I don't think I can add much to this fascinating paper - except to encourage you to click on the link and read the Conclusion.
Combined ascorbic acid and T3 produce better healing compared to bone marrow mesenchymal stem cells in an Achilles tendon injury rat model: a proof of concept study
Francesco Oliva, Nicola MaffulliEmail authorView ORCID ID profile, Clarissa Gissi, Francesca Veronesi, Lucia Calciano, Milena Fini, Silvia Brogini, Marialucia Gallorini, Cristina Antonetti Lamorgese Passeri, Roberta Bernardini, Rosella Cicconi, Maurizio Mattei and Anna Concetta Berardi
Journal of Orthopaedic Surgery and Research201914:54
Received: 10 June 2018Accepted: 7 February 2019Published: 18 February 2019
Abstract
Background
This pilot study aimed to ascertain whether the local application of ascorbic acid (AA), of T3, and of rat (r) bone marrow mesenchymal stem cells (BMSCs), alone or in all possible combinations, promoted healing after an Achilles tendon injury in a rat model.
Methods
An Achilles tendon defect was produced in 24 6–8-week-old male inbred Lewis rats. The animals were then randomly divided into eight groups of three rats each. The tendon defect was filled with 50 μL of phosphate-buffered saline (PBS) containing (1) 50 μg/mL AA (AA group), (2) 10−7 M T3 (T3 group), (3) 4 × 106 rBMSCs (rBMSC group), (4) 50 μg/mL AA + 10−7 M T3 (AA + T3 group), (5) 4 × 106 rBMSCs + 50 μg/mL AA (rBMSC + AA group), (6) 4 × 106 rBMSCs + 10−7 M T3 (rBMSC + T3 group), (7) 4 × 106 rBMSCS + 50 μg/mL AA + 10−7 M T3 (rBMSC + AA + T3 group), and (8) PBS only (control group: CTRL). All treatments were administered by local injection immediately after the tendons had been damaged; additionally, AA was injected also on the second and fourth day from the first injection (for groups 1, 4, 5, and 7), and T3 was injected again every day for 4 days (for groups 2, 4, 6, and 7). At 30 days from initial treatment, tendon samples were harvested, and the quality of tendon repair was evaluated using histological and histomorphological analysis. The structure and morphology of the injured Achilles tendons were evaluated using the modified Svensson, Soslowsky, and Cook score, and the collagen type I and III ratio was calculated.
Results
The group treated with AA combined with T3 displayed the lowest Svensson, Soslowsky, and Cook total score value of all tissue sections at histopathological examination, with fiber structure close to regular orientation, normal-like tendon vasculature, and no cartilage formation. AA + T3 also showed the highest collagen I and the lowest collagen III values compared to all other treatments including the CTRL.
Conclusion
There are potential benefits using a combination of AA and T3 to accelerate tendon healing.
Very important and interesting article Helvella! I believe soft tissue damage is notoriously difficult to heal. Well it may be difficult to determine which is the most effective contribution, Ascorbic acid or T3 because both are used together in this study, however, both are thought to be beneficial for tissue healing at optimal levels. Would be interesting to see studies conducted using one or the other to see if this made a difference in healing time or indeed one was more effective than another. Of course we will always have the voice of controvacy to contend with regarding the use of elevated levels of T3 though be it for relatively short periods of time. Many folk with Hashi’s seem to suffer spontaneous soft tissue damage/muscle pain to various degrees. This study could hold a key to treatment for these people as well as flying the flag for the benefits of T3 treatment for those with less than good levels.
Many folk with Hashi’s seem to suffer spontaneous soft tissue damage/muscle pain to various degrees.
Yes - and the study made me consider whether low T3 is why they end up with the damage and pain. If the ordinary, minor damage we all suffer doesn't repair as quickly or as effectively due to low thyroid hormone levels. Hence, instead of getting better, the damage accumulates.
Yes I’m with you on this! There is also the issue of hormone resistance to consider. How much of circulating T3 actually reaches the tissues? A test to determine this would be so welcome and in my opinion is well overdue! Would possibly save many a Endo confrontation in relation to claimed high or over range levels.
Paul Robinson has written on his blog about how misleading serum T3 levels can be in those who take T3 replacement, either on its own or in combination. The advice on this forum is usually that T3 must not exceed the upper lab reference limit, but those of us with forms of TH resistance know that isn't very helpful. Robinson has another, very interesting take on it.
I would think so. In cases of TH resistance (us!) the intracellular levels of T3 need to be even higher than for someone who is taking T3 because of impaired conversion, and that may be reflected in correspondingly very high serum levels. Perhaps that isn't always the case though? Lots to ponder!
Possibly a profound thought coming on here ? Could there be a correlation between poor T4 to T3 converters and those having thyroid hormone resistance?
Also my experience is that most Endos ( all 8 I have visited) don’t seem to consider that muscle pain or fatigue is even vaguely related to inadequate thyroid hormone despite it being included in the very long list of thyroid disease symptoms.
Problems with soft tissue such as achilles tendinitis even being used for early diagnosis of thyroid disorder. Not that they would bother to treat it of course ☹️. I have read achilles tendinitis and arthritis are early signs of thyroid disorder - perhaps the diminishing T3 production sets it off. I certainly had arthritis at just 23 which I was told was very unusual then the Achilles problem developed, these tendons are supposed to last a life time providing trouble free function, I would question as to why on earth it would malfunction at just a quarter of its normal life span it surely indicates an underlying problem. I believe both had everything to do with the course of my hypothyroidism and this study at least demonstrates T3 improves healing. I suspect lack of it leads to damage/malfunction of tendons and bones.
No - injected. From the full paper (and it is confusing because they are saying lots of things in two sentences!):
The injured tendon was filled with 50 μL of phosphate-buffered saline (PBS), a physiological buffer solution which contained
(1) 50 μg/mL AA (AA group),
(2) 10−7 M T3 (T3 group),
(3) 4 × 106 rBMSCs (rBMSC group),
(4) 50 μg/mL AA + 10−7 M T3 (AA + T3 group),
(5) 4 × 106 rBMSCs + 50 μg/mL AA (rBMSC + AA group),
(6) 4 × 106 rBMSCs + 10−7 M T3 (rBMSC + T3 group),
(7) 4 × 106 rBMSCS + 50 μg/mL AA + 10−7 M T3 (rBMSC + AA + T3 group), and
(8) PBS only (control group: CTRL).
Additionally, AA was injected again on the second and fourth day following the initial injection (for groups 1, 4, 5, and 7), while T3 was injected again every day for 4 days (for groups 2, 4, 6, and 7).
No I think they are injecting the different combinations of therapeutic drugs into the site of the tendon damage. But the conclusion that cellular repair is more complete with the AA plus T3 is a result worth noting. Feel a bit smug.....I take high doses of Vit C and T3....having said that I’m nursing a badback at the moment!
Imagine how bad it would be without the T3 and vit c 😱😬🤬as I said I feel for those poor rats....and you of course - hope it resolves fast. I bet an injection is more targeted than oral administration.
Very interesting. I wonder if it might improve matters many years down the line or only at the initial healing stage. I had Achilles’ tendon decompression many years ago. It was successful but has never felt as good as the original until tendinitis became so chronic the op was advised. I feel for those poor rats.
So much is being learned about T3 - low T3 syndrome as a cause of heart failure and also used in recovery from cardiac surgery; being considered as the “new” anti-depressant drug (probably with a fancy new name and price tag). Can’t wait till T3 is patented, dressed up in a fancier capsule, packaged in an eye catching box and marketed as the next great pharma breakthrough for fibromyalgia, MS, diabetic nerve pain, or whatever.
The bummer is that everyone except our GP’s and endo’s seem to know about T3 and it’s importance to the body.
I hear you about that fancy new name trick. People have had great success using plain old niacin to reduce their cholesterol levels. I pay 9 cents per pill on Amazon. Kos Pharmaceuticals got smart and did the safety & effectiveness research the FDA requires for approval of new drugs and brought Nispan to market as a prescription drug. Same chemical -- 500 mg of niacin. At $1.89 per pill.
Q: Did you hear about the pirate suffering from scurvy?
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