Arthritis: Inflammation with a Cause

Arthritis is one of the most debilitating conditions in our culture. It is actually the number one cause of lost work days at Boeing. Unfortunately, treatment is limited and almost solely focused on anti-inflammatory medications, not on eliminating the original trigger of that inflammation. 

If you would like to hear from the mother of a patient treated for juvenile rheumatoid arthritis, please watch this video:

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What Does "Arthritis" Mean?
The Traditional Approach
Is It Possible to Eliminate Inflammation without Drugs?
What Triggers the Immune System to Create Inflammation?
What Foods Cause Arthritis?
How Do I Determine if I Have a Food Allergy?
Case Studies
Painkillers Cause High Blood Pressure, Stomach Damage
Medical Research on Arthritis and Food Allergies

What Does "Arthritis" Mean? 
The word “arthritis” simply means “joint inflammation.” There are basically two types: osteoarthritis and rheumatoid arthritis. 
Osteoarthritis is inflammation caused by degeneration of the joint and is due to chronic wear and tear. Osteoarthritis is most commonly found in the knees. Rheumatoid arthritis (RA) is a more generic term for inflammation, pain, and swelling of joints. Rheumatoid arthritis is most commonly seen in the hands, although it can affect just about any joint in the body. In children this is called juvenile arthritis.

The Traditional Approach to Arthritis 
Rheumatoid arthritis is considered by conventional medicine to be an autoimmune condition of unknown cause. This belief ignores a large volume of scientific evidence pointing to food allergies as a major cause of arthritis. The medical community has focused almost solely on treating arthritis with anti-inflammatory medications, either prescription or over-the-counter. These medications offer temporary relief of the pain and swelling, but they never cure arthritis. Over the long term this type of treatment also comes with a host of side-effects. 

Is It Possible to Eliminate the Inflammation without Drugs? 
Very often it is actually possible to eliminate the cause of the inflammation without resorting to drugs to suppress it. Inflammation is actually caused by the immune system. The important question is, “Why is the immune system creating inflammation?” 

What Triggers the Immune System to Create Inflammation? 
As you already know, bacteria, viruses, and parasites trigger an immune response. But anything that triggers an immune response also triggers inflammation. This includes foods that are incorrectly identified by the immune system as not belonging in the body. Therefore an allergic reaction to a food can result in inflammation of the joints. 

What Foods Cause Arthritis? 
The body can be allergic to any food, therefore any food allergy is capable of causing inflammation and arthritis. This includes RA, juvenile arthritis, and undefined joint pains. This is why it can be so difficult for one to recognize the relationship between their diet and their symptoms.

Let’s use a dairy allergy as an example. If you eat any form of dairy, be it milk, butter, cheese, yogurt, or even dairy in the form of casein or whey in another food product, such as bread or milk chocolate, then you can potentially trigger the symptoms of your food allergy, in this case arthritis. You should also know that allergy symptoms may show up hours or even a day later, well after a food is absorbed into your system. 

How Do I Determine if I Have a Food Allergy? 
Most doctors are not well versed in evaluating patients for food allergies. Skin testing is inadequate, and many blood tests are not thorough enough to discover a food allergy. The best way to determine if you have a food allergy is to have your blood tested for both IgE and IgG antibodies to a variety of foods. This is done with an ELISA Food Allergy Panel, which measures your immune response to approximately 100 different foods. To have this testing done please call 206-264-1111 to schedule an appointment 

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Arthritis Case Studies
Watch the video at the top of this page! Case #1: 10 year old male with juvenile arthritis. This patient had been experiencing pain in his hands and other joints for several years. Food allergy testing demonstrated a severe allergy to all dairy, not just milk. Once this problem was properly identified and his parents were fully educated on the potential sources of dairy contamination in his diet, his pain resolved. He was able to discontinue all pain medications. 

Case #2: 71 year old female with rheumatoid arthritis. This patient came in with chronic pain in the hands, shoulders and knees and a positive test for rheumatoid arthritis. Food allergy testing demonstrated an allergy to wheat and gluten. The removal of these foods led to a tremendous amount of relief in her joint pains and a reduction in joint swelling. 

Case #3: 25 year old female with arthritis, including severe back pain. This patient suffered severe back pain (a history of two back surgeries) as well as digestive problems. Food allergy testing demonstrated allergies to dairy and eggs. Her digestive problems resolved and her back pain improved tremendously due an overall decrease in inflammation in her body. (The back has joints and thus back pain can be type of arthritis.) 

Everyday Painkillers Cause High Blood Pressure and Stomach Damage
Americans consume an estimated $2 billion per year in over-the-counter painkillers like Tylenol, Advil and Motrin. The most common reason for taking them is for arthritis. However, these drugs are not without side-effects. It also doesn’t take as much as you might think to cause damage. And the variety of side effects includes high blood pressure, stomach ulcers, and other problems.

A study of more than 80,000 women found that women who used acetaminophen, the active ingredient in Tylenol, for 22 days or more a month had the greatest risk of high blood pressure, estimated at twice that of non-users. And even those who used the drug as little as one to four days a month had a 22% greater risk of having high blood pressure than non-users.

The risk for those taking NSAIDS (nonsteroidal anti-inflammatory drugs), including ibuprofen products such as Advil and Motrin and naproxen drugs such as Aleve, was similar. Heavy users had a risk of high blood pressure 86% higher than those who didn't use the drug. Light users carried a 17% higher risk. Journal Hypertension November 2002 20(11):2301-2307

Significantly, researchers report that patients with pre-existing kidney disease who took these painkillers at least twice a week for 2 months were two to three times more likely to have the beginning stages of chronic kidney failure, compared with individuals who did not use these painkillers on a regular basis. The New England Journal of Medicine December 20, 2001;345:1801-1808

If you think that you should be taking aspirin to thin your blood, think again. A recent study that investigated the effects of taking low-dose aspirin daily for close to four years found that only participants with compromised kidney function benefited significantly. And another study, in the Journal of the American Medical Association (JAMA), showed that fish oils have a blood-thinning effect similar to aspirin. JAMA. 2001 Jan 17;285(3):304-12

And it may affect your colon, too. A questionnaire of over 35,615 male health professionals showed that regular and consistent use of NSAIDs such as aspirin, acetaminophen, Advil and other prescription anti-inflammatory drugs was associated with diverticular disease, a serious type of colon damage. Arch Fam Med. May 1998;7:255-260

Finally, it is also well known that aspirin and NSAIDS are tied to stomach pain and bleeding ulcers. Yet nearly 30,000 people a year die from using these medications. Many of these deaths are due to bleeding ulcers.

If you have pain, whether it be arthritis or otherwise, you should know that there are a variety of healthy and effective alternatives for reducing inflammation and pain that will put you on the road to better health, not temporarily alleviate your symptoms while causing other problems. 
Please call 206-264-1111 for more information. 

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Medical Research on Arthritis and Food Allergies

Carini et. al. (1987). IgE complexes in food allergy. Ann Allergy. 1987 Aug;59(2):110-7.
"We have studied patients with the diagnoses of … arthralgia by monitoring the formation of immune complexes containing IgE … before and after challenge with food. Following challenge, immune complexes containing IgE, IgG, and antigen are detectable in the circulation. Their appearance correlates with the production of symptoms."

Carini et. al. (1987). Immune complexes in food-induced arthralgia. Ann Allergy. 1987 Dec;59(6):422-8.
"Ten patients are described who, in addition to other allergic symptoms, suffered from arthralgia. Dietary exclusion relieved the symptoms and specific food challenge reproduced them. IgG anti-IgE autoantibodies were high in patients with arthralgia in the serum and in the synovial fluid."

Darlington LG, Ramsey NW. (1993). Review of dietary therapy for rheumatoid arthritis. Br J Rheumatol. 1993 Jun;32(6):507-14.
"There are now sufficient good scientific studies, from the UK and abroad, to suggest that, at least in some patients with RA, dietary therapy may influence at least the symptoms and possibly the progression of the disease."

DaWidowicz et. al. (2008). Unexplained polyarthralgia and celiac disease. Joint Bone Spine. 2008 May;75(3):325-8. Epub 2007 Oct 15.

Diethelm U (1993). Nutrition and chronic polyarthritis Schweiz Rundsch Med Prax. 1993 Mar 23;82(12):359-63.
"The effect of complete fasting on pain in rheumatoid arthritis is remarkable, but not fully understood."

Gaby AR, (1999). Alternative treatments for rheumatoid arthritis. Altern Med Rev. 1999 Dec;4(6):392-402..
"A number of different alternative therapies have been studied, including dietary modifications... some patients have shown dramatic improvement or even complete and long-lasting remission."

Hafström I, et. al. (2001). A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Rheumatology (Oxford). 2001 Oct;40(10):1175-9.
"Sixty-six patients with active RA were randomized to either a vegan diet free of gluten (38 patients) or a well-balanced non-vegan diet (28 patients) for 1 yr. … RESULTS: Twenty-two patients in the vegan group and 25 patients in the non-vegan diet group completed 9 months or more on the diet regimens. Of these diet completers, 40.5% (nine patients) in the vegan group fulfilled the ACR20 improvement criteria… The immunoglobulin G (IgG) antibody levels against gliadin and beta-lactoglobulin decreased in the responder subgroup in the vegan diet-treated patients, but not in the other analysed groups. CONCLUSION: The data provide evidence that dietary modification may be of clinical benefit for certain RA patients, and that this benefit may be related to a reduction in immunoreactivity to food antigens eliminated by the change in diet."

Haugen et. al. (1991). Diet and disease symptoms in rheumatic diseases--results of a questionnaire based survey. Clin Rheumatol. 1991 Dec;10(4):401-7.
"Experiences with food intake, diet manipulations and fast were registered in rheumatic patients. The study was a questionnaire-based survey in which 742 patients participated. Less pain and stiffness were reported by 2/3 of the patients in both groups and half of the patients in both groups reported a reduced number of swollen joints."

Hvatum et. al. (2006). The gut-joint axis: cross reactive food antibodies in rheumatoid arthritis. Gut. 2006 Sep;55(9):1240-7. Epub 2006 Feb 16.
"…food antibodies were measured in serum and perfusion fluid from the jejunum of RA patients and healthy controls to determine the systemic and mucosal immune response. …IgG, IgA, and IgM antibodies to dietary antigens were measured …. CONCLUSIONS: The production of cross reactive antibodies is strikingly increased in the gut of many RA patients."

Inman RD (1991). Antigens, the gastrointestinal tract, and arthritis. Rheum Dis Clin North Am. 1991 May;17(2):309-21.
"There are a variety of forms of arthritis that appear causally related to a primary process in the gastrointestinal tract."

Karatay S, et. al. (2006). General or personal diet: the individualized model for diet challenges in patients with rheumatoid arthritis. Rheumatol Int. 2006 Apr;26(6):556-60. Epub 2005 Jul 16.
"This study was performed to evaluate the effect of individualized diet challenges consisting of allergen foods on disease activity in rheumatoid arthritis (RA) patients. ….Twenty patients with positive skin prick test (SPT) response for food extracts and 20 with negative SPT response were included…. Our results showed that the individualized dietary manipulations may affect the disease activity for selected RA patients."

Karatay S, et. al. (2004). The effect of individualized diet challenges consisting of allergenic foods on TNF-alpha and IL-1beta levels in patients with rheumatoid arthritis. Rheumatology (Oxford). 2004 Nov;43(11):1429-33. Epub 2004 Aug 10.
"OBJECTIVE: To investigate the effect of individualized diet challenges consisting of allergenic foods, defined by the skin prick test (SPT), on tumour necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) levels in patients with rheumatoid arthritis. …(72%) patients in the PPG …experienced disease exacerbation with challenges. This aggravation continued after elimination. CONCLUSIONS: Our results suggest that individualized dietary revisions may regulate TNF-alpha and IL-1beta levels in selected patients with RA."

Parke AL, Hughes GR. (1981). Rheumatoid arthritis and food: a case study. Br Med J (Clin Res Ed). 1981 Jun 20;282(6281):2027-9.
"Exclusion of dairy products from the diet produced a considerable improvement in her previously aggressive disease."

Schrander et. al. (1997). Does food intolerance play a role in juvenile chronic arthritis? Br J Rheumatol. 1997 Aug;36(8):905-8.
"Sixty children with juvenile chronic arthritis (JCA)…of whom three ultimately appeared to have a food intolerance. In one of these three patients, there appeared to be a relationship with joint complaints. …In the course of the elimination/challenge tests which were conducted, severe painful swelling of the knee occurred rapidly after each challenge… In conclusion, the existence of such a connection between food and chronic joint complaints … only plays a role in incidental cases."

Slot, O., Locht, H. (2000). Arthritis as presenting symptom in silent adult coeliac disease [gluten intolerance]: Two cases and review of the literature. Scandinavian Journal of Rheumatology, 29, 260-263.

van de Laar MA, van der Korst JK. (1991). Rheumatoid arthritis, food, and allergy. Semin Arthritis Rheum. 1991 Aug;21(1):12-23.
"One of the most promising lines of research on the etiology and pathogenesis of rheumatoid arthritis (RA) is its association with … food antigens."

van der Laar et. al. (1992). Food intolerance in rheumatoid arthritis. I. A double blind, controlled trial of the clinical effects of elimination of milk allergens and azo dyes. Ann Rheum Dis. 1992 Mar;51(3):298-302.
"The existence of a subgroup of patients in whom food intolerance influences the activity of rheumatoid factor seropositive rheumatoid arthritis deserves serious consideration."

van der Laar et. al. (1992). Food intolerance in rheumatoid arthritis. II. Clinical and histological aspects. Ann Rheum Dis. 1992 Mar;51(3):303-6.
"Although the number of food intolerant patients with RA remains limited and markers of allergic activity are scanty, our observations suggest an underlying immunoallergological mechanism."

Bacteria

Vaahtovuo J, et. al. (2008). Fecal Microbiota in Early Rheumatoid Arthritis. J Rheumatol. 2008 Jun 1. [Epub ahead of print]
"CONCLUSION: These findings support the hypothesis that intestinal microbes participate in the etiopathogenesis of RA."

Parasites

Auer H, Aspöck H. (2004). Nosology and epidemiology of human toxocarosis--the recent situation in Austria Wien Klin Wochenschr. 2004;116 Suppl 4:7-18.
"Toxocara canis and T. cati are not only ubiquitously distributed parasites of dogs, foxes and cats, but may also infest humans, causing a great variety of symptoms (including)… rheumatoid arthritis….. Although many Toxocara infestations do not cause severe clinical manifestations, a few dozen toxocarosis patients have been registered every year during the last years; in reality, however, we have to assume that several hundreds of patients suffer from toxocarosis."

Krüger et. al. (1994). [Blastocystis hominis as a rare arthritogenic pathogen. A case report] [Article in German] Z Rheumatol. 1994 Mar-Apr;53(2):83-5.

Sing A, et. al. (2008). Reactive arthritis associated with prolonged cryptosporidial infection. Infect. 2003 Aug;47(2):181-4.
"8-year-old immunocompetent boy with a symptomatic intestinal cryptosporidiosis over a 13-months period. The protozoan infestation was accompanied by arthritic symptoms involving several joints at different times (migratory arthritis)."

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