Rheumatoid arthritis is an autoimmune disorder that occurs when your immune system mistakenly attacks your own body’s joints. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.
However, it is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition can damage a wide variety of organs, including the skin, eyes, lungs, heart and blood vessels.
While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities and is associated with a number of other health conditions.
Conventional Treatment of Rheumatoid Arthritis
The types of medications used depend on the severity of the symptoms and the aggressiveness of the disease. There is no cure for rheumatoid arthritis. The goal of conventional treatment is to decrease your symptoms and poor function.
- NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Side effects may include ringing in your ears, stomach irritation, heart problems, liver and kidney damage.
- Steroids. Corticosteroid medications, reduce inflammation and pain and slow joint damage. Side effects may include thinning of bones, edema, weight gain and diabetes.
- Disease-modifying antirheumatic drugs (DMARDs). These drugs can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage but they do this by suppressing the immune system. Side effects vary but may include fatigue, liver damage, bone marrow suppression and severe lung infections.
- Biologics. This is the newest class of drugs used to treat rheumatic conditions such as rheumatoid arthritis. Like DMARDs, they target specific immune-mediators involved in inflammation and can slow the progression of the disease by suppressing the immune system. Side effects include pain and rash at the injection site, other allergic reactions and an increased risk of severe infections.
Functional Medicine and Rheumatoid Arthritis
A comprehensive approach to the management of complex conditions such as autoimmune disease must take into consideration many aspects of health, including gut barrier integrity and imbalances of gut flora, liver detoxification capacity and toxic burden, hormone imbalances, energy production capacity, nutrient status and most importantly, immune imbalances which promote autoimmune states. More specifically, Functional Medicine approaches autoimmune disease by identifying the triggers and mediators of the autoimmune attacks, minimizing the self-destructive immune responses and enhancing the body’s ability to recover from flare-ups.
There are 4 areas of management of autoimmune conditions in the Functional Medicine approach:
- Identifying and avoiding the triggers of autoimmune responses
- Modulating the autoimmunity and reducing tissue destruction
- Enhancing and supporting recovery from flare-ups
- Addressing associated conditions that promote autoimmune responses
Identifying and avoiding the triggers of autoimmune responses
Lab testing is a critical first step in identifying the extent of systemic inflammation and ruling out many environmental insults which act as triggers and mediators of autoimmunity, such as chronic infection, heavy metal toxicity and decreased capacity to perform liver detoxification. Food sensitivities can also promote inflammation and potentially drive autoimmune responses.
Identifying and addressing these issues is critical in rheumatoid arthritis patients to minimize damage and promote restorative function.
Modulating the autoimmunity and reducing tissue destruction
Functional medicine uses immune-modulating herbs and nutritional compounds to decrease immune responses to self-tissue.
Identifying the triggers of autoimmunity and modulating the immune response can have powerful long-term positive effects on slowing or stopping tissue destruction and improving quality of life.
Enhancing and supporting recovery from flare-ups
There are a number of natural compounds that help support a faster recovery by breaking down offending triggers, increasing blood flow to target tissue and dampening the immune response.
Addressing associated conditions that promote autoimmune responses
Intestinal permeability promotes autoimmunity
There is growing evidence that increased intestinal permeability plays a pathogenic role in various autoimmune diseases. Increased intestinal permeability and compromised gut integrity appear to precede AI disease and predisposes to immune activation and chronic inflammation. Assessment and proper restoration of the integrity of the intestinal barrier is crucial in managing autoimmune conditions such as RA.
The following nutritional interventions are usually used:
Anti-inflammatory and immune-modulating compounds
Anti-inflammatory and immune-modulating herbs and nutritional compounds to decrease excessive immune responses can very often be helpful.
Nutrients to regenerate the epithelial lining
There are various plant compounds, vitamins and minerals that have been shown to have a restorative effect on a damaged intestinal barrier and a proper selection and regime can be very effective.
Nutrients to decrease food sensitivities
Food sensitivities are very common in people with autoimmune disease. Compounds that have been shown to decrease specific immune responses in the gut related to food sensitivity can be helpful.