Peptides for arthritis?

[Guided_by_Voices]

I go every 6 months to get inter-articular injections in the left knee. That seems relatively easy to do. I tried the same hyaluronic injections in the shoulder and they had to use the ultrasound guided method. Pretty complicated.

I did find this out about prescribing HGH:

In 1988 and 1990, FDA amended the Food, Drugs, and Cosmetic Act after researchers revealed an unforced law that physicians and entrepreneurs were exploiting. As a result, a provision was put so that HGH can be prescribed only for three conditions:

1. HGH deficiency in children might result in dwarfism
2. Adult HGH deficiency due to tumors in the brain and their treatment like radiation therapy
3. Muscle wasting illness related to HIV/AIDS

I have tried several different times to get a prescription for HGH and doctors don't even want to discuss it. No doubt even if you could talk a doctor into it, insurance would not cover it. Doctor seem to be scared of discussing this one. I am glad you mentioned the dosing he suggested. 10-15 iu/wk = about 2iu/d. Which is about what most use for life extension. I did 4iu/d for a few years and as I mentioned had no results. But then it has gotten a lot worse since I stopped the HGH. Not sure if that had anything to do with it. Yes I got a cortisone shot maybe 4 weeks ago and this time it did nothing to help. I got 3 injections last year (every 4 months) and 1 this year so far. The hyaluronic injections in the shoulder did nothing but in the knee it is great.

I am thinking about getting 3 kits of HGH and doing 2iu microdoses in the shoulder and seeing if that has any effect. I did a similar technique after knee surgery with GH/IGF-1/MGF a few years back and it increased healing greatly.

Just to clarify on the dosing, his dosing was into the knee capsule where the HGH stays for an extended period, not systemic. Injecting systemically would not reach anywhere near that amount for the joint tissues themselves. And it would also make sense that if the knee capsule can retain the HGH inside, it might also keep systemically circulating HGH out to a large degree. Hence his dosing is likely astronomically higher than anything that could be achieved directly to the knee (or other joint) tissues when injecting systemically the way the anti-aging protocols do. He's basically trying to induce local acromegaly. The interview is a fairly quick listen so I would check it out in case I am remembering a dosage wrong, however since the dose stays in the joint, the risk of systemic overdose seem low even if you over-did it.

 

[Deleted member 43589]

Just to clarify on the dosing, his dosing was into the knee capsule where the HGH stays for an extended period, not systemic. Injecting systemically would not reach anywhere near that amount for the joint tissues themselves. And it would also make sense that if the knee capsule can retain the HGH inside, it might also keep systemically circulating HGH out to a large degree. Hence his dosing is likely astronomically higher than anything that could be achieved directly to the knee (or other joint) tissues when injecting systemically the way the anti-aging protocols do. He's basically trying to induce local acromegaly. The interview is a fairly quick listen so I would check it out in case I am remembering a dosage wrong, however since the dose stays in the joint, the risk of systemic overdose seem low even if you over-did it.

That is the problem I have, The cortisone injections I get every 4 months are also interarticular. Straight through the anterior deltoid into the glenohumeral joint. With no doubt at all, this goes systemic in around 24 hours as I start feeling some pain relief in my low back. The hyaluronic injections don't go systemic because it is a very thick liquid and stays in the joint. HGH should be much like cortisone and disperse quickly and go systemic. Micro injections might help saturate the area better meaning 4-5 injections of 0.5iu. I have done this very successfully with surgery. I will listen to the interview again. Thanks.

I did find this study that seems to be one of the only studies one on HGH injections for osteoarthritis. Seems like something I will try for sure. My doctor uses a ethyl chloride topical anesthetic spray and then does the injection. It is absolutely painless.

Intra-articular injections of 5.0 mgm of Human Growth hormone(Omnitrope, Sandoz) were give weekly for 5 to 12 weeks.

https://www.oarsijournal.com/article/S1063-4584(12)00584-5/fulltext

Here is a good article about this:

HGH for Osteoarthritis?

HGH for osteoarthritis is a hot topic in the medical community. Dr. Centeno digs into the claims that it will regrow normal cartilage.

centenoschultz.com

 

[Guided_by_Voices]

That is the problem I have, The cortisone injections I get every 4 months are also interarticular. Straight through the anterior deltoid into the glenohumeral joint. With no doubt at all, this goes systemic in around 24 hours as I start feeling some pain relief in my low back. The hyaluronic injections don't go systemic because it is a very thick liquid and stays in the joint. HGH should be much like cortisone and disperse quickly and go systemic. Micro injections might help saturate the area better meaning 4-5 injections of 0.5iu. I have done this very successfully with surgery. I will listen to the interview again. Thanks.

I did find this study that seems to be one of the only studies one on HGH injections for osteoarthritis. Seems like something I will try for sure. My doctor uses a ethyl chloride topical anesthetic spray and then does the injection. It is absolutely painless.

Intra-articular injections of 5.0 mgm of Human Growth hormone(Omnitrope, Sandoz) were give weekly for 5 to 12 weeks.

https://www.oarsijournal.com/article/S1063-4584(12)00584-5/fulltext

Here is a good article about this:

HGH for Osteoarthritis?

HGH for osteoarthritis is a hot topic in the medical community. Dr. Centeno digs into the claims that it will regrow normal cartilage.

centenoschultz.com

Thanks for posting the study. What's really missing here is a large population of patients who have had the procedure under varying conditions whose results can be tracked. Perhaps that will start to happen with the AOD peptide therapies. Best of luck with whatever you try.

Dr. Centeno also wrote an article that said there are other factors besides cartilage that determine pain and function, and that apparently some people who are "bone on bone" can regain a lot of function without necessarily re-growing cartilage. That was on the Regenexx blog but I have not gone back and tracked that down since I thankfully don't have that issue, however the take-away would be that there could be other things besides cartilage that the HGH is benefiting.

 

[Deleted member 43589]

Looks like the dosing of the HGH was 5mg or 15iu once a month. That is a pretty stiff dose but once a month would be very easy to handle. He also said he saw a thickness of the cartilage in the 1st month. He also added that it stayed local for about 4 hours and then went systemic. About what I thought. He thinks this was a direct reaction between HGH and chondrocytes. Interesting stuff. I am going to mention this to my Ortho and see if he will do the HGH injection with the hyaluronic injections.

Can HGH Help Relieve Osteoarthritis? - Life Extension

Current statistics show that 43 million Americans have arthritis.

www.lifeextension.com

 

[Guided_by_Voices]

Looks like the dosing of the HGH was 5mg or 15iu once a month. That is a pretty stiff dose but once a month would be very easy to handle. He also said he saw a thickness of the cartilage in the 1st month. He also added that it stayed local for about 4 hours and then went systemic. About what I thought. He thinks this was a direct reaction between HGH and chondrocytes. Interesting stuff. I am going to mention this to my Ortho and see if he will do the HGH injection with the hyaluronic injections.

Can HGH Help Relieve Osteoarthritis? - Life Extension

Current statistics show that 43 million Americans have arthritis.

www.lifeextension.com

Ah, that makes more sense. My bad. I heard it wrong. Also, I think the once-a-month was due to regulatory issues which he was later able to get around and shorten the interval, but either way seems reasonable.

 

[Deleted member 43589]

Yes, it was due to FDA regulatory issues. What a shame that HGH is treated like a schedule I drug, especially when it is not even listed under the controlled substance act. The only laws for HGH are Section 303 (e)(1)of the *** Federal Food, Drug, and Cosmetic Act (FD&C Act), *** 21 U.S.C. 333 (e)(1), prohibits knowingly distributing, or possessing with the intent to distribute. In fact Atty. Rick Collins says, "Human growth hormone is considered the most regulated drug in the United States." Seems simple possession is not a problem but possession with the intent to sell is a felony.

 

[JimGainz]

Personally, I have found thst running low dose anabolics ( Anavar and/or nandrolon)with TRT plus IM BPC 157, GHRP like Ipamorelin, combined with low intensity weight training to be the best. The protocol will lower inflammation and build some much needed muscle to help stabilize the joints.

 

[Keepfit1]

Personally, I have found thst running low dose anabolics ( Anavar and/or nandrolon)with TRT plus IM BPC 157, GHRP like Ipamorelin, combined with low intensity weight training to be the best. The protocol will lower inflammation and build some much needed muscle to help stabilize the joints.

what sort of doses did you use

 

[mcs]

Yes, in reading the Regenexx blog, they completely ignore or are dismissive of making sure that the body's own regenerative landscape is in good order. If I was going to do stem cells I would use the compounds above, especially HGH at the same time, but it sounds like a patient would have to source them separately and most patients would not even know it was an option.

Where are you seeing that in the Regenexx blog? I have just finished having an in-depth consultation with my local Regenexx clinic and I'm looking at having several joint issues addressed using a combination of special concentrate PRP and BMAC stem cell injections. I brought this issue of getting the preop inflammatory landscape under control before any type of procedures using orthobiologics. I am not sure what more I can do than I've already done. CRP (2.1) is still in the moderate range - always has been no matter what I do or take.

 

[Guided_by_Voices]

Where are you seeing that in the Regenexx blog? I have just finished having an in-depth consultation with my local Regenexx clinic and I'm looking at having several joint issues addressed using a combination of special concentrate PRP and BMAC stem cell injections. I brought this issue of getting the preop inflammatory landscape under control before any type of procedures using orthobiologics. I am not sure what more I can do than I've already done. CRP (2.1) is still in the moderate range - always has been no matter what I do or take.

It’s not what I’m seeing on their blog but what I’m not seeing. While they seem like a legit outfit and I would strongly consider them if I was considering stem cells, they (IMO) are way too focused on a few modalities and are silent or dismissive of other things that would likely increase the chances of success, such as everything in the Fixes for Joint Issues thread which I’ll link below, especially the usual-suspect peptides (e.g. BPC, TB 500, MGF, HGH, etc.). I say “dismissive” because back when comments were enabled on their blog there was an exchange with Dr. Centeno where he basically said that he wasn’t familiar with regenerative peptides (!) such as we discuss in this thread, and that he didn’t think there were enough studies to support their use. Since then he seems to have become aware of HGH (I recently started reading his blog again and he mentioned it) but there weren’t many studies in the early days of PRP and stem cell either. Further, there never seem to be many studies on things that aren’t patentable/proprietary/highly profitable which peptides that the body already produces aren’t. On top of that, it would be very difficult to pin down exactly what compound is doing what, or what synergistic compounds are required given the number of pathways involved and the potential for overlap even if studies were done. It just seems like common sense to give things a try that many report having benefit and which are cheap and safe and would make sense to do in conjunction with stem cells anyway to further aid healing.

Bottom line: If you’re going to spend the money and time to do a stem cell treatment, a reasonable person would 1) heal as much of the problem first as possible by doing, for example everything in the link below (and likely other things as well such as Mechano Growth Factor) and 2) create the most pro-healing environment possible, partially by giving the body all the compounds it might need (including a higher level of HGH that you are likely to naturally have, at least for some period of time) and let the body sort through what it wants to use. If Regenexx is your stem cell provider you will need to find someone else to do the rest (unless they have gotten up to speed on this), such as Dr. Yurth of Boulder Longevity who I referenced earlier in this thread (although I think she also does Stem Cells as well.)

Regarding CRP, that screams food sensitivity, which as I mentioned in the link was key to resolving most of my knee issues. The carnivore people seem to report rock-botton CRP so you might consider a trial of that, but that is a big red flag that you would want to fix since a food sensitivity that is manifesting as joint inflammation would likely just re-damage the joint even if stem cells temporarily fixed it.

Fixes for Joint Issues: A list of Some Basics

Every few months or so, a post seems to come along saying something along the lines of “should I do PRP or Stem Cells or Nandrolone or anti-inflammatory injections or [insert something exotic here] for joint issues”. While all of these and others likely have their place, they are often either...

www.excelmale.com

 

[mcs]

It’s not what I’m seeing on their blog but what I’m not seeing. While they seem like a legit outfit and I would strongly consider them if I was considering stem cells, they (IMO) are way too focused on a few modalities and are silent or dismissive of other things that would likely increase the chances of success, such as everything in the Fixes for Joint Issues thread which I’ll link below, especially the usual-suspect peptides (e.g. BPC, TB 500, MGF, HGH, etc.). I say “dismissive” because back when comments were enabled on their blog there was an exchange with Dr. Centeno where he basically said that he wasn’t familiar with regenerative peptides (!) such as we discuss in this thread, and that he didn’t think there were enough studies to support their use. Since then he seems to have become aware of HGH (I recently started reading his blog again and he mentioned it) but there weren’t many studies in the early days of PRP and stem cell either. Further, there never seem to be many studies on things that aren’t patentable/proprietary/highly profitable which peptides that the body already produces aren’t. On top of that, it would be very difficult to pin down exactly what compound is doing what, or what synergistic compounds are required given the number of pathways involved and the potential for overlap even if studies were done. It just seems like common sense to give things a try that many report having benefit and which are cheap and safe and would make sense to do in conjunction with stem cells anyway to further aid healing.

Bottom line: If you’re going to spend the money and time to do a stem cell treatment, a reasonable person would 1) heal as much of the problem first as possible by doing, for example everything in the link below (and likely other things as well such as Mechano Growth Factor) and 2) create the most pro-healing environment possible, partially by giving the body all the compounds it might need (including a higher level of HGH that you are likely to naturally have, at least for some period of time) and let the body sort through what it wants to use. If Regenexx is your stem cell provider you will need to find someone else to do the rest (unless they have gotten up to speed on this), such as Dr. Yurth of Boulder Longevity who I referenced earlier in this thread (although I think she also does Stem Cells as well.)

Regarding CRP, that screams food sensitivity, which as I mentioned in the link was key to resolving most of my knee issues. The carnivore people seem to report rock-botton CRP so you might consider a trial of that, but that is a big red flag that you would want to fix since a food sensitivity that is manifesting as joint inflammation would likely just re-damage the joint even if stem cells temporarily fixed it.

Fixes for Joint Issues: A list of Some Basics

Every few months or so, a post seems to come along saying something along the lines of “should I do PRP or Stem Cells or Nandrolone or anti-inflammatory injections or [insert something exotic here] for joint issues”. While all of these and others likely have their place, they are often either...

www.excelmale.com

Appreciate the in-depth response.

Although many of Centeno's patients inquire about BPC-157, he remains skeptical of peptides in general mainly due to his past fight with the FDA over his clinic's PRP/stem cell protocols which made him skittish about adding compounds that have, at best, only anecdotal reports and no human studies as of yet.

I talked to my local Regenexx clinic doc and mentioned that I use peptides and he confirmed the above re Dr. C. He further mentioned that one of the Regenexx clinics in the south has started to use BPC-157 with some of the patients, so Dr. C knows the mounting positive anecdotes have to mean something and I believe it is only a matter of time that he will come around the bend.

Does the BPC 157 Peptide Work? | Regenexx® at New Regeneration Orthopedics

The word peptide refers to collections of amino acids that are joined together by chemical bonds. In orthopedics, peptides have been increasing in mainstream popularity. Specifically, a peptide known as Body Protection Compound 157 or BPC 157 has been touted to accelerate tissue healing.

newregenortho.com

An Update on the Magic Wolverine Peptide Called BPC-157 - Regenexx

Regenexx offers non-surgical, regenerative orthopedic treatment options for pain related to osteoarthritis, joint injuries, overuse conditions, spine pain, and common sports injuries.

regenexx.com

CRP is a nonspecific inflammatory marker, so it is anyone's guess what the etiology(s) could be. First things come to mind in addition to possible food sensitivities - hypertension and SIBO. Unfortunately, there are no food sensitivity diagnostics I know of that are reliable and that yield any consistent reproducibility, let alone utility on which to base an actionable protocol, as most of the methodology is based on the IgG delayed food sensitivity model whereby elevated IgG antibody levels have been debunked as normal, non-pathologic responses in recent years.

I agree that the ortho pre-op milieu is rarely ever addressed, except with cutting-edge docs like Dr. Yurth who has made that very clear in many YouTube videos. I considered seeking her out for my MSK issues, however, the distance logistics would make it inconvenient since I would have to travel back and forth each time I need immediate follow up care first-hand.

For me, the two biggest issues in stem cell therapy I am still somewhat skeptical of are:

1) harvesting BMAC MSCs from patients >50. Considering cellular senescence increases over time, could this cancel the benefits of stem cell therapy? This is the marketing tool that the clinics promoting non-autologous stem cells products (i.e. birth tissue) use against autologous (bone marrow/adipose tissue) stem cell harvesting. Dr. C address that here.

2) Regenexx does what's called a viability test of the harvested MSCs which is good. But, here in the States, we are limited by a finite number of those cells, as it is not legal to use cultured MSCs since it would be considered a drug product. That's why Regenexx has what's called Regenexx-C which is only offered outside the U.S., in the Caymans. The cost starts at $20K and goes up from there. Not an option for most folks, except for the affluent few that like to travel to do their medical procedures.

 

[Guided_by_Voices]

Appreciate the in-depth response.

Although many of Centeno's patients inquire about BPC-157, he remains skeptical of peptides in general mainly due to his past fight with the FDA over his clinic's PRP/stem cell protocols which made him skittish about adding compounds that have, at best, only anecdotal reports and no human studies as of yet.

I talked to my local Regenexx clinic doc and mentioned that I use peptides and he confirmed the above re Dr. C. He further mentioned that one of the Regenexx clinics in the south has started to use BPC-157 with some of the patients, so Dr. C knows the mounting positive anecdotes have to mean something and I believe it is only a matter of time that he will come around the bend.

Does the BPC 157 Peptide Work? | Regenexx® at New Regeneration Orthopedics

The word peptide refers to collections of amino acids that are joined together by chemical bonds. In orthopedics, peptides have been increasing in mainstream popularity. Specifically, a peptide known as Body Protection Compound 157 or BPC 157 has been touted to accelerate tissue healing.

newregenortho.com

An Update on the Magic Wolverine Peptide Called BPC-157 - Regenexx

Regenexx offers non-surgical, regenerative orthopedic treatment options for pain related to osteoarthritis, joint injuries, overuse conditions, spine pain, and common sports injuries.

regenexx.com

CRP is a nonspecific inflammatory marker, so it is anyone's guess what the etiology(s) could be. First things come to mind in addition to possible food sensitivities - hypertension and SIBO. Unfortunately, there are no food sensitivity diagnostics I know of that are reliable and that yield any consistent reproducibility, let alone utility on which to base an actionable protocol, as most of the methodology is based on the IgG delayed food sensitivity model whereby elevated IgG antibody levels have been debunked as normal, non-pathologic responses in recent years.

I agree that the ortho pre-op milieu is rarely ever addressed, except with cutting-edge docs like Dr. Yurth who has made that very clear in many YouTube videos. I considered seeking her out for my MSK issues, however, the distance logistics would make it inconvenient since I would have to travel back and forth each time I need immediate follow up care first-hand.

For me, the two biggest issues in stem cell therapy I am still somewhat skeptical of are:

1) harvesting BMAC MSCs from patients >50. Considering cellular senescence increases over time, could this cancel the benefits of stem cell therapy? This is the marketing tool that the clinics promoting non-autologous stem cells products (i.e. birth tissue) use against autologous (bone marrow/adipose tissue) stem cell harvesting. Dr. C address that here.

2) Regenexx does what's called a viability test of the harvested MSCs which is good. But, here in the States, we are limited by a finite number of those cells, as it is not legal to use cultured MSCs since it would be considered a drug product. That's why Regenexx has what's called Regenexx-C which is only offered outside the U.S., in the Caymans. The cost starts at $20K and goes up from there. Not an option for most folks, except for the affluent few that like to travel to do their medical procedures.

I don't really have any insight on the senescense issue other than it may make sense to do a round of senolytics such as rapamycin and/or azithromycin before harvesting the stem cells, although I have no idea if that would help, but rapamycin is something that seems to make a lot of sense on an intermittent basis no matter what, something like 4-6mg every other week is a protocol many people use for general anti-aging.

Regarding food sensitivities, a good old-fashioned elimination diet seems like a good option and an accidental version of that is how I figured out that whey protien was a problem for me. At a minimum, eliminating all the high-risk foods for a while such as seed oils, wheat, eggs, processed foods, dairy (except for butter), legumes and most plant matter will go a long way to tell if that is part of the issue for you. Good luck with your journey.

I can understand Dr. C's concern with regulatory issues, but other Drs seem to use peptides with no problem, it seems reasonable to at least educate the patient as to the options, and a lot of other things like those in the Joint Issues thread have no regulatory issue.

 

[Deleted member 43589]

I just wanted to add to my little experiment with hGH, BPC 157 and TB500 on osteoarthritis. I followed Dr. Dun's regiment to the T and also added the other peptides as prescribed by other Florida doctors. I did this for quite a bit longer that any of these guys did and went through 2 kits if hGH, 2 kits of BPC 157 and 2 kits of TB 500 all injections were done directly into the joint. While I used all three the pain was greatly reduced. However, after I stopped the pain slowly started to return. So it is possible the liquid from all three injections helped and most likely the temporarily reduced inflammation. The real test over time, did any of it regrow bone or anything else. Unfortunately, the answered is NO. I did e-rays on my knee in 2021 and again yesterday and the results show the osteoarthritis is worse and the small gap I had in the medial meniscus and totally gone now and it is bone on bone with quite a lot of visible inflammation. Here is the official diagnoses from the x-rays done yesterday:

Left Knee X-ray Views: 4 view weight bearing series was reviewed Findings: Evidence of tricompartmental osteoarthritis with bone on bone deformity in the medial compartment. There are marginal osteophytes and subchondral sclerosis. Comparison with Prior Films: Progressive loss of joint line space when compared to x-rays from 04/2021

What amazes me is there are a lot of doctors in Florida pushing expensive treatment for osteoarthritis using hGH, BPC 150/TB 500 and do not accept insurance. Of course insurance will not cover these controversial treatments because there is absolutely no evidence they work. I am not surprised since there is a very large population of retired people in Miami and obviously lots of older people seeing help with pain in their joints. So IMHO, the snake oil salesmen come a running. I gave this a realistic try hoping it would work but after 3 months or so and doing a while lot more of the hGH/BPC 157/ TB 500 that these guys used and for a longer period of time, I have evidence it it did absolutely nothing to help my osteoarthritis in the knee or the shoulder. The inflammation in both joints is worse. Of course I am disappointed but life goes on and I will just keep managing the pain.

Subchondral sclerosis is the hardening of the bone just below the cartilage surface12. It is a sign of later-stage osteoarthritis (OA)12. It is common in the bones found at the load-bearing joints, such as knees and hips, but other joints can also be affected1. Subchondral sclerosis is a radiological finding that indicates OA progression2.

 

[sammmy]

Very low sugar diet should suppress the arthritis inflammation. Possible mechanisms are that it suppresses the immune reaction at the core of arthritis, or maybe it starves the intestinal bacteria which feeds on sugar and stimulates the immune system, so the effect is again decreasing the immune system activity.

2 years ago, my hip joint started aching and I was limping, thinking I was developing arthritis and I was younger than 50 years. It turned out it was inflammation from one of my HIV drugs (integrase inhibitor), which I suppressed successfully by stopping eating sugar, not even fruits. Nowadays, I have vit C deficiency because of that, but you can avoid it by eating green vegetables or red peppers that have little sugar and lots of vitamin C and other vitamins.

 

[Deleted member 43589]

My doctor prescribed me a Medrol pac and I got started yesterday. At least I can have a week of some pain relief. She also gave me a script of Celebrix. That relieves the pain some as long as I don't take it every day.

The BPC 157 does have some anti-inflammatory effects as does TB 500 but it only last a few days. It would amount to doing a kit/month to keep the pain down. Eventually I will break down and have knee replacement surgery done. That is not so bad and I can eventually retune to full activity. I am also planning on seeing a pain management doctor for the low back after the 1st of the year.

Other than the shoulder, today is the 1st day in a while that I have not been hurting pretty badly.

 

[mcs]

I just wanted to add to my little experiment with hGH, BPC 157 and TB500 on osteoarthritis. I followed Dr. Dun's regiment to the T and also added the other peptides as prescribed by other Florida doctors. I did this for quite a bit longer that any of these guys did and went through 2 kits if hGH, 2 kits of BPC 157 and 2 kits of TB 500 all injections were done directly into the joint. While I used all three the pain was greatly reduced. However, after I stopped the pain slowly started to return. So it is possible the liquid from all three injections helped and most likely the temporarily reduced inflammation. The real test over time, did any of it regrow bone or anything else. Unfortunately, the answered is NO. I did e-rays on my knee in 2021 and again yesterday and the results show the osteoarthritis is worse and the small gap I had in the medial meniscus and totally gone now and it is bone on bone with quite a lot of visible inflammation. Here is the official diagnoses from the x-rays done yesterday:

Left Knee X-ray Views: 4 view weight bearing series was reviewed Findings: Evidence of tricompartmental osteoarthritis with bone on bone deformity in the medial compartment. There are marginal osteophytes and subchondral sclerosis. Comparison with Prior Films: Progressive loss of joint line space when compared to x-rays from 04/2021

What amazes me is there are a lot of doctors in Florida pushing expensive treatment for osteoarthritis using hGH, BPC 150/TB 500 and do not accept insurance. Of course insurance will not cover these controversial treatments because there is absolutely no evidence they work. I am not surprised since there is a very large population of retired people in Miami and obviously lots of older people seeing help with pain in their joints. So IMHO, the snake oil salesmen come a running. I gave this a realistic try hoping it would work but after 6 months or so and doing a while lot more of the hGH/BPC 157/ TB 500 that these guys used and for a longer period of time, I have evidence it it did absolutely nothing to help my osteoarthritis in the knee or the shoulder. The inflammation in both joints is worse. Of course I am disappointed but life goes on and I will just keep managing the pain.

Subchondral sclerosis is the hardening of the bone just below the cartilage surface12. It is a sign of later-stage osteoarthritis (OA)12. It is common in the bones found at the load-bearing joints, such as knees and hips, but other joints can also be affected1. Subchondral sclerosis is a radiological finding that indicates OA progression2.

Assuming you did intra-articular injection without ultrasound guidance, how do you know you were actually administering into the joint?

 

[Deleted member 43589]

Its honestly not that hard to figure out where the joint is in your knee unless you are fat. I have very low body fat (especially on the knee). I have also had quite a few injections in my knee by my ortho. Now the shoulder is much more difficult but I have no rear rotators so my doctor showed me exactly where to inject. You absolutely don't need ultral sound to inject most knees. Heck the 1st time I got an injection I showed my doctor exactly where he would inject. You can feel the gap between the bone, especially when there is no meniscus. Besides if you miss, its simple, you hit bone. Doctors in this field do what is called "blind" injections all the time.

I have used hGH successfully for years in healing and muscular growth/fat loss. I have also used BPC 157 for injuries many times over the past 10 years very successfully for IMHO all these doctors pushing this treatment are selling snake oil praying off the pain of older people who have no other options other than surgery. PRP included. I was part of a study in 2010 to use this stuff and have had quite a few injection in both the knee and shoulder and it has done nothing to improve my condition. Exactly why insurance will not cover it. IGF-1 injections work much better.

 

[Guided_by_Voices]

My doctor prescribed me a Medrol pac and I got started yesterday. At least I can have a week of some pain relief. She also gave me a script of Celebrix. That relieves the pain some as long as I don't take it every day.

The BPC 157 does have some anti-inflammatory effects as does TB 500 but it only last a few days. It would amount to doing a kit/month to keep the pain down. Eventually I will break down and have knee replacement surgery done. That is not so bad and I can eventually retune to full activity. I am also planning on seeing a pain management doctor for the low back after the 1st of the year.

Other than the shoulder, today is the 1st day in a while that I have not been hurting pretty badly.

Thanks for the update and I'm sorry to hear that you didn't get more benefit, but you are certainly another role model for citizen science and citizen journalism! An obvious question is whether there is a point of damage beyond which certain therapies won't help but which might be helped with intervention at an earlier stage, but that will have to wait for the experimentation of others. I recently saw a Nextdoor social media post about some sort of knee injections (I am forgetting the substance used, Hyaluronic Acid possibly) but the responses basically came back in thirds. One third got no benefit, one third got benefit for a while, and one third got long-term benefit, so there is a lot to learn.

 

[Deleted member 43589]

I believe in the work published the cases were mild to moderate. Mine surpassed that long ago and is considered severe. I also take glucosamine and collagen peptides and I have seen no changed. I am strongly considering dropping both of those. The only thing that has helped my knee is hyaluronic acid injections but it did nothing for the should and they even did ultrasound guided injections with the shoulder. The Medrol pack they prescribed has helped with the little knee pain I had plus the back pain, but zero with the shoulder. I am happy to just have the shoulder pain. I actually got up this morning and mowed the yard.

 

[testiculus]

I believe in the work published the cases were mild to moderate. Mine surpassed that long ago and is considered severe. I also take glucosamine and collagen peptides and I have seen no changed. I am strongly considering dropping both of those. The only thing that has helped my knee is hyaluronic acid injections but it did nothing for the should and they even did ultrasound guided injections with the shoulder. The Medrol pack they prescribed has helped with the little knee pain I had plus the back pain, but zero with the shoulder. I am happy to just have the shoulder pain. I actually got up this morning and mowed the yard.

Glad you're getting some relief. Here's something else that might help if you can find a way to source it:

Effect of Intra-Articular Sprifermin vs Placebo on Femorotibial Joint Cartilage Thickness in Patients With Osteoarthritis
Key Points
Question Does intra-articular administration of sprifermin structurally modify cartilage, as measured by cartilage thickness on quantitative magnetic resonance imaging, in patients with knee osteoarthritis?

Findings In this dose-finding trial including 549 participants randomized to 30 μg or 100 μg of sprifermin every 6 or 12 months vs placebo, there was a significant increase after 2 years in total femorotibial cartilage thickness for 100 μg of sprifermin every 6 months (0.05 mm) and every 12 months (0.04 mm).

Meaning Compared with placebo, intra-articular administration of 100 μg of sprifermin every 6 or 12 months resulted in improvement in femorotibial joint cartilage thickness after 2 years that was statistically significant, but of uncertain clinical importance; the durability of response also was uncertain.

Sprifermin maintains long-term cartilage structural improvements in knee osteoarthritis
According to the researchers, sprifermin demonstrated a significant dose response in total femorotibial joint cartilage thickness (P < .001), as well as a 0.05mm mean difference with the 100-µg dose given every 6 months, compared with placebo (95%CI, 0- 0.1), sustained to year 5. In addition, WOMAC pain scores improved approximately 50% from baseline in all groups. No participants who received 100µg every 6 months underwent replacement of the treated knee.