hi all i dont take any vitamins and only do the meds except calcichew
calcium.. but i found this interesting.. but looooooong
Boney
Cooling Down the Inflammation
Even though there are doctors who specialize in the disease (they're called rheumatologists), rheumatoid arthritis remains something of a medical mystery. No one knows exactly what causes it, and no one knows why the disease seems to come and go. No one knows why some people get it so badly that they are permanently crippled or why a few lucky people have a single flare-up and never again have symptoms.
"There's a lot we still have to learn about this disease," admits Robert McLean, M.D., clinical assistant professor of medicine at Yale University School of Medicine and an internist in New Haven, Connecticut.
In a person with rheumatoid arthritis, the body's own infection-fighting immune cells attack joint tissue and cause inflammation, with pain, redness, heat and swelling. The inflammation doesn't always confine itself to joints; sometimes other organs, such as the skin, heart and lungs, can be affected.
Rheumatoid arthritis is usually treated by simply suppressing symptoms. Doctors prescribe anti-inflammatory drugs such as aspirin or ibuprofen. For severe cases, they may recommend steroid drugs, which dampen the body's immune response and so reduce inflammation. They may recommend other medications that modulate the immune system in different ways, including cancer chemotherapy drugs such as methotrexate (Folex), azathioprine (Imuran) and cyclophosphamide (Cytoxan).
These drugs do reduce pain and swelling, but at a price. Most have side effects, from stomach upset to bone loss and reduced resistance to infection.
Traditional medicine tends to discount any possible benefit of nutritional therapy for rheumatoid arthritis. The Arthritis Foundation, for instance, holds firm to its position that except for a slight benefit from fish oil, no nutritional therapy has been proven to help any kind of arthritis. And indeed, the kind of large clinical trials that might confirm that nutrition does help have yet to be done.
Nutritional Backup for Treatment
Doctors who prescribe nutritional therapy take these tactics: They eliminate foods from the diet that may aggravate rheumatoid arthritis; they add anti-inflammatory fats such as fish oil; and they provide optimum amounts of nutrients, including those nutrients thought to help reduce inflammation and other vitamins and minerals needed for general good health.
"It's a simple premise," says Robert Cathcart, M.D., a physician in private practice in Los Altos, California, who specializes in nutritional therapy. "People who have a chronic disease such as this need extra amounts of certain nutrients to help their bodies fight the disease."
People with rheumatoid arthritis have been found to be low in a number of nutrients. One study by Finnish researchers, for instance, found that people with low blood levels of vitamin E, beta-carotene and selenium (a mineral with anti-inflammatory properties) had more than eight times the risk of developing rheumatoid arthritis compared with people with high levels of these nutrients.
Doctors who specialize in nutritional therapy use an array of nutrients to fight rheumatoid arthritis. "I find that a broad approach is best," says Joseph Pizzorno, Jr., N.D., a naturopathic physician and president of Bastyr University in Seattle. "People won't necessarily be cured of their arthritis, but they will get enough relief to be able to cut back on their medications, and they are often willing to put up with a bit of discomfort in exchange for fewer side effects from drugs."
Here, then, is what doctors who practice nutritional therapy recommend.
Mackerel, salmon and tuna all contain omega-3 fatty acids, which are known to be anti-inflammatory. At least six studies have shown that diets rich in these fatty acids help reduce the pain and stiffness of rheumatoid arthritis and the biochemical signs of inflammation.
Evidence so far suggests that about six grams of these fatty acids a day seems to have an anti-inflammatory effect. If you're not taking fish oil capsules, try eating two or three meals of fatty fish each week. It might be up to four months before you notice any improvement in your condition.
Some doctors recommend plain old cod liver oil, in doses of up to three tablespoons (nine teaspoons) a day. In fact, there's some evidence that it reduces pain and swelling.
Even though cod liver oil has been used over the years with apparent
safety, it is possible to get too much of a good thing. That's because
unlike omega-3 fatty acids, cod liver oil contains hefty amounts of
vitamins A and D. Although it's important to get the Daily Values of
both of these nutrients, more than 15,000 international units of
vitamin A (3 times the Daily Value) or 600 international units of
vitamin D (1½ times the Daily Value) can be toxic if taken over a long
period of time, even if taken in foods. In addition, research has found
that vitamin A can cause birth defects when taken in doses of 10,000
international units during early
pregnancy.
So don't mix cod liver oil with supplements, even in modest doses, without knowledgeable medical supervision, especially if you are a woman who is pregnant or of childbearing age. And stop your regimen if you develop headaches, nausea or vomiting.
Cut back on other fats. Doctors who prescribe fish oil say that this oil works better to relieve pain and stiffness when it's used along with a diet low in animal fats.
That makes sense, since fats compete with each other for use in the body's production of biochemicals called prostaglandins. When the body selects fish oil, as it does when fish oil molecules are abundant, the prostaglandins produced are anti-inflammatory. When the body chooses arachidonic acid from animal fats, the prostaglandins produced are pro-inflammatory.
Cut back on fats by going easy on meats (especially lunchmeats), whole-fat dairy products (such as ice cream, cheeses and butter), mayonnaise, baked goods and salad dressings.
Pinpoint possible trouble foods. Most doctors believe that only a small percentage of people with inflammatory arthritis have symptoms that are aggravated by foods. But many nutrition-oriented doctors believe that more people than previously suspected have food-related arthritis symptoms and that everyone with arthritis should at least try an elimination diet to detect trouble foods.
"Research is looking at the possibility that some people develop antibodies (a normally protective immune system reaction to invasion) against proteins they eat and that those antibodies then go on to attack similar proteins in the body," says Robert McLean, M.D., clinical assistant professor of medicine at Yale University School of Medicine and an internist in New Haven, Connecticut. "So the idea of food-related arthritis is not so far out as it once seemed."
You may want to keep a food diary for a few weeks to see if certain foods seem to be contributing to your symptoms. "One quick way to figure out if foods are part of your problem is to put yourself on a weeklong program of eating foods that you don't normally eat or to go on a juice fast," says Jonathan Wright, M.D., a doctor in Kent, Washington, who specializes in nutritional therapy and is author of Dr. Wright's Guide to Healing with Nutrition. If you improve during this time, then you'll need to slowly reintroduce foods to see if your symptoms flare.
Almost any food may cause problems, but milk, wheat, sugar, corn and soy appear to be common triggers. Some people also seem to have trouble with tomatoes, potatoes, eggplant, paprika, green and red bell peppers and chili peppers, all members of the nightshade family.
When it comes to rheumatoid arthritis or other conditions that involve inflammation, nutrition-oriented doctors almost always include vitamin C in their prescriptions."The theory is that all inflammation is mediated by free radicals, and if you can get rid of the free radicals, you get rid of the inflammation," Dr. Cathcart says. "This is easier said than done."
Free radicals are molecular bad guys that grab electrons from your body's healthy molecules. This electron stealing harms cells. Free radicals congregate in gangs in rheumatic joints because immune cells generate free radicals in their attack on joint tissue. Vitamin C and other antioxidants disarm free radicals by offering their own electrons and so spare cells.
Doctors recommend different amounts of vitamin C, but most call for at least 600 milligrams a day. Dr. Cathcart usually recommends as much ascorbic acid (another name for vitamin C) as an individual can tolerate without developing diarrhea and gas. That may be up to 60,000 milligrams a day, which is well above the Daily Value of 60 milligrams.
He suggests taking powdered ascorbic acid, which can be mixed with water. This mixture should be drunk through a straw to keep it away from teeth, he warns, because ascorbic acid can erode tooth enamel. Powdered ascorbic acid is available in health food stores and through vitamin supply houses.
Although there's good reason to think that vitamin C could be helpful in treating inflammation, and studies with laboratory animals indicate potential benefits, there are no studies with humans to show that large amounts of this nutrient help people with rheumatoid arthritis. Vitamin C is considered safe, even in large amounts, because any extra is eliminated in the urine. If you want to take large amounts of vitamin C--more than 1,200 milligrams a day--it's still a good idea to discuss it with your doctor.
Selenium May Help Stop Inflammation
Selenium is essential to the body in small amounts. It is thought to be helpful for rheumatoid arthritis because it, too, fights inflammation. Selenium is used in the body for the production of glutathione peroxidase, an enzyme that works inside joints to round up free radicals.
In one study done in Belgium, 15 women with rheumatoid arthritis who took 160 micrograms of selenium or 200 micrograms of selenium-enriched yeast every day for four months experienced significant improvement in joint movement and strength compared with women receiving placebos (blank pills).
Doctors who recommend selenium for people with rheumatoid arthritis prescribe 200 to 300 micrograms a day. In large amounts, selenium can be toxic, so experts say that it's probably best not to take more than 100 micrograms a day without medical supervision.
Studies show that people generally get about 108 micrograms of selenium a day in their diets. Top food sources include seafood, meats and whole grains.
Vitamin E Adds Anti-inflammatory Power
Doctors add vitamin E to their rheumatoid arthritis prescriptions because it, too, cleans up free radicals and may fight joint inflammation.
In one study, Japanese researchers looked at laboratory animals deficient in vitamin E as well as at those given large doses of vitamin E. When both groups were given toxins that cause joint damage similar to that caused by rheumatoid arthritis, those deficient in vitamin E had many more of the biochemical markers of inflammation in their blood.
Doctors who recommend vitamin E generally call for amounts far beyond the Daily Value of 30 international units. "I recommend 400 international units a day," Dr. Pizzorno says. Since foods contain relatively little vitamin E, that amount is available only in supplements.
Beta-Carotene May Reduce Swelling
People with rheumatoid arthritis who become vegetarians often report that their symptoms of pain and swelling are relieved.
Such a diet may be helpful in several ways. In particular, a veggie-dense diet is likely to include more than the normal slim pickin's of foods that contain beta-carotene, the yellow pigment found in carrots, winter squash, cantaloupe and other orange and yellow fruits and vegetables.
Like vitamins C and E and selenium, beta-carotene rounds up free radicals. In one study done in Switzerland using laboratory animals, beta-carotene helped stop symptoms of a type of experimentally induced arthritis similar to rheumatoid arthritis.
Doctors who include beta-carotene in their anti-arthritis formulas recommend about 25,000 international units a day. That amount is considered safe, says Dr. Cathcart.
Those who do provide nutritional therapy make sure that a person is getting at least the Daily Value of every essential vitamin and mineral. They might recommend larger doses initially, if necessary, to restore normal blood levels of these nutrients. These doctors also recommend continuing to take large doses of some of the nutrients known to play roles in regulating inflammation in the body. Here's their daily prescription.
Nutrient Daily Amount
Beta-carotene 25,000 international units
Copper 2 milligrams (Daily Value) or 3 milligrams (1 milligram for every 10 milligrams of zinc)
Selenium 200-300 micrograms
Vitamin C 600-60,000 milligrams
Vitamin E 400 international units
Zinc 30 milligrams (zinc picolinate or zinc citrate)
MEDICAL ALERT: Anyone with rheumatoid arthritis should be using vitamin and mineral supplementation only after discussing it with his physician.
Doses of selenium that exceed 100 micrograms daily should be taken only under medical supervision.
If you want to take more than 1,200 milligrams of vitamin C daily, discuss it with your doctor, as large doses can cause diarrhea in some people. If you're taking vitamin C in the form of powdered ascorbic acid, be sure to drink the mixture through a straw, since ascorbic acid can erode tooth enamel.
If you are taking anticoagulant drugs, you should not take vitamin E supplements.
Doses of zinc that exceed 15 milligrams daily should be taken only under medical supervision.
Another mineral that fights inflammation, zinc is an important component of the nutritional package for rheumatoid arthritis. Several studies have shown that people who have rheumatoid arthritis have low blood levels of zinc, often associated with high levels of inflammatory biochemicals in the blood."Our bodies use zinc, along with copper, to make an inflammation-fighting enzyme called superoxide dismutase. This enzyme is found in inflamed joints, where it neutralizes free radicals," says Jonathan Wright, M.D., a doctor in Kent, Washington, who specializes in nutritional therapy and is the author of Dr. Wright's Guide to Healing with Nutrition. Zinc also functions as a building block for 200 or so other enzymes that play essential roles throughout the body, including repairing joints and helping the immune system to do its job.
In one study by researchers at the University of Washington in Seattle, people with rheumatoid arthritis who took 50 milligrams of zinc three times a day for three months experienced significant improvement in joint swelling, morning stiffness and walking time compared with when they were not taking zinc.
In another study, people with psoriatic arthritis, an inflammatory condition that is a combination of arthritis and the skin disease psoriasis, improved while taking 250 milligrams of zinc three times a day. In this study, relief of symptoms reached its peak after about four months of zinc supplementation and continued for several months after participants stopped taking zinc supplements.
"I recommend taking no more than 30 milligrams of zinc picolinate or zinc citrate without medical supervision," says Dr. Wright. Some doctors start their patients at amounts of up to 150 milligrams a day, then cut back as blood levels of zinc rise to normal. But prolonged high doses of zinc can cause problems, Dr. Wright warns. That's why most experts feel that it's a good idea not to take more than 15 milligrams (the Daily Value) of zinc daily without medical supervision.
Most people get 10 to 15 milligrams of zinc a day through foods, although older people may get only half of that amount. Whole grains, wheat bran, wheat germ, beef, lamb, oysters, eggs, nuts and yogurt all contain good amounts of zinc. (Note: Because bacteria in raw oysters can cause serious illness in people with certain health conditions, make sure oysters are fully cooked before you eat them.)
The Copper Connection
For years, doctors have been fascinated--and stumped--by copper's possible link to rheumatoid arthritis. Blood levels of copper are often elevated in people with rheumatoid arthritis, which leads some researchers to believe that copper is being drawn out of body tissue stores and transported by the blood to fight inflamed joints.
What is known is that copper, like zinc and selenium, is used to form anti-inflammatory compounds in the body, including superoxide dismutase and ceruloplasmin, a protein found in the blood. Both of these biochemicals are known to help counteract the inflammation that occurs with rheumatoid arthritis.
Copper is also essential for the body's manufacture of connective tissue, the ligaments, tendons and such that wrap around a joint like rubber bands and keep it stable.
And in the body, copper combines with salicylate, a compound found in aspirin, and improves the drug's pain-relieving ability, Dr. Wright says. "People who take copper supplements often find that they can get by with less aspirin or other nonsteroidal anti-inflammatories," he says.
Doctors who recommend copper supplements say that people should make sure they are getting either the Daily Value of two milligrams or one milligram of copper for every ten milligrams of zinc that they take. The body works on a delicate balance of zinc and copper; too much zinc interferes with copper absorption and can lead to copper deficiency. Higher amounts of copper should be used only under medical supervision. Even in small amounts, copper can be toxic.
Studies show that generally, women get about 1 milligram a day and men get 1.6 milligrams a day in their diets. For food sources, try shellfish, nuts, seeds, fruits, cooked oysters and beans.
Copper bracelets have commonly been promoted as a remedy for the aches and pains of arthritis. The Arthritis Foundation states that "there is no scientific evidence" that copper bracelets have any benefit for arthritis. If you want to get copper into your system, you'll have to take it orally.