|Amino Acid / Protein|| Phenylalanine
| ||The 'D' form of phenylalanine (DPA) has been used to treat chronic pain, including rheumatoid arthritis, with mixed effectiveness.|
| ||The thymus gland contributes to the maturing of T-cells. Thymus gland extracts will assist this process when the thymus gland is shrunken, as happens commonly in aging. Through his clinical experiences with thymic supplementation, Dr. Burgstiner said he observed 28 cases of rheumatoid arthritis cases go into remission where patients no longer needed to use prednisone, methotrexate, or gold shots.|
| ||In a small study of patients with severe to crippling rheumatoid arthritis, 4 were unable to walk, and one could not sit in a wheelchair. After 20 days, 5 showed improvement, and 3 were totally free of pain with almost complete return of joint mobility. All but two were totally pain-free and had recovered mobility in their joints. One of the two had abused steroids as an athlete and the other had cirrhosis of the liver.|
In those with mild to moderately severe rheumatoid arthritis, after 14 days of treatment, 9 patients reported continuing improvement even though treatment had completed. (Unpublished study)
Fish Oil / Krill
| ||Beside the comments under essential fatty acids, please see the link between Rheumatoid Arthritis and Vegetarian Diet.|
Turmeric Extract, Curcumin
| ||Clinical studies have substantiated curcumin anti-inflammatory effects, including a significant beneficial effect in Rheumatoid Arthritis. In one study, curcumin was compared to phenylbutazone, a very potent NSAID that has fallen out of favor because of frequent side effects. The improvements in the duration of morning stiffness, walking time, and joint swelling were comparable in both groups.|
Cat's Claw (Urticaria tomentosa)
| ||Uncaria tomentosa extract over a 6 month period reduced the number of painful joints in a well-controlled study involving 40 patients with active rheumatoid arthritis already being treated with sulfasalazine or hydroxychloroquine. An additional 7 months of treatment with Uncaria tomentosa extract reduced the number of painful and swollen joints with the same group of patients. [J Rheumatol 2002;29(4): pp.678-81]|
Evening Primrose Oil / GLA
| ||Scientists at the University of Pennsylvania reported that high doses of GLA helps in treating rheumatoid arthritis patients. An earlier study by them had shown that administration of 1100mg of GLA per day from borage seed oil reduced synovitis in six of seven patients with rheumatoid arthritis.|
The anti-inflammatory properties of EPO have been studied in double-blind research with people suffering from rheumatoid arthritis. Some, but not all, studies have reported that EPO supplementation provides significant benefit to these people.
Antiinflammatory Combination Products
| ||Some combination products contain enzymes which have anti-inflammatory activity as well as other ingredients which may have fibrinolytic, immune modulating and blood cleansing effects too.|
Cayenne Pepper (Capsicum frutescens)
| ||Topically for pain control only.|
Green / Oolong / BlackTea (Camellia sinensis)
Picrorhiza (Picrorhiza kurroa)
| ||Open-label studies conducted in India show a preliminary benefit for persons with primarily rheumatoid arthritis. [Langer JG, Gupta OP, Atal CK (1981) “Clinical trials on Picrorhiza kurroa” Ind J Pharmacol 13: pp.98-103 (review)] More study is needed before any definite conclusions can be drawn.|
See also [T Hart BA, Simons JM, Knaan-Shanzer S, et al. Antiarthritic activity of the newly developed neutrophil oxidative burst antagonist apocynin. Free Rad Biol Med 1990;9: pp.127-31]
Lei Gong Teng (Tripterygium wilfordii Hook F)
| ||Treatment with an extract of Tripterygium wilfordii Hook F (360mg per day to 570mg per day) improved clinical anifestations and laboratory findings in a study of 13 patients with rheumatoid arthritis. Three patients withdrew during the first 16 weeks of|
dose escalation, including one patient who developed diastolic hypertension at a dose of 180mg per day. [J Rheumatol 2001;28(10): pp.2160-7]
Liver/Gall Bladder Flush
| ||It is commonly reported that arthritic symptoms decrease with repeated liver/gallbladder flushes.|
| ||Researchers in one study found that participants who ate the greatest number of servings of cooked vegetables were about 75% less likely to develop rheumatoid arthritis than those who reported eating the fewest servings. [American Journal of Clinical Nutrition: November 1999;70: pp.1077-1082]|
"... 43 patients with rheumatoid arthritis, those assigned to a vegan diet... had improvement in rheumatoid arthritis symptoms." [British J Rheumatology, 36(1) 1997]
Another study found that of 22 patients with rheumatoid arthritis who completed 9 months of a vegan diet that did not contain any dairy products or gluten, 40% noted an improvement in symptoms compared with minimal improvement in rheumatoid arthritic patients who consumed a non vegan diet. [Rheumatolozy 2001;40: pp.1175-1179]
Rheumatoid arthritis patients consumed either the typical Western diet or an antiinflammatory diet, which was a modified lactovegetarian diet for an 8-month period. Patients in both groups received either placebo or an oil which provided 30mg of total fish oil omega-3 fatty acids (EPA, DHA) per kg of body weight. Those on the antiinflammatory diet compared with the Western diet experienced a reduction in tender and swollen joints by 14% during the placebo treatment while during the fish oil supplementation, the antiinflammatory diet compared with the Western diet had a reduction in the number of tender joints at 28% versus 11%, respectively, and swollen joints at 34% versus 22%, respectively. [Rheumatol Int. 2003;23:27-36]
Increased Fruit/Vegetable Consumption
| ||Please see the link between RA and Vegetarian Diet.|
| ||Researchers found that people who used the most olive oil were significantly less likely to develop rheumatoid arthritis than people who consumed the least. [American Journal of Clinical Nutrition: November 1999;70: pp.1077-1082]|
Dairy Products Avoidance
| ||Here is a letter received by Robert Cohen, arch enemy of the dairy industry and despised by most dairy farmers. The letter was sent to him in January, 2002 by a long-time dairy farmer and speaks for itself:|
You and I have stood on different sides of the fence for a number of years, but I've got a story to tell you, and an apology to offer. Catherine (my wife of 21 years) and I both grew up on dairy farms. We've been raising Holsteins as long as we can remember. Cath is just 42 years old, but she is crippled with rheumatoid arthritis. There is no record of this disease in her family, but she has been in pain for the past two years, much of it bedridden.
We've tried traditional and alternative therapies and medicines, but she only got a little short term relief. We even tried acupuncture. Try finding an acupuncturist in the rural Midwest! It was expensive, and didn't really work. Catherine's pain has been unbearable at times.
Despite there being no information on the internet linking dairy consumption to rheumatoid arthritis, and nothing in medical journals (I've searched online Medline), we made a resolution together to discontinue drinking our own milk, and not eat cheese or any other dairy product for six months, just to see if there would be some improvement.
I have to tell you this. Catherine feels like she's been to Lourdes. She's cured. There is some pain, but most is gone. I've had changes too which I'll discuss some other time. I thank you, and curse you at the same time. Milking cows is my livelihood. I've always believed that what I was doing was the right thing. I'm not going to sell my cows and sell my farm. I love the business. I just don't feel that good about it anymore. You were right about the arthritis. I don't know about the cancer and heart attacks, but you have given us a miracle that doctors were not able to provide. It did not take us three to six months to learn the truth. It took just three weeks. I've ridiculed your work in the past. Please accept my apology.
Since this type of joint pain can be a symptom of food allergy, dietary change may have a profound effect. Dairy products - the most common food allergen, are one likely causative factor.
"In the case of the eight year old female subject, juvenile rheumatoid arthritis was a milk allergy. After avoiding dairy products, all pain was gone in three weeks." [Journal of the Royal Society of Medicine, 1985, 78]
"In systemic arthritis, like Rheumatoid, the cause is coursing through the blood, and it got there through the diet. When all of the joints are involved, the cause is not physical, but chemical. It's usually casein. (Eighty percent of milk protein is casein)." ["No Milk", by Daniel Twogood, D.C.]
"Certain foods trigger the symptoms of rheumatoid arthritis, and eliminating these foods sometimes causes even long-standing symptoms to improve or even remit entirely. It is important to avoid the problem foods completely, as even a small amount can cause symptoms. All dairy products should be avoided: skim or whole cow's milk, goat's milk, cheese, yogurt, cream, etc." [Neal Barnard, M.D. Physicians Committee for Responsible Medicine]
| ||The fast allows the entire system to restore its cellular and immunogenic integrity. Fasting can cause regression of some autoimmune and inflammatory disorders, such as rheumatoid arthritis. [Controlled trial of fasting and a one-year vegetarian diet eased symptoms of rheumatoid arthritis. The Lancet, 1991, 338]|
Nightshade Food Avoidance
| ||Elimination of nightshade family foods does not help all people with arthritis, but people who respond are usually helped a great deal. |
According to a study conducted in 1993 by Childers, eating nightshade foods results in “a buildup of cholinesterase inhibiting glycoalkaloids and steroids …and may cause inflammation, muscle spasms, pain, and stiffness." The less cholinesterase the body produces as it ages, the less agile the body will be. Therefore, anything that additionally inhibits cholinersterase will add to joint deterioration and stiffness. Cholinesterase inhibitors such as nightshade foods affect mostly rheumatoid-type arthritis.
LDN - Low Dose Naltrexone
| ||Ten patients with this disease have been treated with LDN in recent years. In all ten patients the joint pain and swelling cleared, in some, leaving residual joint distortion. Two of the patients stopped LDN for several weeks because of travel. Both had an immediate exacerbation. One patient who was responding well on LDN had a mild exacerbation during a period of severe marital stress.|
Conventional Drugs / Information
| ||Sulfasalazine is a prodrug, that is, it is not active in its ingested form. It is broken down by bacteria in the colon into two products: 5-aminosalicylic acid (5ASA), and sulfapyridine. There is some controversy as to which of these two products are responsible for the activity of azulfidine. Whereas it is known that 5ASA has therapeutic benefit, it is not clear whether sulfapyridine adds any further benefit. In the colon, the products created by the breakdown of sulfasalazine work as anti-inflammatory agents for treating inflammation of the colon. The beneficial effect of sulfasalazine is believed to be due to a local effect on the bowel, although there may also be a beneficial systemic immune-suppressant effect as well. Following oral administration, 33% of the sulfasalazine is absorbed, all of the sulfapyridine is absorbed, and about 33% of the 5ASA is absorbed. Sulfasalazine was approved by the FDA in 1950.|
Plaquenil may be used for short or long-term rheumatoid arthritis treatment. In treating rheumatoid arthritis, Plaquenil may slow down the substances which harm the joints.
Centocor, Inc., Schering-Plough Corporation, and Mitsubishi Tanabe Pharma Corporation have announced that an estimated one million patients have now been treated with REMICADE® (infliximab), the leading anti-tumor necrosis factor (TNF)-alpha therapy worldwide (2007). In fact, REMICADE has been used to treat more patients worldwide than all other anti-TNF-alpha agents combined. REMICADE was the first anti-TNF-alpha treatment approved by the U.S. Food and Drug Administration (FDA), when it was indicated for the treatment of acute moderate to severe Crohn's disease in 1998. The indication for Crohn's disease was quickly followed by additional indications, such as rheumatoid arthritis.
"Rheumatoid arthritis derailed my life," said Ellen Shmueli, RA patient. "Simple tasks like lifting my child or holding a pen were nearly impossible. It's hard to put into words what REMICADE has meant to me."
Through a long line of firsts in the biotechnology industry, the history of REMICADE includes 15 FDA indications spanning across inflammatory diseases that include Crohn's disease (adult and pediatric), ulcerative colitis, rheumatoid arthritis (RA), ankylosing spondylitis, psoriatic arthritis and psoriasis.
"This significant milestone was achieved as a result of nearly three decades of expanding and improving access for people living with life-altering inflammatory diseases," said Neal Fowler, President, Centocor, Inc. "In partnership with Centocor R&D, we will continue our pledge of bringing the promise of biomedicine to physicians and patients through continued research and development, REMICADE and our promising pipeline portfolio."
REMICADE has been studied in more than 37 clinical trials, evaluating its use in a wide variety of diseases of the immune system and is approved for use in 88 countries.
| ||Antibiotic therapy has been controversial. Doctors haven't proved, or disproved, that an infection causes rheumatoid arthritis. Early studies of minocycline showed only a modest effect, discouraging many physicians, said Dr. Doyt Conn of The Arthritis Foundation.|
Most rheumatology investigators believe that an infectious agent causes rheumatoid arthritis. There is little agreement as to the involved organism. Investigators have proposed the following infectious agents: Human T-cell lymphotropic virus Type I, rubella virus, cytomegalovirus, herpesvirus, and mycoplasma. There is evidence supporting the hypothesis that mycoplasma is a common etiologic agent of rheumatoid arthritis.
Minocycline is a more potent antibiotic than tetracycline and penetrates tissues better. These characteristics shifted the treatment of rheumatic illness away from tetracycline to minocycline. Minocycline may benefit rheumatoid arthritis patients through its immunomodulating and immunosuppressive properties as well.
Thinking that treatment earlier in the disease might work better, 46 patients were treated who had rheumatoid arthritis for less than a year and were not taking strong arthritis medicines. Sixty-five percent of the minocycline patients showed a 50% improvement in joint swelling, stiffness and pain after six months of therapy. Just 13% of patients given a dummy pill had a similar response. How long improvement lasted was key, because many other treatments either wear off or eventually cause serious side effects. Over a period of three years, 44% ultimately improved by a dramatic 75% or more.
Such improvement over time is encouraging, said Dr. Eric Schned, a Minneapolis rheumatologist who has followed O'Dell's work.
The definitive scientific support for minocycline in the treatment of rheumatoid arthritis came with the MIRA trial in the United States. This was a double blind randomized placebo controlled trial done at six university centers involving 200 patients for nearly one year. The dosage they used (100mg BID) was much higher and likely more effective than what most clinicians were using. They also did not employ any additional antibiotics or nutritional regimens, yet 55% of the patients improved. This study finally provided the "proof" that many traditional clinicians demanded before seriously considering this treatment as an alternative regimen for rheumatoid arthritis.
| ||Frequent Oil Changes Linked to Rheumatoid Arthritis.|
Changing the oil frequently may not help the joints. Occupational exposure to mineral oils, particularly hydraulic and motor oils, increases the risk of developing rheumatoid arthritis by 60% in certain groups of patients, researchers here say.
Exposure increased the risk for rheumatoid factor-positive arthritis but not RF-negative arthritis, said Lars Klareskog, Ph.D., of the Karolinska Institute here and colleagues reported in a study published online by Arthritis Research & Therapy. [Sverdrup B et al. Association between occupational exposure to mineral oil and rheumatoid arthritis: results from the Swedish EIRA case-control study. Arthritis Research & Therapy. 2005; 7:R1296-R1303.]
Plant Sterols / Sterolins (Phytosterols)
| ||In a clinical model of chronic inflammation, rheumatoid arthritis patients were followed over a period of 6 months and this study (double-blind, placebo-controlled) showed attenuation of indices of disease activity due to the potent anti-inflammatory properties of the sterols/sterolins. [Am. J. Clin. Nutr. J (2002) 75, Abstract 40, 351S]|
| ||Some fibrinolytic enzyme products contain other enzymes as well, giving them anti-inflammatory, fibrinolytic, immune modulating and blood cleansing effects. Vitalzym is one such product.|
| ||The incidence of osteoporosis is elevated in women with rheumatoid arthritis. DHEA levels correlated significantly with, and were predictive of, bone mineral density, even after corticosteroid therapy was taken into account. Raising DHEA levels by supplementation in these women should reduce the risk of osteoporosis. [Gaby, AR. Holistic Medicine. Spring, 1993: p.22]|
Dr. Hackethal has observed some rheumatoid patients taking DHEA become well even when C-reactive protein and Rh- factor are positive.
| ||Topical progesterone has been reported to be useful in alleviating symptoms.|
Test for Food Allergies
| ||While virtually any food can result in aggravation of rheumatoid arthritis, the most common offending foods are dairy protein, wheat, corn, citrus fruits, eggs, beef, sugar, fats, salt, caffeine and nightshade (Solanum) family foods (tomato, potato, eggplants, peppers and tobacco).|
In order to test whether foods trigger symptoms, a food elimination protocol was followed in a blind, placebo-controlled study that resulted in significant improvement in arthritic symptoms, including shorter duration of morning stiffness and fewer painful joints. [Lancet 1986:1, pp.236-8]
While many doctors believe that the percentage of rheumatoid arthritis patients benefiting from diet manipulation is small, there is an increasing number of scientific studies suggesting that food elimination may help a higher percentage of patients.
"Nutritional therapy, not drugs, is the cornerstone of alternative treatment. A treatment for arthritis that relieves symptoms in a large percentage of patients is based on the theory that most arthritic symptoms are allergic reactions." [Jane Heimlich (wife of Dr. Henry Heimlich, the "Heimlich Maneuver" physican), in her book, "What Your Doctor Won't Tell You"]
Test Zinc Levels
| ||Zinc levels amongst patients with rheumatoid arthritis are usually reduced. Results from zinc supplementation trials amongst rheumatoid arthritis patients have been mixed, though most find some improvement.|
Test Essential Fatty Acid Profile
| ||Manganese functions in the antioxidant enzyme superoxide dismutase (manganese SOD), which is deficient in patients with rheumatoid arthritis. Manganese supplementation has been shown to increase SOD activity, indicating increased antioxidant activity. A good dosage for a manganese supplementation is 5 to 15mg per day.|
| ||Selenium levels are generally low in patients with rheumatoid arthritis. Low selenium levels in joint tissues may be a significant factor contributing to the inflammatory process in rheumatoid arthritis. Selenium plays an important role as an antioxidant and serves as the mineral cofactor in the free-radical scavenging enzyme glutathione peroxidase. This enzyme is also important in reducing the production of inflammatory compounds that cause much of the damage to tissues seen in rheumatoid arthritis. A deficiency of selenium would result in even more significant damage.|
| ||There is increasing evidence that boron is an essential trace element for both man and animal. It does influence calcium and magnesium metabolism, and this is possibly through the parathyroid gland. It does alleviate and seems to cure arthritis either by acting against whatever organism may cause rheumatoid diseases and/or as a membrane catalyst that permits repair of damaged cartilage and collagen.|
| ||Copper has a mild anti-inflammatory effect. The use of copper bracelets in the treatment of arthritis has a long history, and wearers continue to claim positive results. The copper in the bracelets reacts with the fatty acids in the skin to form copper salts that are absorbed into the body. The copper salts may cause a blue-green stain on the skin, but this can be removed with soap and water. Recent research suggests that copper salicylate used to treat arthritis reduces symptoms more effectively than either copper or aspirin alone.|
MSM (Methyl Sulfonyl Methane)
| ||The reason why MSM is beneficial against arthritis is unclear. It may be because of its sulfur content, or because of its anti-inflammatory and analgesic properties. Unlike aspirin, which offers immediate pain relief, MSM takes 3 to 4 weeks before it produces noticeable change, except in rheumatoid patients who have been known to feel differences in just one day, and almost always within 3 to 4 days.|
In an animal study on rheumatoid arthritis-like joint degeneration, MSM was effective in reducing joint inflammation, and completely prevented the breakdown of cartilage. According to Dr. Stanley Jacobs, MD, MSM can be helpful in most musculoskeletal pain and inflammation, including rheumatoid arthritis.
Essential Fatty Acids
| ||Both Omega 6 and Omega 3 EFAs and their metabolites Gamma Linolenic Acid (GLA) and EPA have shown effectiveness in Rheumatoid Arthritis. One study showed that use for 12 months produced meaningful improvement in 76% of subjects. The oil from cold water fish falls into the Omega 3 category, and has shown positive results in reducing inflammation. Some researchers believe that if you regularly eat small amounts of cold-water fish (which contain Omega 3 fatty acids) over many years, you may be able to avoid rheumatoid arthritis.|
In a review that was completed by the medical research firm, Metaworks, Inc. in Medford Mass, lead researcher Dr. Marya Zilberberg reported that GLA is not only safe, but it is also an effective natural therapy. In her review of close to 40 clinical papers on GLA, she noted that GLA consistently reduces inflammation and joint stiffness without any of the serious side effects associated with pharmaceutical drugs. Zilberberg found that GLA is particularly useful for reducing morning stiffness. "We saw about a 60-65% reduction in morning stiffness for these patients," said Zilberberg. "In other words if you have two hours of morning stiffness, that goes down to about a half hour. It is an extremely striking difference."
Also see the link between Rheumatoid Arthritis and Vegetarian Diet.
| ||In a Danish study, arthritis patients were treated with injections of superoxide dismutase, an enzyme containing copper (or manganese and zinc) that is found within the cells. Many obtained relief from symptoms such as joint swelling, pain and morning stiffness.|
Oxygen / Oxidative Therapies
Ozone / Oxidative Therapy
| ||Many people with arthritis report that the hydrogen peroxide bath has helped them greatly.|
International studies are finding that hyperbaric oxygen therapy is markedly superior to the routine treatment of RA. In 1995, the Proceedings of the Eleventh International Congress on Hyperbaric Medicine published the results of one particular study. These results indicated the following effects of hyperbaric oxygen on the disease.
Obvious effect: 51.4%
No effect: 8.1%
The total summarized effective rate of hyperbaric oxygen in treating RA was 91.9%. The authors of the study concluded, "In the treatment we find that hyperbaric oxygen is markedly superior to the routine treatment of rheumatoid arthritis." From PatientsMedical.com.
Calming / Stretching Exercises
| ||According to a 1994 study published in the British Journal of Rheumatology, 20 patients with rheumatoid arthritis participated in a yoga program. Left hand grip strength improved significantly and all patients who completed the course expressed the desire to continue after the study.|
| ||Applying leeches to involved joints in rheumatoid patients reduced muscle and joint pain, duration of early morning stiffness, improved joint range of motion and functional activity, and reduced erythrocyte sedimentation rate, C reactive protein, prothrombin index (PTI), activated partial thromboplastin time (APTT) and prolonged coagulation time without any adverse effects being reported. [2002 European Congress of Rheumatology, June12-15, 2002, Stockholm, Sweden]|
| ||A small clinical trial for RA and a vitamin D metabolite was conducted over a three-month time period. The results were positive: "Therapy showed a positive effect on disease activity in 89% of the patients (45% with complete remission and 45% with a satisfactory effect). Only two patients (11%) showed no improvement, but no new symptoms occurred". [Clin. Exp. Rheumatol. 1999 (17): pp. 453-456] Also see the link between Autoimmune Tendency and Vitamin D.|
Researchers have found women who eat a diet rich in vitamin D may reduce their chances of developing rheumatoid arthritis (RA) and multiple sclerosis (MS). Two studies involving women have shown proof of the vitamin's benefits.
The RA study followed 29,368 women aged 55 to 69 years, and the MS study looked at more than 185,000 women. The participants were given questionnaires to fill out about their dietary habits and vitamin D intake at the beginning of each study, and researchers followed up with the women every four years for up to 20 years. They discovered that women were 30 percent less likely to develop RA, and 40 percent less likely to develop MS, when taking the recommended daily amount or more of vitamin D.
Out of 100 people worldwide, one or two will develop RA and around 0.04 percent have MS. Both of these conditions are thought to occur when the body’s immune system turns against itself. Researchers suggest that vitamin D may work by calming overactive immune cells.
Responding to this study, vitamin D experts advise future researchers studying vitamin D levels to administer a blood test to read the levels more accurately, and cautioned that this study did not use the best way to determine vitamin D levels in the participants. [Neurology January, 2004 13;62(1):60-5, Arthritis & Rheumatism January, 2004;50(1):72-7]
Dr. Joseph Mercola, D.O. reports that he has "seen several hundred patients with rheumatoid arthritis in the last two years, and I have measured their levels. I have yet to analyze the results, but I cannot recall any RA patients who had normal levels of vitamin D. In fact, it is so consistent that I immediately start any new patient who comes in with RA on supplemental vitamin D, in addition to vitamin D in cod liver oil."
Vitamin B6 (Pyridoxine)
| ||When nodules (Heberden's nodes) are present, vitamin B6 at 100-150mg per day may help. One doctor reports seeing even better results if one handful of raw pecans is eaten every day. The nodes may not go away but pain and mobility are better over several weeks.|
Vitamin B5 (Pantothenic Acid)
| ||Low pantothenic acid levels are implicated in the development of human osteoarthritis and rheumatoid arthritis, as whole blood pantothenic acid levels have been reported to be lower in rheumatoid arthritis patients compared with normal controls. In addition, disease activity was inversely correlated with pantothenic acid levels.|| |