Rheumatoid Arthritis

Rheumatoid Arthritis can be a crippling, progressive and painful disease. It differs from the more commonly seen, osteoarthritis or “wear and tear” degenerative disease in that Rheumatoid Arthritis (RA) is a systemic, inflammatory autoimmune disorder that can affect multiple body systems, not just our joints. It is usually diagnosed in adults, and is found more commonly in women than men. There is a juvenile form that affects children and young adults. The main treatment goal is to prevent joint destruction and disease progression as well as to control pain and optimize independence.

The diagnosis of RA is based upon a combination of positive immunological and inflammatory markers found in our blood combined with a detailed history and clinical presentation. Although there is not a general consensus among the various medial discipline as to the exact cause of this disease , many treatment approaches are aimed at decreasing inflammation and “quieting” the immune system. For many patients, this includes the use of powerful immunosuppressive drugs and steroids. Pharmaceutical research has proven these types of medications may benefit the patient but they are not without potentially significant adverse effects which may include increased susceptibility to infections and certain types of cancers.

Medications such as Remicaide and Enbrel work to alter our immune system’s recognition of any “friendly fire”. In doing so, they exert a significant effect on cytokine regulation. While this treatment has a potent anti-inflammatory effect, it also may not allow one’s immune system to recognize and interrupt aberrant cellular activity and other infectious processes. The body’s immune system is complex and intricate. When we inhibit its normal regulatory functions we are leaving ourselves “wide-open” for other problems to arise. Still, each individual must weigh the pros and cons of their treatment options as discussed with their physician. The adverse long-term effects of corticosteroid use are well documented in RA as well as other chronic illnesses such as asthma and allergy.

Examining our individual biochemistry can provide insight regarding underlying mechanisms. There are numerous infectious organisms that can be identified in the blood and/or the gut (intestinal mucosa) that may be at least partially responsible for inappropriately activating our immune system via a process called “molecular mimicry”. Prior, high-dose and repeated use of antibiotics can alter the normal intestinal balance between organisms that are beneficial and those that cause disease. This disruption can damage the integrity of the finger-like projections(microvilli) in our small intestine further compromising the body’s ability to discriminate between what belongs in the gut verses the blood. This is commonly known as “leaky gut” or increased intestinal permeability. This process can be further worsened and often coincides with multiple food intolerances. The two are generally seen together. Other intestinal imbalances of good bacteria and parasitic or fungal pathogens can contribute to additional pathology. There are also various forms of infectious organisms that present a more difficult challenge to the body’s immune system. These include some of the atypical pathogens such as mycoplasma and L-form bacteria. Strep-related infections have also been proven to trigger inflammatory arthritis, particularly in children. Remember, it is the bacteria’s goal to thrive at the expense of our well-being. Thus, bacteria are “getting smarter” and finding ways to survive traditional doses and methods of anti-infective medication. (known as drug resistance in the medical world) This is one of several avenues to explore in this complex illness.

There are many ways to reduce factors that heighten the body’s inflammatory response. We take a biochemical and investigative approach; looking at potential infectious processes, environmental insults, an individual’s unique chemical make up, their genetics and nutritional status to reduce contributing factors in arthritis. This comprehensive approach may often times lessen the need for medications in treating the illness.

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