AI SEs increased by jogging?

Joanne....Try to hang in there because, if you're at all like me, it will get better with time, as long as you keep moving and don't give up. I'm convinced that those of us who have side effects right away from the AIs just need to give our bodies time to adjust to the sudden estrogen depletion. I too had alot of soreness & stiffness in the first year of taking Aromasin (though not my knees....more hips and shoulders). But I maintained an active schedule that included running several times a week. I built up to this schedule gradually and made sure to do plenty of strengthening exercise as well in order to build the muscles supporting the joints. And like Anne, I took (and still take) fish oil supplements and vitamin D3 as well as magnesium, calcium and glucosamine chondroitin. I believe that this approach worked well and today, two-and-a-half years on Aromasin, I have almost no joint issues at all and the only pain I have is after working out too strenuously.

Go slowly, strengthen your hamstrings and quads with extra muscle-building exercises, check out some of the supportive supplements and, most of all, have hope! You seem to have determination and I think that will help you to heal more than anything else! Of course, massage and hot bubble baths can't hurt either !

~Marin

I have been thinking about this for a long time and ran across this news alert....It makes sense that the main issue is lack of estrogen rather than the AI ..the AI only facilitates the problem. The evidence re: pain perception and lack of estrogen was very interesting........

9/02/05

Arthritis & Rheumatism News Alert

Joint Pain and Estrogen Deprivation

Recent evidence suggests caution in prescribing hormone therapy for breast cancer and sheds new light on "menopausal arthritis"

One of the most effective new treatments for breast cancer is a hormone therapy. Aromatase inhibitors work by powerfully blocking the conversion of androgen precursors into estrogens, which lowers estradiol levels in the bloodstream and estrogen levels in peripheral tissues. Because aromatase inhibitors reduce the rates of recurrence in women with early-stage postmenopausal breast cancer, these agents are not only becoming widely used in breast cancer treatment, but also being explored for their potential to prevent the disease in women at high risk. While focusing on this therapy's promise, advocates have tended to downplay one of its drawbacks. Women treated with aromatase inhibitors often experience joint pain and musculoskeletal aching-severe enough, in some cases, to make them stop the treatment.

Two noted researchers, David T. Felson, M.D., of Boston University Clinical Epidemiology Unit, and Steven R. Cummings, M.D., of California Pacific Medical Center Research Institute and University of California, San Francisco, have thoroughly examined the evidence linking aromatase inhibitors and, more broadly, estrogen deprivation joint pain. In the September 2005 issue of Arthritis & Rheumatism ( http://www.interscience.wiley.com/journal/arthritis), they share their insights to alert oncologists, primary care physicians, and other health care professionals to this widely overlooked, potential problem for women.

"Estrogen's effects on inflammation within the joint are not well known," Dr. Felson and Dr. Cummings observe. Yet, as they note, estrogen has well-established tissue-specific effects on inflammatory cytokines. Estrogen's role in joint inflammation could account for the increased sensitivity to pain that some women suffer with estrogen depletion. Citing studies of pharmacological suppression of estrogen and studies of natural menopause, the authors offer a look at compelling evidence associating estrogen deprivation with joint pain, including:

• Aromatase inhibitors have been linked to higher rates of joint and muscle pain than tamoxifen and placebo in various clinical trials for breast cancer treatment and prevention. One example: In a National Cancer Institute of Canada study, 5,187 postmenopausal women who completed a 5-year course of tamoxifen therapy for breast cancer were randomized to a further 5 years receiving the aromatase inhibitor letrozole or a placebo. 21 percent of women taking letrozole reported joint pain compared with 16 percent of the women receiving placebo.
• In a study of leuprolide, a hormonal agent used to treat infertility and a variety of gynecological disorders, 102 premenopausal women experienced symptoms of estrogen deprivation, such as vaginal dryness, after 2 weeks of treatment, and suffered joint pain between weeks 3 and 7 of treatment. Overall, 25 percent of the women developed persistent joint pain, affecting the knees, elbows, ankles, and other areas, during the study. The pain was resolved in all women between 2 and 12 weeks after stopping the leuprolide therapy.
• In a postmenopausal estrogen/progestin intervention trial, women who received estrogen had a significantly decrease chance of musculoskeletal symptoms-between 32 and 38 percent-compared with women randomly assigned placebo. Symptoms reported in the placebo group included joint pain, muscle stiffness, and skull and neck aching. In other studies, however, estrogen replacement therapy had no beneficial effect on musculoskeletal pain.

Dr. Felson and Dr. Cummings also highlight recent data showing that Asian women undergoing menopause have lower estradiol levels than Caucasian women and seem to be more vulnerable to a syndrome commonly known as "menopausal arthritis." They also note the high rate of both osteoarthritis and rheumatoid arthritis in postmenopausal women. They conclude by stressing the need for further research into the contribution of estrogen deficiency to arthritis, as well as for recognizing the risks of musculoskeletal syndrome when prescribing aromatase inhibitors and other estrogen-depleting treatments.

Joanne-Elizabeth....Are you wearing a good knee support? If not, try finding one that is comfortable and gives support while still allowing you to feel completely free and mobile at the knee (i.e., not too tight!). Many people in my step aerobics classes wear knee supports and many of them are also runners.

~Marin

Go to chirunning.com. It will help you learn a new, lower impact body position to run in.

 The books and the videos are worth every penny, but the site has a lot of helpful tips too. I doubled my running distance using the technique and I have very bad painful knees. 

This is a technique that will simply make you a better runner with less pain, that may help while you are having the extra pain from the treatments.