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 »
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 »
Saturday, July 25th, 2009
This is a tasty recipe that is loaded with anti-inflammatory such as ginger,garlic, turmeric, honey and cabbage. It also has vitamins C, D, E and Folic Acid. It is a great lunch or a nice light dinner.
Marinade:
1 Cup Orange Juice
1 Tablespoon Paprika
1 teaspoon Turmeric
2 teaspoon Cumin
1 ½ teaspoon Orange Zest
1 Tablespoon Fresh Ginger Minced
2 Whole Boneless Skinless Chicken Breast
With a mallet pound out the chicken to a uniform thickness. Place all the dry ingredients into a zip close bag with the chicken and coat the chicken completely just be moving it around the bag. When coated add the orange juice, orange zest and ginger. Close bag and refrigerate.While the chicken is marinating, prepare the dressing and vegetables.
Dressing:
3 Tablespoon Tahini
½ Cup Orange Juice
½ Cup Sour Cream or Yogurt
2 Clove Garlic (minced)
1 Shallot (minced)
2 Tablespoon Soy Sauce (Good Quality like Tamari)
1 Tablespoon Sushi Vinegar
¼ teaspoon Chili paste
2 Tablespoon Honey
1 Tablespoon Cilantro
Mix all the dressing ingredients together in a bowl and whisk until everything is incorporated.If whisking is an issue you can put all the ingredients in the blender in pulse until well mixed. Place in refrigerator and chill.
Filling:
½ Cup Shredded Cabbage
1 Carrot Julienned
½ Cucumber peeled, seeded and julienned
½ Cup Bean Sprouts
1/8 Red Onion sliced really thin
½ Zucchini julienned
6 Whole Wheat Wraps ( I used the rectangular ones. I find it easier to wrap)
The longer you marinade the chicken the more flavors it will have. I only marinaded mine for the time it took me to prepare the dressing and the vegetables and it tasted great. Make sure your grill is really hot and grill the chicken for about 8-10 minutes per side depending on the thickness of the chicken. Let the chicken rest for about 5 minutes. Slice the chicken into thin strips.
Layer the vegetables close to the end of the wrap leaving about 1 inch on either side(the short side) and about 2 inches from one edge(the long side) of the wrap. . Drizzle the dressing over the vegetables. Layer chicken strips on top of vegetables.
Fold up the sides and while holding them in grab the end on the wrap with your thumbs and fold over the filling then start to roll the wrap toward the end the wrap. I like to cut the wrap into 2 pieces to make it a little easier to hold. Serve and enjoy!
Tags: anti-inflammatory, arthritis, Chicken, chili paste, cumin, ginger, marinade, nutrients, orange, paprika, rheumatoid, Rheumatoid Arthritis RA, Tahini, Thai, turmeric
Posted in Autoimmue Disease, Diet/Nutrition, Health/Fitness, Recipe, Rheumatoid Arthritis RA | No Comments »
Friday, June 26th, 2009
I haven’t added a recipe in a quite a while so today I thought I would share one of my favorite salads. This is a nice light summertime dish that won’t weigh you down on the hottest of days. We enjoy it for either lunch or dinner and the kids really love it. On the rheumatoid arthritis front this salad has garlic, ginger, vitamin C, folic acid, omega 3′s and beta carotene. All of which are good for fighting inflammation.
Marinade:
1 Tablespoon Minced Ginger
1 Tablespoon Minced Garlic ( about 2-3 cloves depending on the size of the cloves)
1 Tablespoon Soy Sauce ( a good quality soy sauce like Tamari is best )
1 Cup Orange Juice
1 Tablespoon Orange Zest
Put all the above ingredients in a zip close bag ( gallon size is probably best)
Chicken:
Prepare 2 full skinless boneless chicken breast by trimming away any excess fat. Place chicken between 2 pieces of plastic wrap and take out any anger and aggression you have about having rheumatoid arthritis out on your chicken. I use a metal mallet so that I don’t have to use a lot of muscle to pound the chicken out. Pound the chicken to about 1/2 inch thickness. Add chicken to the marinade and zip up plastic bag making sure to squeeze out any excess air and place in refrigerator while preparing the salad.
Salad:
You can use whatever salad greens that make you happy. When I made this recipe today for lunch. I used the lettuce and spinach from the garden. If you don’t feel like cutting up salad greens getting the prepackaged stuff will work just as well.
2 Large Carrot peeled and julienned ( My son gave me an oxo julienne peeler that makes the process easy with very little effort ) or you can buy prepackaged stuff
2 Cup shredded Red Cabbage
2 Oranges Supremed (How to supreme and orange) or if it is easier for you or your hands are bothering you use a jar of mandarin oranges
1/2 Cup Toasted Slivered Almonds ( just place slivered almonds in a non stick fry pan and heat for about 5 minutes stirring occasionally to make sure that the almonds release some of their oils and get crunchy)
Wash and dry all the vegetables. ( My kids like to use the salad spinner so they do that for me ) Tear lettuce into bite sized pieces unless of course you have purchased the ready made stuff.
Take the marinading chicken out of the refrigerator and grill until fully cooked. Cooking times will vary based on the grill size and the amount of btu’s that it puts out. It usually only takes me about 15 minutes flipping the chicken halfway though the cooking process. When the chicken is fully cooked place on a cutting board to rest while you prepare the dressing.
Dressing:
1 Tablespoon Dijon Mustard
1 Tablespoon Soy Sauce ( a good quality soy sauce like Tamari is preferable )
1 Tablespoon Sesame Oil
1 Tablespoon Rice Wine Vinegar
1/4 Cup Orange Juice
2 Tablespoon Honey
2 Teaspoon Grated Ginger
Whisk all ingredient together in a mixing bowl. ( You can also just throw everything together in the blender and mix )
Place the lettuce, cabbage and carrot in a large salad bowl or serving platter and toss until well mixed. Place oranges randomly about the bowl or plate. Slice grilled chicken and place warm chicken on top of lettuce mixure. Top with slivered almonds and drizzle with dressing. Serves 4 – 6
Enjoy!
Tags: arthritis, beta carotene, Chicken, folic acid, garlic, ginger, inflammation, omega 3, orange, oriental, rheumatoid, salad, vitamin C
Posted in Diet/Nutrition, Recipe | 7 Comments »
Friday, May 1st, 2009
I created this recipe last night and honestly it is the best chicken I have ever eaten.
Marinade:
1/2 cup White Wine
2 Tablespoons Worcestershire Sauce
2 Tablespoons Honey
2 Cloves Garlic Minced
1 Tablespoon Grated Ginger ( approximately I usually just break off a “finger” of ginger and use that )
1/2 of zest from 1 orange
1/2 of zest from 1 lemon
Marinate skinless boneless chicken breast for about 1 hour. This marinade was enough for 6 chicken breasts. Grill on low heat until cooked through. (or until 180 degrees on meat thermometer) Cooking times will vary based on size of chicken breast and size and btu’s of grill.
Mango Chutney:
1 Mango peeled and diced
2 Cups Pineapple( fresh is best but canned Pineapple is okay too) diced
1/2 cup Red Onion diced
1 Cup Cantaloupe peeled and chopped
2 Cups Watermelon chopped
1 1/2 tablespoon honey
1 teaspoon cinnamon
Make sure all ingredients are at room temperature. Mix all ingredients together and let sit for about an hour.
Spoon over warm chicken. Serve.
The garlic, ginger,mangoes, onions, pineapple, honey and cinnamon are all beneficial for fighting inflammation in people with rheumatoid arthritis.
Tags: arthritis, Chicken, garlic, ginger, Mango, marinade, rheumatoid
Posted in Recipe | 4 Comments »
Monday, March 23rd, 2009
Ginger is one of my favorite spices to cook with. I use it in everything from Chicken Soup to Stir Fry. Ginger is an anti inflammatory, antioxidant and analgesic. Traditional medicine has used ginger to stimulate digestion, and quell nausea and vomiting. Ginger (Zingiber officinale) is the root of a lily plant.
In a recent Danish study, researchers found that up to 74% of patients with rheumatoid arthritis experienced some pain relief by simply drinking tea made from ginger. The researchers believe that ginger was able to give relief to those with rhuematoid arthritis because ginger contains compounds that inhibit the production of prostaglandins and leukotrienes that causes pain and inflammation.
To make ginger tea, take 2 Tablespoons of fresh ground ginger and steep in hot water. I like to add a bit of honey as well. I prefer to make my own tea, but if you are in a hurry and just want something easy to pop in a hot cup of water I found these
Hot compresses using ginger root has also been found effective for pain relief, although I have not tried this method.
Tags: analgesic, anti-inflammatory, antioxidant, arthritis, cook, ginger, ginger tea, pain, refef, rheumatoid
Posted in Diet/Nutrition, Wellness | 8 Comments »
Subscribe to LivingRheum with RSS