Accelerating the healing of injuries with nutrients.

Recovery from injuries due to outdoor activities can often be hastened with the aid of nutritional supplements. Take vitamin C and the healing of fractures as an example. Compared to controls, rats with tibial fractures given a single high dose of vitamin C went through the stages of fracture healing faster. (1)

Moreover, a double-blind study reported in The Lancet randomly gave 123 adults who had sustained wrist fractures either 500 mg ascorbic acid or placebo daily for 50 days. While 22% of patients in the placebo group developed reflex sympathetic dystrophy (persistent pain along with skin and other changes near the site of the injury) over the next year, it developed in only seven percent of the supplemented group. (2) A larger dose-response study by the same research group confirmed these findings and noted little, if any, additional benefit from a higher dosage. (3)

Several nutrients can aid in the recovery from traumatic brain injuries. In one study, half of a group of 68 victims of severe closed head injuries randomly received supplemental zinc in addition to standard treatment Twenty-eight days after injury, 26% of the controls had died compared to only 12% of the supplemented patients, and a measure of coma was significantly better in the supplemented group. (4)

Citicoline, also called CDP-choline, is an essential intermediate in the synthesis of the structural phospholipids of cell membranes and has been studied extensively for its neuroprotective effects following head trauma. (5) Also, animal work has shown that creatine supplementation prior to brain (6) or spinal cord (7) injury is strongly neuroprotective, suggesting that the supplement could help to minimize acute and delayed neurodegenerative processes. (6) In a randomized study, 39 children and adolescents with traumatic brain injury received 0.4 gr/kg of creatine daily in an oral suspension. Compared to controls, supplementation was associated with statistically significant improvements in the categories of cognitive, personality/behavior, self-care, and communication aspects in all patients--and there were no side effects. (8)

While there have been fears that supplementation with creatine before strenuous exertion could cause an increase in muscle strains or tears, these fears have proved to be unfounded. (9) In fact, when, prior to a 30 km race, experienced marathon runners were supplemented for five days with 15 g maltodextrine daily with or without 5 gr creatine, creatine was found to reduce markers of cell damage and inflammation. (10) Moreover, when experienced football players took 0.3 g/kg creatine daily for five days followed by an average of 0.03 g/kg per day after workouts, practices, and games, the incidence of cramping or injury was significantly reduced. (11)

Because of their free-radical-quenching, iron-chelating, and anti-inflammatory properties, flavonoids such as quercetin may also reduce the effects of brain and spinal cord injuries. (12) When, for example, athletes were administered citrus flavonoids prior to injury in a series of controlled trials from the 1960s, they were protected against sprains, and recovery time was greatly reduced. (13)

Sports may cause damage to the cartilage of the kneecap {chondropathia patellae), and glucosamine sulfate 500 mg three times daily appears to speed the healing process. (14) In a double-blind study of 106 competitive male athletes following acute knee injury, subjects randomly received either glucosamine 1500 mg daily or placebo. After 28 days, patients from the glucosamine group, as compared to those in the placebo group, demonstrated significant improvement in knee flexion and extension. (15)

Finally, several studies, most of them double-blind, have demonstrated the benefits of administering hydrolytic enzymes following injuries. For example, when players sustained blunt wounds to the soft tissue with distortion of the ankle joint, ice and tape were applied, and one group received hydrolytic enzymes, while the other received placebo. Based on objective measurements of swelling and joint motility as well as on subjective measurements of pain during rest and with motion, recovery was better in the enzyme-treated group. The time during which the players were unable to work or train was found to be significantly reduced by about 50% with enzyme therapy. (16)

Notes

(1.) Yilmaz C, etal. The contribution of vitamin Cto healing of experimental fractures. Arch Orthop Trauma Surg. 2001 |ul;121(7):426-8.

(2.) Zollinger PE, et al. Effect of vitamin C on frequency of reflex sympathetic dystrophy in wrist fractures: a randomised trial. Lancet. 1999; 354:2025-8.

(3.) Zollinger PE, et al. Can vitamin C prevent complex regional pain syndrome in patients with wrist fractures? A randomized, controlled, multicenter dose-response study. J Bone joint Surg. 2007; 89(7):1 424-31.

(4.) Young B, et al. Zinc supplementation is associated with improved neurologic recovery rate and visceral protein levels of patients with severe closed head injury. J Neurotrauma. 1996; 13:25-34.

(5.) Griffin SL, et al. A review of cholinergic agents in the treatment of neurobehavioral deficits following traumatic brain injury, J Neuropsychiatry Clin Neurosci. 2003; 15:17-26.

(6.) Sullivan PC, et al. Dietary supplement creatine protects against traumatic brain injury. Ann Neurol. 2000;48(5):723-9.

(7.) Hausmann ON, et al. Protective effects of oral creatine supplementation on spinal cord injury in rats. Spinal Cord. 2002 Sep; 40(9):449-56.

(8.) Sakellaris G, et al. Prevention of complications related to traumatic brain injury in children and adolescents with creatine administration: an open label randomized pilot study. J Trauma. August 1, 2006; 61(2):322-9.

(9.) Watsford ML, et al. Creatine supplementation and its effect on musculotendinous stiffness and performance, J Strength Cond Res. February 1, 2003; 17(1):26-33,

(10.) Santos RV et al. The effect of creatine supplementation upon inflammatory and muscle soreness markers after a 30 km race. Life Sci. September 3, 2004; 75(16):191 7-24.

(11.) Greenwood M, et al. Cramping and injury incidence in collegiate football players are reduced by creatine supplementation. J Athl Train. September 1, 2001; 38(3):216-19.

(12.) Juurlink BH, Paterson PG. Review of oxidative stress in brain and spinal cord injury: suggestions for pharmacological and nutritional management strategies. J Spinal Cord Med. 1998; 21(4):309-34.

(13.) Broussard MU. Evaluation of citrus bioflavonoids in contact sports. Citrus in Medicine. October 1963; 2(2).

(14.) Bohmer D, et al. Treatment of chondropathia patellae in young athletes with glucosamine sulfate. In Bachl N, et al, eds. Current Topics in Sports Medicine. Proc World Congress of Sports Med, Vienna, 1982. Urban & Schwarzenberg, 1984.

(15.) Ostojic SM, etal. Glucosamine administration in athletes: effects on recovery of acute knee injury. Res Sports Med. April 1, 2007; 15(2):113-24.

(16.) Baumuller M. [Therapy of ankle joint distortions with hydrolytic enzymes: results of double-blind clinical trials.] Allegemeinmedizin. 1990; 19:178-82. fin German)

In his latest book, Dr. Werbach has assembled a unique library of case reports concerning nutritional and herbal treatments for 155 different illnesses. It is available in print or on diskette from Third Line Press Inc., 4751 Viviana Drive, Tarzana, California 91356, USA; 818-996-0076; Fax: [phone]; http://www.third-line.com; e-mail: [e-mail].

by Melvyn R. Werbach, MD [e-mail]