification pathways and preventing cell mutation in osteoarthritis.
A 2017 study in the International journal of molecular sciences (6) found that Vitamin C can prevent against anti-apoptosis (prevents cell death and breakdown of cartilage and bone), work as an anti-inflammatory while effectively turning into a pro-inflammatory (signaling for the good inflammation that creates healing.)
Vitamin C’s benefit on stem cells in a damaged joint
There is a lot of research concerning the role of vitamin support stem cells and their many functions throughout the body. In regard to joint problems:
- A 2017 study in the journal Stem Cells International (7) suggests: “Vitamin C regulates extracellular matrix/collagen homeostasis (the building of cartilage through collagen production) and plays a key role in the differentiation of mesenchymal stem cells towards osteoblasts (bone cells), chondrocytes (cartilage cells), and tendons.“
Despite these published benefits, a 2022 paper found (8) High intake of vitamin C or E did not reduce knee osteoarthritis risk.
Vitamin C supplementation can help many people with joint pain. How much can it help? That is the debate within the medical community and a discussion for you and your doctor.
References
1 Lepetsos P, Papavassiliou AG. ROS/oxidative stress signaling in osteoarthritis. Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease. 2016 Apr 1;1862(4):576-91.
2 Dunlap B, Patterson GT, Kumar S, Vyavahare S, Mishra S, Isales C, Fulzele S. Vitamin C supplementation for the treatment of osteoarthritis: perspectives on the past, present, and future. Therapeutic Advances in Chronic Disease. 2021 Oct;12:20406223211047026.
3 Peregoy J, Wilder FV. The effects of vitamin C supplementation on incident and progressive knee osteoarthritis: a longitudinal study. Public health nutrition. 2011 Apr;14(4):709-15.
4 Ripani U, Manzarbeitia-Arroba P, Guijarro-Leo S, Urrutia-Graña J, De Masi-De Luca A. Vitamin C May Help to Reduce the Knee’s Arthritic Symptoms. Outcomes Assessment of Nutriceutical Therapy. Med Arch. 2019 Jun;73(3):173-177. doi: 10.5455/medarh.2019.73.173-177. PMID: 31404121; PMCID: PMC6643354.
5. Lindsey RC, Cheng S, Mohan S. Vitamin C effects on 5-hydroxymethylcytosine and gene expression in osteoblasts and chondrocytes: Potential involvement of PHD2. PLoS One. 2019 Aug 7;14(8):e0220653. doi: 10.1371/journal.pone.0220653. PMID: 31390373; PMCID: PMC6685624.
6 Chiu PR, Hu YC, Huang TC, Hsieh BS, Yeh JP, Cheng HL, Huang LW, Chang KL. Vitamin C Protects Chondrocytes against Monosodium Iodoacetate-Induced Osteoarthritis by Multiple Pathways. Int J Mol Sci. 2016 Dec 27;18(1):38. doi: 10.3390/ijms18010038. PMID: 28035982; PMCID: PMC5297673.
7. D’Aniello C, Cermola F, Patriarca EJ, Minchiotti G. Vitamin C in Stem Cell Biology: Impact on Extracellular Matrix Homeostasis and Epigenetics. Stem Cells Int. 2017;2017:8936156. doi: 10.1155/2017/8936156. Epub 2017 Apr 20. PMID: 28512473; PMCID: PMC5415867. — 930
8 Xu C, Wang S, Ti W, Yang J, Yasen Y, Memetsidiq M, Shi SQ. Role of dietary patterns and factors in determining the risk of knee osteoarthritis: A meta-analysis. Modern Rheumatology. 2022 Jul;32(4):815-21.