Q. What are the best natural treatments for rheumatoid arthritis?
A. Rheumatoid arthritis is an autoimmune disease that responds very well to naturopathic treatments. Well researched natural treatments such as diet, herbs, vitamins, and other holistic therapies implemented early on can prevent the need for the overuse of harsh medications such as chemotherapeutic agents, corticosteroids, and drugs with a myriad of side effects such as hydroxychlorquine typically needed to aggressively manage symptoms.
Most of my MD colleagues are happy to refer patients with frustrating autoimmune conditions such as rheumatoid arthritis off to naturopaths, as a thorough diet and lifestyle cleanup typically works wonders for improving the disease course. Although this article is primarily discussing RA, the general treatment concept should be helpful for most cases of autoimmunity.
Please consult with your doctor or naturopathic physician to develop an individualized plan that is right for you, natural medicines may have interactions with your medications or other health conditions that should always be researched thoroughly before implementing.
What is Rheumatoid Arthritis?
Rheumatoid arthritis is an autoimmune condition in which the body’s own immune system attacks the joints creating inflammation and the resultant symmetrical poly-arthritis typically affecting the wrists, knees, elbows, shoulders, ankles, and neck.
Swelling, heat, deformity of joints, morning stiffness and pain with passive motions are all hallmark symptoms. Seventy percent of patient’s exhibit radiologic signs of damage within three years of onset, so early aggressive preventative therapies are important to protect joint integrity.
Reversing joint damage is difficult. An “ounce of prevention” is truly “worth a pound of cure” in this case. Systemically patients additionally experience fatigue, depression, general malaise, loss of appetite, enlarged lymph nodes and spleen, and visual impairments.
What is the Cause of Rheumatoid Arthritis?
Since the etiology of RA is currently unknown, and all we know about RA in our current medical model is that “anti-body-complement complexes result in intra-articular inflammation” it is thus important that we eliminate all potential immune system aggravators, and ALWAYS address causes of health imbalance in the patient where applicable.
In layman’s terms, the immune system is reacting to something in the system, and those immune complexes are depositing in the joints, causing inflammation, the resultant inflammation is systematically destroying the joints. Until the cause of RA is further understood, as a biochemist and physician I think it is imperative that all food additives and other chemicals are removed from the diet and lifestyle. Something in the system is likely triggering the inflammatory autoimmune response, and it is better to error on the side of caution. Whole foods eating is the way to go.
All patients with RA will surely improve from a diet and lifestyle clean up, as from a sensible standpoint; a pure whole foods diet will only improve the total health of the patient while we investigate other potential causes of this frustrating and debilitating painful disease.
I have yet to see someone with an autoimmune disease that did not improve dramatically from healthier eating and living. If changing your diet and lifestyle seems overwhelming from reading this article, please consider your long term health, and make small goals to achieve systematically. Stay positive and don’t get caught by a potentially debilitating case of the “I cants”.
What can Naturopathic Medicine do for Rheumatoid Arthritis?
Naturopathic Medicine can help reduce the side effects of medications, reduce symptom severity and frequency, and alleviate the need to take as much prescription medicine.
As with any modality naturopathic medicine also has its own set of limitations. Natural treatments take more time than prescription drugs. Keep in mind the immune system turns over a new supply of white blood cells about every 4 months. Joints are avascular meaning that they lack a blood supply and receive all their nutrients through simple diffusion. The natural treatment of joint problems therefore requires time, discipline, and dedication.
Patient compliance is typically an obstacle to cure when it comes to natural healing techniques for autoimmune disease. Be sure to work with a licensed naturopathic physician for the best holistic management of this complex condition, preferably one with a special interest in autoimmune conditions. Initially, frequent appointments should help you stay more motivated to make these changes.
Diet for Rheumatoid Arthritis
- Generally decrease animal fats and Omega 6 Fats (found in most vegetable sources) and increase Omega 3 oils (found almost only in Alaskan Wild salmon, flax seeds, and walnuts).
- Stop eating junk food. McInflammation is just pouring gasoline on the inflammatory fire of RA!
- A vegan, gluten free diet has been shown to be the most efficacious for those with RA.
- The Mediterranean Diet was also shown to be effective.
- Anti-inflammatory Diet. RA is an inflammatory condition. Eating an anti-inflammatory diet will prime your system to produce less prostaglandins and other inflammatory products. The ultimate goal is to reduce the total load of inflammation in your body, so that less prednisone, methotrexate, and other RA medications will need to be used. Improvement may be seen immediately but ultimate improvement will result after six months of this diet once most of the body’s cellular membranes have integrated the less inflammatory lipids in to their cellular structures.
- Allergy Elimination Diet: Most patients under naturopathic care reportedly improve with the elimination of foods they might be allergic to. Since 70% of our immune system surrounds our gut in the form of GALT (Gut Associated Lymphatic Tissue), most conditions of autoimmunity will respond to the reduction of foods that the patient is allergic or intolerant to. For instance, the current naturopathic theory with gluten in the diet purports that the protein sequence of gluten is similar to the protein sequence of healthy cells in our body, so the immune system becomes confused if it is reacting to gluten, and begins to see healthy cells in the body as a threatening antigen as well…attacking them and marking them for destruction. Most common allergen offenders are: wheat, dairy, peanuts, tomatoes, potatoes, beef, corn, soy, and the nightshades such as eggplant, tomatoes, and peppers.
- Whole Foods Diet to eliminate the toxic burden on the immune system. Research shows that pesticides in the diet affect the functioning of the immune system. Eat organic whenever possible.
- Eat sources of probiotics- if you have digestive problems in addition to RA, then eating probiotics such as acidophilus will help break down your food and make your immune system less reactive to it. Healthy gut flora is imperative to a healthy immune system!
- Absolutely eliminate aspartame! Let me re-emphasize the importance of this. ABSOLUTELY ELIMINATE ASPARTAME. After writing about aspartame in my post on “The Kitchen Table Villains”, many readers came forward with their various autoimmune issues with aspartame causing symptom flares. Elimination of food additives, chemicals, and the other “Kitchen Table Villains” have had many case reports of symptom improvement from the removal of these unnecessary additions to the diet. To error on the side of caution…get all chemicals out of your diet and eat a Whole Foods Diet.
- Eliminate arachidonic acid from the diet. This is the inflammatory component of fat found in animal products such as red meat and high fat dairy. Almost all prescription anti-inflammatory medications work to inhibit cycloxygenase at some point in the biochemical pathway of arachidonic acid metabolism. When we ingest arachidonic acid we make it easier for the body to make inflammation. Without ingesting arachidonic acid dietarily, the body will be forced to have to make its own supply, which takes time, and ultimately results in a slower inflammatory response, and less dramatic inflammatory flares.
Lifestyle Considerations for Rheumatoid Arthritis
- Quit smoking! Smoking is known to exacerbate the symptoms of RA. From a biochemical standpoint smoking creates more ROS (Reactive Oxygen Species) that attack normal healthy cells. The destructive process of these cells then adds to the total inflammatory load of the body. Our goal is to reduce inflammation; smoking is thus a major contributor to inflammation.
- Exercise moderately. Gentle exercise is shown to improve symptoms in some cases of RA, just don’t over do it! Avoid either extreme of excessive activity and inactivity. Find the level of activity that works for you.
- Manage stress. Stress and anxiety are the underlying causes of most chronic health conditions.
Vitamins and Minerals for Rheumatoid Arthritis
- Vitamin E 1800 IU was shown to improve symptoms via its antioxidant capacity.
- Zinc and selenium may be effective, although studies conflict. This may just be due to their antioxidant characteristics, as antioxidants reduce inflammation in the body by reducing Reactive Oxygen Species that destroy healthy cells.
Herbs for Rheumatoid Arthritis
- Herbs are great for managing symptoms initially while we get the diet and lifestyle aspects of this disease under control. Anti-inflammatory herbs usually improve symptoms within a week.
- Anti-inflammatory Herbs: Turmeric, Ginger (pictured above), Boswellia, and Quercetin (technically a bioflavonoid).
- Tripterygium wilfordii has been used successfully to manage RA symptoms. I would work with a naturopathic physician if opting to use this herb though, as this is “big medicine” that is not intended for self treatment. However, I wanted to include it on this list as it has two rather decent research studies showing its efficacy.
NATURE CURE for Rheumatoid Arthritis:
When all else fails with chronic disease, naturopathic medicine works wonders when we apply nature cure philosophies such as “remove the obstacles to cure” and “treat the whole person”.
Remove the Obstacles to Cure
Obstacles to cure are the things that are getting in the way of bringing your body in to a healthier state of balance. Anything listed above that you struggle to implement is therefore an “obstacle to cure”. Identify your challenges and work on overcoming them systematically. Start with the simplest obstacles to improve self efficacy, or tackle the hardest like quitting smoking to make the most significant impact in your health.
Treat the Whole Person
You are not a symptom. You are not a body. You are not inflammation. You are not pain. You are a complex being that is challenged by a painful case of arthritis. This is not just about your body, it is also about the mind and spirit that have to live in this body. The growing field of “psychoneuroimmunology” investigates how our minds affect our immune system. Nurture the mind and spirit connection to support your body.
Sample Naturopathic Treatment Plan for Rheumatoid Arthritis:
*PLEASE NOTE*Always check with your physician for drug interactions or medical contraindications before implementing any new treatments as this is not individualized care. Included for example only.
- Vegan, Gluten free, Anti-inflammatory Diet
- Anti-inflammatory Smoothie: Eat 1 cup of frozen blueberries daily in “Dr. Nicole’s Smoothie Recipe” (be sure to include the L-glutamine to heal your gut and the flaxseeds for omega 3’s.)
- Quit smoking.
- Gentle exercise such as yoga, walking, and swimming.
- Acidophilus 1 capsule with each meal (three times daily) to restore healthy gut flora.
- Fish Oil 1 tablespoon twice daily with food (not to be used by those with bleeding disorders or on anti-coagulant medications, or by pregnant women due to vitamin A content).
- Anti-inflammatory herbs: Find a blend of turmeric, ginger, boswellia, and quercetin in capsules at a quality health food store and take as directed.
- Counseling. Addressing emotional components of our health and anxiety surrounding chronic disease is especially important for a good outcome. Anyone sick with a chronic disease deserves a safe place to discuss their fears and challenges surrounding pain and chronic illness. Address past emotional issues and work to let go of them. Forgive those that have hurt you or caused you upset.
Research for Rheumatoid Arthritis:
- PMID: 11600749; A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens.Rheumatology (Oxford). 2001 Oct;40(10):1175-9.
- PMID: 12594104; An experimental study of a Mediterranean diet intervention for patients with rheumatoid arthritis.Ann Rheum Dis. 2003 Mar;62(3):208-14.
- PMID: 12548439; Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis. Rheumatol Int. 2003 Jan;23(1):27-36. Epub 2002 Sep 06.
- PMID: 11890437; Effects of a very low-fat, vegan diet in subjects with rheumatoid arthritis. J Altern Complement Med. 2002 Feb;8(1):71-5.
- PMID: 11154796; Antioxidants in vegan diet and rheumatic disorders. Toxicology. 2000 Nov 30;155(1-3):45-53.
- PMID: 9117178; Faecal microbial flora and disease activity in rheumatoid arthritis during a vegan diet. Br J Rheumatol. 1997 Jan;36(1):64-8.
- PMID: 15077267; Physical activity behavior in older women with rheumatoid arthritis. Arthritis Rheum. 2004 Apr 15;51(2):246-52.
- PMID: 15513677; Aetiological factors of importance for the development of rheumatoid arthritis. Scand J Rheumatol. 2004;33(5):300-6.
- PMID: 8912502; gamma-Linolenic acid treatment of rheumatoid arthritis. A randomized, placebo-controlled trial. Arthritis Rheum. 1996 Nov;39(11):1808-17.
- PMID: 12069368; Effect of cod liver oil on symptoms of rheumatoid arthritis. Adv Ther. 2002 Mar-Apr;19(2):101-7.
- PMID: 11708441; Fish oils are beneficial to patients with established rheumatoid arthritis. J Rheumatol. 2001 Nov;28(11):2563-5.
- PMID: 12610802; A randomized double blind, placebo controlled trial of topical Tripterygium wilfordii in rheumatoid arthritis: reanalysis using logistic regression analysis. J Rheumatol. 2003 Mar;30(3):465-7.
- PMID: 12124856; Benefit of an extract of Tripterygium Wilfordii Hook F in patients with rheumatoid arthritis: a double-blind, placebo-controlled study. Arthritis Rheum. 2002 Jul;46(7):1735-43.
For more support surrounding your diagnosis of rheumatoid arthritis, you can follow my friend Sandy’s Rheumatoid Arthritis Support Site.
Best of luck to you. Thanks for asking about natural treatments for RA. Diet and stress management are key for autoimmune conditions, if the changes are overwhelming, focus on one change at a time until you get it down. Give yourself a month for each important goal. Implement all the things that you can easily do now. Remind yourself that it is all about “progress and not perfection”.
If you have any additional questions or insight to share about RA please do so in the comments.