Elisa/Act allergy testing for foods, molds, medications, and chemicals (O, RA, PA, AS)Arthritis refers to more than a hundred diseases that cause inflammation of the joints. The old-fashioned term for arthritis is rheumatism, and today physicians who specialize in arthritis are called rheumatologists. Arthritis affects 40 million Americans and accounts for 46 million medical visits per year. It affects about 15 percent of our population and 3 percent of those severely, but it is severe in 11 percent of people ages 65 and older.
The two most common types of arthritis are osteoarthritis and rheumatoid arthritis. Other common types include psoriatic arthritis, ankylosing spondylitis, gout, Lyme disease, Reiter’s syndrome, lupus, and Sjögren’s syndrome. Each of these diseases has its own characteristics, but they all share the symptoms of pain and inflammation in joints.
There are many causes for arthritis: genetics, infections, physical injury, nutritional deficiencies, allergies, metabolic and immune disorders, stress, and environmental pollutants and toxins. Several types of arthritis have well-documented associations with faulty digestive function. Osteoarthritis responds well to dietary changes. Rheumatoid arthritis, ankylosing spondylitis, lupus, Sjögren’s syndrome, and Reiter’s syndrome are all autoimmune conditions. As such, leaky gut probably plays a role, along with environment and genetics.
The current drugs of choice for mild to moderate arthritis pain are nonsteroidal anti-inflammatory drugs (NSAIDs). Although they may help with the pain, many NSAIDs also have a negative effect on the ability of cartilage to repair itself. They block our body’s ability to regenerate cartilage tissue by lowering the amounts of healing prostaglandins, glycosaminoglycans, and hyaluronan, and by raising leukotriene levels. NSAIDs block the production of healing prostaglandins, which stimulate repair of the digestive lining. This causes increased intestinal permeability. (See Chapter 4 for more information on NSAIDS and leaky gut.) Use of NSAIDs in children with rheumatoid arthritis showed that 75 percent had gastrointestinal problems caused by the drugs. And the more NSAIDs people take, the leakier the gut wall becomes; the leakier the gut, the more pain and inflammation follows, which sets up a continuously escalating problem. For rheumatoid arthritis and other autoimmune types of arthritis, disease-modifying anti-arthritic drugs, also called DMARDS, are used. There is a wide variety of these, and they all have significant long-term unwanted effects.
Use of natural therapies and dietary change for arthritis can reduce the need for such medications and their accompanying side effects. Natural therapies can be used to help relieve pain, reduce inflammation, help regenerate cartilage, and slow the disease process. These natural therapies can be astonishingly effective. Look to all aspects of the DIGIN model if you have arthritis of any type. Balancing these can be the key to resolving your pain.
The dietary connection between rheumatoid arthritis and food sensitivities was first noted by Michael Zeller in 1949 in Annals of Allergy. He found a direct cause and effect by adding and eliminating foods from the diet. He joined forces with Drs. Herbert Rinkel and Theron Randolph to publish a book called Food Allergy in 1951.
Theron Randolph, M.D., is the father of a field of medicine called clinical ecology, which studies how our environment affects health. He found that people with rheumatoid arthritis who were not reacting to foods had at least one sensitivity to an environmental chemical. Randolph sent questionnaires to more than 200 of his patients with osteoarthritis and rheumatoid arthritis to assess how well treatments were working. Their responses showed that when they avoided food and environmental allergens, there was a significant reduction in arthritic symptoms. Randolph also felt that other types of arthritis, including Reiter’s syndrome, ankylosing spon-dylitis, and psoriatic arthritis, have an ecological basis.
Since then, other studies have been done on the relationship between food sensitivities and arthritis. In a study of 43 people with arthritis of the hands, a water fast of three days brought improvement in tenderness, swelling, strength of grip, pain, joint circumference, function, and SED rate (a simple blood test that determines a breakdown of tissue somewhere in the body). When some of these people were tested with single foods, symptoms recurred in 22 out of 27 people. In other studies, the foods most likely to provoke symptoms after an elimination diet were, in order of most to least, corn, wheat, bacon or pork, oranges, milk, oats, rye, eggs, beef, coffee, malt, cheese, grapefruit, tomato, peanuts, sugar, butter, lamb, lemon, and soy. Cereals were the most common food, with wheat and corn causing problems in more than 50 percent of the people.
In another study, it was found that 44 out of 93 people with rheumatoid arthritis had elevated levels of IgG to gliadin. Among these 44 people, 86 percent had positive RA factors. In yet another study, 15 out of 24 people had raised levels of IgA, rheumatoid factor, and wheat protein IgG with a biopsy of the jejunum. Six of the wheat-positive people and one of the wheat-negative people had damage to the brush borders of their intestines. The researchers felt that the intestines play an important role in the progression of rheumatoid arthritis. Increased intestinal permeability allows more food particles to cross the intestinal mucosa, which triggers a greater sensitivity response.
Hvatut and colleagues measured IgG, IgA, and IgM antibodies in serum and intestinal fluid in 17 people with rheumatoid arthritis and 20 healthy controls. They concluded that measuring food antibodies in intestinal fluid gives a more “striking” result between rheumatoid arthritis, food sensitivities, and the immune activation of the mucosal lining (MALT).
Kallikorm and Uibo reported that of 74 people admitted to the hospital with arthritic diseases, 12 percent had elevated antigliaden antibodies, indicating gluten intolerance; 1 person had celiac disease. Because people with one autoimmune disease are more susceptible to other autoimmune diseases, it’s good to screen for celiac and gluten intolerance.
The concept of food sensitivity and increased intestinal permeability is gaining acceptance as more physicians see the clinical changes in their patients when they use this approach. Testing for food and environmental sensitivities, parasites, toxic metals, candidiasis, and intestinal permeability and performing a comprehensive digestive stool analysis (CDSA) often provide an understanding of an underlying cause of the disease.
Candidiasis frequently plays a role in “fungal” arthritis and is a possible aggravator in rheumatoid arthritis. While common in people who are on immunosuppressant drugs, it is beginning to be seen in people who have normal immune health. It has been found in the synovial fluid of knee joints, yet how often do physicians actually test synovial fluid for infection? Fungus in people with arthritis can be the result of using antibiotics, oral contraceptives, or steroid medications; increased use of alcohol or sugar; or a stressed immune system. Treatment of candidiasis in the digestive system has improved rheumatoid symptoms in many cases.
In many types of arthritis, known microbes trigger a molecular mimicry that then activates the disease. Rheumatoid arthritis is associated with Proteus mirabilis infection; ankylosing spondylitis is associated with Klebsiella sp.; reactive arthritis is triggered by a GI infection of salmonella, yersinia, campylobacter, and in the urinary tract chlamydia.
Infection can trigger arthritis and joint inflammation. Why they move to the joints or cause joint pain is unknown at this time. But the phenomenon is well documented. If candida, Lyme disease, chlamydia, klebsiella, salmonella, or another infection is present, your physician can recommend a variety of therapeutics, including both natural and pharmaceutical remedies.
There is documentation in the literature about arthritis and deficiencies of nearly every known nutrient. When the needed nutrients are supplied, the body can begin to balance itself. Though many nutritional and herbal products help arthritis sufferers, no one thing works for everyone, so persist until you find the therapies that work best for you. Give each one at least a three-month trial before giving up on it. I remember Abram Hoffer, M.D., speaking about a patient at a conference many years ago. He had recommended the man take 1,000 mg of vitamin C daily for his arthritis. The man took the vitamin C faithfully each day without any improvement. After a whole year, he suddenly became pain-free.
People with arthritis are often too acidic. To buffer this acidity, the body pulls alkaline minerals out of the bones. These minerals are sometimes deposited in joints throughout the body. (See Chapter 17 for more on pH balance.)
Exercise and stretching are useful for all types of arthritic conditions. Yoga has been found to help with range of motion, pain, stiffness, and joint tenderness. Walking, swimming, physical therapy, and massage therapy may all play a role in reduction of symptoms. Movement is not optional. Even small amounts can give great relief.
Osteoarthritis is the most common type of arthritis and the one we associate with aging, although nutritionally oriented physicians believe it has more to do with poor dietary habits and biochemical imbalances than age. Pain is usually the first symptom. The main characteristics are stiffness, aches, and painful joints that creak and crack. Stiffness may be worse in the morning and after exercise. Osteoarthritis begins gradually and usually affects one or a few joints, most commonly in the knee, hip, fingers, ankles, and feet. As joints enlarge, cartilage degenerates. Eventually, hardening leads to bone spurs. You lose flexibility, strength, and the ability to grasp, accompanied by pain. Risk of osteoarthritis, especially arthritis in the knee, increases if you are overweight; losing weight helps. Acid-alkaline balance is also important in treating this illness.
Rheumatoid arthritis is characterized by inflammation of joints, most often in the hands, feet, wrists, elbows, and ankles, with symmetrical involvement. It can start in virtually any joint. The onset may be sudden, with pain in multiple joints; or it may come on gradually, with more and more joints becoming involved. Joints become swollen, feel tender, and can degenerate and become misshapen. Joints are often stiffest in the mornings and also feel worse after movement. RA is most common in women and in people who smoke. In a blood test, the rheumatoid factor (RF) will be elevated in most cases of rheumatoid arthritis. While it may get better or worse, once established RA is nearly always present to some extent. Treatment is aimed at lowering inflammation and TNF-alpha.
Many drugs are being used to treat rheumatoid arthritis, and all have complicating side effects. Natural therapies are an adjunct or replacement for medical intervention. For example, fish oils and curcumin lower TNF-alpha.
Rheumatoid arthritis has a genetic component, often running in families. It is believed to be triggered by a bacterial infection (Proteus mirabilis), having the “right” genetics (HLA-DR1/4), and autoimmunity caused by a molecular mimicry. When genes meet the environment, the illness is triggered. The gene marker HLA-DR1/4 is present in 50 to 75 percent of people with rheumatoid arthritis.
There are many microbes that have been associated with rheumatoid arthritis. Here are some of the many microbes that have been indicated in RA: proteus mirabilis, Epstein-Barr virus, mycobacteria, mycoplasma, chlamydia, yersinia, salmonella, shigella, campylobacter, staphylococcus, streptococcus, candida, clostridium, borrelia, leptospira, erysiplotrix, klebsiella, and oral bacteria.
Proteus mirabilis is a bacterium commonly found in the urinary tract and can be found in urine. It causes no problems in most people, but in people who have the HLA-DR1/4 genotype, it acts as a genetic mimic that cross-reacts with collagen XI and hyaline cartilage, breaking down the cartilage. Proteus mirabilis antibodies in people with RA have been found in people in 14 countries. Proteus mirabilis has not been found to have an association with any other disease. I was able to find 44 studies on PubMed regarding the role of Proteus mirabilis, and the mechanisms are beginning to be very well understood. It’s postulated that incidence of RA is higher in smokers because smoking puts people more at risk of developing urinary tract infections. In one study, a decrease in antibodies to Proteus mirabilis was observed in subjects on a vegetarian diet. Proteus infections can be treated with either natural or pharmaceutical therapy.
Proteus mirabilis is also found in biofilms. Although there are no studies yet on the relationship of this particular bacteria, biofilms, and arthritis, I look forward to seeing those in the future.
Waldemar Rastawicki and colleagues in Poland studied 92 patients with RA. They were tested for bacterial genes in synovial fluid and blood. While bacterial genes weren’t discovered, antigens to pathogenic bacteria were found: salmonella (8.6 percent), yersinia (20.7 percent), and enterobacterial common antigen (34.9 percent).
A 1973 study by Mardh and colleagues reported mycobacteria in synovial fluid. Just recently, a friend with chronic knee issues had her synovial fluid tested and discovered that she had Lyme disease.
Vegetarian, vegan, and raw-food diets have been shown in numerous studies to be successful at reducing the symptoms of rheumatoid arthritis. Vegetable-based diets help balance pH levels. They also provide an abundance of antioxidants, natural anti-inflammatory factors, vitamins, minerals, and phytonutrients. This diet also tends to be more hypoallergenic. Add fish oil to increase the benefits. Short-term fasting prior to beginning the vegetarian diet has also been shown to provide long-term benefits. Please work with a good nutritionist.
It’s hard to generalize or predict which of these factors will be found in each person, but usually one or more is present. Each of them needs to be investigated. Leaky gut is probably not a primary cause of rheumatoid arthritis, but long-term use of medications used for the arthritis often makes it a factor.
Psoriatic arthritis affects 30 percent of people with psoriasis (the incidence used to be 3 to 7 percent), about 1.4 million Americans. People with severe psoriasis are more likely to develop psoriatic arthritis. In addition to the usual symptoms of psoriasis, they also have joint pain, tenderness, or swelling in the fingers, toes, or spine. Other symptoms include reduced range of motion, morning stiffness, redness and pain of the eye that is similar to conjunctivitis, and nail changes with pitting or lifting of the nail. Psoriatic arthritis is rarely found in people who do not also have psoriasis. Psoriatic arthritis is associated with bone erosion and deformities that affect half of the people with this disease. Skin and joint symptoms may flare up or improve simultaneously. Psoriatic arthritis closely resembles rheumatoid arthritis, although people with psoriatic arthritis usually have a negative rheumatoid factor. This disease can be mild, but it can also be severely deforming and disabling.
Like other types of autoimmune disease, psoriatic arthritis has genetic, environmental, and immunologic origins. The gene marker HLA-B27 is present in most people with this disease.
Inflammation of psoriatic arthritis is involved with arachidonic acid pathways and TNF-alpha. New drug therapies, such as injectable infliximab and etanercept, aim at lower TNF-alpha levels. A healthful diet plus essential fatty acids help reduce and prevent further inflammation. Evening primrose, borage, and fish oils; turmeric; curcumin; bromelain; and quercetin all work on these pathways.
Li and Wang used traditional Chinese medicine (TCM) and integrative medicine in working with 47 people with psoriatic arthritis. Seventeen people were given TCM only. Thirty were given a combination of TCM and integrative medicine. Dosages of medications were reduced as symptoms were relieved, cured, or improved. They conclude that TCM and integrative medicine are effective for people with psoriatic arthritis with fewer negative effects than current medical treatment.
Ankylosing spondylitis is characterized by a progressive fusion of joints in and around the spine. Caucasian men constitute 90 percent of those with the illness, and it typically becomes evident between the ages of 10 and 30. It starts off as a low backache, which is often worse in the mornings. Symptoms get progressively worse and spread from the lower back to the midback and up to the neck. The spine gradually becomes fused. Later, shoulders, hips, and knees may be affected. Symptoms flare and subside.
The role of dysbiosis in ankylosing spondylitis is the most researched and best understood of all the arthritic diseases. Most researchers believe that AS is triggered by an inherited gene and interactions with the environment. Much research has been done on the role of infection as a primary trigger of AS. The gene implicated is HLA-B27, although others may still be found. HLA-B27 is present in 96 percent of people with ankylosing spondylitis. This marker is also present in 8 percent of the general population. Research shows 70 to 80 percent of people with ankylosing spondylitis have klebsiella bacteria in their stools. Yersinia, shigella, and salmonella bacteria are also associated with this process and may contribute to the disease in people who are not infected with klebsiella. These bacteria may not normally cause disease, but in people with the HLA-B27 gene marker, antibodies produced to kill the bacteria cross-react, causing pain and inflammation. This concept of autoimmune disease may explain why some people get certain illnesses and others don’t. It’s the presence not only of a specific gene but also of a microbe or other environmental trigger that activates the disease process.
What begins as a local infection triggers an autoimmune disease. In the paper “Enteropathic arthritis, Whipple’s disease, juvenile spondyloarthropathy, and uveitis,” published in Current Opinions in Rheumatology 1994, Finnish rheumatology researcher Marjatta Leirisalo-Repo states, “An association between inflammatory bowel disease and enteroarthritis and the spondyloarthropathies has been known for awhile … and it now seems evident that chronic gut inflammation is either associated with or is even the cause of chronicity of peripheral arthritis and the development of ankylosing spondylitis.”
It is important to make an early diagnosis of ankylosing spondylitis so that progression of the disease can be slowed or halted. Because it usually appears as a low backache, many people will tend to seek chiropractic help or massage therapy or take anti-inflammatory medications. But such remedies can’t correct dysbiosis in the intestinal tract. Because many men commonly have low-back pain, they often have irreversible damage before a correct diagnosis is made.
In people with ankylosing spondylitis, also think about gluten intolerance. In one study of 30 people by Togrol, 36.7 percent were found to have antigliaden antibodies. Three of these people (10 percent) also had positive anti-endomysial antibodies. I personally know two men with AS who have experienced positive benefit from being on a gluten-free diet. Other studies have failed to show any significant difference in gluten intolerance in people with AS in comparison with control groups.
Leaky gut syndrome is present in people with ankylosing spondylitis. Unfortunately, NSAIDs are commonly used to treat ankylosing spondylitis, causing even greater intestinal permeability. This, in turn, causes more sensitivity to foods and environmental substances.
About half the people with ankylosing spondylitis experience dramatic improvement when they eliminate dairy products. Thirteen out of 25 people who were studied had good results, and another 4 had moderate improvements. Of the respondents whose results were good, 8 were able to discontinue NSAID medication. Six patients from this study remained dairy-free for more than two years because they were so satisfied with the results. The elimination of dairy products is a simple and effective treatment to try. Although the mechanism for this improvement is unclear, it is suggested that a dairy-free diet modifies the bacterial ecosystem of the gut, which may have benefits. Another hypothesis is that milk allergy causes chronic irritation to the gut as well as gut permeability.
Klebsiella and other disease-producing microbes that can contribute to ankylosing spondylitis use sugars as their main food source. Some physicians are experimenting with a low-starch diet and are getting good results. Eliminate all breads, grains, pasta, cookies, candy, root vegetables, and legumes. Be patient: you may get amazing results, but you will need to stay on the diet for at least six months before you really reap the benefits.
I recently queried two friends with AS about what has been most helpful. They both responded that exercise and stretching have given the best response.
The letters following each list item indicate the illness that that test can be used to detect. Note that O = osteoarthritis, RA = rheumatoid arthritis, PA = psoriatic arthritis, and AS = ankylosing spondylitis.
Elisa/Act allergy testing for foods, molds, medications, and chemicals (O, RA, PA, AS)
Organic acid testing (O, RA, PA, AS)
Comprehensive digestive stool analysis (O, RA, PA, AS)
Intestinal permeability screening; stop use of NSAIDs for three weeks prior to test (O, RA, PA, AS)
Candida testing, either separately or in CDSA (O, RA, PA, AS)
Heidelberg capsule testing for HCl status (RA)
Small intestinal bacterial overgrowth breath test (RA)
Liver function testing; people with rheumatoid arthritis are also shown to have reduced function in the detoxification pathways (RA)
Some of these suggestions will significantly help your arthritis; others may not help at all. You can look for products that combine these nutrients and herbs. Be patient and give whatever you try time to work. Try one or two at a time until you find a program that suits your body’s unique needs and your lifestyle. Recommendations work for all types of arthritis, unless I’ve specifically noted a type after the suggestion.
Try an alkalizing diet. Bring your body into acid-alkaline balance. See Chapter 17 for a discussion.
Exercise. It’s important to use your body as much as you can without aggravating the condition. Yoga, walking, swimming, stretching, water exercises, physical therapy, massage, and acupressure massage may all be of help. Do something nearly every day.
Try an elimination-provocation diet. Follow the directions outlined in Chapter 15. For best results, work with a nutritionist or physician who is familiar with food sensitivity protocols.
Try the Nightshade Diet. In the 1970s, Norman Childers, a horticulturist, popularized the Nightshade Diet. Elimination of nightshade foods helps only about 15 percent of people with arthritis, but the people who respond are usually helped a great deal. The nightshade foods are potatoes, tomatoes, eggplant, and peppers (red, green, yellow, and chili). An elimination diet of two weeks followed by a reintroduction of these foods provides a good test. Blood testing also picks up these sensitivities.
Try yucca. Yucca has been used by Native Americans of the Southwest to alleviate symptoms of arthritis and improve digestion. It’s a rich source of saponins with anti-inflammatory effects. Studies have been done with both rheumatoid and osteoarthritis with significant improvement in 56 to 66 percent of the people who tried it. People taking yucca for more than one and a half years had the additional advantage of improved triglyceride and cholesterol levels and reduction in high blood pressure, with no negative side effects. Take two to eight tablets daily.
Take cetyl myristoleate (CM). Harry Diehl, a researcher at the National Institutes of Health, found that mice did not develop arthritis when CM was given. When he himself developed arthritis, Diehl took CM and his arthritis resolved. Jonathan Wright, M.D., has found CM to be clinically valuable in about half of his patients. CM appears to actually cure arthritis in many instances. I was able to find two studies on CM that had astounding results. CM was found to be best used in combination with glucosamine sulfate, sea cucumber, and methylsulfonylmethane (MSM). Recommended duration of use is two to four weeks. Carbonated beverages, caffeine, chocolate, and cigarettes are not allowed while taking CM and its associated supplements.
Take vitamin C ascorbate. Vitamin C is an essential nutrient for every anti-arthritis program. It is vital for formation of cartilage and collagen, a fibrous protein that forms strong connective tissue necessary for bone strength. Vitamin C also plays a role in immune response, helping protect us from disease-producing microbes. Many types of arthritis are caused by microbes, which vitamin C helps combat. It also inhibits formation of inflammatory prostaglandins, helping to reduce pain, inflammation, and swelling. Vitamin C is also an antioxidant and free radical scavenger; free radical formation has been noted in arthritic conditions. Take 1 to 3 grams daily in an ascorbate or ester form. For best results, try a vitamin C flush weekly for four weeks. (See Chapter 10.)
Increase omega-3 fatty acids and fish oils. Fish oils come from cold-water fish and contain eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). The fish with the highest levels are salmon, mackerel, halibut, sardines, tuna, and herring. These omega-3 fatty acids are essential because we cannot synthesize them and must obtain them from our foods. Fish oils inhibit production of inflammatory prostaglandin E2 series, cyclooxygenase, and thromboxane A2, all of which come from arachidonic acid. Fish oils shift the production to thromboxane A3, which causes less constriction of blood vessels and platelet stickiness than thromboxane A2. Research has shown fish oils are really helpful for some people with arthritis, reducing morning stiffness and joint tenderness. Fish oil capsules produce moderate but definite improvement in arthritic diseases at dosages from 8 to 20 capsules daily. Similar results can be obtained by eating fish with high EPA/DHA two to four times a week. Because fish oils increase blood clotting time, they should not be used by people who have hemophilia or who take anticoagulant medicines or aspirin regularly. High dosages in capsule form should be monitored by a physician.
Take gamma-linolenic acid (GLA) (RA). In one study, patients with rheumatoid arthritis were given 1.4 grams of GLA from borage oil daily. It significantly reduced their symptoms: swollen joints by 36 percent, tenderness by 45 percent, swollen joint count by 28 percent, and swollen joint score by 41 percent. (Some people responded in more than one area.) Use of evening primrose oil in the study group and olive oil for the control group showed that both oils helped reduce pain and morning stiffness. Several people were able to reduce use of NSAIDs, but none were able to stop the medication. The modest results in this study were probably due to the use of NSAIDs with the evening primrose oil. The same results could be obtained by use of evening primrose or borage oil alone. Take 1,400 mg.
Take and/or eat ginger. Ginger is an old Ayurvedic remedy that was given to people with RA and OA. In one study it reduced pain and swelling in various amounts in 75 percent of the people tested, with no reported side effects over three months to two and a half years. Ginger can be used as an ingredient in food and tea or taken as a supplement. Take 2 ounces fresh ginger or 3,000 to 7,000 mg powdered ginger daily.
Take niacinamide. Most of the B-complex vitamins have been shown to reduce inflammation and swelling associated with arthritis. Dr. Kaufman, M.D., Ph.D., an expert on arthritis, recommends using niacinamide at a rather high dosage with excellent results. It doesn’t cure the arthritis, but it really helps while you take it. If you are going to try this, do so with your physician’s supervision. High levels of niacinamide can be liver toxic. Take 250 to 500 mg daily. Soft gel capsules are recommended. Make sure to get a brand without colors, preservatives, or solvents.
Take folic acid plus vitamin B12. In a recent study, those with osteoarthritis in their hands were given 20 mcg vitamin B12 plus 6,400 mcg folic acid daily. They reported a significant reduction in symptoms. This is a tiny amount of vitamin B12 and a large amount of folic acid, which is nontoxic even at these high levels.
Take superoxide dismutase (SOD). SOD plays an important role in reducing inflammation and has been used alone, with copper, manganese or copper, and zinc for various arthritic conditions. Some physicians are using SOD in injections. Oral SOD doesn’t seem to work as well, except when used in a copper-zinc preparation. Wheatgrass extracts of SOD can be purchased at health-food stores. Most people who try them experience benefits, but there is little scientific research to date. Some veterinarians are using wheatgrass SOD with arthritic animals with excellent results.
Take S-adenosylmethionine (SAMe). A recent player on the scene is SAMe, a chemical that is found naturally in every living cell. Research in 10 studies that included more than 22,000 people has shown SAMe to have powerful antide-pressant effects without the side effects of pharmaceutical antidepressant medications. SAMe has also been shown to be as potent an anti-inflammatory drug as indomethacin and other NSAIDs, with fewer negative effects. This product is expensive because it is difficult to stabilize. Use it with a good multivitamin that contains B-complex vitamins. Take 400 mg twice daily. Adjust up or down as needed.
Take methylsulfonylmethane (MSM) or dimethylsulfoxide (DMSO). DMSO is highly effective for reducing arthritis pain when used on skin. It has a distinct odor that prevents many people from using it, but MSM is odorless. MSM, a naturally occurring derivative of dimethylsulfoxide, is now being used as a supplement. MSM has been found to be an antioxidant and anti-inflammatory in animal studies, probably because of its high sulfur content. It helps reduce pain and inflammation and gives the body the sulfur compounds necessary to build cartilage and collagen. It is also useful in allergies, blood sugar control, and asthma. Take 1,000 to 5,000 mg daily. It is best when taken with 1,000 to 5,000 mg of vitamin C for absorption. Or use DMSO topically on skin.
Take bromelain. Bromelain is an enzyme derived from pineapple that acts as an anti-inflammatory in much the same way that evening primrose, fish, and borage oils do. It interferes with production of arachidonic acid, shifting to prostaglandin production of the less inflammatory type. It also prevents platelet aggregation and interferes with the growth of malignant cells. It appears to be as effective as NSAID medications at reducing inflammation. Bromelain can be taken with meals as a digestive aid, but as an anti-inflammatory, it must be taken between meals. Take 500 to 1,000 mg two to three times daily between meals.
Take quercetin. Quercetin is the most effective bioflavonoid in its anti-inflammatory effects; others include bromelain, curcumin, and rutin. Bioflavonoids help maintain collagen tissue by decreasing membrane permeability and cross-linking collagen fibers, making them stronger. Quercetin can be used to reduce pain and inflammatory responses and for control of allergies. Take 500 to 2,000 mg daily. It appears to reduce inflammatory cytokines.
Take boswellia. Boswellia is taken over the long term as a treatment for rheumatoid arthritis, not specifically for immediate pain. Boswellia serrata, an Ayurvedic remedy that has been traditionally used for arthritis, pain, and inflammation, has been shown to moderate inflammatory markers such as nitric oxide and 5-lipoxygenase. In a study, a specific preparation of boswellia called H-15 was given to 260 people and found to be effective in treating rheumatoid arthritis. Fifty to 60 percent of the subjects had good results. Take 1,200 mg two or three times daily.
Take turmeric or curcumin. Turmeric has been shown to have powerful anti-inflammatory properties. Some of the mechanisms involved include its ability to block leukotrienes and arachidonic acid, both of which cause inflammation and pain. An effective dosage of turmeric is 10 to 60 grams daily. Curcumin, the active pain-relieving ingredient, can be taken in much smaller doses, 500 mg three times daily. For those lucky enough to live in warm areas where turmeric can be grown and used fresh, it can be juiced, grated, used in stir-fry, and eaten freely. Turmeric is also a lovely flowering garden plant.
Take devil’s claw. Devil’s claw (Harpagophytum procumbens) is a South African root that is commonly used as an arthritis remedy. It reduces pain and inflammation. Several studies have shown it to work as well as phenylbutazone, a common NSAID medication. It is commonly used in low-potency homeopathic dilutions of 2X in Germany. This is a dilution of one part per hundred of devil’s claw in a homeopathically potentized form.
Use black cohosh. Black cohosh (Cimicifuga racemosa) has long been used by European and American herbalists to reduce muscle spasm, pain, and inflammation. It can be used as either a tincture or in capsules.
Use capsicum (cayenne pepper). Cayenne has been well studied for its temporary relief of arthritis pain. Creams with capsicum are used topically to relieve pain. (These creams may burn when first applied.) In various studies, typically more than half of topical-cream users experience pain relief. These are available over the counter and by prescription.
Try DL-phenylalanine (DLPA) (RA). DLPA is an amino acid that is used therapeutically for pain and depression. It is effective for treating rheumatoid arthritis, osteoarthritis, low-back pain, and migraines. “D” is the naturally found form, and “L” is its synthetic mirror. The combination of DL slows down the release of the phenylalanine. It appears to inhibit the breakdown of endorphins, our body’s natural pain relievers. Take 400 to 500 mg three times daily.
Take a multivitamin with minerals. People with arthritis are often deficient in many nutrients. Aging, poor diet, medications, malabsorption, and illness all contribute to poor nutritional status. At least 21 nutrients are essential for formation of bone and cartilage, so it’s important to find a supplement that supports these needs. Look for a supplement that contains 500 to 1,000 mg calcium, 400 to 500 mg magnesium, 15 to 45 mg zinc, 1 to 2 mg copper, 10,000 IU vitamin A, 200 mcg selenium, 50 mg vitamin B6, and 5 to 10 mg manganese in addition to other nutrients. Follow dosage on bottle to get nutrients in the appropriate amounts.
Take glucosamine and chondroitin. Glucosamine sulfate and chondroitin sul-fate are nutrients used therapeutically to help repair cartilage, reduce inflammation, and increase mobility. Studies have consistently shown benefits of both glucosamine and chondroitin supplementation. Green-lipped mussels are a rich source of glycosaminoglycans. Use of glucosamine sulfate has no associated side effects, although anecdotally it may raise serum cholesterol levels. It either works or it doesn’t. Give it a three-month trial. It’s important to buy a product that has been broken down into a molecular size that your body can use. It’s worth it to spend more on this product.
Take vitamin E. Twenty-nine study participants with osteoarthritis were given 600 IU of vitamin E or a placebo daily. Out of 15 who received vitamin E, 52 percent reported improvement. Another study showed no improvement in those with osteoarthritis who were given vitamin E supplementation of 1,200 IU daily. Try 800 IU for two to three months. It is very safe and may help some people. Best is the “d-alpha” form of mixed tocopherols. Look for high levels of gamma-tocopherol.
Use copper to treat RA symptoms. Copper is involved in collagen formation, tissue repair, and anti-inflammatory processes. Rheumatoid arthritis sufferers often have marginal copper levels. Traditionally, copper bracelets have been worn to help reduce arthritic symptoms. W. Ray Walker, Ph.D., tested those who had benefited from copper bracelets by having them wear copper-colored aluminum bracelets for two months. Fourteen out of 40 participants deteriorated so much they couldn’t finish the two months. More than half reported that their arthritis had worsened. Dr. Walker found that 13 mg of copper per month was dissolved by sweat, and presumably much of that was absorbed through the skin. Supplementation with copper increases levels of superoxide dismutase (SOD). Wear a copper bracelet or supplement with 1 to 2 mg daily in a multivitamin preparation. If you are working with a physician, you may temporarily add a supplement of copper salicylate or copper sebacate until copper levels return to normal.
Eat or take alfalfa. Alfalfa is a tried-and-true folk remedy for arthritis. Many people attest to its benefits, but more research is needed on it. Alfalfa is an abundantly nutritious food, high in minerals, vitamins, antioxidants, and protein. Alfalfa may help because of its saponin content or its high nutrient and trace mineral content. It is widely used as a nutritional supplement in animal feed. Take 14 to 24 tablets in two or three doses daily, or grind up alfalfa seeds and take 3 tablespoons of ground seeds each day. You can mix them with applesauce, cottage cheese, or oatmeal or sprinkle them on salads. Another method is to cook 1 ounce of alfalfa seeds in 3 cups of water. Do not boil them, but cook gently in a glass or enamel pan for 30 minutes and strain. Toss away the seeds and keep the tea. Dilute the tea with an equal amount of water. Add honey if you like. Use it all within 24 hours. Yet another method is to soak 1 ounce of alfalfa seeds in 3 cups of water for 12 to 24 hours. Strain and drink the liquid throughout the day.
Address hypochlorhydria and small intestinal bacterial overgrowth (RA). Low levels of hydrochloric acid (HCl) were found in 32 percent of people tested with rheumatoid arthritis. Half of these people had small intestinal bacterial overgrowth. Thirty-five percent of patients with normal levels of HCl had SIBO compared with none of the control group. SIBO was found most in people with active arthritic symptoms. (See Chapter 2 for information on HCl and Chapter 8 on small intestinal bacterial overgrowth.)
Examine side effects of breast implants. Silicone breast implants may cause rheumatoid-like symptoms in some women, although research is divided. If you have rheumatoid arthritis and silicone or saline breast implants, it would be smart to be tested for silicone antibodies or allergies on an annual basis. Many women feel remarkably better once breast implants have been removed.