Arthritis
38 Case Studies
40 Member Stories
2299 Research

Functional Medicine takes a deeper look at the source of inflammation of arthritis and gives you options for reversing the process where it begins.

What is Arthritis?

Arthritis is the swelling and tenderness of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The most common types of arthritis are osteoarthritis and rheumatoid arthritis.

- Osteoarthritis causes cartilage — the hard, slippery tissue that covers the ends of bones where they form a joint — to break down.

- Rheumatoid arthritis is a disease in which the immune system attacks the joints, beginning with the lining of joints.

Uric acid crystals, which form when there's too much uric acid in your blood, can cause gout. Infections or underlying diseases, such as psoriasis or lupus, can cause other types of arthritis. Treatments vary depending on the type of arthritis. The main goals of arthritis treatments are to reduce symptoms and improve quality of life. Something has changed in our environment, which makes all kinds of arthritis increasingly more prevalent.

Inflammation is the most elementary problem in most arthritis, whether it is what we traditionally call "inflammatory arthritis" like rheumatoid arthritis, or arthritis many associated with wear and tear on joints over time, osteoarthritis.

The traditional medical approach to these two types of joint swelling is to use drugs to block the inflammation procedure. Though these can be effective in decreasing symptoms and may sometimes prevent further joint destruction, the drugs do not get at the root cause of why you developed the inflammation, to begin with.

Functional Medicine takes a deeper look at the source of inflammation and gives you options for reversing the process where it begins: at the gut, in the gut, from the food, and by the stress reaction.

Traditionally, doctors almost never appraise these factors when fixing joint pain, but fortunately, integrative therapies like functional medicine have the toolbox to do precisely that.  If you want your body to heal naturally without drugs or other invasive procedures, then you can try a different approach. Functional medicine focuses on treating the root cause of the disease rather than just relieving the person from arthritis symptoms.

See: Best anti-inflammatory foods for arthritis

How does Functional Medicine view Arthritis?

Functional medicine's strategy is always to get to the root cause of disease in a holistic and systemic approach. By taking a look at the body's systems as a whole we could detect indications of illness present before acute imbalances in your blood levels are evident. This approach to disease is fantastic for chronic diseases like arthritis where early detection is paramount to recovery and prevention.

Functional Medicine incorporates gastrointestinal, musculoskeletal, endocrine, neurological, and psychological therapies to support the whole body's healing capacity. The functional medicine approach for arthritis is based on the belief that our intestine comprises 70-80% of our immune system. Correcting leaky gut and improving digestion are high priorities for a functional medicine approach to both kinds of arthritis. This is because most arthritis is brought on by chronic inflammation throughout the body. Though each category is a bit different, they both have exactly the identical functional medicine treatments focused on the gut and diet. Increasing antioxidants, gut recovery, and anti-inflammatory foods are ways to get in front of this inflammation and balance the immune system.

Rheumatoid arthritis (RA) affects more than 1.5% of the worlds' inhabitants. Genetic and environmental factors play a part in the start and the progression of this disease. Ahead of the illness emerging, patients enter a psychiatric condition. What factors can tip the scale to cause RA? Genetics plays a big role in the development of RA. Heritability estimates for RA range from 53-65%. There are close to 60 loci associated with susceptibility to RA across several populations. These loci are at least partly shared across ethnicities. Within an RA person, enzymes that promote methylation growth in reaction to the stimulation lead to both hypo- and hypermethylation in synovial cells. The upregulation of histone phosphorylation raises cytokines and contributes to a pro-inflammatory state.

This may explain the increased generation of autoantibodies, which can be detectable over 10 years before RA could be diagnosed. Environmental factors may exacerbate this pro-inflammatory state, acting as a mediator that could accelerate the development of RA. What lifestyle factors contribute to the epigenetic procedure?

Increased urbanization has been associated with a greater prevalence of RA. Rural populations have significantly lower rates of RA than urban populations. This could partially be attributed to the hygiene hypothesis. An urban environment may decrease exposure to allergens, especially in early life. Prenatal and early life environment play an essential role in autoimmune conditions like RA.

No contributing environmental element is quite as recognized as smoking to predispose someone to autoimmune conditions. The higher likelihood of P. gingivalis disease in smokers may explain a number of such a correlation. Underlying bacterial infections and lipopolysaccharides (LPS) are supposed to play a role in RA. On the other hand, like for many other chronic conditions, a diet full of fruits and vegetables may be protective especially if it contains citrus and mushrooms and reduced red meat. Further study is required to understand more of the epigenetic factors in RA.

See: Foods To Avoid For Arthritis

Functional medicine treatment for arthritis

There are various types of arthritis. In general, rheumatoid arthritis/autoimmune rheumatoid arthritis, and osteoarthritis are associated with the wear and tears on joints over time and are a common cause of disability. The most basic problem in all arthritis is found to be inflammation which what we traditionally call “inflammatory arthritis”. Arthritis can be caused due to various factors and functional medicine aims to take a deeper look at the causes of inflammation and thus proves to be a better option for reversing the process where it starts: in the body, gut, mouth, or from the food you consume, and from the stress response.

A functional medicine treatment program for arthritis will incorporate nutrition therapy, supplementation, practical neurology to boost brain function, and other alternative therapies to enhance cell function, particularly immune system function. A practical approach recognizes that the immune system is in control of both inflammation and anti-inflammation. Inflammation is necessary for the body to permit the immune system to do its job and clean up the villain bacteria. The issue of autoimmunity and metabolic syndrome isn't that there is inflammation, but that there's something confusing the body to attack itself and lead to chronic inflammation. Functional medicine exposes the origin of the confused immune system and once we sort this out and treat this, the human body is able to realign the natural immune reaction. 

1. Correcting leaky gut

The gut is an important part of the body that comprises of about 70-80% of our immune system. Individuals with rheumatoid arthritis have increased intestinal permeability caused due to food allergies. Some of the foods are also known to release histamine and other allergic compounds that contribute to leaky gut. Increase intestinal permeability attracts bacteria and other food molecules that act as antigens. The resulting immune complex then triggers the immune system that protects the body from harmful influences in the environment by triggering inflammatory mediators to destroy it. These inflammatory mediators released can worsen the arthritis condition.

Correcting leaky gut and improving digestion by consuming food that is not allergic are high priorities for a functional medicine approach to treat arthritis and its symptoms. Probiotics and prebiotics consumption has also shown its beneficial effects in correcting leaky gut and inflammation caused by it.

2. Eliminating anti-inflammatory or allergic foods

One of the best ways to get ahead of the inflammation and balance your immune system is by eliminating foods that cause allergy. Some dietary foods can trigger an inflammatory reaction by acting as an important mediator of allergy and inflammation through their ability to form inflammatory prostaglandins, thromboxanes, and leukotrienes that can aggravate the symptoms of arthritis. Altering these types of foods can prove to be significantly powerful in decreasing inflammation, allergies, arthritis, and other health conditions. The most common foods that can aggravate rheumatoid arthritis symptoms may include wheat, corn, and dairy products like milk and others, eggplants, beef, tomato, peppers, potato, tobacco as well as food additives.

3.      Physical therapy

Physical therapy may not be curative but can help improve patient comfort and preserve joint and muscle function in a person suffering from arthritis. Physical therapy involves regular stretching and strengthening of muscles through a range-of-motion exercise under the supervision of a licensed physical therapist. Proper physical management like heat applied to the area can help relax muscles, relieve stiffness and pain, and increase range of motion.

4.       Weight loss to relieve pressure on joints

Excessive weight can add a compressive load on your joints making the pain caused due to inflammation unbearable. In such cases shedding those extra pounds with the help of dietary modification and physical activity can help reduce pressure off arthritic knee joints thus protecting the knee’s soft tissues, including ligaments and tendons from being damaged.

 5.       Detoxify your body

Toxins present in our surroundings generated from pollution, industrial wastes, and other sources can harm our body and its tissues when exposed to such toxins. Detoxification which aims in removing and eliminating toxins from your blood in the liver through excretory systems like kidneys, intestines, lungs, lymphatic systems and skin can play a vital role in promoting health benefits. Eliminating toxins and then feeding your body with healthy nutrients can help protect you from disease and renew your ability to maintain optimum health. Some of the harmful toxins and its contribution in aggravating the disease are mentioned below:

Mercury is a heavy metal that is found to be present in seafood is capable of altering or damaging the cells of various bodily tissues. A seldom amount of mercury is essential but amounts exceeding the requirement of the body can cause damage to the cells causing your own immune system to attack your cells and organs

 Mycotoxins- Mycotoxins are poisonous (toxic) secondary metabolites produced by filamentous fungi, that enter into our food chain through various plant-based products. These are volatile organic compounds that can aggravate autoimmune conditions like rheumatoid arthritis. The best way to avoid these mycotoxins is to consume fresh foods and re-dry the seeds, nuts, and destroy contaminated products.

Stay away from infections: there are various viruses and bacteria Prevotella copri or Proteus mirabilis, Epstein-Barr virus that cause infection, and give rise to inflammation. So, it’s essential to take antibiotics and treat such infections. one can also use herbs to treat these infections naturally 

6.   Support the immune system through dietary supplements 

Since the immune system plays a considerable role in inflammation caused in arthritis supplementing and maintaining a healthy immune system may help reduce inflammation in the entire body, either by modulating the immune system or by detoxifying it. Supplements like vitamin D, omega-3 fish oils, and glutathione has been shown to help regulate the immune system.

- Omega-3 fatty acids

Various research has shown that consuming Omega-3 fatty acids rich foods can decrease the long-term requirements for nonsteroidal anti-inflammatory drugs as they can suppress the production of inflammatory compounds secreted by the white blood cells. The studies have also demonstrated that supplementation of these fatty acids can improve various symptoms like morning stiffness and joint tenderness. 

- N-Acetyl cysteine

It is the most common supplement that is used as adjuvant therapy in patients suffering from Rheumatoid arthritis. N-acetyl Cysteine is known to reduce several oxidative stress factors and inflammatory cytokines. Consuming N-Acetyl cysteine supplements is also known to produce analgesic effects.

- Flavonoids

Flavonoid-rich fruits and vegetables can function as "biological response modifiers." Flavonoids appear to have anti-inflammatory, anti-allergic, antiviral, and anticancer properties that can modify the body's reaction to foreign compounds like allergens, viruses, and carcinogens. Flavonoids can help prevent the destruction of collagen structures by inhibiting the release and synthesis of compounds that promote inflammation such as histamine. 

- Selenium

Selenium plays an important role in serving various enzymatic reactions that takes part in our body. It is a potent antioxidant and serves as the mineral cofactor in the free radical scavenging enzyme glutathione peroxidase which helps in reducing the production of inflammatory prostaglandins and leukotrienes. The best sources of selenium are fish and grains.

- Zinc

Zinc can be found in whole grains, nuts, and seeds and has antioxidant effects that can reduce inflammatory mediators and protect from cell damage.

- Vitamin C 

Vitamin C an important antioxidant is found to be in decreased amounts in rheumatoid arthritis patients. Supplementation with vitamin C provides some anti-inflammatory action by increasing SOD activity and lowering the histamine levels. Vitamin C rich foods include broccoli, Brussels sprouts, cabbage, citrus fruits, tomatoes, and berries. 

- Curcumin 

Curcumin an active constituent found in turmeric or Curcuma longa works to enhance the body's own anti-inflammatory mechanisms. Curcumin is a powerful antioxidant and has greater effects in preventing free radical damage when compared to vitamin C, vitamin E, and superoxide dismutase. 

- Glucosamine

Compounds containing glucosamine supplements are among the most commonly used products for osteoarthritis. Although the evidence is not entirely consistent, most research suggests that glucosamine sulfate can improve symptoms of pain related to osteoarthritis, as well as slow disease progression in patients with osteoarthritis of the knee. Chondroitin sulfate also appears to reduce osteoarthritis symptoms and is often combined with glucosamine.

See: Leaky gut syndrome, symptoms & best diet

Studies in Functional Medicine for arthritis

Rheumatoid arthritis treated with vegetarian diets. 

A single-blinded randomized controlled, trial that included 53 patients suffering from rheumatoid arthritis was studied to know the effects of a vegetarian diet on rheumatoid arthritis. 

Group 1 (n=27)- were initially tested in fasting state for 7-10 days after which they were recommended to take, gluten-free, vegan diet for 3.5 mo, and then consuming an individually adjusted lactovegetarian diet for 9 mo in patients with RA. While the other 26 patients were on an omnivorous diet.

The result was calculated at baseline and after one year of treatment. The results reported showed that some patients with RA can benefit from a fasting period followed by a vegetarian diet. Thus, dietary treatment may be a valuable adjunct to the ordinary therapeutic armamentarium for RA. 

See: Heavy Metal Detox Diet and Foods

Summary

There are a number of promising functional medicine approaches available for preventing and treating various types of Arthritis. Several nutritional supplements along with various other factors like stress management, lifestyle modification, exercise, and physical therapies have been shown to be as effective as NSAIDs at relieving the symptoms of arthritis. Functional medicine supplements can be effectively and safely recommended to reduce the usage of NSAIDs. However, this mode of treatment is still unclear and requires more high-quality research with a large amount of data.


See: Pool Exercise for Arthritis

References

1.   http://www.ecopolitan.com/Rheumatoid-Arthritis

2.   The effect of nutritional supplements on osteoarthritis.

3.  IFM,  https://www.ifm.org/news-insights/ai-risk-rheumatoid-arthritis/

4. Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/arthritis/symptoms-causes/syc-20350772

5. MacGregor AJ, Snieder H, Rigby AS, et al. Characterizing the quantitative genetic contribution to rheumatoid arthritis using data from twins. Arthritis Rheum. 2000;43(1):30-37. doi:10.1002/1529-0131(200001)43:1<30::AID-ANR5>3.0.CO;2-B.

6. Araki Y, Mimura T. The mechanisms underlying chronic inflammation in rheumatoid arthritis from the perspective of the epigenetic landscape. J Immunol Res. 2016;2016:6290682. doi:10.1155/2016/6290682.

7. Viatte S, Plant D, Raychaudhuri S. Genetics and epigenetics of rheumatoid arthritis. Nat Rev Rheumatol. 2013;9(3):141-153. doi:10.1038/nrrheum.2012.237.

8. Glant TT, Mikecz K, Rauch TA. Epigenetics in the pathogenesis of rheumatoid arthritis. BMC Med. 2014;12:35. doi:10.1186/1741-7015-12-35.

9. Nielen MM, van Schaardenburg D, Reesink HW, et al. Specific autoantibodies precede the symptoms of rheumatoid arthritis: a study of serial measurements in blood donors. Arthritis Rheum. 2004;50(2):380-386. doi:10.1002/art.20018.

10. Tracy A, Buckley CD, Raza K. Pre-symptomatic autoimmunity in rheumatoid arthritis: when does the disease start? Semin Immunopathol. 2017;39(4):423-435. doi:10.1007/s00281-017-0620-6.

11. Solomon L, Robin G, Valkenburg HA. Rheumatoid arthritis in an urban South African Negro population. Ann Rheum Dis. 1975;34(2):128-35.

12. Chou CT, Pei L, Chang DM, Lee CF, Schumacher HR, Liang MH. Prevalence of rheumatic diseases in Taiwan: a population study of urban, suburban, rural differences. J Rheumatol. 1994;21(2):302-306.

13. Okada H, Kuhn C, Feillet H, Bach J-F. The “hygiene hypothesis” for autoimmune and allergic diseases: an update. Clin Exp Immunol. 2010;160(1):1-9. doi:10.1111/j.1365-2249.2010.04139.x.

14. Edwards CJ, Cooper C. Early environmental factors and rheumatoid arthritis. Clin Exp Immunol. 2006;143(1):1-5. doi:10.1111/j.1365-2249.2005.02940.x.

5. Silman AJ, Newman J, MacGregor AJ. Cigarette smoking increases the risk of rheumatoid arthritis. Results from a nationwide study of disease-discordant twins. Arthritis Rheum. 1996;39(5):732-735.

16. Stolt P, Bengtsson C, Nordmark B, et al. Quantification of the influence of cigarette smoking on rheumatoid arthritis: results from a population based case-control study, using incident cases. Ann Rheum Dis. 2003;62(9):835-841.

17. Hutchinson D, Shepstone L, Moots R, Lear J, Lynch M. Heavy cigarette smoking is strongly associated with rheumatoid arthritis (RA), particularly in patients without a family history of RA. Ann Rheum Dis. 2001;60(3):223-227. doi:10.1136/ard.60.3.223.


See: Ayurvedic Herbs For Arthritis Remedies

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