When it comes to preventing and/or treating disease my approach is with Naturopathic Medicine or a Functional Medicine approach to address the underlying cause of a condition. The reason for this is because I have lived with a chronic inflammatory or what is referred to as an Auto-inflammatory disease for the last 20 years. For 7 years my symptoms of pain and immobility were covered up with pharmaceutical drugs and eventually I started to experience even more symptoms that were far worse than the original.
After 7 years I had enough of the symptom suppression model and began to address the underlying cause of my condition. For the last 10 years I have been free of prescription drugs and l have the least amount of pain than at any other point in my life. I began to ask why I had inflammation, pain, digestive problems, anxiety, depression, insomnia, and chronic fatigue. When I began to ask why that led me to search for the reasons and answers to understand what was causing my symptoms.
The question of why we are experiencing the symptoms we are and trying to understand the underlying cause of our issues is rarely addressed with the current medical model. Because of the experiences and success I have had over the last 20 years I focus on a functional medicine approach with my patients focusing on the underlying cause of their health concerns.
For example, with the autoimmune disease Rheumatoid Arthritis one of the first areas I will assess is an individuals digestive health and run a functional stool analysis. The test is performed even if an individual does not have any digestive issues because the majority of individuals with a rheumatological or chronic inflammatory disease will have what is referred to as subclinical bowel inflammation. This means that they will have inflammation and damage in their GI tract, but will have no digestive symptoms. Their symptoms are appearing in extra-intestinal areas such as in the joints and brain.
The functional lab test I run focuses on the health of an individuals gut bacteria and gut lining. It will show if there are any bad bacteria, viruses, parasites, fungi, or yeast present that need to be eliminated. The test will also show if there are any opportunistic bacteria that can be potential autoimmune triggers. Proteus, Klebsiella, and Citrobacter have been associated with Rheumatoid arthritis. If these potential autoimmune triggers are present I use anti-microbial botanicals as opposed to antibiotics. Botanicals such as Tribulus, Berberine, Grape Fruit extract, Barberry extract, Black Walnut, Arctostaphylos uva-ursi, and Oil of Oregano can be used to eliminate the above pathogens. Silver is also powerful and effective for eliminating dangerous microbes.
The test will also assess an individual’s levels of good bacteria such as Bifidobacter and Lactobacillus and if there is a need for probiotics. The ratio of good to bad bacteria in the gut is one of the most important players determining the health of the gut lining and the function of the immune system. When needed, probiotics can be extremely beneficial when dealing with autoimmune disease and/or digestive issues.
That brings us to another underlying cause for autoimmune disease such as Rheumatoid Arthritis, which is the health of the gut lining and a potential leaky gut. If an individual’s functional stool analysis shows markers such as a bacteria, virus, parasite, low good bacteria, a potential autoimmune trigger, gluten sensitivity, and/or signs of inflammation this can indicate a leaky gut. This allows toxins, bacteria, and undigested food particles to stimulate the immune system and lead to autoimmune disease.
If a leaky gut is suspected botanicals and nutrients such as L-Glutamine, N-Acetyl-D-Glucosamine, DGL, Aloe Vera extract, Ulmus fulva, Althea officinalis, Chamomile, MSM, Quercetin, and Zinc Carnosine can be used to help repair the gut lining.
In the case of Rheumatoid arthritis a strong potential autoimmune trigger is Proteus mirabilus. This bacteria produces enzymes that are recognized by antibodies of the immune system. The problem is that these bacterial enzymes resemble proteins on type XI collagen that are present in the small joints of the body such as the hands and feet. The body’s immune system thinks the small joints of the body are a problem and a danger to the body just like the bacteria Proteus. Proteus is called a potential autoimmune trigger because it is usually only a problem in individuals with genetic predispositions. Individuals that have an autoimmune disease usually have a genetic predisposition and are exposed to an environmental trigger. The environmental trigger can be a certain microbe, undigested food particles, or a toxin.
Another effective treatment for autoimmune disease such as Rheumatoid Arthritis is a combination of Curcumin and N-Acetyl-D-glucosamine. Curcumin is a powerful anti-inflammatory and N-Acetyl-D-glucosamine is a powerful blocking agent. If leaky gut is present and antigens such as undigested food particles and bacterial toxins stimulate the immune system, N-Acetyl-D-glucosamine acts as a blocking agent to prevent the stimulation of the chronic inflammation and autoimmune attack.
Nutrients that can be effective in treating Rheumatoid Arthritis are vitamins and minerals such as Vitamin D, B12, Folate, Vitamin C, Flavonoids, Vitamin K, Magnesium, Omega-3 fatty acids, CoQ10, and other B vitamins. Another functional lab test that I use to assess the underlying cause of a patient’s condition and to guide specific treatment is an Organic Acids Test. This test will assess the need for B12, Folate, other B vitamins, CoQ10, Vitamin C, Flavonoids, and other antioxidants. Metabolites are measured in the urine and elevations show specific nutrient needs, levels of energy production, toxins, methylation status, and oxidative stress.
Low levels of vitamin D are associated with Autoimmune Disease because of the major role vitamin D has in balancing the immune system. Chronic inflammation causes oxidative stress and can damage blood vessel walls. Antioxidants such as vitamin C and Flavonoids are effective against oxidative stress and help to maintain the strength and integrity of blood vessel walls. Anemia of chronic disease can be associated with Rheumatoid Arthritis and deficiencies of B12 and Folate have been associated with the disease. Vitamin B12 and Folate are needed for red blood cell production as well as iron. If needed, CoQ10 and other nutrients for energy production can be very helpful for chronic fatigue that is often associated with Rheumatoid Arthritis and other Autoimmune Disease. Osteoporosis can also be a problem from living with Rheumatoid Arthritis and vitamins D, K, Magnesium, and Calcium are very helpful in maintaining strong bones to avoid complications such as fractures. Serum 25 OH Vitamin D testing is needed to measure vitamin D levels to know whether there is a need for supplementation and proper dosing.
Natural Pain relievers and natural anti-inflammatory nutrients and botanicals are also very effective for the pain and inflammation associated with Rheumatoid Arthritis. In my practice, in addition to the above nutrients and botanicals I use systemic enzymes and a medical food formulation containing flavonoids and collagen peptides with success for Rheumatoid Arthritis and other chronic inflammatory conditions.
Nutritional Medicine, Alan R. Gaby, M.D.
By Dr. Andrew Cummins
Andrew Cummins is a Naturopathic Doctor in Westport. Find him at the Shalva Clinic. http://shalvaclinic.org/andrew-cummins-nd/
Shalva Clinic (203) 916-46008 Lincoln St.Westport, CT 06880