Rheumatoid Arthritis: The Holistic Approach
Rheumatoid arthritis is an autoimmune disease is a condition in which the body’s immune system dysfunctions and confuses “self” with “non-self.” The immune system begins attacking the body’s own cells. Any tissue or organ of the body can be targeted. Rheumatoid Arthritis (RA) is an autoimmune disorder that primarily effects synovial joints of the body (i.e. hands, shoulder, knee, elbow). The disorder involves a deterioration of healthy synovial fluid in between bones, leading to a painful inflammatory response in the affected joint and can often lead to systemic inflammation over time (William C. Shiel Jr., 2011).
It is still unclear what triggers such an immune system disorder such as RA, but genetics, environmental toxins, “dietary factors, food allergies, bacterial overgrowth, “leaky gut” syndrome, and immunizations have all been suggested as possible causes”(Murray, 2000, p.169). Unfortunately, many people experience long years of pain before finding lifestyle changes that manage their pain.
Rheumatoid Arthritis symptoms may come and go. Swelling, fatigue, pain, stiffness, redness and warmth are the most common symptoms. Because RA can cause systemic inflammation through out the body, malaise, loss of appetite, and muscle aches are also associated with the condition (WebMD, 2011). RA mostly affects the hands, knees, wrists, neck, shoulders, elbows and the jaw are other joints that this disease can target.
Doctors Diagnose RA if four or more of the following seven factors are present. The patient must experience the first four symptoms for 3 months or longer to qualify as a criterion.
The American College of Rheumatology uses this list of criteria:
- Morning stiffness in and around the joints for at least one hour.
- Swelling or fluid around three or more joints simultaneously.
- At least one swollen area in the wrist, hand, or finger joints.
- Arthritis involving the same joint on both sides of the body (symmetric arthritis).
- Rheumatoid nodules, which are firm lumps in the skin of people with rheumatoid arthritis. These nodules are usually in pressure points of the body, most commonly the elbows.
- Abnormal amounts of rheumatoid factor in the blood.
X-ray changes in the hands and wrists typical of rheumatoid arthritis, with destruction of bone around the involved joints.
Sadly, RA is often overlooked in the early stages of the disease and therefore most diagnoses lead directly to a prescription for NSAIDs, narcotics, TNF alpha inhibitors, or glucocorticoids. These pharmaceuticals work to mask inflammation and pain, but they have terrible side effects (a few examples of side effects include intestinal distress, low blood counts, fatigue, skin rashes, and mouth ulcers). They are often also addictive and ineffective in the long-term. NSAIDs may actually worsen the pain over time because of the damage they cause to the intestine. There are specific drugs on the market that claim to inhibit the underlying immune processes causing the arthritis.
The Integrative Approach:
Recommended assessments and lab tests include all the standard procedures. However, testing for food allergies is a must. A leaky gut test may also be beneficial to guide the focus of treatment. Often RA patients do have “leaky gut” syndrome and strongly benefit from some GI repair that inevitably reduces systemic inflammation and pain.
Identifying food allergies and balancing fatty acid intake are the two most impactful measures you can take to reduce the symptoms as well as the chronic inflammation preventing the body from healing. (Murray, 2000, p.169). Repairing the intestinal cells, reducing inflammation, and removing allergens and toxins will change the internal environment of the body and calm the immune system, consequently reducing pain and symptoms.
Other healing modalities that also work to change the internal milieu include stress management, relaxation, meditation, stretching, and light physical activity. These activities are meant to calm the mind and reduce stress, while also stir around the lymph, getting the blood circulating, and also stimulating muscles and joints.
Because RA is an autoimmune disorder, the main focus of nutritional therapy should be to optimize immune health, reduce toxin exposure, and reduce inflammation. Flooding the body with antioxidants and healthy fatty acids will work to counteract the deteriorating effects of RA on the body.
Having one autoimmune disorder does increase your risk of developing additional autoimmune disorders. With the new advances in testing, it is now possible to test every tissue in your body to see if you are at risk for another autoimmune disease. Doing some general blood work (CBC) and testing for inflammatory markers (like CRP) will help understand the weaknesses in the body and help to develop a targeted health-supportive protocol.
Diet:
A nourishing diet for Rheumatoid Arthritis is a diet that is organic, toxin-free, hypo-allergenic, low-glycemic, and contains minimal animal products. You want to support the immune system, digestive, and detoxification systems, as they are often the weakest systems in a client with RA. “Leaky gut” syndrome is often associated with RA so digestive support and repair (The 4 R’s) are appropriate for healing. Glutamine is the preferred energy source of enterocytes so supplementing with glutamine and other nutrients that strengthen and repair the intestinal lining (gamma oryzanol, deglycyrrhizinized licorice, antioxidants, aloe, slippery elm…) is critical for reducing inflammation throughout the body while also reducing the burden on the liver and immune system.
Common allergenic foods linked with RA include wheat, dairy, eggs, soy, corn, beef, nightshades and peanuts. Coffee, sugar, and alcohol are depleting, acid-forming foods that will prevent optimal healing. Avoiding processed foods will also help the client avoid rancid, oxidized, and trans fats. It is best to avoid any source of irritation or stress on the body in order to foster a healing environment internally.
Protein, fats, fiber, vitamins, and antioxidants are invaluable to a healing diet. Eating a rainbow of colors each day will help ensure a full spectrum of phytochemicals and nutrients are consumed. A solid foundational diet is essential for relief from RA.
Omega 3 fatty acids in the diet are very important to increase circulation and decrease inflammation. Salmon, sardines, walnuts, and flaxseeds are the highest sources of these anti-inflammatory fatty acids. While increasing omega-3 intake, decrease omega-6 intake because excess omega-6 fatty acids upregulate inflammation.
Supporting liver detoxification with foods such as cruciferous vegetables, onions, garlic, dandelion teas, milk thistle, and plenty of organic food will support the liver as it tries to cleanse all the toxins in the client’s body. Eggs are rich in sulfur and great unless the client has an allergy. Avoiding processed foods, food colorings or additives will decrease toxic exposure, also relieving the burden off the liver. Avoiding these foods will also reduce exposure to potentially allergenic and inflammatory ingredients.
Drinking enough water is key to keeping things moving and fluid. Drinking herbal teas are a great way to intake both water and beneficial nutrients. For example, chamomile is great for calming; Echinacea is great for supporting the immune system. Drinking vegetable juices will also increase nutrient intake while alkalizing the body.
It is best to reduce your intake of meats because they generally lead to inflammation. Occasionally having fish is still beneficial for the omega-3 fatty acids, but many individuals can find relief of their pain with a whole foods vegetarian or vegan diet, assuming all nutrients are optimized and there is sufficient protein (Mateljan, 2007, p.819). Small amounts of healthy beef liver may also benefit because of high levels of minerals and b vitamins.
I also recommend supporting the immune system with selenium, magnesium, and zinc rich foods and supplements. Increasing potassium, magnesium, and calcium intake by consuming plenty of green vegetables, while also having fish will work to balance the body with supportive nutrients. When you cook, choose to steam your veggies and drizzle olive oil on after cooking. Use extra virgin olive oil for it’s high monounsaturated fats and anti-inflammatory properties (use unheated only – olive oil easily goes rancid when exposed to heat, light, and air).
Lifestyle:
Healing from RA with a natural, integrative approach necessitates some lifestyle changes. It takes time for the body to slowly adapt to these changes, but over time your body will become healthier and stronger, and consequently more resistant to other diseases and disorders. Moreover, you may be able to halt or even reverse RA symptoms with dietary and lifestyle changes.
Walking, stretching, yoga, and Pilates are all beneficial activities that improve circulation and overall vitality. Some form of activity is recommended each day to strengthen muscles and regulate metabolic processes.
Exercise and participation in activities you enjoy will also boost your mood and immune system. Guided imagery, laughing, comics, and playing outdoors will help you enjoy life, distract yourself from pain and stress, and allow your body to heal and repair.
Choose organic, non-toxic beauty care products because lotions and other environmental toxins are associated with pain and inflammation. Although we can’t completely avoid toxins, there are choices that we are in control of, such as buying water filters for the house, air filters, and natural household cleaning products, that can significantly reduce your daily toxin exposure and therefore give your body a chance to detoxify chemicals already in the body, while also restoring healthy function to your organs to reduce inflammation and symptoms of RA.
For more details about the integrative approach to Rheumatoid Arthritis, contact Katherine.
Resources:
Bond, Owen. (2011, may 2). Retrieved from http://www.livestrong.com/article/433180-resveratrol-arthritis/
Higdon, Jane. (2005). Linus Pauling Institute. Retrieved from http://lpi.oregonstate.edu/infocenter/phytochemicals/curcumin/
Mateljan, G. (2007) The World’s Healthiest Foods: Essential guide for the healthiest way of eating. Washington: GMF Publishing.
Murray, M. (2000). Total Body Tune-Up. New York: Bantam Books.
William C. Shiel Jr., M. (2011, november 20). Retrieved from http://en.wikipedia.org/wiki/Rheumatoid_arthritis
WebMD. (2011). Symtoms of rheumatoid arthritis. Retrieved from http://www.webmd.com/rheumatoid-arthritis/guide/rheumatoid-arthritis-symptoms
Tags: autoimmune diseases, inflammation, pain, Rheumatoid Arthritis
