Monday, September 28th, 2009
Over the past several months I have received comments that I think need to be addressed in a much longer format than a comment response. The comments are related to treatment options for rheumatoid arthritis and which treatment is best.
We are fortunate enough to have many options available to us today to manage our rheumatoid arthritis (RA). Traditional medicine offers everything from NSAIDs (Non Steroidal Anti-Inflammatory Drug) like Advil and DMARD s(Disease Modifying Antirheumatic Drugs) such as Plaquenil, Arava, Methotrexate, Gold, and Cyclosporine to biologics like Remicade, Enbrel and Humira. There is a growing trend toward alternative medicine as a solution to deal with this disease. Each option has its benefits, risks and side effects.
NSAIDs are a class of drug that are used primarily to treat inflammation and mild to moderate pain. These medications vary in potency and include the brand names Advil, Motrin, Naproxen, Anaprox and Celebrex. Between 10% to 50% of patients are unable to tolerate NSAIDs because of their side effects. These side effects include upset stomach, stomach pain, and diarrhea. About 15% of people on long term NSAID treatment develop ulcers of the stomach and/or the duodenum.
DMARDs cover a variety of different of drugs. Anti-malarial drugs such as Plaquenil (Hydroxycloroquine) are considered a DMARD and were initially used to treat malaria. It was discovered to help arthritis when patients noticed an improvement in their arthritis symptoms while taking plaquenil for malaria. Plaquenil effects the immune system but doctors do not know how it works for rheumatoid arthritis. Arava (leflunomide) interferes with genes in developing immune cells. When taking Arava, liver monitoring for toxicity is required. You should not take this drug if you are planning to get pregnant or are currently pregnant because of birth defects. The most common side effects for patients taking Arava are rash, nausea, hair loss, liver enzyme elevation and anemia. Methotrexate is a chemotherapy drug that initially was used to treat acute leukemia. Methotrexate (MTX) has become the gold standard for treatment of rheumatoid arthritis (RA). Methotrexate interferes with the growth of cells in the bone marrow. The most common side effects from methotrexate include stomach upset, hair loss, diarrhea, and mouth sores. Folic acid is given while taking this medication to reduce the side effects. Liver function monitoring is necessary to watch for toxicity. Methotrexate should also not be taken if you are pregnant or planning to get pregnant. Injectable Gold has been shown to improve symptoms of rheumatoid arthritis however toxicity is common and constant monitoring in necessary. Side effects include rash, diarrhea, conjunctivitis and marrow suppression. Cyclosporine is a medication that is used primarily for the prevention of rejection of transplanted organs. It is effective for the treatment of rheumatoid arthritis because it stops an overactive immune system from attacking the joints. Side effects can be severe and include hypertension, kidney problems, headache, nausea and diarrhea.
Biologic response modifiers (biologics) are the latest treatment option for rheumatoid arthritis pain and inflammation. They work by blocking the tumor necrosis factors(TNF) components of the immune system. People with RA have too much TNF in their bodies and it overwhelms the immune systems response to inflammation. Biologics such as Enbrel, Remicade and Humira are genetically engineered proteins that binds to and deactivates the TNF molecules before they can do damage. The risks in taking this class of drug include serious infection including sepsis and tuberculosis, nervous system diseases such as multiple scholosis, allergic reactions, lymphoma and congestive heart failure. Because these drugs are fairly new their long term side effects are not known.
There has been much debate on the effectiveness of complimentary and alternative treatments options for rheumatoid arthritis. These treatments include GLA (Gamma Linolenic Acid), DHA (Docosahexaenoic Acid, Tai Chi, herbal supplements and acupuncture. There are many more complimentary and alternative treatment options that will be discussed in future posts.
GLA (Gamma-linolenic Acid) is an essential fatty acid found primarily in plant oils. It is found in borage oil and black currant seed. In preliminary testing it has shown to reduce morning stiffness and swelling however studies have been small to date and additional research would provide more information. DHA (Docosahexaenoic Acid) is an omega 3 fatty acid found in cold water fish. Several studies have shown that DHA reduces inflammation but not the progression of the disease. The movements of Tai Chi improve strength, flexibility and balance. There is no indication that Tai Chi effects the progression of rheumatoid arthritis. Acupuncture in thought to stimulate the release of chemicals called endorphins that block pain. Acupuncture is very effective in treating chronic pain like that in rheumatoid arthritis. The list of supplements as an alternative solution to conventional medicine for the treatment of rheumatoid arthritis include vitamin E, MSM, copper, manganese, vitamin C, selenium, zinc, bromelain, ginger, turmeric and boswellia. These alternatives have proven to help in inflammation and in some cases joint damage.
The benefits of using conventional medicine for the treatment of rheumatoid arthritis are that knowledgeable doctors using this method are readily available and the medications work for many people. These medications have significantly improved the lives of many with rheumatoid arthritis. The downside to this treatment option is the side effects can vary from mild to severe and some long term effects are not even known.
The benefits to choosing an alternative medical solution for the treatment of rheumatoid arthritis is that the side effects to these treatment are few and are less damaging to the body. The disadvantage to complimentary and alternative treatments are that finding a qualified medical professional that can help guide you through all the options available can be a challenge and there is debate on whether or not they can help with joint damage.
Ultimately the choice for a treatment option is a personal one. What matters is what works for you. Everyone has their own body chemistry. What works for one person may not work for another. The advantage that we have today is that we have options, many options, and if something is not working for us we can try in another direction until we find our own solution. It is not up to me or anyone else to decide what is best for you and your body. Trust yourself to figure out what is best for you.
Tags: acupuncture, advil, ananprox, anemia, Arava, arthritis, black currant oil, bone marrow, borage oil, boswellia, bromelain, celebrex, chemotherapy, congestive heart failure, copper, damage, DHA, diarrhea, DMARD, Enbrel, folic acid, ginger, GLA, gold, hair loss, headache, Humira, hypertention, immune system, joint, kidney, leflunomide, leukemia, liver enzyme, lymphoma, m, manganses, methotrexate, MSM, multiple sclerosis, naproxen, nausea, NSAID, plaquenil, pregnant, RA, rash, Remicade, rheumatoid, rheumatoid arthritis, selemium, Tai Chi, toxicity, tuberculosis, turmeric, vitamin C, vitamin E
Posted in Autoimmue Disease, Coping, Decisions, Diet/Nutrition, Good News!, Health/Fitness, Lesson Learned, Rheumatoid Arthritis RA, Solutions, Wellness | 10 Comments »
Wednesday, September 16th, 2009
One of my favorite healthy snacks this time of year is the pomegranate. The kids and I just love to pick at the little gems and eat the sweet, crunchy seeds just as nature made them.
Pomegranates are native to the mediterranean region and are a good source of vitamins A, C, E , folic acid and potassium. The name “pomegranate” in Latin is translated as seeded apple. The polyphenols in pomegranate juice are antioxidants that can prevent and repair oxidative damage caused by free radicals.
In a recent study funded in part by the National Center for Complimentary and Alternative Medicine researchers from Case Western Reserve University studied the effect that the dietary supplement made from pomegranate extract called POMx had on an animal model of rheumatoid arthritis (RA) in mice. The mice were treated before and after the arthritis was induced. The mice that were treated with the POMx before the induced arthritis had significantly reduced incidence and severity of disease than the untreated mice. In mice that were treated to exhibit arthritis symptoms before receiving the POMx, the effected joints showed less inflammation and less destruction of cartilage and bone that those that did not receive the POMx.Future studies will test the disease modifying effects of POMx on mice that have been treated to mimic the symptoms of RA.
Pomegranates are available in the market in the northern hemisphere from September to February. In the southern hemisphere you can find them from March to May but the juice is available year round.
Tags: antioxidant, arthritis, Case Western Reserve University, folic acid, health, inflammation, liver health, National Center for Complimentary and Alternative Medicine, pain, polyphenol, pomegranate, POMx, RA, rheumatoid, rheumatoid arthritis, Rheumatoid Arthritis RA, vitamin A, vitamin C, vitamin E, vitamins
Posted in Autoimmue Disease, Diet/Nutrition, Health/Fitness, Rheumatoid Arthritis RA, Solutions, Wellness | 3 Comments »
Wednesday, August 26th, 2009
According to a National Institutes of Health clinical trial, most patients with Rheumatoid Arthritis(RA) do not have high enough intake of potassium in their diet. Deficiencies in potassium reduces cortisol, a hormone that is involved in immune function and inflammatory response and can result in many RA symptoms.
Potassium is an electrolyte that plays a role in muscle contraction and nerve transmission. It is also involved in the storage of carbohydrates for muscles. The relationship between Potassium and sodium and choride is important in maintaining the body’s ph balance. Many expert have recommended that the ratio between potassium and sodium should be 5 times more potassium than sodium.
How can you increase you intake of potassium? Well the best way to increase your potassium intake is in your diet. Food rich in potassium include, sweet potato, banana, potato, plums, prunes, orange juice and oranges, tomatoes, cantaloupe, peaches, spinach, almonds, and molasses. Cooked foods can loose significant levels of potassium, so when possible choose raw fruits and vegtables. You can get potassium in a multi-vitamin suppliment as well, however the preferred method is in your diet.
Tags: arthritis, cortisol, diet, electrolyte, immune function, inflammatory reponse, muscle, nerve, oranges, peaches, plums, potato, RA, rheumatoid, Rheumatoid Arthritis RA, suppliment, sweet potato, symptoms
Posted in Autoimmue Disease, Decisions, Diet/Nutrition, Health/Fitness, Rheumatoid Arthritis RA | 6 Comments »
Saturday, August 22nd, 2009
This is a great tasting iced tea recipe that fights the inflammation from rheumatoid arthritis (RA) with both ginger and white tea.
2 Cups Cold Filtered Water Heated to a boil
6 Cups Cold Filtered Water
Ice
8 White Tea Bags
About 2-3 inches of Ginger Root peeled and sliced thin
1 Lemon cut into wedges
Sugar, Honey or Agave to sweeten to taste
Steep the tea bags and the ginger in the boiling water for at least 10 minutes. Add the remaining cold water. Chill about 1 hour till cold.Strain. Pour over ice. Sweeten with your favorite sweetener to taste. Garnish with lemon. Enjoy!
Tags: agave, arthritis, ginger, ginger root, ginger tea, honey, ice, iced tea, lemon, RA, rheumatoid, Rheumatoid Arthritis RA, sugar, tea bags, water, white, white tea
Posted in Autoimmue Disease, Diet/Nutrition, Health/Fitness, Recipe, Rheumatoid Arthritis RA | 4 Comments »
Friday, August 21st, 2009
New research at the School of Life Sciences at Kingston University in South West London indicate that white tea reduces the risk of inflammation in those with inflammatory diseases such as rheumatoid arthritis(RA). The study was conducted at the Kingston University in conjunction with Neal’s Yard Remedies to test the health benefits of 21 herb extracts and plants.
White tea is made from the same plant that produces both black and green tea. Because white tea comes from the buds and young leaves of the plant it is believed that they contain higher levels of antioxidants than the black and green variety which is made from older plant leaves.
The findings published in the August issue of Complementary and Alternative Medicine state that white tea prevented the activity of certain enzymes that are associated with inflammatory diseases such as rheumatoid arthritis (RA). Professor Naughton from Kingston University stated: “These enzymes and oxidants are key components of normal body processes. However, in inflammatory conditions, suppressing the activities of the excess components has been the subject of decades of research”. “We were surprised to find such high activity for the white tea extracts in all five tests that were conducted.’ added Naughton. “The early indicators are that white tea reduces the risk of inflammation which is characteristic of rheumatoid arthritis and some cancers, as well as wrinkles.”
The researchers also added that they used a very small amount of white tea in their tests-”…far less than you would find in a drink”. Other natural remedies tested in this study were green tea, anise and pomegranate. All were shown to decrease inflammation however not as significantly as the white tea.
Tags: anise, antioxidant, arthritis, black tea, green tea, inflammatory, Kingson University, pomegranate, RA, research, rheumatoid, Rheumatoid Arthritis RA, School of Life Science, South West London, study, tea, white tea
Posted in Autoimmue Disease, Decisions, Diet/Nutrition, Good News!, Health/Fitness, News, Rheumatoid Arthritis RA | 9 Comments »
Tuesday, August 11th, 2009
Strawberries are at their peak of sweetness in this part of the planet right now. Strawberries are sweet and delicious and great for fighting inflammation as well. They are loaded with vitamin C and Manganese. Strawberries also have Iodine, Potassium, Folate and Vitamins B2, B5 & B6 as well as Vitamin K, Omega 3 fatty acids, magnesium and copper.
Strawberries lower blood levels of C-reactive protein in the blood. C-reactive protein signals inflammation and is high in RA and lupus patients when they are experiencing a flare. At the Harvard School of Public Health, researchers found that women who ate 16 or more strawberries per week were 14 percent more likely to have lower levels of this protein than non strawberry eaters.
It is important to note that strawberries are known to be heavily treated with pesticides. When in comes to strawberries it is organic or nothing for me.
Tags: anti-inflammatory, arthritis, C-reactive protein, flare, folate, Harvard School of Public Health, immune system, inflammation, lupus, manganese, omega 3, potassium, RA, rheumatoid, Rheumatoid Arthritis RA, vitamin C, vitamins
Posted in Autoimmue Disease, Decisions, Diet/Nutrition, Good News!, Health/Fitness, Rheumatoid Arthritis RA, Solutions, Wellness | 4 Comments »
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