Rheumatoid Arthritis: Natural treatment

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Rheumatoid arthritis is an autoimmune, inflammatory, destructive and chronic disease. It consists in progressive destruction of diverse joints, preferably those of the hands, feet and knees. Its fast development can produce articular destruction in only three months. Therefore, early treatment is mandatory in order to reduce irreversible damage. RA is not only limited to joints, it can also attack other parts of the body (pericarditis, Sjogren’s Syndrome, etc…).

On image (a) we can see the typical joint destruction present in RA. (b) represents the symptoms that this disease may produce in our body.

Traditional treatment consists in low dose Methotrexate (drug usually used in chemotherapy) both in oral and injection form. The use of Hydroxychloroquine (drug originally designed to treat Malaria!) or Leflunomide is becoming less common because of their huge side effects and few benefits. On the other side, huge doses of Prednisone are still in use during flare ups, something that will produce osteoporosis and hormonal problems for many patients. Finally, NSAIDS are commonly used for pain control, something that we don’t consider convenient and  will be further discussed below.

Knee oedema, typical in RA

The introduction of biological drugs during the last years of the 20th century and their popularization during the last years has meant a real revolution in RA treatment. However, their high price and the risk of possible adverse events such as cancer and death make doctors recommend these kinds of drugs only to selected few patients. We consider that these drugs should be used with patients with high risk of articular destruction immediately after the diagnosis and during the first months while the patient is adjusting his or her diet and supplementation.

In order to summarise the seriousness of this disease, it should be said that RA patients see their longevity decreased by ten years and, today, 80% of the patients have some kind of disability after 10 years of disease. Therefore, although there have been many improvements in the treatment during the last years, we’re still far away from a RA cure. As drug treatment is clearly insufficient and is not going to bring a cure in the next few years (research is focused on suppressing symptoms) we consider necessary the establishment of a natural treatment that would support and maybe even replace drugs in some cases.

The origin of the disease is still to be established but it seems obvious that, at least in rats, the bowel flora takes part in the disease. Our opinion is similar to Loren Cordain’s: the lectins from food perpetuate the inflammatory pathway although they probably don’t originate it. Our theory is that an external factor (infection, antibiotic treatment, etc…) produces a dysregulation of the innate immune system, which is perpetuated after the ingestion of lectins. Another reason because of which it may seem obvious that we’re still far away from the truth are some little strange details: RA patients don’t show inflammation  in colonoscopies and not all of them respond to a dietary change. All this makes us think that we’re a longer way from discovering the origin of RA than the one of Ankylosing Spondylitis, for example.

Swelling of the interphalangeal joint, normally the first symptom of RA

Diet in Rheumatoid arthritis:

During the last 50 years, the evidence of the importance of diet in the treatment of RA has been increasing. As far back as in 1979, Skoldstam fasted 16 patients for a week and 5 of them went into remission. One year later, Stroud showed 44 cases that entered into remission after an elimination diet. In 1984 Kroker reported that 25 out of 31 patients went into remission after one week of fasting. That same year, Ratner made half of his patients go into remission by simply eliminating dairy from their diet. In 1986 Darlington showed how grains increased symptoms in more than 50% of the RA patients. Darlington’s research is very interesting because one third of the 150 patients treated by him were still in remission after 10 years.

Seignalet’s book

Another doctor who was particularly interested in diet changes in RA was Jean Seignalet. This french immunologist treated almost 300 patients, 227 of which improved their symptoms by more than 90% with his ancestral diet. Seignalet’s diet was easy and cheap, Reading his book “Nutrition, the third medicine” should be mandatory for all RA sufferers. During more recent years Sarah Ballantyne’s book, which is all about the autoimmune paleo protocol has become famous. Her diet is stricter than Seignalet’s but it may be useful for inducing remission quite fast. In general, the results of a dietary change are seen before the 3 months mark so this should be the time to wait before considering the diet is not working.

Ballantyne’s book

In summary, a diet that eliminates all grains (except white rice), legumes and dairy should be enough for most patients. Others, will have to eliminate red meat, eggs, nightshades, nuts and soya in order to see an improvement. Reading Seignalet and Ballantyne’s books will be useful to understand all this logic behind using diets for RA treatment.

We also recommend reading our article about the best diets for autoimmune diseases:

Fasting:

10 studies have been conducted trying to understand the effects of fasting in RA disease activity. The conclusion has always been the same: after 7 days of fasting, between 30% and 50% of patients go into remission. It should be said that the groups used in the studies were small and without placebo group. Even knowing that, we still think that intermittent fasting is a good strategy in the daily treatment of RA. Longer fasts (up to 3 days) may be useful during flare ups.

Thunder god vine:

Also called Tripterygium wilfordii , this herb has been used in RA treatment in China for over 50 years. The research shows that it works better than Methotrexate (standard treatment for this disease). About 70% of the patients respond to the treatment and almost half of them enter remission. Although its profile is safer than Methotrexate, it doesn’t come without side effects (temporal infertility or hair loss) so it should be used under supervision. You can buy Thunder God Vine in Amazon following this link.

Curcumin:

There’s enough evidence to support the use of curcumin in RA treatment. In a well designed study curcumin was more effective than NSAIDS, and without any of their side effects. It’s mode of action is similar to biological drugs. The fact that it doesn’t come with side effects and its other properties such as anti-cancer effects makes us recommend it to all RA patients. The product that we recommend can be bought here.

Boswellia:

Although it isn’t well known for the treatment of inflammatory diseases, three studies have shown its efficacy in RA. Its effects are increased when combined with curcumin and it also hasn’t got adverse effects. We recommend using slightly superior doses than those used in the studies. Our favourite Brand of Boswellia is sold in Amazon.

Vitamin D:

Several studies have observed Vitamin D deficiency in RA patients. Moreover, Vitamin D levels are related with the severity of the disease. You should obtain Vitamin D from direct sun exposure (minimum of 15 minutes per day without protection) and from oily fish like salmon or trout. If you don’t achieve levels of 50-60 ng/ml consider supplementing with this Vitamin D product. Remember that patients with RA have average levels of Vitamin D between 20-25ng/ml.

Ginger:

Some components of the ginger root extract have particles that inhibit inflammatory cytokines produced in RA. Its effectiveness increases when combined with boswellia and curcumin. Buy ginger root extract here.

Omega 3:

A 1:1 ratio of omega 3 and 6 inhibits the building up of proinflammatory cytokines and also reduces C reactive protein. Unfortunately, western diets are rich in refined oils and fast food. This type of nutrition may result in an 1:20 or even 1:50 ratio of these fats. After changing your diet you’ll be able to invert this proportion. Try to eat more oily fish such as anchovies, mackerel, salmon or trout. Even if you eat lots of healthy fats, you should supplement with a high quality omega 3 product like this one.

Low dose naltrexone:

Several studies have shown that LDN is effective in treating chronic pain. Its low cost and zero side effects make it worth a try in RA. You should be aware that it’s currently very difficult to get this drug from a doctor so you may need to search the Internet quite thoroughly.

Antibiotics:

Doctor Brown popularised the use of antibiotics in the treatment of AR. The drugs of choice were generally minocycline and doxycycline. Brown believed that RA was caused by infections that could be treated with antibiotics. Although he saw great results, we don’t recommend the use of antibiotics mainly because the majority of them give benefits because of their immunosuppressive activity and not because they are fighting any infection.

Probiotics:

Several studies have shown that probiotics are effective in RA treatment. Mainly the use of lactic acid bacteria is subject of research but it seems that quite a few different species may be useful. We recommend reading our article about the best probiotics:

Faecal Transplants:

Despite the lack of proper research around RA and faecal transplants, internet is full of testimonies of people CURED after this procedure. We think that the lack of side effects that characterizes this treatment may mean that it’s worth the try for some patients that can afford it.

Criotherapy:

There is much evidence for using cryotherapy in the treatment of RA symptoms. Cryotherapy increases endorphin production, which calms down the inflammation in our body.

Summary of our rheumatoid arthritis treatment:

  • Diet: Autoimmune protocol by Sarah Ballantyne in order to induce remission (+/- 3 months) after that in many cases Seignalet diet will be enough.
  • Intermittent fasting: 16/8 every day and short 3 day fasts during flare ups.
  • The asiatic herb Thunder God Vine: As useful as Methotrexate but without its side effects. Always under medical supervisión.
  • Natural anti-inflammatories: Curcumin, Boswellia, Ginger and Omega 3.
  • Probiotics: Eat a great variety of fermented foods like kéfir or sauerkraut (remember that kéfir, despite being in the dairy category, hasn’t got proteins that affect autoimmune diseases) We also recommend supplementing with soil based organisms, lactic acid bacteriaand clostridium butyricum.
  • Low dose naltrexone if all of the above is not enough.
  • Faecal transplant in some cases.
  • Full body cryotherapy.

We also recommend reading our article about the best natural anti-inflammatories:

Use our link to Iherb.com and get a 5% discount in all supplements!

 

 

Sources:

McInnes, I. B., & Schett, G. (2011). The pathogenesis of rheumatoid arthritis. New England Journal of Medicine365(23), 2205-2219.

Beri, D., Malaviya, A. N., Shandilya, R. E. N. U., & Singh, R. R. (1988). Effect of dietary restrictions on disease activity in rheumatoid arthritis. Annals of the rheumatic diseases47(1), 69-72.

Darlington, L. G. (1994). Dietary therapy for rheumatoid arthritis. Clinical and experimental rheumatology12(3), 235-239.

Cordain, L., Toohey, L., Smith, M. J., & Hickey, M. S. (2000). Modulation of immune function by dietary lectins in rheumatoid arthritis. British Journal of Nutrition83(03), 207-217.

Benito Ruiz, P., & Pros Simón, A. (2001). ¿ Por qué un tratamiento precoz en la artritis reumatoide?. Medifam11(6), 53-61.

Ohtsuka, E. (1992). Upper gastrointestinal endoscopic findings and gastric mucosal blood flow in patients with rheumatoid arthritis. Fukuoka igaku zasshi= Hukuoka acta medica83(2), 62-71.

Chandran, B., & Goel, A. (2012). A randomized, pilot study to assess the efficacy and safety of curcumin in patients with active rheumatoid arthritis. Phytotherapy research26(11), 1719-1725.

Lv, Q. W., Zhang, W., Shi, Q., Zheng, W. J., Li, X., Chen, H., … & Wei, W. (2014). Comparison of Tripterygium wilfordii Hook F with methotrexate in the treatment of active rheumatoid arthritis (TRIFRA): a randomised, controlled clinical trial. Annals of the rheumatic diseases, annrheumdis-2013.

Etzel, R. (1996). Special extract of Boswellia serrata (H 15) in the treatment of rheumatoid arthritis. Phytomedicine3(1), 91-94.

Kostoglou-Athanassiou, I., Athanassiou, P., Lyraki, A., Raftakis, I., & Antoniadis, C. (2012). Vitamin D and rheumatoid arthritis. Therapeutic advances in endocrinology and metabolism3(6), 181-187.

Al-Nahain, A., Jahan, R., & Rahmatullah, M. (2014). Zingiber officinale: A potential plant against rheumatoid arthritis. Arthritis2014.

Younger, J., Parkitny, L., & McLain, D. (2014). The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain. Clinical rheumatology33(4), 451-459.

Vaghef-Mehrabany, E., Alipour, B., Homayouni-Rad, A., Sharif, S. K., Asghari-Jafarabadi, M., & Zavvari, S. (2014). Probiotic supplementation improves inflammatory status in patients with rheumatoid arthritis. Nutrition30(4), 430-435.

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