Western and Alternative Medicines: Making Wise Choices
You can control RA with diet.
Natural medicine is better for you than conventional medication.
We've all heard these statements. Sometimes it's from a well-meaning acquaintance, sometimes it's on a television program. We want to believe them. Searching for something — anything — that can help is normal when you live with a chronic illness like RA that has no known cure or and can be difficult to control. When people use complementary and alternative medicine (CAM) or diet, the three most important expectations are "the hopes to influence the natural history of the disease, to prevent illness and to receive treatments free of adverse effects." (1) The big question is whether CAMs and diet can deliver on those expectations.
How do you assess if an approach is safe and effective? First, identify the goal. Whether it's alternative or conventional, the aim of any RA treatment is to suppress the disease and/or control the symptoms, such as pain and fatigue. Together, this leads to better health and better quality of life.
Research, Research, Research
Do a lot of research, read everything you can find about the particular diet or remedy. Remember that everyone has a bias, so consider the source of your information. For instance, a website that focuses on alternative medication is going to be more positive when evaluating such treatment. A website rooted in a conventional Western approach will likely lean towards recommending such treatments. In other words, don't take anything at face value, not even this post! Do your own research, find information from a variety of sources and approach your topic armed with a healthy dose of critical thinking.
One important part of critical thinking is finding research investigating the efficacy of a treatment. The best way to assess this is through clinical studies that use the scientific process to eliminate bias and statistics to analyze the result. This gives you an objective measure of the safety of the treatment in question. There hasn't been a lot of research into diet and alternative medication and their effect on RA. This is unfortunate, as it would give us a much better basis for making decisions. The studies that have been done have largely shown no effect on suppressing the disease, although certain remedies, such as fish oil, are supported by evidence as providing relief of RA symptoms.
Natural Medication is Medication
Many seek out alternative treatments that involve natural medication such as supplements and herbal medicine in the belief that they don’t have adverse effects. You may be aware of a recent story in the New York Times Magazine about a boy diagnosed with juvenile arthritis by a rheumatologist. An alternative practitioner stated he had leaky gut syndrome, which can be accompanied by joint pain. He was treated with diet and alternative. The story presents him as doing well without taking medication, but is this true? In fact, in addition to diet and probiotics, he is also treated with a remedy called four marvels powder.
Four marvels powder is a combination of four compounds. It is a powerful anti-inflammatory used in Traditional Chinese Medicine (TCM) for various kinds of arthritis, but not all types of arthritis, according to David S. Surman, TCM Practitioner in Toronto. "The formula is great if it's used right," he says, "but if it's misused or if the practitioner misdiagnoses, it could cause injuries, as with any [medication]." For instance, this particular remedy is not recommended for pregnant women, as it can cause miscarriages. In other words, just like conventional Western medication like methotrexate, this "natural" medication has potentially serious side effects.
Listen to Your Body
Listening to your body means listening to what makes it feels good and to what doesn't. Cathy Kramer has used the Paleo diet for years to control digestive issues. She says that "there is a direct correlation between my digestive issues and RA symptoms." For Cathy, eating Paleo is an important part of managing different health conditions. She "started diet changes to cure my RA, it didn’t. However, it took care of a lot of health issues I have had my whole life that I just assumed were natural for me – digestive issues, rashes, dry skin, and PMS. I believe these are all signs that diet plays an important part in the healing process, even if it doesn’t make RA magically disappear."
Britt J. Johnson is taking Actemra and methotrexate and follows a vegan diet. She says "I have way more energy … my swelling is better controlled and I basically have no GI symptoms any more." She adds the she "wouldn't recommend it for everyone, as I think each body needs what it needs … I would never strictly use diet to treat my RA, but I have and always will use it as a co-therapy,"
Be Safe, Ask the Experts
Many complementary and alternative remedies, including something as innocuous as supplements and vitamins, have side effects and can potentially interact with other medication. It's important to consult experts to make sure that any treatment you want to try will be safe for you.
Most rheumatologists will support you supplementing your conventional medication with alternative treatments and diets, as long as you do so safely. Being honest with your healthcare team about incorporating other remedies in your approach to managing RA will help flag potential interactions that may be unsafe. As well, consulting an expert in alternative medicine, such as a licensed naturopath will also help you be safe when you make choices.
When Cathy Kramer reached a point where she was in a lot of pain, she said "my naturopath wisely asked me, 'what are the side effects of not taking the meds?' Ultimately, it was that I wasn’t doing the things I wanted to do in life – hug my family without pain, complete household chores, take nature walks, and bike with my family." She is now taking Enbrel and Arava, as well as using the Paleo diet.
Manage Your Expectations
At this time, the prevailing evidence shows that Western or allopathic medicine is the most effective treatment in suppressing RA and controlling the joint damage that can lead to deformity and disability. However, many people feel that alternative remedies and diet are helpful in controlling their symptoms, some quite drastically so. When you evaluate whether a particular treatment should be part of your regimen, there is an additional factor to include: managing your expectations. If you expect a particular remedy to cure your RA, you may be disappointed. However, if you expect it to be one of several tools to use in managing your symptoms, improving your general health and quality of life, this can be an attainable goal.
The term used for non-Western treatments is Complementary and Alternative Medicine or CAM. The key word here is complementary, i.e., used to complement or supplement the care you already received from your rheumatologist. You don’t have to choose only Western-based medicine or alternative treatments. Using a variety of treatments and techniques to feel better is something many of us do. Just remember to be safe when you do.
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(1) Macfarlane, Gary J., et. al. “Evidence for the efficacy of complementary and alternative medicines in the management of rheumatoid arthritis: a systematic review.” Rheumatology 2011;50;1672-1683.
Lene is the author of Your Life with Rheumatoid Arthritis: Tools for Managing Treatment, Side Effects and Pain.