Hyaluronic Acid

I suspect that hyaluronic acid deficiency is significant in both the natural withering experienced in old age and the onset of cancers in the elderly as well.  It certainly slows the development of cancers.

So though it will not be a complete answer, it appears likely to be a valuable addition to the diet as one enters the ranks of the elderly.  This does not give much assistance in terms of dosage although I suspect large dosages to the limits of tolerance is a good beginning to establish the effect.  Then once any effect is optimized, tapering down is certainly called for.

We do not have all the answers yet, but we now know to pay attention.  It may make an excellent carrier for telomeres or something like that.

Hyaluronic Acid

(Hyaluronan) 

Can It Prevent Premature Aging?

 http://www.ctds.info/hyaluronic_acid.html

What is Hyaluronic Acid? 

Hyaluronic acid (also called Hyaluronan) is a component of connective tissue whose function is to cushion and lubricate.  Hyaluronan occurs throughout the body in abundant amounts in many of the places people with hereditary connective tissue disorders have problems such as joints, heart valves and eyes.  Hyaluronic acid abnormalities are a common thread in connective tissue disorders.  Interestingly, they are also common biochemical anomalies in most of the individual features of connective tissue disorders such as mitral valve prolapse, TMJ, osteoarthritis, and keratoconus. 

Hyaluronic acid has been nicknamed by the press as the "key to the fountain of youth" because it has been noted that at least some people who ingest a lot of it in their diets tend to live to ripe old ages. ABC News had a show on a village in Japan and hyaluronic acid entitled, "The Village of Long Life: Could Hyaluronic Acid Be an Anti-Aging Remedy?". (It should be noted that the people in the ABC news show were thought to get high amounts of HA from starchy root vegetables their natural diets. They were not taking supplements.)

While a number of studies have linked abnormal levels of HA to either connective tissue disorders (CTDs) or conditions common in CTDs, such as premature aging, there are also a number of studies on Pubmed noting associations of high levels of HA to some forms of cancer. With HA as with other substances in the human body, such as estrogen and cholesterol, there are most likely optimal levels, and disease often occurs when these levels become out of range in either direction. Low estrogen levels have been linked to bone loss, while high estrogen levels have been associated with breast cancer. High cholesterol levels have been linked to heart attacks and stroke, while low levels have been linked to bleeding problems and depression. HA has been studied less than either cholesterol or estrogen, but the prudent path would be to assume that the body has optimal levels of HA, as it does for cholesterol, estrogen and many other substances.

As such, it is always prudent to consult your doctor before you decide to take HA or any other type of supplement to make sure it is an appropriate treatment for your particular health condition.

---

Hyaluronic Acid and Connective Tissue Disorders 

The list below contains links to a sample of the studies where subjects with connective tissue disorders have been shown to have hyaluronic acid (HA) abnormalities:  

Ehlers-Danlos syndrome  Marfan syndrome Osteogenesis imperfecta   Stickler syndrome

Not surprisingly, these disorders all have a lot of overlapping features, and many of these overlapping features, when studied individually, are also linked to hyaluronic acid abnormalities.  In every study I looked at for connective tissue disorders that examined hyaluronic acid, the levels were always abnormal in patients with connective tissue disorders. 
 
In human and animal studies, hyaluronic acid abnormalities occur in:  

Heart valves with MVP 
TMJ 
Joint instability  
Osteoarthritis  
Detached retinas 
Muscle contractures   

Rachitic skeletal features (pectus excavatum, pectus carinatum, scoliosis, bowed limbs, hypermobility, etc.)  

Glaucoma 
Keratoconus 
Poor scar formation (fetuses do not scar because of the high content of HA in amniotic fluid) 
Acrogeria (prematurely wrinkled skin) 
Fibromyalgia 
Premature aging syndromes* (which share many features with connective tissue disorders, especially Ehlers-Danlos) 
 
Hyaluronic acid, or commercial preparations containing hyaluronic acid, are in use, or being studied to be used, to prevent, treat or aid in the surgical repair for many the types of problems people with connective tissue disorders tend to have such as:

Fractures 
Hernias  
Glaucoma  
Keratoconus 
Detached retinas  
Osteoarthritis (HA injections are the new breakthrough treatment for this condition) 
Muscle contractures  
TMJ 
Prevents scarring 
Vocal cord insufficiency  
Wrinkled skin  
Cartilage damage 
Wound healing 
Ligament Healing 

The list below contains a partial list of common features of several connective tissue disorders.  Both the syndromes and the individual features of the syndrome (even when the individual features are studied in the general population, not just in people with genetic disorders), all have links to hyaluronic acid abnormalities. 
 

Syndrome with hyaluronic acid abnormalities	Features linked to both the syndrome and hyaluronic acid abnormalities
Ehlers-Danlos syndrome	mitral valve prolapse, prematurely wrinkled skin, pectus excavatum, pectus carinatum, scoliosis, bowed limbs, hypermobility, keratoconus, hernias, poor wound healing, joint instability, TMJ, contractures, osteoarthritis, fractures
Osteogenesis imperfecta	mitral valve prolapse, pectus excavatum, pectus carinatum, scoliosis, keratoconus, fractures, bowed limbs, hernias
Stickler syndrome	mitral valve prolapse, keratoconus, pectus excavatum, pectus carinatum, scoliosis, osteoarthritis, hypermobility, bowed limbs
Marfan syndrome	mitral valve prolapse, scoliosis, pectus excavatum, pectus carinatum, osteoarthritis, keratoconus, hypermobility, bowed limbs, hernias, detached retinas, glaucoma

  
 

Since the ABC special on hyaluronic acid called it the "Fountain of Youth", it is interesting that one of the defining characteristics of premature aging syndromes, such as Progeria, is hyaluronic acid abnormalities.

Related article:

Intra-articular Hyaluronic Acid Injections for Knee Osteoarthritis - Article from the American Academy of Family Physicians on beneficial effects of using HA for osteoarthritis.

---

Hyaluronic Acid and Environmental Factors

   
There are many factors known to influence hyaluronic acid levels.  Genes are likely to be a factor, but there are many environmental factors that are known to have an impact, including zinc and magnesium availability.  Not surprisingly, magnesium and zinc deficiencies are known to be associated with many of the same symptoms associated with hyaluronic acid abnormalities, such as mitral valve prolapse and poor wound healing, respectively. Perhaps this is because the zinc or magnesium deficiency contributes to the hyaluronic acid abnormality, which in turn causes the symptom.

 
There are a multitude of studies on Medline regarding hyaluronic acid and a wide variety of environmental factors.  Here is a sample of some of the interesting ones that relate to connective tissue disorders:

Hyaluronic acid becomes abnormally elevated in the skin of swine who have zinc deficiencies.  Magnesium is needed for hyaluronic acid synthesis. Perhaps a lack of magnesium is one of the  factors in some connective tissue disorders. Magnesium supplementation is an established treatment for many of the symptoms of connective tissue disorders, such as fibromyalgia, mitral valve prolapse and contractures.

Ascorbic acid can degrade hyaluronic acid.  Estrogen treatment increases activity of hyaluronic acid.  Estrogen is known to increase utilization of nutrients like magnesium and zinc  - nutrients that are known to affect hyaluronic acid levels.  Cigarette smoke is known to degrade hyaluronic acid.

In a study of rats, hyaluronic acid  turnover and metabolism were affected by age, dietary composition, and caloric intake.  If what rats ate affected their hyaluronic acid levels, then this may be a good clue that diet may well affect hyaluronic levels in humans, too. In another study on rats, hyaluronic acid deposition in rat cerebellum is affected by thyroid deficiency, thyroxine treatment and undernutrition.  In a study of humans, hyaluronic acid levels were altered by physical activity and food ingestion. 

In a study on rats, skin hyaluronic acid concentration was higher than normal in energy deficiency, but below normal levels in prolonged protein deficiency.  In rats suffering from prolonged malnutrition, the collagen concentrations are reduced.  (Reduced collagen concentrations are also found in some of the connective tissue disorders such as osteogenesis imperfecta, as are a plethora of other conditions also associated with hyaluronic acid abnormalities.  Not surprisingly, zinc deficits are known to affect hyaluronic acid levels. In a study on rats, among other symptoms, a deficiency in zinc resulted inimpaired collagen synthesis.)

Strep and staph bacteria emit an enzyme called hyaluronidase. Hyaluronidase is an enzyme which breaks down hyaluronic acid, thus allowing an entry point for the bacteria to enter the body. This may be why people may become hypermobile or develop heart aliments like mitral valve prolapse after illnesses such as rheumatic fever--because the hyaluronic acid in their connective tissue has been degraded by the bacteria that causes their illness. (See my section on "What Causes Mitral Valve Prolapse? Hyaluronic acid as a clue" for more on this topic.)

If animals that are genetically similar to humans such as rats can have reduced collagen levels and hyaluronic acid abnormalities from changes in their diets, then it would be logical to consider diet as a causative factor in people with the hyaluronic acid abnormalities.  

---

Summary  

Hyaluronic acid occurs in abundant amounts in many of the places people with connective tissue disorders have problems such as the joints, the eyes, the skin and heart valves.  Hyaluronic acid is needed to cushion and lubricate joints, eyes, skin and heart valves.  

People with connective tissue disorders and related features all seem to have abnormalities of hyaluronic acid.  In every study I found that analyzed hyaluronic acid levels in people with connective tissue disorders or related disorders, when compared to controls they alwayshad hyaluronic acid abnormalities.

HA is influenced by nutrition and other environmental factors.  Many of the features of premature aging syndromes and connective tissue disorders are also known to be caused by nutritional deficiencies, and not surprisingly these are often the same nutritional factors that influence the manufacture of hyaluronic acid. My theory is that this is not all one big coincidence. Logically, it is more likely to be a predictable sequence of causes and effects.

Hyaluronic acid is being used commercially or experimentally  to correct a large portion of the problems found in connective tissue disorders such as fractures, eye disorders, poor wound healing and prematurely wrinkled skin.  It would be highly logical to consider the possibility that hyaluronic acid works to correct these problems because defects or deficiencies of hyaluronic acid are what cause these problems in the first place.   

   
Perhaps controlling or optimizing the environmental factors, such as modifying ones diet,  to optimize hyaluronic acid levels would be helpful in treating many inherited connective tissue disorders and premature aging syndrome.

Also see my next section: Frequently Asked Questions About Hyaluronic Acid for answers to questions about food containing HA and vitamin C interactions with HA, and the studies linking high levels of HA with cancer.  

Question: What foods contain hyaluronic acid?"

Answer: I have found very little information on this myself, though I am aware of two possible sources. The first was mentioned in a segment from ABC news about a hyaluronic acid consumption in a village in Japan . In the 20/20 segment, "The Village of Long Life: Could Hyaluronic Acid Be an Anti-Aging Remedy?" the town doctor attributed the villager's long lives to "starchy root vegetables"-- satsumaimo, a type of sweet potato; satoimo, a sticky white potato; konyaku, a gelatinous root vegetable concoction; and imoji, a potato root. The doctor believes "these locally grown starches help stimulate the body’s natural creation of a substance called hyaluronic acid, or HA, which aging bodies typically lose. This may ward off the aging process by helping the cells of the body thrive and retain moisture, keeping joints lubricated, protecting the retina in eyes and keeping skin smooth and elastic. 'I have never seen anyone suffer from skin cancer here, ' he says. 'I have seen a woman in her 90s with spotless skin.' ”

I have never read anything else about these vegetables stimulating hyaluronic acid per se, but root vegetables do tend to have high amounts of magnesium, so it would seem plausible that this could be true. Recent research shows that root vegetable consumptions may also reduce the risk of certain types of cancer.

The second source of hyaluronic acid I can think of would be to eat animal parts known to contain a lot of hyaluronic acid. I make broth for soup from boiled animal parts that contain a lot of skin, tendons and joints. This is the one food that helped my fibromyalgia more than anything else. I've also noticed that if I eat too much of this broth my blood pressure rises, which is interesting because people like me with connective tissue disorders usually have unusually low blood pressure. It also seems to improve my breathing. My kids don't like to eat a lot of soup, so I make a nutritious broth from bones and vegetables for them and use it instead of water when I make rice, a food they do like.

Related Links:

Traditional Bone Broth in Modern Health and Disease

Chicken soup is medicine, U.S. scientists confirm - One of the ways that bacteria enter the body is by breaking through the hyaluronic acid barrier. So perhaps this is one of the reasons chicken soup really does work against infections and colds. Maybe the hyaluronic acid in the broth prevents bacteria and viruses from invading the body. My kids like Campbell's healthy Request Chicken Noodle Soup, so I give that to them whenever they are sick and most of the time they start to feel better right away. (See the chart from the actually study on "The effect of various commercial soups on neutrophil chemotaxis").

See my section on "What Helped Me - Diet Changes" for the dietary changes that helped my family's connective tissue disorder problems.

Question: Should I take HA supplements?

You should check with your doctor before taking HA or any other supplements.

I've gotten a number of questions on hyaluronic acid and breast cancer. To see all of the study abstracts linking these conditions, go to PubMed, and enter:

hyaluronic acid breast cancer

in the search box.

In particular, check out this abstract, from cancer researchers at the University of California San Francisco:

"A hyaluronan-rich environment often correlate with tumor progression, and may be one mechanism for the invasive behavior of malignancies. Eradication of hyaluronan by hyaluronidase administration could reduce tumor aggressiveness and would provide, therefore, a new anti-cancer strategy."

For information on hyaluronidase (an enzyme that breaks down HA) and hyaluronic acid, check out my MVP page.

Women with too low of estrogen levels are at higher risk for conditions like fractures, osteoporosis and a lack of menstruation. Women with high levels of estrogen tend to have increased risks of blood clots, high bone density, high blood pressure and breast cancer. It's not that estrogen is good or bad, it's just that both unusually high levels and unusually low levels are linked to a variety of adverse (and interestingly inverse) health conditions. Perhaps the same may be true for hyaluronic acid.

HA and Other forms of Cancer -

In a paper on hyaluronic acid and colon cancer, researchers wrote that "Hyaluronan (HA) is a cell-surface glycosaminoglycan that has been implicated in cancer progression......These data suggest that HA promotes adhesion to laminin and may thereby facilitate invasion of the basement membrane and metastasis in colon carcinoma."

In another study, researchers found that, "Hyaluronan a high-molecular weight glycosaminoglycan, is considered to be involved in the growth and progression of malignant tumours."

Question: I've read a lot of articles about the benefits of large quantities of vitamin C. Your hyaluronic acid section mentions that ascorbic acid (vitamin C) might be bad for hyaluronic acid. Is vitamin C good to take or not?

Answer: I personally have not had good experiences with taking large supplemental doses of any single nutrient. Every nutrient in the human body has a multitude of co-factors that need to be consumed in balanced amounts for good health, so taking a single supplement may solve one deficiency and then create more problems by triggering co-factor deficiencies.

Vitamin C is a nutrient your body needs in the right amounts. If you don't consume any vitamin C, sooner or later you will develop scurvy, like sailors used to who went on long sea voyages. (British sailors were named "Limies" because of the limes they would take on their voyages to prevent scurvy.) Yet, too much vitamin C, as with too much of any nutrient, can be toxic. Large doses of vitamin C may lower other nutrient levels including vitamin B12, copper and selenium blood levels

I do note a study in my hyaluronic acid section that found that ascorbic acid can degrade hyaluronic acid. But this isn't necessarily bad, in fact for some people, this maybe good thing. While insufficient defective hyaluronic acid isn't ideal, too much HA may not be so great either. High levels of hyaluonic acid have been linked to different types of of cancers, including breast cancer, in a variety of different studies. Interestingly, vitamin C is often mentioned as being beneficial for breast and other cancers.

Think of it this way: Your body needs a variety of ingredients in the right proportions to function, just like you need a variety of ingredients to make a cake. If you are making a cake and you are short on eggs, it's okay to add more eggs, up to a certain amount. If you are not short on eggs, then just adding more eggs is going to ruin your cake. If you are short on flour but not eggs, but you keep adding more eggs but no extra flour, you are really going to end up with a mess.

It's the same basic principle with your body, only on a larger and much more complex scale. Some people might have defective collagen because they are short on vitamin C. For those people, getting extra vitamin C in their diets would probably be good. But taking massive doses of vitamin C, especially if a person isn't deficient in vitamin C to begin with, probably isn't a good thing.

If you are concerned you may have a vitamin C deficiency or any other nutritional deficiency, see my sections on Holistic Doctorsand Nutrition Testing.