Achy Bones: Rheumatoid Arthritis

Let’s talk about rheumatoid arthritis.  Less than half the number of people get it than get gouty arthritis, which I talked about in my last post, but it’s a much bigger problem because it’s much less easily treated.  People over the years are probably going to become debilitated by it at some point in time.

We don’t know what causes rheumatoid arthritis.  There seems to be some genetic predispositions.  Caucasians get it more than other races.  There are certainly environmental factors.  We do know that women get it about 2-3 times as often as men.  We certainly know there are some immunological factors involved.  Why that is we don’t know.  There is certainly a sign of a deranged immune response where the body starts attacking itself.  There’s something in the synovial linings of the joint that the body identifies as wrong.  It frequently occurs after another infection, virus or bacterial infection.  The immune system, in fighting that infection or whatever it was, identifies a certain part of your body as the enemy.  There must be a structure in the joint surface or synovial lining that looks enough like that which the body starts attacking.   

It’s kind of the opposite of gouty arthritis.  You usually get a number of different joints involved at the same time.  It’s not immediate, rapidly developing pain like gout.  It’s usually much more insidious, slow, and over time there’s a little bit of ache and then a little bit more.  It will come and go.  We're all familiar with the phenomena of people being able to predict the weather by the arthritis or at least predicting when the weather changes.  That is simply the barometric pressure changing and it does make people with arthritis hurt.  

We’ve tried many things over the years to treat rheumatoid arthritis, from non-steroidal anti-inflammatories to injections of gold, even oral gold.  Gold creates an immune response.  It lowers the immune response as do a lot of heavy metals; lead, platinum, gold.  A number of heavy metals lower immune response.  That’s a fact.  In my cancer clinic in Atlanta that was one of the first things I looked at was heavy metal toxicity, to lower the burden on the immune system and allow it to begin to respond again with these patients.  

Immune alteration is a great big problem with rheumatoid arthritis.  Non-steroidals have been a main stay even though they do not alter the course of disease.  Then we try gold and platinum and things like that.  We’ve even tried cancer drugs; cyclosporine and other very toxic cancer drugs to try to decrease the inflammation.  We know that they damage the immune system and lower the immune system. That’s why we always check the white blood count when the patients get chemotherapy and they come back in.  Doctors are using that to try to lower the immune response in rheumatoid arthritis.  

Alternative medicine wise, the things that work we’ve mentioned for both of the other arthritis’; anti-inflammatory agents, digestive enzymes.  There’s not a whole lot in the alternative field that benefits this type of disease either.  We do, certainly, need to remember that in relationship to my work with The Healing Codes arthritis is related to both self-control and patience.  As it concerns emotional issues, we know that a lot of times these arthritis’ onset after an emotional event, after a sickness or a traumatic event.  We certainly want to look at the emotional issues related to that.  How can we get well if we haven’t changed that emotional issue?  

In my last post I mentioned fibromyalgia.  It deserves it’s own post, so next time we’ll talk about fibromyalgia.  

Achy Bones: Gout

Last week we talked about osteoarthritis because it affects the biggest group of arthritis sufferers.  About 20 million people in the U.S. have doctor-diagnosed arthritis.  If you look at statistics 5 years ago more people had arthritis than they do today.  You have to scratch your head over that.  Well, the CDC changed the criteria.  Back then it was people reporting joint pain and arthritis.  Today it has to be physician-diagnosed.  All of a sudden the numbers when way down from 50-60 million people to 20 million people. If you’re looking at numbers, according to what vintage your numbers, they will vary dramatically. 

This week and next we’re talking about the next two most prominent types of arthritis: gout and rheumatoid.  Rheumatoid gets our attention more because it’s so chronic and debilitating.  There are actually twice as many people who have gouty arthritis than rheumatoid.  I guess it’s a good thing since gout is more treatable.

Then there’s another group of people, nearly as many as have gout, and twice as many as have rheumatoid.  These are people that have fibromyalgia.  That’s been now kind of included in the arthritic “family” if you would.  By the way  90% of fibromyalgia patients are women.  Doctors were telling women just a few years back that they were hypochondriac or that it didn’t exist.  But we were, as a group of physicians, disrespecting women and ignoring their symptoms.  Much worse than that, impugning them by suggesting that it was only in their minds.  I ask forgiveness but I can’t speak for the rest of the medical community

Today we’re going to talk specifically about gouty arthritis.  Gouty arthritis is a situation in which uric acid builds up in the system and it forms crystals.  The solution becomes super-saturated with uric acid and so it crystallizes.  If you put too much sugar in your tea and keep putting more and more sugar in until it’s in solution while the tea is warm, when you put it in a refrigerator it can actually precipitate out.  The same reason honey goes to sugar after a while if it just sits there on your shelf.  It will crystallize.  That’s the type of situation we have here: crystallization.  

When there is too much uric acid in your system, your kidneys aren’t clearing enough.  That can be a genetic predisposition and can also be a situation where it’s environmental to some degree, in the sense of what we’re eating.  If we’re eating to many rich foods, too much meat with fat in it that can contribute to gout. Alcohol can also precipitate gout.  In the past it was known as the rich man’s disease, back as early as the 1500’s.  These were people who were able to afford lots of wine and ducks, fatty foods and things like that to eat.  

Gout is crystals that form in the joint space.  These little crystals are just like if you’ve ever gotten into fiberglass.  It itches.  It irritates.  This is kind of like fiberglass in your joints.  These pointy little crystals just irritate the heck out of the synovial lining.  As a result it becomes inflamed. 

Gouty arthritis usually occurs in one joint to begin with.  If you’ve got one joint that’s inflamed and hurting then the first question in your mind should be whether it’s gout.  The body demographics have changed over the years.  First-time attacks occurred 70-80% of the time in the great toe.  But in recent years that’s decreased.  We’re getting much more in the knees and elbows and hips these days than we did in times past.  It’s interesting to see that for centuries it stayed the same with the great toe being the fist joint to show up and then it’s changed a little bit.

Standard medical treatment for gout is non-steroidal anti-inflammatories that we talked about the other day.  Then some treatment drugs are Probenecid and sulfuric tyroione,  Allopurinol and things like that.  They do a fairly effective job of taking care of gout and keeping the uric acid out of the body.  Natural treatments include curamin, MSM, and digestive enzymes.  Digestive enzymes are interesting because if you put them in the bowel with food, they help digest food.  But if you take them on an empty stomach they go into the blood stream and are very anti-inflammatory there.  Black cherries as an old-wive’s treatment are known to help gouty patients.  We don’t know the mechanism because none of the big labs are going to put a couple million dollars into research in that.  It’s probably not patentable.  

Then just recently in the last year I’ve heard of a gentleman who stumbled across, just by the power of association with his own personal experience, that baking soda helped his gouty arthritis.  He mentioned it to other people who had gout.  They used it and so this has become another “ma and pa” treatment.  I just personally treated four or five patients with bicarbonate.  It’s worked on every one of them.  It’s an intriguing, new, alternative, very inexpensive treatment which you can find in any grocery store, probably in your own cabinet in the kitchen.  That’s interesting to see how that’s going to turn out and what percentage of people are benefiting over time. 

I'll talk early next week about a third type of arthritis: rheumatoid arthritis.