Is there any biological or natural treatment for rheumatic diseases such as lupus, scleroderma, and rheumatoid arthritis?
In our practice, we treat a wide variety of immunological conditions, and an even broader spectrum of diseases in which imbalances or deficiencies of the immune system are involved. Often times, a basic understanding of the immune system helps to go a long way in the common disease process in these conditions, and also the way in which the system can be restored to health.
The immune system has basically two competitive arms: they are called cell-mediated immunity (also known as Th1) and humoral immunity (also known as Th2). In simplistic terms, these two sides of the immune system can be considered to be in competition with each other, so that when one side is over-active the other side is under-active – similar to a tug-of-war or teeter-totter system. This is very much an oversimplification, as we also know now that there are regulatory branches, Th3 branches - but clinically the teeter - totter analogy is still useful.
Th1 – cell mediated immunity
- viral infections
-intra-cellular or cell wall deficient germs
Stimulated by cytokines such as IL-12, IFN, TNF
Th2 – protein mediated immunity
-responsible for fighting bacteria in some cases, parasites especially also
-can cause allergies
Stimulated by cytokines such as IL-6
When one side of the system is active and being stimulated by certain cytokines, the other side is inhibited. In cases of rheumatic disease, this system is out of balance and the cytokines are not balancing each other correctly.
It is theorized that chronic infections can cause certain types of rheumatic disease, and the link seems to be the strongest for rheumatoid arthritis. A subset of patients may benefit from antimicrobial treatment. Early versions of this protocol have been described by “the Road Back Foundation” - The catch is that the antibiotic has to be one that easily penetrates into the cells because many of these infections are theorized to be cell-wall deficient, and thus much more adept at hiding from the immune system by seeking shelter inside otherwise healthy human cells. These antibiotics include doxycycline, minocycline, and tetracycline. While this may be an effective approach, long-term use of antibiotics is slow and many patients cannot tolerate them. There is considerable risk with such treatment.
From an infection point of view, an alternative treatment approach is called oxidative medicine. We often find that chronic infections can lead to hyperviscosity of the blood (it becomes too thick) and the oxidative therapies directly address this blood stagnation. Often times rheumatic patients will tell us that their blood feels “thick” and thus the muscles and joints ache – the patients may be right. This also correlates with the traditional Chinese medical diagnosis of “blood stagnation” in these disorders.
Ann Hematol. 2001 Dec;80(12):745-8. Epub 2001 Oct 13.
Ozonized autohemotransfusion improves hemorheological parameters and oxygen delivery to tissues in patients with peripheral occlusive arterial disease.
Twenty-seven subjects suffering from peripheral occlusive arterial disease (POAD, clinical stage II-III according to Fontaine) were enrolled in this study to evaluate the effect of oxygen-ozone therapy upon hemorheological parameters and hemoglobin-oxygen affinity in patients with POAD. All patients underwent a major ozonized autohemotransfusion consisting of the slow reinfusion of 100 ml of autologous blood, previously exposed to a O(2)-O(3) mixture in a glass box for 10 min. Whole blood viscosity, erythrocyte filterability, hematocrit, and fibrinogen levels were assessed at the basal time and 30 min after the reinfusion of ozonized blood. At the same time p50 standard (p50std) values (an indicator of hemoglobin-oxygen affinity) and plasma values of malonyl dialdehyde (MDA, an indicator of lipid peroxidation) were evaluated. At the baseline, patients had significantly higher ( p<0.05- p<0.001) whole blood viscosity, MDA, and p50std values and significantly lower blood filterability ( p<0.01) as compared with 20 matched healthy volunteers (controls). Thirty minutes after the end of a major autohemotransfusion, whole blood viscosity significantly decreased ( p<0.01). This was accompanied by a significant fall in plasma fibrinogen level ( p<0.01) with no change in hematocrit. Blood filterability, MDA plasma level, and p50std values increased significantly at the same time ( p<0.01- p<0.005). The 2,3-DPG value did not change significantly. No significant changes occurred when the same patients received a non-ozonized autohemotransfusion (control test). In conclusion, ozonized autohemotransfusion may be useful to improve both the poor rheological properties of the blood and the oxygen delivery to tissues in patients suffering from POAD.
These oxidative treatments are simple to administer and usually well tolerated. In rheumatic patients, a temporary worsening can sometimes happen on initiation of therapy. In this reaction, symptoms temporarily get worse before they get better; this is a normal response to therapy. The treatments themselves are called ozone therapy by major autohemotherapy or ultraviolet blood irradiation. Generally in chronic cases, a treatment is given twice a week for 3 weeks and then once a week for 4 weeks. Supportive treatment can be given once every 1-2 months usually.
In certain cases, an analysis of triggers that may be aggravating symptoms is useful. Usually food-sensitivities such as gluten and casein or dairy are important. We prefer blood testing for this analysis, as if there is a gluten sensitivity there should be a detectable protein or immunoglobulin in the blood. From a blood sample, a panel of tests is run against 100 foods to see if certain foods can be propagating (they don’t initiate it, but can make it worse) the immune system imbalance. While other doctors seem to like Vega testing or energetic testing for the foods, we prefer to see that the actual protein is there before making such a difficult lifestyle change. If the food sensitivities are there, the reconditioning and reprogramming of the immune system can make it so that the foods can usually be tolerated again in a few months.
Conventional serological testing such as tissue transglutaminase IgA may be useful as well.
Eur Ann Allergy Clin Immunol. 2015 Mar;47(2):54-7.
High prevalence of gluten sensitivity in a cohort of patients with undifferentiated connective tissue disease.
The aim of this study was to investigate if co-morbid conditions as hepatitis C virus infection and celiac disease may be associated to undifferentiated connective tissue disease.
We studied retrospectively and prospectively 52 patients with diagnosis of undifferentiated connective tissue disease, subdivided, according to Vaz criteria, in systemic lupus erythematosus, systemic sclerosis and Sjögren's syndrome-like subgroups. Serological markers of celiac disease as anti-gliadin, anti-endomysium and anti-tissue transglutaminase antibodies were investigated. An esophagogastroduodenoscopy with duodenal biopsy and histological examination was proposed to patients with positive celiac disease serology. In addition antibodies directed to hepatitis C virus and total IgA-antibodies were investigated.
Six patients (11,5%) were positive for celiac disease serological tests although two of them were asymptomatic. Four patients underwent an esophagogastroduodenoscopy, showing total or subtotal villous atrophy at duodenal biopsies. Hepatitis C virus serology was negative in all patients and none had IgA deficiency. 83% of celiac patients showed a scleroderma-like phenotype. We observed a statistically higher incidence of autoimmune symptoms in patients with gluten sensitivity. Fatigue and myalgia regressed early after the beginning of gluten-free diet.
In our cohort of patients the prevalence of celiac disease was higher than that reported in the general population. We believe that all patients with diagnosis of undifferentiated connective tissue disease, especially those with a systemic sclerosis-like presentation, should be investigated for celiac disease, even in absence of gastrointestinal symptoms. Gluten-free diet should be early recommended to all patients having undifferentiated connective tissue disease and gluten sensitivity.
One of the best resources for patients who have rheumatoid diseases is a non-profit foundation called the Arthritis Trust of America. They have a wide variety of articles on their website, and although some may be a bit technical for the average reader, they provide a wealth of information on natural treatments for arthritis. Their website is www.arthritistrust.org.
Questions and Answers:
How are the food sensitivities tested for?
Blood testing is the most convenient. Sometimes an elimination and challenge diet is done, but in rheumatic disease it is much more clinically useful to know which foods have the ability to stimulate immunoglobulins present in the blood.
Are the therapies to balance the immune system risky?
All treatments have risks - and invasive ones such as IV therapy can always have risk of infection, procedural complications, clots. Having said that - the vast majority of treatments are very well tolerated.
How long until results are seen?
Usually a course of treatments from 6-10 times is needed. If triggering foods are avoided also, and oral supplements given, the response rate can be potentiated. Evaluation is done after 1-2 weeks following the initial course and may involve repeating some lab tests (usually not the foods test though).