Rheumatoid Arthritis Treatment


Natural remedies for rheumatoid arthritis:

Anti-Inflammatory Remedies

BioPerine: (by brain is slightly anti-inflammatory in its own right but its main purpose is to increase the absorption of the curcumin from turmeric)
1 tablet twice a day with breakfast and dinner. Chew the tablet just before you start eating to give it a head start before the curcumin starts to be absorbed, this practice significantly increases the amount of curcumin you absorb. [Source Naturals 10 mg available from the UK Amazon or iherb.com
Available from the UK Amazon: https://www.amazon.co.uk/Source-Naturals-Bioperine-Pepper-Extract/dp/B000GFSRAY/ref=sr_1_2?ie=UTF8&qid=1429758026&sr=8-2&keywords=Piperine
The active ingredient in turmeric is called curcumin, curcumin has anti-inflammatory, BDNF boosting and antidepressant effects. Unfortunately curcumin is very poorly absorbed from regular turmeric and the difficulty has been delivering sufficient quantities of curcumin to the human brain, in laboratory experiments curcumin is often administered to rats by injection. The new turmeric preparations now deliver sufficient curcumin to the brain to make it a useful medicine for human brain/mental health.
Preparations that I have found to be effective include:
Natures Best Turmeric
In the UK I recommend Natures Best Turmeric 10,000 mg

Super Bio Curcumin 
1 capsule twice a day after breakfast and dinner.
This is available from iherb or the UK Amazonhttps://www.amazon.co.uk/Life-Extension-Curcumin-Vegetarian-Packaging/dp/B00IZ15BOG/ref=pd_sim_d_2?ie=UTF8&refRID=07WAMTWW6YA7Q07M3HKB
Another alternative is to buy a big bag of organic turmeric powder, this is nothing like as concentrated or potent as the products above and you have to take about 1-2 full desert spoons in place of one of the above capsules. I've tried this alternative myself, it does deliver good results when combined with the BioPerine. It is considerably cheaper to use this method than the super bio curcumin but only slightly cheaper than the nature’s Best turmeric tablets and because it is very unpleasant tasting and inconvenient to mix the powder I no longer recommend this method. You can buy large bags of organic turmeric powder online including from Amazon.
Another herb specifically useful for treating rheumatoid arthritis is Boswellia
1 capsule twice a with meals.
EGCg (EGCg’s are optional extras they are the antioxidants obtained from tea particularly green tea)
1 capsule twice a day with meals.
Now Foods: https://www.iherb.com/Now-Foods-EGCg-Green-Tea-Extract-400-mg-180-Veggie-Caps/11598
A pilot study in the Journal of pain found a reduction in pain by a third by following a very high potassium diet (6000 mg plus per day[i]). It has been observed that people with rheumatoid arthritis have lower levels of potassium, a very high potassium diet seems to increase circulating corticosteroids and reduce inflammation[ii];  one of the functions of corticosteroids is to enable the kidneys excrete potassium, it seems that by increasing potassium levels we can stimulate the output corticosteroids from the adrenals.
It’s believed that our hunter gatherer ancestors ate as much as 10,500 mg of potassium a day compared to a mere 2500 mg a in the modern diet a high potassium diet has protective effects against stroke and cardiovascular disease and so unless you have kidney failure or kidney disease it’s safe and desirable to quadruple your potassium intake. 

To reduce inflammation and rheumatoid arthritic pain you should aim for 8000 to 9000 mg of potassium a day.

High-strength potassium supplements are very caustic and potentially damaging to the stomach wall, many years ago I took high-strength potassium liquid and developed severe stomach pains within several days. To avoid damage to the stomach the maximum legal amount of potassium in the supplement in the UK is 100 mg but this is too low to be useful. Fortunately however it’s very easy to consume very high amounts of potassium simply by consuming very high amounts of vegetables particularly leafy green vegetables; bananas are famous for containing potassium and although they do contain healthy amounts of potassium they also contain far more carbohydrates and less fibre than green and coloured vegetables.
The standard recommendation of five portions of fruit and vegetables a is woefully insufficient, to obtain 8000-9000 mg of potassium you need to consume in the region of 9 to 10 portions of fruit and vegetables a day. This may sound like a daunting task but it can easily be achieved by consuming lots of liquidised vegetable soup and vegetable smoothies.
Potassium is not destroyed by cooking it may however be lost if you boil your vegetables and then throw the water away along with some of the potassium; although it’s common to see potatoes and carrots added to vegetable soups/stews I do not recommend using a lot of carrots and potatoes because of their high carbohydrate content and absolutely do not cook carrots and potatoes for an extended period because this breaks down the carbohydrate and increases the speed at which carbohydrates are turned into glucose i.e the glycaemic index goes up. You can use some sweet potatoes carrots and new/small potatoes but have them towards the end of cooking so that they are still al dente. I recommend using lentils as a thickener and a simple hand blender is quicker and easier to use than a big mixer.
By far the most practical and time saving way to consume potassium is to buy blender/smoothie maker. The old style blenders are usually too big and slow, the new compact high-speed smoothie makers such as the nutribullet are cheap and very effective. I have the 12 piece set Nutribullet in my own kitchen and highly recommend it. In addition to eating some vegetables with your meals drink either three of the small cups or two of the large nutribullet cups filled with primarily green and leafy vegetables such as spinach and broccoli. I recommend the mixture of a small handful of blueberries, just a half a banana, broccoli and spinach along with slightly round teaspoon of Amla powder (Amla powder is super high in antioxidants and combat high blood sugar which is another source of inflammation).
Whatever you do do not make smoothies with a lot of fruit containing sugar, so avoid using mangoes, pineapple, peach, apple and other fruits that deliver a lot of sugar without delivering a lot of antioxidant polyphenols, basically all the berries are a good choice, a half a banana is acceptable because it is high in potassium but what you’re really after our leafy and green vegetables. Lastly do not swallow your smoothie down quickly, because you are not chewing the vegetables they do not get mixed with the enzymes contained in our saliva so drink your smoothie one sip at a time and swish each mouthful before swallowing.

SAM-e (SAM-e is optional, it’s a super powerful anti-inflammatory, unfortunately however it’s very expensive and some people find it a little harsh on the stomach, if your situation is bad and you in a lot of pain it may be worth buying enough SAM-e for the initial 4 to 6 weeks just to speed up the healing process)
800 mg once a day on an empty stomach.
SAM-e is quite expensive, I recommend Dr's Best 200 mg.
Super Omega-3 with Sesame Lignin and Olive Oil (supplementing high doses of omega-3 EPA and reducing the intake of omega-6 oils from vegetable oils is a central component of reducing inflammation).
This product comes in two sizes: the capsules in the 120 capsule bottle size contain twice as much as the capsules in the 240 capsule bottle.
Take between 1500 and 2000 mg of EPA per day for the first six weeks or until you feel signs of improvement, at which point you can experiment with reducing the dosage to about 1000 mg and see what dosage you need to take to maintain the improvements. These doses may seem high but this is what it takes to switch off inflammation.
Some people find if they take the fish oil supplement after a meal it gives them an upset stomach so always take it at the start of your meal so that the food sits on top of it.
Omega-3 fish oils are very delicate and breakdown when exposed to light and heat so it’s important to keep them in the fridge or ideally the freezer and avoid exposing them to direct sunlight.
Low-Dose Aspirin
Some people don’t want to take aspirin because it’s a pharmaceutical drug however at low doses it has numerous health promoting qualities, aspirin was originally an extract from willow bark and it’s safe for most people to take especially at the very low doses I recommend.
I recommend taking a single 75 mg baby aspirin (which is the smallest can buy) once a day.
Aspirin reduces the formation of a fat called arachidonic acid and reducing arachidonic acid levels is the central target of the anti-inflammation diet you should follow to improve the health of your brain; furthermore it’s been observed that inflammation promoting arachidonic acid builds up in the bipolar brain and one of the ways lithium is works is that it counteracts this problem.  By combining a very low dose of aspirin with the anti-inflammatory diet gives the lithium you’re taking a helping hand so that you get a bigger effect from the low dose.
NB this very low dose of aspirin should not present any problem interactions however please consult with your Dr before combining aspirin with other medication.
Ginger is a well researched anti-inflammatory remedy with useful properties in the treatment of rheumatoid arthritis.
I recommend Jarrow ginger 500 mg 1 capsule 2 to 3 times a day with meals
Nigella Sativa Seeds
The seeds are commonly called black cumin or black caraway they are not to be confused with black sesame seeds.
Nigella seed oil improved rheumatoid arthritis in 40% of cases in a small study[iii], in my practice I’ve employed nigella seeds successfully to lower blood sugar in people with type II diabetes and insulin resistance.
The dosage is just a half a teaspoon of seeds a unfortunately however they do have to be grounded in a coffee grinder just before use, they can be sprinkled into a smoothie. When you buy them in a little bag as a spice their expensive but you can find 1 pound or half a kilogram bags more cheaply online.
Probiotics can significantly improves outcomes; they reduce inflammation throughout the body including the brain and specific strains can induce specific brain health benefiting effects.
Lactobacillus rhamnous and reuteri encourages GABA production and calm down overactivity in the HPA axis, and lactobacillus plantarum and bifidobacteria longum encourage BDNF production and may have an overall antidepressant effect.
Primadophillus superior probiotic multi-strain for these two bacteria, it’s available in capsules and powder which is cheaper.
I recommend starting with the Primadophillus probiotic to assist down regulating overactivity in the HPA axis for the first 2 to 3 months and then moving onto a multi-strain such as hyperbolic’s pro 15.
Hyperbolic’s Pro 15 available from iherb:
Also available from the UK Amazon:
**The above products are usually sufficient and will work on their own however if digestive health problems especially leaky gut are also a feature of your condition or if you’ve had a lot of antibiotics in the past you could consider adding the following high potency probiotic containing a high number of Lactobacillus plantarum bacteria. You could consider taking this additional probiotic for up to the first six months but even just a single month in the beginning will help to kickstart your recovery.:
I don’t think iherb sell this product so you have to shop around for US suppliers or find something equivalent with a high dosage of Lactobacillus plantarum.

Adrenal Support Remedies

Pantothenic Acid (pantothenic acid significantly helps the adrenal glands to regenerate -see below for the connection between the adrenal and rheumatoid arthritis- when taken in large quantities pantothenic acid is very non-toxic and safe at high doses).
3000 mg twice a with meals.
I recommend Now Foods 500 mg pantothenic acid capsules. If you want to cut costs by pantothenic acid in powder form with empty size 00 capsules, it’s easy to fill by hand while watching the television example.
For your information: I do not particularly recommend adrenal function tests that simply take measurements of cortisol throughout the day because they susceptible to producing false readings.
Also if you’re adrenals are very exhausted it can be worthwhile taking the bioidentical hormone DHEA, it’s probably a good idea to have blood tests before supplementing DHEA but supplementing up to 25 mg especially if you’re over the age of 50 is probably safe even without testing.
Normal levels depending on age are: 16.2-49 2 mcg/dL for men and 12-40 7 mcg/dL for women.
Optimal levels are: 350-50 0 mcg/dL for men and 275-400 mcg/dL for women.
DHEA can be difficult to obtain without a prescription in some countries including the UK, you can however find it online.
A recent development is to substitute 7-Keto for DHEA, 7-Keto is a metabolite of DHEA that is not converted into either oestrogen or testosterone like DHEA can be and therefore does not have the possibility of upsetting other hormonal balances; unfortunately however it’s not clear to me yet whether or not 7-Keto is an appropriate substitution with regard to inflammation and RA.
When choosing a liquorice product to regenerate the adrenals you must choose one that has not been de-glycerided, the glycerides are often removed because long-term use can lead to high blood pressure but this component is what we want for the adrenals, if you have high blood pressure avoid using liquorice.
Two per Day (Life Extension): 
1 capsule twice a day with breakfast and dinner.
This multiple vitamin/mineral contains methylfolate in place of folic acid, we must avoid taking the synthetic folic acid form of this vitamin just in case you have the MTHFR gene mutation, if you take folic acid and you have this mutation it blocks your ability to methylate and control inflammation. It also contains the right type of methylcobalamin or B12 which further reduces inflammation in place of the more typical cyanocobalamin.
Magnesium Citrate 
2 tablets twice a day with breakfast and dinner.
[Now Foods they do a 250 tablet bottle available at a good price from iherb.com alternatively you can buy magnesium citrate from Now Foods in powder form, take 400 mg of magnesium twice a day]
Vitamin D 3
Vitamin D3 levels in observed below in people with rheumatoid arthritis and supplementing D3 can enhance the effectiveness of other treatments[iv].
I recommend 10,000 IUs vitamin D either continuously or the first six months thereafter 5000 IUs
Source Naturals 5000 IU D3 capsules represent excellent value for money
Taurine (you would include taurine if you have high blood sugar or if you want to enhance your memory by growing new cells in the hippocampus)
Take 3000 mg 2 times a day I recommend buying this in powder form it is cheap and completely tasteless, you can put the powder in your drinking water and consume it throughout the day. (Now Foods or any brand you can find)

Cortisol Adrenals and Rheumatoid Arthritis

People with RA have lower levels of circulating corticosteroids, you may only be familiar with corticosteroids as a pharmaceutical drug, but our adrenal glands manufacture natural corticosteroids and you could say that we only need to take prescription corticosteroids when our body is unable to make sufficient to naturally control inflammation in our system or under exceptional circumstances when we have exceptional and dangerous levels of inflammation.
You’ve probably heard of the hormone cortisol, this is actually one of our primary corticosteroids. Cortisol is sometimes called a stress hormone which is somewhat misleading because cortisol is not only produced when we have a stress response but has many roles in the body. We should actually get a surge of cortisol every morning which activates our immune system and energy levels in readiness for the day and then are cortisol levels should decline rapidly throughout the afternoon down to minimal levels as we sleep.
Prolonged periods of excessive stress responses can result in chronic inflammation[v]. When our body produces a stress response hypothalamus in the brain tells the pituitary in the brain to tell the adrenal glands to release the corticosteroid hormone cortisol this is known as the hypothalamus pituitary adrenal axis (HPA axis) and prolonged periods of stress can lead to permanent over activation of the HPA stress pathway. Initially this leads to prolonged elevated cortisol levels that results increased inflammation (increased cytokine levels), what happens is persistent elevated cortisol causes our body to become desensitised or resistant to cortisol so that the cortisol we make works less efficiently. To make matters worse gradually over time our adrenals can become exhausted, worn out and able to make less and less cortisol.
Eventually combination reduced cortisol production from exhausted adrenals and needing higher than normal levels of cortisol due to cortisol resistance results in chronic inflammation that will take some concerted effort to shift.
One of the essential components to eliminating chronic inflammation is to restore health to the adrenal glands, my observation is that the adrenal glands have a remarkable ability to regenerate and recuperate, we can use natural remedies to stimulate regeneration in the adrenals but you absolutely must not just start stimulating regeneration of your worn out adrenals without either before or at the same time taking measures to switch off excess activity in the HPA stress pathway. When I began practice in the late 80s I didn’t know this and treated people with chronic adrenal fatigue syndrome with natural remedies to boost their adrenal function; initially the treatment seemed to be working fantastically as the adrenal support restored their deficient levels of cortisol resulting in decreased inflammation, stronger immune system and more energy; unfortunately however 6 to 9 months later their energy levels crashed again because we hadn’t switched off the chronic overactivity in their HPA axis so their adrenals and cortisol levels used the remedies, revved themselves up then collapsed again. This problem is easy to avoid by implementing the following.

Switching off Overactive Stress Physiology

There are three ways you can reduce excessive unwanted stress responses:-
1/ You may or may not be able to reduce the sources of external stress in your life, but of course life will subject you to high levels of stress that you cannot control from time to time; in addition to external life events causing stress much of the stress responses we produce in our body are generated within our own mind by our psychology or the way we think. Talking psychotherapy can be very helpful at changing ways of thinking that provoke unnecessary stress responses and if you are really serious about combating inflammation you should try some form of psychological therapy to remodel this source of stress responses.
2/ You can train your brain how to switch off stress responses quickly and efficiently (see The Stress Solution), this involves performing at least 30 and I would recommend 45 to 50 hours of lying on your back and inducing a deeply and profoundly relaxed state. We now know that when you repeatedly perform an exercise for sufficient hours you can hardwire the ability to perform the exercise into the brain. When you perform this exercise and induce a deeply relaxed condition you hardwire into the brain and enhanced ability to switch off stress responses, I like to think of it as throwing a bigger of superior off-stress switch to compensate for the bigger on-stress switch your brain will have grown in response to a prolonged period of elevated stress.
People often think meditation and deep relaxation of the same thing but they are distinctly different physiological conditions and it’s a mistake to think that meditation can achieve the same brain training effect as a course of deep relaxation training; when your primary goal is to set off overactivity in the HPA axis do 45 to 50 hours of deep relaxation brain training first and then optionally follow this on with meditation. If you suspect you carry a significant amount of psychological trauma you may want to start with psychotherapy or dinner psychotherapy simultaneously with deep relaxation training, you may also need to repeat another round of 45 to 50 hours of deep relaxation brain training after the course of psychotherapy.
3/ Meditation has been shown to reduce stress related cortisol production[vi]. Great meditation systems include mindfulness meditation where you focus your attention on either your sensations such as your breathing, hearing et cetera, or focusing openly on your thoughts, focused based meditations where one focuses on chanting a mantra, meditating on cultivating the ceiling and psychology of compassion and lovingkindness. Choose any meditation that you enjoy doing and practice about 20 minutes a day, even just 15 minutes is better than nothing. If you wanted to sample several meditation techniques to find a method that works for you I offer one-to-one coaching sessions, alternatively I do small group meditation classes. 
[i] A Pilot Study of Potassium Supplementation in the Treatment of Hypokalemic Patients With Rheumatoid Arthritis: A Randomized, Double-Blinded, Placebo-Controlled Trial Reza Rastmanesh, Reza Rastmanesh et al. DOI: https://dx.doi.org/10.1016/j.jpain.2008.03.006
[ii] Med Hypotheses. 2009 Oct;73(4):564-8. doi: 10.1016/j.mehy.2009.05.035. Epub 2009 Jun 27. Hypothetical hormonal mechanism by which potassium-rich diets benefit patients with rheumatoid arthritis. Rastmanesh R1. PMID:19560875 DOI: 10.1016/j.mehy.2009.05.035
[iii] Phytother Res. 2007 Sep;21(9):895-7. Effects of thymoquinone (volatile oil of black cumin) on rheumatoid arthritis in rat models. Tekeoglu I1, Dogan A, Ediz L, Budancamanak M, Demirel A. PMID: 17562570 DOI: 10.1002/ptr.2143
[iv] Rheumatology (Oxford). 2014 Nov;53(11):1994-2001. doi: 10.1093/rheumatology/keu173. Epub 2014 Jun 6. Associations between serum 25-hydroxyvitamin D and disease activity, inflammatory cytokines and bone loss in patients with rheumatoid arthritis. Hong Q1, Xu J2, Xu S3, et al. The aim of this study was to describe the associations between serum levels of 25-hydroxyvitamin D [25(OH)D] and disease activity, inflammatory cytokines and bone loss/erosions in patients with RA. PMID: 24907153DOI: 10.1093/rheumatology/keu173
[v] J Endocrinol Invest. 2002;25(10 Suppl):19-23.
Hypothalamic-pituitary-adrenal axis impairment in the pathogenesis of rheumatoid arthritis and polymyalgia rheumatica.
Cutolo M1, Foppiani L, Minuto F. PMID: 12508908
[vi] Proc Natl Acad Sci U S A. 2007 Oct 23;104(43):17152-6. Epub 2007 Oct 11.
Short-term meditation training improves attention and self-regulation. Tang YY1, Ma Y, Wang J, et al PMID:17940025 PMCID:  PMC2040428 DOI:     10.1073/pnas.0707678104
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Hi my name is Peter Smith I specialise in treating and coaching people how to live well with mental health problems, digestive health problems/IBS, sleep problems and type II diabetes using natural therapies.
I used these techniques to overcome and live well with my own bipolar disorder and IBS. I've been in practice as a natural medicine practitioner since 1988.

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