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Rheumatoid Arthritis-Conventional and Natural Treatments

Updated on August 4, 2014
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An experienced integrative healthcare professional & Member of the International Alliance of Holistic Therapists

INTRODUCTION

  • Rheumatoid arthritis is a type of inflammatory arthritis that usually affects women and girls
  • It is an autoimmune disorder in which the body’s own overactive immune system mistakenly attacks the synovium (cell lining inside the joint) as it recognises it as foreign
  • This causes the synovium to become inflamed and thickened, damaging cartilage and tissues in and around the joints. Often the bone surfaces are destroyed too due to joint inflammation that triggers production of enzymes that slowly digest adjacent tissue. The body then replaces the damaged tissue with scar tissue, forcing normal spaces in joints to narrow and bone to fuse together
  • Frequently occurs in people below forty years of age
  • Currently, 1.3 million Americans suffer from this debilitating disorder
  • Women are two to three times more likely than Men to develop rheumatoid arthritis
  • The onset of rheumatoid arthritis is associated with physical or emotional stress, poor nutrition and bacterial infection
  • Rheumatologists have discovered that the blood of many rheumatoid arthritis sufferers contain antibodies called rheumatoid factors that can aid in diagnosis
  • Though osteoarthritis affects individual joints, rheumatoid arthritis affects all the body’s synovial joints
  • Arthritis can be caused by bacterial, viral or fungal infection of a joint (micro-organisms involved are streptococci, staphylococci, gonococci, hemophilus or tubercle bacilli and fungi such as Candida albicans. In these cases, the infecting organism travels to the joint though the bloodstream from an infection elsewhere in the body. However, injury or even surgery can result in joint infection as well


SIGNS/SYMPTOMS

  • Stiffness, Swelling, Fatigue, Anaemia, Weight loss, Fever and often crippling pain


Clinical Tests [2]

  • Diagnostic Tests can include one or more tests:

Diagnosis in the early stages can be difficult. There is no single test that can clearly identify rheumatoid arthritis. Instead, doctors diagnose it based on factors which are strongly associated with the disease. The American College of Rheumatology uses this list of criteria:

  1. Morning stiffness in and around the joints for at least one hour.
  2. Swelling or fluid around three or more joints simultaneously.
  3. At least one swollen area in the wrist, hand, or finger joints.
  4. Arthritis involving the same joint on both sides of the body (symmetric arthritis)
  5. Firm lumps called rheumatoid nodules in the skin of people with rheumatoid arthritis). These nodules are usually in pressure points of the body, most commonly the elbows.
  6. Abnormal amounts of rheumatoid factor found in the blood
  7. X-ray changes in the hands and wrists typical of rheumatoid arthritis, with destruction of bone around the involved joints. However, these changes are typical of later-stage disease.

Rheumatoid arthritis is officially diagnosed if four or more of these seven factors are present. The first four factors must have been present for at least six weeks. More recently, guidelines have changed somewhat in an attempt to diagnose RA in its earlier stages.

Symptoms of rheumatoid arthritis can come and go but are usually persistent. To diagnose RA, your doctor may need to see your joints when the disease is active for several reasons:

  • Patients may find it difficult to describe symptoms to doctors in a way that allows them to make the diagnosis.
  • Rheumatoid arthritis can appear similar to other common causes of pain in joints, leading to the wrong diagnosis.
  • Patients often think they are feeling "normal" aches and pains and ignore or just live with their symptoms for a long time before seeking treatment.

Several diseases can be mistaken for rheumatoid arthritis, thus contributing to the difficulty in diagnosis. These other diseases include:

  • Osteoarthritis
  • Gout
  • Fibromyalgia
  • Other autoimmune disorders such as systemic lupus erythematosus (SLE)
  • Joint inflammation caused by infections

Because of these difficulties, a proper diagnosis is often missed early on. In fact, the average time between the onset of symptoms and the official diagnosis of rheumatoid arthritis is almost nine months.

Though diagnosing rheumatoid arthritis isn't easy, it is extremely important to correctly identify those with the disease. Delaying the diagnosis can be harmful because damage to the joints can occur early in the disease. Some experts think that blocking early joint damage can have huge long-term benefits.

The problem arises when it looks like someone has rheumatoid arthritis but they don't yet meet the criteria for diagnosis. If someone doesn't actually have it, it would be wrong to treat them because the pharmaceuticals used to treat RA are powerful and can have serious side effects.

TREATMENT

Conventional:

Rheumatoid arthritis medicines fall into two groups:

  • Drugs that help control disease and limit joint damage, which include DMARDs (disease-modifying antirheumatic drugs) and biologics.
  • Drugs that treat pain and inflammation but do not limit joint damage, which include corticosteroids (or steroids), NSAIDS (nonsteroidal anti-inflammatory drugs), and other pain medicines.

Etanercept/Enbrel

  • Is a drug used to treat Rheumatoid Arthritis
  • Blovks the action of tumour necrosis factor (TNF) alpha, an infection fighting protein linked to inflammation
  • However, tthis drug does not affect the immune system and has been linked to a number of infections like tuberculosis

The Natural Approach (with doses):

  • Diet and Lifestyle
  • Drink plenty of fresh filtered water
  • Stop smoking
  • Avoid eating fast foods and greasy fried foods
  • Eat high fibre food that is low in unhealthy versions of saturated fats (e.g. fried chips); Fruits, vegetables and legumes and grains should be your primary foods as these will create a more alkaline environment (because if the blood is too acidic, the joints lose their normal smooth sliding motion, causing bones to rub together and become inflamed and thus cause pain) and lean meat sources
  • Reduce amount of fat in your diet. Do not consume milk, dairy products or red meat. Avoid caffeine, citrus fruits, paprika, salt, tobacco and everything containing sugar
  • Regular Moderate joint-friendly Exercise (30 minutes daily at least three times per week like swimming) Regular exercise helps reverse joint stiffness, builds muscle, and boosts overall fitness. With regular exercise, you can feel stronger with less fatigue. But first, see your doctor before starting an exercise program.
  • Spend time outdoors with fresh air. This also increase Vitamin D3 absorption which is essential for proper bone formation
  • Check for possible food allergies and foods that aggravate symptoms and inflammation (i.e. keep a food diary)
  • Stress-Management Techniques; hobbies, music, exercise, meditation
  • Avoid the nightshade vegetables (peppers, eggplants, tomatoes, white potatoes) as these foods contain solanine which to some people, especially those suffering from arthritis are highly sensitive. Solanine also interferes with enzymes in the muscles and may cause pain and discomfort
  • Avoid iron supplements or multivitamins with iron as iron supplementation has been suspected to be involved in pain, swelling and joint destruction. Consume iron foods instead (e.g. blacstrap molasses, broccoli, Brussel sprouts, cauliflower, fish, lima beans and peas)
  • Hot tubs and baths may provide relief. Also Raw lemon scrubs and hot castor oil packs may help too
  • Take free form amino acids regularly to help repair tissue
  • Supplement with folic acid, protein and zinc as people with rheumatoid arthritis tend to have lower blood levels of these
  • Avoid high heeled shoes as these place greater compressive pressure on the knees than flat footwear

  • Nutrients & Herbs [1,4]
  • Bromelain; As directed on label three times daily; enzyme that helps to stimulate production of prostaglandins. Reduces inflammation when taken between meals. Helps digestion of proteins when taken with meals.
  • Chondroitin sulphate; 500-1000mg daily; Nutritional support for strengthening joints, ligaments and tendons
  • Essential fatty acids; As directed on label taken twice daily with meals; enhance production of anti-inflammatory prostaglandins & help control arthritis pain and inflammation
  • Gamma-linoleic acid (GLA), an Omega 6 fatty acid that may ease rheumatoid arthritis symptoms through suppressing production of prostaglandins that trigger inflammation (e.g. Evening primrose oil, borage oil)
  • Glucosamine sulphate; As directed on label, Very important in formation of bones, tendons, ligaments, cartilage and synovial (joint) fluid
  • Methylsulfonyl-methane (MSM); 500-1000mg three times daily, a sulphur compound required for reducing inflammation and for joint and tissue repair
  • S-Adenosylmethionine (SAMe) 400mg twice daily, a deficiency causes the inability to maintain cartilage properly. Reduces pain and inflammation (avoid in those with bipolar mood disorder or those taking prescription antidepressants)
  • Vitamin E (d-alpha tocopherol form), 200IU daily; strong antioxidant protecting the joints from damage from free radicals
  • Folic acid; 500mcg daily
  • Zinc; as directed on label
  • Recommendations as per health questionnaire[1,4]:
  • Vitamin B Complex; 50mg each of each major vitamin B three times daily
  • Chlorophyll liquid; 10mL once daily or L-cysteine 500mg twice daily on an empty stomach with water or juice (a detoxifier essential for immune function, a source of sulfur and a component of collagenous tissue
  • Inner Health Plus capsules (1 capsule daily) to assist with absorption of vitamins and supplements and as a probiotic
  • Calcium to promote healthy bone formation [ 600-1500mg daily
  • Magnesium to assist with health muscles
  • L-histidine; as directed on label’ Helps build joints and connective tissue
  • Buffered form of Vitamin C with bioflavonoids; 3000m-10000mg Vitamin C with 500mg bioflavonoids daily (free radical destroyer, pain relief)
  • Cod liver oil to reduce dose of NSAIDs (and source of Vitamin A & D); 1-2 capsules daily [or take separately as Vitamin D3 from the sun or 1000iu (or 25mcg) daily

& Vitamin A (food sources like carrots, kumara)]




PROGNOSIS

  • Regular monitoring and adhering to the diet, exercise and lifestyle advice is imperative to minimise inflammation and increase comfort for those with rheumatoid arthritis

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