Rheumatoid Arthritis
Now you can cope with this painful condition!
If you have rheumatoid arthritis, your body’s infection-fighting immune cells decide that you’re the enemy. They attack your joints and cause inflammation, with pain, redness, heat, swelling, and tissue damage. The inflammation doesn’t always confine itself to joints, either, says Andrew Rubman, N.D., director of the Southbury Clinic for Traditional Medicine in Connecticut and consultant to the Office of Complementary and Alternative Medicine at the National Institutes of Health. "Other organs, such as the skin, heart, and lungs, can be affected," he says.
Rheumatoid arthritis is usually treated with aspirin, ibuprofen, naproxen sodium, or various other, more powerful versions of anti-inflammatory drugs. If necessary, your doctor may call on steroid drugs to knock out inflammation.
Alternative practitioners attack rheumatoid arthritis on several additional fronts, says Jody Noé, N.D., a naturopathic doctor at the Brattleboro Naturopathic Clinic in Vermont. They use anti-inflammatory nutrients and herbs. Often, these supplements are prescribed in large doses, so you’ll need the advice of a practitioner or doctor before you start taking them.
Some of the recommended supplements also work to restore proper immunity and to get the adrenal glands functioning better. These glands, located above the kidneys, are powerful little organs that secrete hormones such as epinephrine and steroids that affect many organ functions and influence the use of energy throughout your body.
Alternative practitioners also try to address what they believe are potential triggers of autoimmune diseases such as rheumatoid arthritis. Naturopathic doctors believe that one of the triggers is increased intestinal permeability, or "leaky gut," a condition that occurs when molecules of incompletely digested food or bacterial fragments appear to be seeping through the walls of the intestine, setting off an immune response.
People also have allergic reactions to foods, and if you see an alternative practitioner about rheumatoid arthritis, you’re likely to be questioned closely about what foods you eat and when. Realizing that adrenal gland problems can arise from too much physical or emotional stress, alternative practitioners may try to treat the stress as a way of avoiding an autoimmune reaction. If you’ve been diagnosed with rheumatoid arthritis and want to try these options, get your doctor’s approval first.
Antioxidants That Ax Inflammation
Any time you have inflammation, there’s production of free radicals, unstable molecules that can harm surrounding cells, causing what’s called oxidative damage. Some nutrients that may help stop free radicals and prevent that damage include vitamins E and Reining In Radicals with C and E
In our bodies, inflammation is usually a protective response brought on by an infection or injury. If your immune system is in good operating order, it detects any foreign organism that’s been able to invade at the site of the wound or infection, and your body begins setting up its defense. The response is designed to wall off the infection or foreign matter from the rest of the body, destroy any organisms involved, and break down any injured tissue, clearing the way for new construction.
The classic signs of inflammation are heat, redness, swelling, and pain. These symptoms are the result of increased blood flow into the affected area. The blood vessels actually change size, making room for immune cells to travel through the bloodstream to the site of injured or infected tissue. This process also produces a number of chemicals that orchestrate the process and that can cause pain and fatigue.
In this process, free radicals are normally generated, according to Maret G. Traber, Ph.D., principal investigator at the Linus Pauling Institute and associate professor of nutrition at Oregon State University in Corvallis. Free radicals are molecules that can cause damage to healthy cells by stealing electrons from other molecules in cells. “Immune cells, such as lymphocytes, macrophages, and neutrophils, generate oxygen and hydrogen peroxide as part of the clean-’em-up, move-’em-out process,” notes Dr. Traber.
Macrophages are amoeba-like cells that engulf bacteria and foreign matter. Inside the voluminous macrophages are sacs of hydrogen peroxide, and when the invaders are trapped in these sacs, they’re killed by the interaction with hydrogen peroxide.
As inflammation progresses, some free radicals end up on the wrong side of the battlefield. They may react with the membranes of cells that are essentially innocent bystanders, damaging some of the molecules in those otherwise healthy cells. If the healthy cells’ membranes are damaged enough, the cells may be killed or maimed.
If there are antioxidants in the neighborhood during this reaction, less damage may occur. Some antioxidants, such as vitamin E, act as shields. They are incorporated into cell membranes and can give up one of their own electrons, thus neutralizing a free radical and making it settle down rather than hunting for other electrons.
Vitamin C can collaborate in neutralizing free radicals. If vitamin C is available to give vitamin E one of its electrons, vitamin E can put the damper on free radical activity. “It actually travels through the cell membrane, and each molecule of vitamin E can protect about 1,000 molecules in the membrane,” Dr. Traber says.
Other antioxidants act in different ways, but the end result is the same: More cells are protected and emerge unscathed despite being under assault from the free radicals that have been unleashed during inflammation.
Nutrients to Improve Digestion
Some kinds of arthritis have a clear link with inflammatory bowel disease. Two with confirmed links are arthritis of the knees, ankles, and wrists and ankylosing spondylitis (rheumatoid arthritis of the spine).
These links, as well as other clues, have suggested to doctors of alternative medicine that digestive problems can play a role in rheumatoid arthritis. Here’s where the leaky gut theory comes in. If incompletely digested food and bacterial fragments are seeping through the intestinal lining into the bloodstream, so the thinking goes, maybe they’re setting off an improper immune response that ends up causing rheumatoid arthritis.
"It’s possible to do tests that can confirm if someone is having an immune reaction that could cause rheumatoid arthritis," Dr. Noé says. Your rheumatologist or a naturopathic doctor can order these tests.
In addition, she recommends nutritional supplements that nourish and rebuild the intestinal lining and restore good bacteria to the bowel. Some foods that commonly aggravate leaky gut are wheat gluten, corn, and dairy products.
"I may also recommend enzymes that help break down food for proper digestion if tests suggest that someone’s pancreas is not producing enough for normal digestion," Dr. Noé says.
To provide nourishment directly to intestinal cells, she suggests a large number of supplements that are specifically used to treat autoimmune diseases like rheumatoid arthritis and lupus. They include:
- 500 to 750 milligrams of the amino acid glutamine.
- 100 to 300 milligrams of gamma-oryzanol, a component of rice bran oil.
- 50 to 100 milligrams of fructooligosaccharides (FOS), taken two or three times a day between meals. (Fructooligosaccharides are naturally occurring sugars that help to promote the growth of friendly bacteria in the intestines.)
- One or two capsules two or three times a day of a supplement containing various forms of lactobacillus and other so-called friendly bacteria—Lactobacillus acidophilus, L. rhamnosus, L. casei, L. plantarum, Bifido- bacterium bifidum, B. longum, and B. breve. The recommended dose has two to five billion active organisms per capsule.
- 500 to 1,000 milligrams of 10X U.S.P. of digestive enzymes. (10X U.S.P. is a measure of strength, listed on the bottle.)
- A mixture of other enzymes derived from plants, including 12,500 to 18,000 U.S.P. of protease, 2,675 U.S.P. of lipase, 12,000 to 27,000 U.S.P. of amylase, and 175 CU(2) of cellulase.
Dr. Noé says that these supplements are safe to take on a continuous basis as long as you get your doctor’s approval and remain under supervision. Some of the supplements may only be available through a naturopathic physician or holistic doctor.
A Spicy Way to Ease Aches
Turmeric, an Indian spice, contains an anti-inflammatory and antioxidant compound called curcumin that might be helpful for people with rheumatoid arthritis, especially during flare-ups, says Dr. Rubman. "In animals, curcumin has excellent anti-inflammatory and antioxidant effects, without any toxicity," he says.
When curcumin is present, the body is much less likely to form the compounds that are instrumental in causing inflammation, according to Dr. Rubman. Research with humans is still sketchy, but some preliminary studies have suggested benefits.
The recommended dose of curcumin is 400 to 600 milligrams three times a day with or without food, Dr. Rubman says. If you don’t notice some relief within 10 days, stop taking it. It is safe to take indefinitely as long as you don’t have a digestive problem, but for best results, he recommends seeking the care of a naturopathic physician. Curcumin is available from naturopathic doctors and is also sold at health food stores.
Bringing in Bromelain
To enhance absorption of curcumin and add more anti-inflammatory power, supplement manufacturers sometimes mix curcumin with bromelain, an enzyme found in pineapple, Dr. Rubman says.
"Bromelain can activate compounds that break down fibrin, tissue that blocks off areas of inflammation," Dr. Rubman explains. He points out that the fibrin blocks blood vessels, which can prevent tissues from draining and cause them to swell.
Bromelain also blocks the production of compounds produced during inflammation that increase swelling and cause pain.
The usual dosage for bromelain, according to Dr. Rubman, is 400 to 600 milligrams three times a day, taken at the same time as curcumin on an empty stomach. Mixtures of bromelain and curcumin in a ratio designed to reduce inflammation are available at some health food stores or from a naturopathic doctor.
Going with Ginger
Ginger, a relative of curcumin and the same spice used in baking, has anti-inflammatory and antioxidant properties that make it helpful for rheumatoid arthritis, Dr. Rubman says. In two small studies, ginger helped to reduce muscle stiffness, pain, and swelling.
You can take ginger instead of curcumin if you prefer, he says. The doses he recommends are 100 to 200 milligrams three times a day of ginger extract standardized to contain 20 percent gingerol and shogaol, the active ingredients. You also have the option of 8 to 10 grams (about 1½ tablespoons) of fresh ginger or 2 to 4 grams (about one teaspoon) of dry powdered ginger daily. Do not use the dried root or powder if you have gallstones.
Ginger can be especially soothing if your rheumatoid arthritis includes gastrointestinal problems. If you tend to "run hot," as Dr. Rubman puts it—if you tend to sweat a lot or have hot, swollen joints—you’re better off avoiding ginger, he says.
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