Aspartame and arthritis pain
One person says that aspartame helped his arthritis and another has said it has made arthritis worse. This is one of the most bizarre discoveries we have ever heard about. You be the judge. A scientist noticed that when he got up out of his chair after watching a football game, his arthritis pain was greatly diminished. During the course of the game he had consumed a six-pack of diet soda containing aspartame. Putting two and two together, he thought this artificial sweetener might have contributed to his relief. He organized a placebo-controlled trial involving aspartame (aka Equal, NutraSweet) and confirmed that doses of 76 to 152 mg did indeed provide pain relief, roughly comparable to anti-inflammatory agents. This research was published in the very respectable scientific journal, Clinical Pharmacology and Therapeutics.* *Edmundson, A. B., and C. V. Manion. "Treatment of Osteoarthritis with Aspartame." Clin. Pharmacol. Ther. 1998; 63:580-593.
Joint pain requiring analgesics was experienced by 58 patients whoconsumed moderate to large amounts of aspartame, a popular sweetener. Thisassociation seems convincing in light of (1) the prompt improvement of boththese pains and other aspartame-associated complaints after abstinence fromaspartame, and (2) their prompt recurrence following aspartame rechallenge,known or inadvertent. Clinicians should inquired about aspartame use in all patients whopresent with unexplained join pain or the exacerbations of rheumatologicdisorders. A therapeutic trial of aspartame avoidance is warranted beforeordering expensive studies, consultations and potent drugs. An impressive, but unexpected, finding in an analysis of complaintsassociated with aspartame, a sweetener currently being consumed by over 100million persons in the United States, was troublesome joint pain. Accordingly, this symptom was incorporated in both the routine questioningof apparent aspartame reactors and a computerized nine-page nationwide surveyof such individuals.
Data were obtained from 551 persons having apparent systemic reactionsto aspartame. They consisted of 160 private patients and individuals whowere personally interviewed, and 391 persons who described their adverseside effects in a questionnaire - including observations after rechallenge.The names of the latter group were supply by Aspartame Victims and TheirFriends (courtesy of Mrs. Shannon Roth), the Community Nutrition Institute(courtesy of Mr. Rod Leonard), and Dr. Woodrow Monte of Arizona StateUniversity. The completed questionnaires were analyzed with assistance of theManagement Information System staff at the Good Samaritan Hospital, West PalmBeach. Results Joint pain was a major complaint in 58 (10.5%) of 551 aspartamereactors. Its convincing association with aspartame is derived from thefollowing clinical evidence. They also experienced many of the symptoms reported by other aspartamereactors. Both the join pain and nonrheumatic complaints subsided whenaspartame-containing products were avoided...generally withinseveral days or weeks. The most notable exceptions were severe visual andneuropshychiatric disturbances. These symptoms promptly and predictably recurred on rechallenge withaspartame, known or inadvertent. The average age was 45 years. Females outnumbered males 3:1. Representative Case Reports Case 1. A 55-year old secretary developed "arthritis" and aching of thelower extremities one week after she began drinking an aspartame-flavored teamix. Concomitant symptoms included memory loss, severe dizziness anddepression. These features subsided within one week after stopping theaspartame product. After each of several rechallenges, "my whole body achedfrom my toes to the neck. I felt as though I had arthritis in my whole bodyand it hurt to move an arm or even my hand....Since that time, I have nottouched anything sweetened with aspartame, and have experienced no unusualaches, memory loss or dizziness. Case 2. A 45-year old technician consumed two packets of an aspartametabletop sweetener daily for three weeks. He became markedly impairedbecause of "severe joint irritation" and "less that 1/4 my normal strength." These complaints improved within one day after avoiding aspartame. Thejoint symptoms recurred within one day after retesting himself with thisproduct on three separate trials. Case 3. A 62-year old supervisor complained that "all my joints ached allthe time" while consuming aspartame. He used eight packets of an aspartametabletop sweetener in his coffee, one glass of aspartame hot chocolate, andtwo services of aspartame puddings or gelatins daily. Otheraspartame-associated symptoms included loss of vision in one eye, markedsensitivity to noise in both ears, intense headache, severe drowsiness,paresthesias of the limbs, atypical facial pains, extreme irritability, and aparadoxic weight gain of 30 pounds. His joint pains and other complaintsregressed within five weeks after stopping aspartame. All recurred withineight hours during two rechallenges. Discussion Experienced clinicians understandably will balk at the suggestion that acorrelation exists between joint pain and consumption of a popularRDA-approved sweetener for several reasons. First, they have not heard orreach of such an association. Second, the frequency of rheumatologiccomplaints in the general population is likely to be superimposed upon theuse of any drug, food or additive. Third, this pilot investigation lacks"controls" and objective quantifiable measurements during prospectivedouble-blind studies. Fourth, the proposition that foods and additives caninduce joint symptoms in not novel. On the other hand, the occurrence of joint pain, generalized or focal,in 58 individuals so closely associated with aspartame use ought not bedismissed as "anecdotal" or "idiosyncratic." The prompt regression of suchcomplaints after abstinence from this chemical, and their prompt andpredictable precipitation on rechallenge seems convincing. In effect, suchpatients served as their own controls. These observations offer intriguing insights concerning variousrheumatologic disorders. A case in point was the occurrence of transient"dry eyes" in 46 (8.3%) of 551 reactors while taking aspartame. The frequentoccurrence of arthropathy in the Sjogren syndrome is recognized. Other interesting rheumatologic associations were encountered inaspartame reactors. Some patients emphasized the prompt exacerbation of their long-standingarthropathies after using aspartame, and improvement within several daysafter stopping it. Resort to considerable aspirin for the relief of joint pan intensifiedaspartame-associated ear and neurologic problems - especially tinnitus,dizziness and hearing impairment. Several patients with polymyalgia rheumatica who had been well controlledon small doses of a corticosteroid experienced severe exacerbations afteringesting aspartame. They also promptly improved when it was avoided. The probably underlying pathogenetic mechanisms of aspartame reactionsincluded direct effects of its three ingredients (phenylalanine, asparticacid, methanol), altered neurotransmitter metabolism, decreased tissuesubstrate due to the combination of increased insulin release and decreasedfood intake by persons attempting to lose weight, and immunologic reactionsto aspartame or its metabolites - perhaps acting as haptenes. Concerning thelatter, the following allergic-type reactions were encountered among 551aspartame reactors: severe itching without a rash - 44 (8.0%); severe lipand mouth reactions - 21 (5.3%), urticaria - 25 (4.5%); other eruptions - 48(8.7%); and the aggravation of respiratory allergies - 10 (1.8%) Correspondence
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