Newer Drugs for Rheumatoid Arthritis All Have Similar Risks -- Maybe It’s Time to Go Natural?
September 27, 2012
By Dr. Mercola
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease afflicting an estimated 1.5 million Americans,1 the majority of which are women. RA affects just over 53 women per 100,000, compared to nearly 28 men per 100,000.
Unlike osteoarthritis, which is a degenerative joint disease, rheumatoid arthritis is an autoimmune disease that causes your body to break itself down – your immune system starts attacking your joints, leading to pain, deformities and a substantial loss of mobility. As a result, RA is generally treated with very aggressive medications. In fact, the drugs used for RA are some of the most dangerous drugs used in medicine. High doses of prednisone are common, as well as immunosuppressants and anti-cancer agents to treat the severe pain and swelling.
A newer class of RA drugs is the "biologic" drugs called TNF-alpha inhibitors, sold under the brand names Humira, Enbrel, and Remicade. While these drugs are aggressively promoted, there are still concerns about their safety. A recent safety analysis2 on these three drugs shows that, when it comes to your risk of death from taking them, there's no difference between the three drugs. According to MedlinePlus:3
"...Simard's team compiled information on patients with rheumatoid arthritis who began treatment between 2003 and 2008. Of these patients, more than 1,600 started taking adalimumab (Humira), almost 2,700 were prescribed etanercept (Enbrel), and more than 2,000 began treatment with infliximab (Remicade). During the five-year study, 211 of the patients died. However, the researchers found no difference in death rates among the three drugs."
Potentially serious side effects from these drugs include infection and cancer. With risks like that, maybe it's time to try more natural and holistic methods of preventing and treating this painful disease?
First, Address Your Diet
I have personally treated over 3,000 patients with rheumatoid arthritis in my practice, which is well over 10 times the amount a typical family physician would treat in their entire career. So I have a fair amount of experience here. My rheumatoid arthritis treatment protocol has helped thousands of RA patients go into remission, and one of the key factors that dramatically improved the response rate was the dietary modification.
I cannot emphasize strongly enough the importance of this aspect of the program. It is absolutely an essential component of the RA protocol. Following these general guidelines alone will go a long way to dramatically reduce your risk of developing any kind of problem with chronic inflammation:
- Eliminating sugar/fructose and most grains
- Optimizing your gut flora with the use of high potency fermented vegetables and/or probiotics
- Eating unprocessed, high-quality foods, organic and locally-grown if possible
- Eating your food as close to raw as possible
- Getting plenty high-quality animal-based omega-3 fats, such as krill oil
A Novel Approach for Treating RA With a 60-90 Percent Likelihood of Improvement
The natural course of rheumatoid arthritis (RA) is quite remarkable in that less than one percent of RA sufferers have a spontaneous remission. Some disability occurs in 50-70 percent of people within five years after onset of the disease, and half will stop working within 10 years.
This devastating prognosis is what makes this novel form of treatment so exciting, as it has a far higher likelihood of succeeding than the conventional approach.
My original RA treatment was based on a protocol developed by a maverick but well respected rheumatologist, Dr. Thomas Brown. He died in 1989 shortly after I started using his approach. I first became aware of Doctor Brown's protocol, which focused on the elimination of mycoplasma using antibiotics, in 1989 when I saw him on ABC's 20/20. This was shortly after the introduction of the first edition of his book, The Road Back.
My application of Dr. Brown's protocol has changed significantly since I first started implementing it. Initially, I rigidly followed Dr. Brown's work with minimal modifications; about the only change I made was changing Tetracycline to Minocin. I believe I was one of the first physicians who recommended the shift to Minocin and most people who use his protocol now use Minocin. After using the antibiotic approach for the first 10 years, my prejudice became more fixed on natural therapies, so my current program allows for a completely drug-free treatment of RA.
As I learned more about natural medicine, I integrated more of that wisdom, starting with the addition of my nutritional plan. This addition alone would oftentimes accelerate the response rate by several months. I wrote an article on my revised protocol in 1995, which I presented at a conference. Since then, I've further revised the protocol twice. The first revision since that paper is presented in the video above. Below, I'll discuss the latest additions.
Besides the nutritional plan, the latest additions to my RA protocol are:
- Low dose Naltrexone. It is inexpensive and non-toxic, and I have a number of physician reports documenting incredible efficacy in getting people off of all their dangerous arthritis medications using low-dose Naltrexone (LDN).
Naltrexone is a pharmacologically active opioid antagonist, conventionally used to treat drug and alcohol addiction – normally at doses of 50mg to 300mg. As such, it's been an FDA approved drug for over two decades. However, researchers have found that at very low dosages (3 to 4.5 mg), naltrexone has immunomodulating properties that may be able to successfully treat a wide range of autoimmune diseases, including rheumatoid arthritis, multiple sclerosis (MS), Parkinson's, fibromyalgia, and Crohn's disease, just to name a few.
For a more in-depth review of low-dose Naltrexone and how it can help RA sufferers, please see this previous article.
- Astaxanthin, a powerful anti-inflammatory antioxidant that could have very powerful benefits in controlling the joint pain. Astaxanthin at 4 mg per day is particularly important for anyone placed on prednisone as it offers potent protection against cataracts and age related macular degeneration
- Vitamin D. Vitamin D deficiency is strongly associated with the development of RA. From my perspective, it is now virtually criminal negligent malpractice to treat a person with RA and not aggressively monitor their vitamin D levels to confirm that they are in a therapeutic range of 50-70 ng/ml. For more information, please see my previous article on how to safely maximize your vitamin D production through appropriate sun exposure
- Probiotics (beneficial bacteria). While you can certainly take a high quality probiotics, I would also strongly encourage you to work up to 4-6 ounces a day of fermented veggies, which will supply about 10 trillion beneficial bacteria, which is about 10 percent of the population of your gut. Ideally you would consume them regularly if not daily. The best way to learn how to prepare them properly is to get the GAPS book or listen to my interview with Caroline Barringer
- Incorporating regular exercise into your daily schedule, especially the Peak Fitness Program
Factors Associated with Your Success on this Program
There are many variables associated with an increased chance of remission or improvement.
- The younger you are, the greater your chance for improvement
- The more closely you follow the nutrition plan, the more likely you are to improve and the less likely you are to have a severe flare-up. I now offer the Nutritional Typing Test for free, so please do not skip this essential step
- Smoking seems to be negatively associated with improvement
- The longer you have had the illness and the more severe the illness, the more difficult it seems to treat
Drug-Free Pain and Inflammation Relief
One of the primary problems with RA is controlling pain. If this is not achieved, you can go into a depressive cycle that can clearly worsen your immune system and cause the RA to flare. The goal is to be as comfortable and pain free as possible with the least amount of drugs. Fortunately, there are a number of safe, non-toxic dietary supplements that can be helpful in the treatment of RA pain:
- Curcumin (turmeric) in particular has been shown to be effective against both acute and chronic pain. Curcumin is most known for its potent anti-inflammatory properties. It has been shown to influence more than 700 genes, and can inhibit both the excessive activity and the synthesis of cyclooxygenase-2 (COX2) and 5-lipooxygenase (5-LOX), as well as other enzymes that have been implicated in inflammation. In experiments on rats, turmeric appeared to block inflammatory pathways associated with rheumatoid arthritis.
A study published in April 20124 revealed that a highly bioavailable form of curcumin was more effective in alleviating RA symptoms, including tenderness and swelling of joints, than the NSAID drug Voltaren. Not only that, those who were taking the curcumin only actually experienced the most improvement across the board
- Boswellia, also known as boswellin or "Indian frankincense" is another herb I've found to be particularly useful against arthritic inflammation and associated pain
- Ginger also has anti-inflammatory properties and can offer pain relief. Fresh ginger works well steeped in boiling water as a tea or grated into vegetable juice
- Astaxanthin has been shown to effectively reduce pain associated with inflammation. In one study, RA sufferers experienced a 35 percent improvement in pain levels, as well as a 40 percent improvement in their ability to perform daily activities after receiving astaxanthin for only eight weeks
Is it Really Safe to Exercise with Rheumatoid Arthritis?
Rheumatoid arthritis tends to affect your middle joints, especially your hands and fingers, which causes the joint pain, stiffness and deformities that are a hallmark of this disease. However, RA does not only impact your joints, it also leads to diminished muscle mass and reduced strength that can be nearly as debilitating as the damage to your joints.
Getting regular exercise when you have RA is crucial to avoid this kind of physical decline.
A 2009 study5 found that people with RA who did weight training for 24 weeks improved their function by up to 30 percent and their strength by 120 percent.
That said, inflamed joints are very vulnerable to damage from improper exercise, so you must be cautious. People with arthritis must strike a delicate balance between rest and activity, and must avoid activities that aggravate joint pain. Avoid any exercise that strains a significantly unstable joint. If your joints are stiff, stretch and apply heat before exercising. Swollen joints, on the other hand, may benefit from applying ice for 10 minutes prior to exercise.
Your program should include a range of activities, just as I recommend for any exerciser. Weight training, high intensity exercises, cardio, stretching, and core work are all important elements to integrate into your routine. A good rule of thumb to follow is that if you're in pain for longer than one hour after your exercise session, you should slow down or choose another form of exercise. Assistive devices are also helpful to decrease the pressure on affected joints during your workout.6
The Importance of Addressing Emotional Traumas
Lingering emotional trauma is pervasive in people with RA. With the vast majority of the patients I treated, some type of emotional trauma occurred early in their life, before the age their conscious mind was formed, which is typically around the age of five or six. However, a trauma can occur at any age, and has a profoundly negative impact. If that specific emotional insult is not addressed with an effective treatment modality then the underlying emotional trigger will continue to fester, allowing the destructive process to proceed, which can predispose you to severe autoimmune diseases like RA later in life.
In some cases, RA appears to be triggered by an infection, and it is my experience that this infection is usually acquired when you have a stressful event that causes a disruption in your bioelectrical circuits, which then impairs your immune system. This early emotional trauma predisposes you to developing the initial infection, and also contributes to your relative inability to effectively defeat the infection. Therefore, it's very important to have an effective tool to address these underlying emotional traumas.
In my practice, the most common form of treatment used is the Emotional Freedom Technique (EFT). Although EFT is something that you can learn to do yourself in the comfort of your own home, it is important to consult a well-trained professional to obtain the skills necessary to promote proper healing using this amazing tool.
For my full recommendations on how to treat rheumatoid arthritis naturally, please review my rheumatoid arthritis protocol.
There is no doubt in my mind that this protocol, summarized above, is highly effective for the treatment of autoimmune arthritis like rheumatoid arthritis. I strongly encourage anyone with this disease to adopt the program to help prevent the nearly inevitable poor outcomes that are the result of seeing a conventional rheumatologist. In my experience they have very little to offer except dangerous drugs that only relieve symptoms and do nothing to address the underlying cause of the disease, which continues to ravage the body and cause crippling joint deformities.