How to Treat Rheumatoid Arthritis Without Drugs

I want to tell you about a patient I had in my clinical rotation at UConn Health Center.  She was in her 60's, and she was hospitalized following a surgical procedure to fix a pericardial effusion (fluid buildup around the heart).  Other than this acute issue, she had very few health problems, and nothing heart-related.  What she did suffer from, however, was rheumatoid arthritis (RA), a nasty autoimmune, inflammatory disease in which the body attacks its own cells in joints, often in the hands or feet.  Over time, this can lead to deformities in the structure of the hands and feet, like here:

And this is what her hands looked like.  I asked her if her RA bothered her in everyday life, and she said only rarely.  But I saw her hands.  Maybe she could perform easy tasks without any trouble, but she's not opening a jar of tomato sauce any time soon.  Of course, this patient was being treated the same way most RA patients are treated:  with glucocorticoids like Prednisone.  But drugs like Prednisone come along with approximately 4,732 serious side effects, such as increased blood pressure, weight gain, mood swings, osteoporosis, increased risk of infection, and diabetes.  Not exactly "safe" over the long-term.

I am fully aware that a paleo-type diet would help her control her RA; I thought long and hard about whether or not to bring it up with her.  But in the end I didn't, because I'm a student, and paleo isn't exactly protocol at UConn Health Center.  Besides, she eats a super-low-fat, cholesterol-is-deadly, 80s-style diet, full of egg beaters and vegan sausage.  (Her total cholesterol was an extremely low 87 mg/dl by the way, something none of the doctors seemed to be even remotely worried about *palmtoforehead*).  I wasn't about to broach that subject with a 10-foot-pole.  She wouldn't have believed me, and my preceptor never would have signed off on it anyway.

Ironically, later on that week, I listened to a Chris Kresser podcast in which he discussed how he treats RA using diet and supplements.  No Prednisone.  No side effects.  This is the information my patient really needed, along with everyone else who suffers from this debilitating disease.  This is how you get to the root cause of RA and fix it, not simply cover it up with corticosteroids. 



1.  The Foundation of Rheumatoid Arthritis Treatment - Heal the Gut!
What does that mean, you may ask?  I haven't talked about the gut much on the blog.  According to Dr. Alessio Fasano, a leading researcher on intestinal permeability (or leaky gut), it may not even be possible to have an autoimmune condition without a permeable gut.  In short, a leaky gut leads to undigested food getting into the bloodstream, and this may be the underlying cause of autoimmune conditions (other similar conditions include multiple sclerosis, lupus, celiac disease, and type 1 diabetes.  Yes, this treatment is applicable to any disease that is autoimmune in nature). 

There are a few things you can do to ensure the integrity of your gut, and this comes directly from Chris Kresser:  Identify potential pathogens, improve stomach acid, rebalance gut flora, and remove harmful foods from the diet.  The first three would require the help of a naturopath or functional medicine practitioner; Google it, I don't have time to go into it here.  But the last one can be done at home.  The paleo diet is perfect for this, as it eliminates most of the potentially harmful foods.  Grains, legumes, and dairy are the biggies, but it may also be worth eliminating eggs, nuts, and nightshades, at least for the first 30 days.  Check out Robb Wolf's autoimmune protocol.

This guy is not your friend.  Plus he steals Christmas.

This is the foundation of RA treatment, and you will not have much success without healing the gut!  But the following factors have also been shown to be important.

2.  Low-Dose Naltrexone
Yes, this is a drug.  But it's mild in low-doses, and in this case the benefits outweigh the risks.  Originally designed to help drug addicts quit their habit, naltrexone blocks the opiate receptors in the brain that are responsible for addiction.  So if a heroin addict took 50 mg of naltrexone, then shot up heroin, he wouldn't feel a thing.  Unfortunately, not only does naltrexone prevent that happy feeling you get from a heroin injection, it prevents happy feelings in ALL aspects of life, making the patient into a mental vegetable.  Not so good.

When taken at a lower dose, however, naltrexone stimulates T regulatory cell function.  T regulatory cells balance the immune system, and they're responsible for turning off inflammation when needed.  And that's one of the main characteristics of RA and similar disorders:  excessive inflammation.  In fact, low-dose naltrexone has been shown to be very effective in Crohn's disease, another autoimmune condition, reducing symptoms in 89% of subjects in one study with no side effects (1).  Even if there's no direct evidence for RA, it's likely to be just as effective via the same mechanism.  And since there are no side effects, there's very little risk but a high potential benefit.

3.  Glutathione
You've probably never heard of glutathione.  But it's the master antioxidant in the body, so it's vitally important.  One of the main functions of glutathione is to promote healthy T regulatory cell function.  Sound familiar?  And, in autoimmune diseases like rheumatoid arthritis, glutathione levels are typically depleted.  There are ways to check your gluathione status, but I won't go into that here.  Refer to that Chris Kresser podcast I linked to before.

Food is going to be the most important way you can increase glutathione production:  raw milk, non-denatured whey protein, and sulfur-rich veggies like onions, cabbage, and broccoli.  Since glutathione is just a tri-peptide (three amino acids), you can't simply take a glutathione pill; the tri-peptide will be cleaved into amino acids in the digestive tract and that's it.  No more glutathione.  As for supplements, though, S-acetyl-glutathione and liposomal glutathione may be effective in promoting endogenous glutathione production, but they're super expensive.  Like $100-a-bottle-expensive.  I'd stick with the food. 

4.  Vitamin D
Seems like Vitamin D is essential for everything.  See this old blog post I wrote about how it relates to cancer.  Those with autoimmune diseases like RA are often particularly deficient.  No surprise, vitamin D is also involved in T regulatory cell function.  So either get outside and get some sun (without burning, obviously), or try a D3 supplement.  Higher than average vitamin D levels may be beneficial; between 50-60 ng/ml would be good to shoot for.

5.  Fish Oil
It's no secret these days that omega-3's from fish are good for you.  Fish oil's popularity has been skyrocketing lately, as they have some powerful anti-inflammatory effects..  And for those with inflammation-driven diseases like RA, they're even more important.

There are a number of ways to get your fish oil.  The best way would be to eat fatty fish like salmon and sardines.  Shoot for about a pound a week.  If you don't like fish, I would highly recommend the butter oil/cod liver oil blend from Green Pasture.  It's got the omega-3's you need, as well as some very beneficial fat-soluble vitamins like A, D, E, and K2.  If you really want to be cheap, you can go out and buy a fish oil supplement at your local Walgreens.  But I'd recommend something a little better if you're trying to treat RA.



So there you have it.  That's how you treat rheumatoid arthritis and other autoimmune conditions safely and effectively.  No Prednisone, no side effects, no treating the symptoms.  You're getting to the root cause of the problem and fixing it, as it should be.  I only wish I could have shared this information with my patient at the hospital that day.

Does anybody out there have any first-hand experience treating autoimmune diseases naturally?  I'd love to hear about it in the comments section.