October 2023
Soaking your hands in a water/dextrose solution reduces reduces and at times stops the pain of basal thumb arthritis.
Here is my story. I am 69 years
old.
Four years ago, I was diagnosed with Basal Thumb arthritis
in both hands. I tried cortisone injections
and exercises/stretching and neither helped.
The exercises increased my pain. When
I went to the OT she mentioned one of her patients was getting sugar injections. My husband is a chemist and he looked into what
is known about sugar for basil thumb arthritis.
He found dextrose (a.k.a. glucose) is absorbed through the skin and is used
by the body to make galactose that is required for joint lubrication. I have
been soaking my hands in for 2 ½ years which has reduced my pain substantially
and most of the time I am in no pain.
When I first started, I soaked my hands for 10 minutes each
day. Now I soak a few times a week
depending on what activities I have done or how my hands are feeling. For activities which I know will increase the
pain I soak before and after. Gardening
and birding (holding binoculars) can increase my pain. I have had to adjust my gardening but not my
bird watching. I also wear the push meta grip hand braces for these activities which
I learned about from this group.
When I was 1st diagnosed I didn’t realize I was
in constant pain until they numbed my hand for the cortisone injection. I had my worse hand done 1st and
on the way home my ‘better’ hand hurt. I didn’t realize I was in constant
pain.
I started the soaks 2 ½ years ago. I soaked both hands daily. In about 4 weeks I saw consistent improvement
in pain reduction. I have also modified
my activities, got some adaptive kitchen tools and as I mentioned above I wear
push meta grip for activities which can increase my pain.
Mix 130 grams or 7/8 of a cup of dextrose
in 5 cups of water.
You can use a scale to weigh 130 grams or use a dry measure measuring cup for 7/8 cup.
You want the solution to be around
body temperature (98 to 100 degrees). When
I make the solution, I heat the water before adding the sugar. When I reuse the solution, I put around ¾ of
cup of the solution in microwave and heat on high for about 1 ½ minutes. The solution will keep at room temperature for
a few days. When it starts to smell or
gets really cloudy make a new batch.
Make sure to wash your hands before and after your soaks. I got a skin rash during the 2nd month. I have not gotten a rash since I started washing my hands after I soak.
Here is a link for ordering the dextrose by Nutricost. .Order Dextrose
Decreasing Pain and Joint Space Narrowing with D-Glucose Soaks
A Tale of Two Sugars – D-Glucose (a.k.a. Dextrose) and D-Galactose
by Dennis N Crouse
My wife has
been diagnosed by x-ray with osteoarthritis in both of her first carpometacarpal (CMC) joints of her left and right hands.
This joint is at the base of thumb and is also called the trapeziometacarpal
(TMC) joint. Carpometacarpal osteoarthritis (CMC OA or TMC
OA)) of the thumb is painful and occurs when the cushioning cartilage of the
joint surfaces wears away (at arrow in figure 1) and/or the metacarpal bone
becomes offset from the joint as seen by x-ray:
When joint
space narrowing occurs, the cartilage no longer keeps the bones
a normal distance apart. This can be painful as the bones can put too much
pressure on each other. Joint space narrowing is seen in osteoarthritis
(OA) or rheumatoid arthritis (RA). A
proposed solution is to both lower the pain and widen joint space by promoting
the increase of proteoglycans, such as aggrecan
required for cartilage restoration and lubricin for joint and tendon sheath
lubrication. This may be possible with periodically (i.e., every few days)
soaking of the hands in 10% D-glucose for 10 minutes. The dextrose is converted
to D-galactose by the body and they diffuse into the synovial fluid that
surrounds the joint. Both D-glucose and D-galactose are biosynthesized to
aggrecan and lubricin that keep the joint lubricated.
Articular cartilage is the smooth, white tissue that covers the ends of
bones where they come together to form joints. Healthy articular cartilage in
our joints makes it easier to move as it allows the bones to glide over each
other with very little friction. Articular
cartilage contains up to 10% proteoglycan by weight, most of which is aggrecan.
Aggrecan consists of many galactose-containing
chondroitin and keratan sulfate glycosaminoglycan chains in a bottlebrush
structure. Aggrecan’s loss is an early sign of OA or RA.
Lubricin (a.k.a. proteoglycan 4) is a mucinous,
synovial fluid glycoprotein that enables near frictionless joint motion via
both adsorption to the surface of articular cartilage and its lubricating
properties in solution. Lubricin is biosynthesized by chondrocytes located at the surface of articular
cartilage, and also by
synovial lining cells. In total, lubricin is approximately 200nm +/- 50 nm in
length and has a diameter of a few nanometers (see
figure 2). The glycoprotein
consists of >5% serine and >20% threonine residues, which give rise to a
large number of O-glycosylations. This glycosylated mucin-like domain is
thought to contain short polar (-GalNAc-Gal) and negatively charged
(-GalNAc-Gal-NeuAc−) sugar groups with Gal being D-galactose. Synovial
fluid of patients with OA and RA has been shown to exhibit reduced levels of
lubricin when compared to healthy patients. (Kosinska)
Figure 2. Not drawn to scale as 98% of lubricin’s length is
galactose containing filaments represented in blue linked by O-glycosylations
to serine and threonine residues in the core of the bottlebrush.
Another component of articular
cartilage and synovial fluid is hyaluronic acid (HA) a glycosaminoglycan that
with lubricin are the fluid’s main lubricating components. (Wiki) HA is a long
chain of two alternating glucose derivatives: glucuronic acid and N-acetylglucosamine.
Lower than normal levels of
the following are found in the synovial fluid of those with TMC OA:
·
D-Glucose –
precursor of D-galactose
·
Lubricin (a.k.a.
proteoglycan 4, PRG4) - a superficial zone protein (SZP) (Kosinska)
·
Chondroitin sulfate
proteoglycans (CSPGs) - protein core and chondroitin side chain
·
Hyaluronic acid (HA)
– a non-sulfated glycosaminoglycan whose molecular
weight is also shifted lower in OA and RA (Kosinska)
The MOVES study published in
2016 demonstrated that chondroitin sulfate (CH, 1,200mg/day) and glucosamine
hydrochloride (GH, 1,500mg/day) augmentation (i.e.,
400mg CH and 500mg GH 3 times per day orally) has been shown after 6 months to
lower joint pain by 50%. (Hochberg) This conclusion is supported by a 2015
meta-analysis of recent published research indicating that both CH and GH alone
can reduce joint space narrowing. (Zeng)
Glucosamine sulfate is more orally bioavailable than glucosamine
hydrochloride. (Meulyzer) It has been shown that daily oral glucosamine sulfate
augmentation (1,500mg/day) increases plasma and synovial fluid concentrations
of glucosamine by more than 20-fold. (Persiani)
In addition, several
injections of glucose into the synovial fluid of the TMC joint can lower pain
for a year by 50% and reduce joint space narrowing by 14%. (Reeves) Increasing
D-glucose in the synovial fluid surrounding the TMC joint can be done by:
·
Monthly injections of
10% glucose into the joint’s synovial fluid (i.e., prolotherapy)
·
Periodic soaking
both hands and wrists in a warm aqueous 10% solution of D-glucose
·
Daily augmenting
with D-glucose and D-galactose as lactose in whole or skim milk
Adults endogenously produce
approximately 1 gram of D-galactose every day but this declines by 50% due to
aging. One cup of whole or skim milk contains 6 grams of D-galactose and 6
grams of D-glucose both of which make up lactose. D-Galactose augmentation does
not impact D-galactose endogenous production. (Bosch)
Prolotherapy with D-Glucose for TMC
Joint Osteoarthritis
Prolotherapy with one half cc of 10% d-glucose injected into the TMC joint at 0, 2,
and 4 months with assessment at 6 and 12 months showed a 42% improvement pain
after finger and thumb movement. Significant reduction in joint space narrowing
(14%) was observed at 12 months versus 7% joint space narrowing in the group
receiving a placebo. (Reeves)
Similarly, monthly prolotherapy for 3 months with 20% d-glucose compared with a single dose of methylprednisolone at 3 months showed 3 months after
the last injection that both d-glucose
and methylprednisolone increased functional level, but d-glucose seemed to be more
effective. (Jahan)
Note that one-half cc of a 10% d-glucose solution contains only 50mg of
d-glucose. (Giri)
Soaking Therapy with D-Glucose for TMC
Joint Osteoarthritis
Diffusion of one-half cc of 10% d-glucose in water could occur in 10 to
20 minutes of soaking a human hand in 10% D-glucose. For instance, a human foot exposed to
water takes in 1–2 gm of water per hour or 1/6 to 1/3cc in 10 minutes. A small
portion of this uptake is imbibed by the stratum corneum, the major portion
seems to enter the system. The transfer has been observed for periods exceeding
50 hours. (Buettner) d-Glucose in water has been shown to
passively diffuse through skin. (Kang)
Soaking the entire hand and 1 inch up
the wrist in 10% D-glucose for 10 minutes daily for a week reduced the TMC
joint pain. The benefits of this soaking can last for several weeks. Soaking in
higher concentrations of sugar can cause skin irritation. To avoid skin
irritation and hives always wash hands and wrists before and after soaking. The
D-glucose (dextrose) was packed by Nutricost and purchased from Amazon. Order Dextrose
