Rheumatoid arthritis (RA) is a chronic inflammatory condition that affects the synovial membranes of the multiple joints, and may cause joint deformities of the hands and feet. The usual age of onset is 25-50 years old, although it may begin at any age. Two million Americans are afflicted, and approximately one percent of the world’s population has this debilitating disease.
Causes may be due to an auto-immune reaction, genetic or microbial factors. Auto-immune means that your white blood cells are attacking the tissue that aligns your joints. RA may be from large intestine wastes traveling in the small intestine and into the bloodstream for runaway virus inflammation causing auto-immune phagocytes to attack healthy cartilage tissue and the bone. RA may affect the entire body causing swelling and pain in the joints, cartilage scar tissue fusion and crippling stiffness with tiredness, weight loss and fever. Joint stiffness upon awakening that lasts an hour or longer; swelling in specific finger or wrist joints and in the soft tissue around the joints. It can be aggravated by cold and damp conditions. 35% of RA patients have liver trouble.
RA is a chronic, autoimmune disease and extensive “animal” research that supposedly mimics human disease advocates a possible dominance of Th1 (a T-helper cell directly affecting immune system regulation) over Th2 (which has to do with the re-uptake of antibody production to fight off extra-cellular organisms. The theory of immune regulation involves a balance or homeostasis between Th1 and Th2. Dominance of either one may lead to immune system diseases. RA has strong predominant Th1 clones in the blood. The rationale is that human autoimmune diseases often involve Th1 cells reactive against self antigens.
Conventional treatments for RA present a number of problems, in terms of both safety and efficacy. Drugs such as prednisone, methotrexate, antibiotics, COX-2 inhibitors, and imuran have a high degree of side effects. Nutritional supplements, botanicals, and dietary modification have proven to have dramatic effects, and sometimes elicit lasting remission.
Food allergies have been reported to play a role in a number of inflammatory and auto-immune conditions, including RA. It is important to identify possible food allergies, since they may contribute to an increase in inflammation. In one study, nearly 90% of patients suffering with RA had reported specific foods that exacerbated their symptoms. Each patient should utilize the ELIMINATION DIET. This basically means that you eliminate certain foods from your body one at a time for 12 weeks and note the effects.
The most common foods that cause ALLERGIES or SENSITIVITIES per patient were:
- Cow’s milk and dairy
- Wheat gluten and grains, rye
- Bacon, pork
The most common foods that add to an INFLAMMATORY RESPONSE are
- Cow’s milk and dairy
- Wheat and grains
- Citrus fruits
- Nightshades (Potatoes, Tomatoes, Peppers, Eggplant)
[A report from Good Medicine claimed that a patient with RA who eliminated all dairy products and eggs from his diet for 5 weeks became totally pain-free, with increased grip strength].
SAFE FOODS: Brown rice, cooked and dried fruits: cherries, cranberries, peaches, prunes, (minimize citrus fruits), herbal teas, cooked green, yellow & orange vegetables, water, condiments.
OVERALL DIETARY APPROACH:
- A paleo diet might benefit RA patients the most
- Reduce intake of fatty acids that metabolize inflammation
- Avoid common food allergens
- Consume more anti-inflammatory compounds such as plant enzymes (bromelain, papain)
CURRENT MEDICAL TREATMENT
Traditional treatments consist of non-steroidal anti-inflammatory drugs (NSAIDs) taken alone or in combination with disease-modifying anti-rheumatic drugs. Prolonged use of NSAIDs has been linked to numerous side effects, including gastrointestinal bleeding and renal malfunctions. Some of the COX-2 inhibitor drugs (i.e., Celebrex) may reduce inflammation, but do not address the underlying cause, and COX-2 drugs have recently been under scrutiny for causing heart diseases. Short or long-term dosing with prednisone can be effective as an anti-inflammatory, but side effects become a problem with extended use. Omega-3 essential fatty acids including ALPHA LINOLENIC ACID (ALA) which includes flaxseed oil, linseed, fish oil, soybean oil, canola oil, walnut and wheat germ oil are effective natural anti-inflammatory products. Omega-6 essential fatty acids contain GAMMA LINOLENIC ACID (GLA) and include products such as borage oil, evening primrose, and black current oil.
There is a definite heredity component, although with all auto-immune diseases there is a definite diet, lifestyle, and environmental component. There is a cartilage and joint involvement in RA that can be associated with osteoporosis. If food allergies are suspected, try the Elimination Diet. Proteins found in milk and other animal foods can generate an immune reaction that cause immune cells to attack your own tissues (i.e. mild aches, pains, stiffness in joints, runny nose, postnasal drip, asthma, eczema, fluid in middle ears). RA patients also have a problem with digestion. These patients have common symptoms of low pH (not hyperacidity). Symptoms include bloating, belching, flatulence after meals, indigestion, diarrhea or constipation, and nausea after taking supplements, acne, iron deficiency, intestinal parasites and undigested food in stool.
- OMEGA-3 and OMEGA-6 FATTY ACIDS
Omega-3 (fish or flaxseed oil) and Omega-6 (primrose or borage oil) act as significant anti-inflammatory agents in the body decreasing both prostaglandin and leukotrienes (inflammatory mediators in the body). Supplementing the diet with eicosapentaenoic acid (EPA) found in fish oil, has brought about significant improvement in RA sufferers. Gamma-linolenic acid (GLA) primarily found in Omega-6 fatty acids has been found to suppress acute and chronic inflammation. RA has been shown to especially respond well to borage seed oil. Dosage: 1-6 Gm daily.
- GLUCOSAMINE with CHRONDROITIN
Although RA is not primarily a cartilage problem, glucosamine/chrondrotin supplementation is important for the formation of bones, tendons, ligaments, cartilage and synovial (joint) fluid. These supplements provide nutritional support for strengthening bone and maintaining cartilage, a major concern in patients suffering with RA. Dosage: 500-1500 mg per day of glusosamine, and 250-750mg of chrondroitin.
- POTENT MULTI-VITAMIN/MINERAL FORMULA
A basic foundation of good nutrition and health. Find a vitamin preferably with additional green foods. Dosage: As directed.
- VITAMIN C (with BIOFLAVONOIDS), VITAMIN E and other ANTIOXIDANTS
Antioxidants function to reduce levels of free radicals that encourage arthritis by destroying body tissues. Scientists have found that RA, in which the immune cells attack the joints, has been tied to a diet low in antioxidants (especially ZINC). Vitamin C with bioflavonoids also helps to decrease inflammation, increases SOD activity, and helps to strengthen joints. high doses of vitamin E was compared with diclofenac sodium (Voltaren) for effectiveness against chronic rheumatoid arthritis. The intake of high-doses vitamin E is a possible alternative an effective treatment of pain. Dosage: Vitamin C 1,000-5,000 mg daily, Vitamin E 1,000-2,000 IU daily. Bioflavonoids include quercetin, rutin, and hesperidin.
- CALCIUM CITRATE, MAGNESIUM and VITAMIN D3
A combination of calcium, magnesium and vitamin D can help the underlying cause for any degenerative disease associated with bones and muscles. Vitamin D3 deficiency is a common consequence of RA. Dosage: a 2:1 ratio of calcium (1,000-1,500 mg) to magnesium (500-750 mg) and vitamin D3 (400-2,000 IU) daily.
- HYALURONIC ACID (HA)
HA is a naturally occurring polymer found in connective tissue in the human body whose function is to cushion and lubricate. Supplemental hyaluronic acid is derived from rooster comb and provides support for a healthy and youthful appearance by hydrating and soothing the skin. It also supports joint function and comfort by promoting healthy synovial fluid composition (a direct problem in RA patients) and joint lubrication. Dosage: 140-420 mg daily.
- MSM (METHYLSULFONYLMETHANE)
MSM is a sulfur-based nutrient, helps bind water to the cartilage matrix, keeping the cartilage between the joints soft and spongy. Dosage: 100mg 2-5 times a day as needed for acute pain.
- COX-2 INHIBITING, ANTI-INFLAMMATORY HERBS
Many have anti-inflammatory action and support joint and bone health. Herbs with COX-2 inhibiting action (that work similar to prescription NSAIDs) include CURCUMIN (TURMERIC), BOSWELLIN, BROMELAIN, GINGER, GREEN TEA, STINGING NETTLES, WHITE WILLOW BARK, DEVIL’S CLAW. Dosage: See specific package.
- DEHYDROEPIANDROSTERONE (DHEA)
DHEA is produced by the adrenal glands and supports the body’s adaptive stress responses. It may also be involved in immune regulation. Men and women with RA reportedly have low DHEA in their blood, synovial fluid and saliva. This is consistent with RA being predominantly a Th1 disease. Use of this hormone has been associated with reduced joint pain. DHEA may enable the patient to wean off prednisone sooner. Caution: larger doses may cause acne or mild hirsutism. Dosage: 5-50 mg a day. See qualified health practitioner when dosing over 25mg a day.
- PLANT STEROLS
A mixture of phytosterols and beta-sitosterol has been investigated for its immune-modulating properties. They enhance Th1 function and are safe and effective as a long-term immunotherapy for people with autoimmune diseases. A popular brand is called MODUCARE. Dosage: See package.
- TYPE II COLLAGEN
Several studies have found that supplementation with type-II collagen improves the swelling in joints, as well as tenderness and morning stiffness of RA. No reported side effects. Dosage: Up to 10 grams per day.
- PANCREATIC ENZYMES
Enzymes including BROMELAIN (pineapple) taken 5-15 minutes before larger meals to aid in digestion and gastric emptying. Multiple pancreatic enzymes are also effective at decreasing inflammation associated with RA. One of the most popular and effective products is called WOBENZYME. Dosage: As directed on package. BETAINE HCL may be added if low stomach acid is suspected. Dosage: 200-400 mg with meals.
Serum selenium levels are low in patients with rheumatoid arthritis. This may be a significant factor, as selenium plays a role as an antioxidant, and when combined with vitamin E, shows a positive effect in improving the symptoms of decreasing the inflammation associated with RA. A double-blind study found that supplementing with 200 mcg of selenium per day for three months significantly reduced painful joint involvement.
Encouraging studies have shown that individuals with RA might experience an aggravation of symptoms in 1-3 weeks, but generally notice improvement in four weeks, when taking boron supplementation at doses of 6-9 mg daily. Even in children, improvement was found with similar doses.
Probiotics may be uniquely useful for rebuilding declining immunity in diseases and the elderly. The existence of Lactobacillus and Bifidobacterium in the intestinal tract can stimulate cell-mediated immunity. Dosage: 1-2 capsules between meals or as directed.
- CAT’S CLAW
Cat’s claw is a spiny vine from South America that may be useful as adjunct therapy to conventional RA treatment. Cat’s claw reduces the number of painful and swollen joints. A recent Swiss study showed a 53% reduction of painful and swelling joints when Cat’s Claw was added to a pharmaceutical regimen over 24 weeks. Dosage: 100mg extract 1-3 times a day.
- PROGESTERONE CREAM
The improvement of RA during pregnancy is consistent with lower Th1 and elevated Th2. Some evidence suggests that progesterone may up-regulate Th2 in arthritic mice. Dosage: See a qualified practitioner.
Zinc is a mineral with anti-oxidant function. Zinc levels are typically reduced in patients with RA and several studies have been done using zinc sulfate in the treatment of RA. Zinc is linked to Th1 maturation and is also essential to natural-killer cell activity and T-cell maturity. Zinc also inhibits the inflammatory response. Dosage: 50mg 2-3 times a day.
- ALOE VERA JUICE
This miracle herb works at the cellular level. Aloe can systematically reduce pain, swelling, and inflammation in the involved joints and bones associated with arthritis. Dosage: 2-4 ounces daily.
- CAPSAICIN or ARNICA GEL
When these products are applied topically, they may afford the patient pain and inflammatory relief.
- PHENYLALANINE (DLPA)
DLPA is a mixture of the natural form of phenylalanine (L-form) with its mirror image (the D-form). The D-form has been shown t be an effective pain reliever against the chronic pain osteoarthritis. Dosage: As directed.
B complex vitamins are beneficial for decreasing homocysteine levels, and may increase cell utilization and healing. There are certain B complex vitamins that appear to be deficient in patients with RA. PANTOTHENIC ACID (VITAMIN B5) is one of the most common. FOLIC ACID should be supplemented along with the prescription drug methotrexate. Folic acid supplementation decreases the drug’s side effects (including liver, pulmonary distress, fibrosis, gastric distress, and low immunity). Dosage: 1-4 mg daily.
- COPPER and MANGANESE
Copper is known to have anti-inflammatory activity and has been used effectively by some rheumatologists. Dosage: 2-3 mg a day. MANGANESE supplementation is sometimes necessary if discovered to be deficient and aids in utilization of carbohydrates into energy. Dosage: 10-20 mg daily.
- THYMUS EXTRACT
Supplementing with thymus extract may be beneficial because cell-medicated immunity is altered in RA. Dosage: As directed.
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