Perthes disease

(Amy Ramadan) #1

Hey everyone!! Hope everybody is doing well!! Does anyone know anything about Perthes disease, and whether or not a keto WOE will help? Asking for a very dear friend who has this and has been having trouble walking. Wondering if a Keto diet can help in any way? Thank you in advance, for all help and it advice on this.

#2

Hi Amy.

Seems like a very rare condition and I canā€™t find any info on here or on the net about treating Perthes with Keto.

But just off the top of my head, keto would allow that person to get healthy and lose weight without having to rely on physical exercise, so that would be a benefit.

(Brenda C) #3

There is often an inflammatory component when one lives with Legg-Perthes. A ketogenic diet, in as far as it reduces inflamation for the individual, might be helpful in reducing pain levels and increasing mobility, IMO. Maintaining normal weight levels through keto, if that is an issue, would help take stress off the affected hip, as well. I think keto, and maybe later some IF would be a good experiment. Good luck to your friend!

(Amy Ramadan) #4

Thanks so much for your responses!! Weight is not an issue here. I have been helping his wife as she is interested in starting Keto, and just happened to think that it may help her hubby as well, since the health benefits are endless. So hard to see such a loving, wonderful person detoriate in such a way, and makes you feel helpless when there isnā€™t much you can do to help!! Thanks again!!

(Bunny) #5

Just a few of my personal thoughts about this:

Knowing that a high glucose metabolism blocks human growth hormone HGH, in adults who lose the ability to oxidize sugar as rapidly as they age, however children oxidize sugar much faster so they are going to utilize HGH much better[1] including DHEA?

HGH is secreted mainly by the pituitary gland (usually during sleep) and that a low sugar diet also increases DHEA when high levels of glucose are not blocking HGH?

GHT (growth hormone treatment) below[1] and its effect on children but what about in adulthood with a congenital medical condition?

Ketosis or a ketogenic diet is going going to change the way the body utilizes HGH and DHEA if the glucose is oxidized (or the significant usual amount is not present; glucose metabolism?) at a much faster rate either through diet or manipulating through supplementation the way the body oxidizes sugars?

References:

[1] Legg Calve Perthes disease and growth hormone treatment Background: Current extension in the usage of growth hormone therapy (GHT) has increased the prevalence of bone complications. Legg CalvĆ© Perthes disease (LCPD) is characterized by idiopathic avascular necrosis of the proximal femoral epiphysis. More frequently in boys between 4 and 8 years, LCPD is of unknown ethology. An increased incidence has been stated in case of GH deficiency. There is increasing data that children with LCPD may have a more widespread skeletal disorder involving short stature, disproportionate growth retardation and delayed bone age. Case reports: Case 1: 8 years 8 months old boy, addressed for growth retardation. At 8 years 3 month he was diagnosed with LCPD of the right hip. He was small for his age (115 cm, āˆ’3.2 S.D.), underweight, with small and triangular facies, flat feet, lower limb length asymmetry (right& left with 2 cm), bilateral genu recurvatum, clinodactyly of the 5th finger. He had delayed bone age of ~7 years. Somatotropin axis investigations revealed low IGF-1 (48 ng/ml, N: 64ā€“345). GHT was considered contraindicated due to the higher risk of contralateral LCPD. Case 2: 7 years old male, presented in January 2014 height deficit (97 cm, āˆ’2.54 S.D.) and significantly delayed bone age (2 years) and GHT was started: Somatropin 0.23 mg/kg per week, with good evolution (height velocity & 0.6 cm/month). In August 2016, his growth velocity decreased to 0.35 cm/month and he complained of pain in his left hip, increasing with activity. Limping and a deficit in internal rotation of the left hip were noted. Radiography of the lower extremity was conducted and left LCPD was diagnosed. GHT was interrupted. Conclusion: Orthopaedic complications associated with GHT are rare, but severe. Whatever the causal association, the presence of LCPD imposes caution in children with GHT. To our knowledge there have been only a few reported cases of LCPD in children with GHT. Before beginning GHT, it is essential to take into account all the risk factors of the individual patient. Close monitoring with clinical and radiographic check-up is required to allow early diagnosis and treatment of these complications, but no published guidelines exist to date.

[2] ā€œā€¦A large nested case-controlled study in the GPRD has overcome some of the previous methodological concerns. 29 This study was able to confirm an association between Perthes disease and congenital genitourinary disease (hypospadias, inguinal hernia and undescended testes), an association first proposed by Catterall et al .30This may indicate that the aetiological factor responsible for these diseases, believed to be fetal androgen metabolism, may be influential in the onset of Perthes disease. This may go some way to explaining the male disease preponderance.
ā€¦ā€ ā€¦Unravelling the enigma of Perthes disease