Arthritis patient with pain’s email on stem cell clinic & my answer

knee arthritis stem cells
Example of a joint (knee in this unrelated case) with osteoarthritis evident by x-ray.
knee arthritis stem cells
Example of a joint (knee in this unrelated case) with osteoarthritis evident by x-ray.

Stem cells for arthritis and pain are hot topics these days and I’m getting an increasing number of patients reaching out with questions and sharing their situations related to arthritis or pain (or usually both together). I asked one arthritis patient who reached out to me if they would be OK with me sharing their email, with all identifying information removed, along with my answer to them. The point was to use this as example that would be helpful to the community. They agreed. Below you’ll see their slightly edited and redacted email and my answer.

The patient email:

Hi Paul,
I am in my fifties and was scheduled for a Stem Cell Therapy procedure here in —–, CA at —– Therapy with Dr. —–. I cancelled my appointment today because I was afraid of any risks in my future health. I didn’t really research it. I was just desperate to be out of pain due to an injury that has become inflamed in the joint, has loss of cartilage, and now has osteoarthritis degeneration. I was given a book of testimonies but when I was signing the consent forms and release of liability, I became suspicious of it being experimental and not approved by the FDA. Can you shed any light on the liposuction that extracts stem cells from your own fat in the belly and then injected back into the joint? Dr. —– would be in charge of injecting it in the joint after the extraction. He works at —–.
After cancelling my appointment, the receptionist said I should have done my research before making my decision and directed me to Cell Surgical Network. She said Dr. —– is affiliated with that organization. But I could not find how to maneuver through this site. I was supposed to then go to Stem cell resolution(or revelation) Not sure which one. I didn’t find anything. I was truly afraid to go through with it in ignorance. Can you please help me settle my wonderings? I want to know is this safe or not? Will it help or not? Am I foolish or not? Am I passing up an opportunity to be pain free or jeopardizing my health?
Thank you for your time, Paul.

And my answer:

Hi —–,

These are good questions and I understand where you are coming from with the pain.
I personally wouldn’t get a fat stem cell treatment for a variety of reasons. While these cells are unlikely to produce tumors, there are some risks particularly from the systemic injection into the blood. Although the risks probably aren’t high for each individual patient, they aren’t very well understood and aren’t zero. 
Beyond the safety question, a big reason in my opinion to not do it is that there isn’t good evidence that this stuff really works so I think in the big picture that the fat stem cells sold by the various clinics around the U.S. are going to be a waste of hard-earned money. 
I also tell people: At a minimum give it as much thought as you could before buying a car — would you buy a car if you didn’t know it would work? If there was no information on MPG, no warranty, and no crash safety data at all? 
You mentioned the FDA and also a group called Cell Surgical Network. Check out this recent FDA action via the Department of Justice in federal court (scroll down about half way): https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm607257.htm. For me this is another reason to pause.
My best wishes to you,
Paul

15 Comments


  1. I recently was offered traumeel injections for my toes and I was surprised by its effectiveness in dimining pain and increasing toe flexibility. Stem cells are also good but one has to be careful with what facility and physician one selects. Not all clinics are of equal quality.


  2. This is a great concern; For those of us facing debilitating surgery to relieve pain of osteoarthritis in knees, hips, backs – when will reliable and professional stem cell treatment be available as an alternative to surgery?
    How many years are we looking at?
    What and where are serious studies currently being done?
    How does one sort out the fraudulent from the authentic on stem cell clinics? Are there any authentic ones?
    Many of the clinics I see advertised contain the names of actual physicians, besides Chiropractors. If these procedures are not sincerely effective and safe, isn’t that a blight on the medical physician?
    It is tremendously confusing to those of us who are suffering but are hesitant to undergo surgical procedures. Where are the answers?


    • @BJ,
      These are great questions, but it’s hard to find answers to some of them or the answers are gray.
      There are many serious studies being done via clinical trials.
      Such a trial should not charge the patient, should not be designed to make a profit from the trial itself, should be based on common sense, etc. but sometimes for-profit clinics masquerade as real clinical trials so it can be tricky.
      You can see more in my patient’s guide: https://ipscell.com/patients-guide-to-stem-cell-treatments/
      I also go into my detail in my book, which although 4.5 years old now, is still very timely and affordable: https://ipscell.com/stem-cell-book/
      And yes some surgeries such as certain joint replacements are not always going to be good options and have risks too.
      As you wrote/asked, I do worry that some physicians have gone down a dark path on stem cells. Others maybe don’t totally understand that what they are doing is risky to patients and to their own medical practices.
      I posted this email from a patient in today’s blog post because I thought others would find it useful to know you aren’t alone and that there are at least answers or places from discussions on tough questions. I get a lot of these kinds of emails. Best, Paul


  3. I think there is another, basic question that needs to be addressed in treatments offered by unregulated clinics. How do you really know what is being injected in your body? Can you really trust these folks who promote their products/services with hype and anecdotes instead of evidence and facts?

    David Jensen, California Stem Cell Report


    • David, your “basic question” hits the nail on the head. With all due respect to Paul, I say that one needs to do a hell of a lot more research than one would for buying a used car.


      • @Brian,
        My point, which I perhaps should have been clearer about, is that the analogy is just at a minimum and I agree this requires a lot of thought and research. Quite a few patients have indicated they have done nearly zero research on this before considering taking the plunge. Best, Paul


  4. I can say as a person who has had 3 Adipose Derived Stem Cell (ADSC) treatments via IV here in New Zealand (around 2+ years apart for heart and kidney problems) over an 8 year period I have never had any problems at all. I can say without doubt my health has improved and I live a fairly normal life now. I have and still are taking some drugs and some have caused me health problems so they are also not perfect. It is very funny how people think drugs pushed by the pharmaceutical companies are safe and condemn stem cell treatment. Yes there are rouge operators out there but there are some that have the patients interest at heart and do get results. I suggest if you are going under the knife, ask around and find out if they always come out with no pain or problems. You may be surprised and that surgery is not cheap either. I personally would have no hesitation of having stem cell treatment for knee joint problems and my wife has had 2 treatment for arthritis with some positive results. No it has not cured it but has stopped a lot of the pain and slowed down the effects. From my research I believe Adipose Derived Stem Cell (ADSC) seem to work best for knees.

    My parting comment is that I don’t think I have ever seen any of Paul’s posts or replies showing any stem cell treatment by any person or clinic in a positive light. I do appreciate Paul’s site and posts but I also think he is very conservative and cautious in his post and replies possibly because he is a scientist and for various other reasons.


  5. Hi Paul,

    The patient was talking about injection into the joint, so I’m not sure that your point about injection into the blood is relevant. On the other hand, injecting into the joint is not trivial, a bad doc might miss!

    There are a lot of issues about using fat cells that you don’t address. But some which would be relevant to the patient are discussed here:
    https://www.regenexx.com/fat-vs-bone-marrow-stem-cell-research/
    At least that site points towards some primary research, which should be the least unreliable starting point for getting some sort of an understanding of the “state-of-the-art”, such as it is.


    • Dr. Centeno presents an obviously biased view of things, which is all things Regenexx are the best and everything else doesn’t work as well or at all, and/or is a scam. Their purposefully misleading outcome data tells me all I need to know. It really doesn’t make any scientific sense that knee patients would continue to improve over the course of 3 years. Do the cellular products they administer last for 3 years inside a patient’s knee?

      How do they do it? Well, they take the average of all all pre-treatment data, which should be the worst even if their treatment doesn’t work at all given the placebo effect. Then, at one month, they take the average of those who completed surveys, which is higher than pre-treatment data since those who improved are probably more likely to complete the surveys than those who don’t. By the time they get to 3 years out, there are almost no patients left in the sample, just the ones who are still doing well and have continued responding for 3 years. They used to show sample sizes in these graphics but they’ve since removed them.

      For example, they are taking the average scores of the people who are left at 3 years and comparing it to the average score of ALL pre-treatment patients. This is disingenuous at best and certainly misleading to a layperson relying on Regenexx data to make a treatment decision.

      The way Regenexx crunches numbers, almost every patient they treat could get worse (and none improve) and their average outcome score would still improve over time. Here’s how:

      0 = worst 4 = best
      Pre-treatment we have 4 patients with scores of 1,2,3, and 4 -> avg = 2.5

      At 1 month, the first patient goes from 1 to 0 and drops out. The other 3 do not improve 0 2,3,4 -> avg = 3 So, one patient got worse and the average score improves to 3.

      At 3 months, the second patient goes from 2 to 1 and drops out. 0,1 3,4 -> avg = 3.5 Now, we have 2 patients who got worse and 2 who have not improved and yet the average rises to 3.5

      Finally, at 6 months the third patient goes from 3 to 2 and drops out. 0,1,2 4 -> avg = 4 No patient improved and 3 of them actually got worse, yet the avg outcome score shows that over 6 months the average increased from 2.5 to a perfect score of 4.

      “There are three kinds of lies: lies, damned lies, and statistics.” – Benjamin Disraeli


      • Regenexx’s new Live Outcome Data page proves what I’ve laid out. above It gives the number of patients reporting at each time period. So, they compare the average of 302 patients at 4 years with the average of 2197 pre-treatment patients for example, which is an apples to oranges comparison to artificially inflate their results.

        “The number of patients reporting at these time-points are: 2197, 3231, 3041, 2362, 1709, 1229, 641, 302”

        https://www.regenexx.com/live-outcome-data/


        • In fact, the more patients they treat with severe pain who drop out, the better their results will appear to be over time because it skews the pre-treatment number.

          Theoretically, they could have no patients improve out of 1000 and still show pretty good results. Imagine 0 = no pain and 10 = worst pain. 1000 pre-treatment patients average 7.5 Suppose the by the 4th year, 999 of them get worse and drop out. The last one does not change: pre-treatment = 4 and at 4 years their score still = 4. Regenexx math would show that the average decrease in pain at 4 years is from 7.5 to 4, when in fact, nobody improved and 999 out of 1000 got worse.

          I just added this example because I though my previous one might be a little confusing.


  6. I have an appointment tomorrow with a Naturopathic doctor who injects stem cells from placentas to cure many, many things. Are stem cells from placentas better than other types? These costs of these treatments range from $3,000 to $16,000 but if 3 of my friends also have the treatment, mine would be free. BIG RED FLAG!.


    • @Lois,
      As a stem cell biologist, I doubt claims of cures. To my knowledge there is no good scientific/medical evidence that placental stem cells can treat ANY disease successfully and safely.
      A lot of questions to ask.
      Ask this person what data they have to back it up.
      Do they have approval from the FDA?
      What qualifies them as a naturopath to do stem cell transplants?
      What are the risks?


  7. Hi Paul
    What are your thoughts on this type of stem cell for treatment claim from an outfit in SoCal: “stem cells have been derived only by umbilical cord, that’s the safest and most least-invasive technique of extraction accessible.” I DO have advanced hip arthritis, but minimal pain (and only following a run – sometimes…). Probably will need to do something within the next 5? years max and hoping this field will have more data/less shysters? What are your thoughts on all of this?

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