Dec
19
2020

The Use of Biologics for Treatment of Autoimmune Diseases

Notably, the use of biologics for treatment of autoimmune diseases is one of the newer achievements of medicine. In particular, a recent review summarized the use of biologics. For instance, chronic inflammatory conditions like skin eczema and asthma are some of the diseases where physicians use biologics.

Dupilumab (Dupixent)

It is important to realize that biologics are newer medications. They are mostly monoclonal antibodies developed in the lab and directed against various receptors. In particular, one of these is an interleukin-4 receptor. Specifically, this blocks inflammatory mediators such as interleukin-4 and interleukin-13. Dupilumab (Dupixent) is a monoclonal antibody. It must be remembered that it is a useful tool to treat atopic dermatitis (eczema), asthma and nasal polyps from chronic allergic rhinitis. For one thing, the common denominator for all these conditions is chronic inflammation. Here is more background information about Dupilumab. Specifically, this drug blocks certain proteins from attacking your own body. Besides, side effects of the drug are pink eye like inflammation of the eyes. Another side effect were mild skin rashes at the injection site.

Omalizumab (Xolair)

This drug is a monoclonal antibody also. It is given by injection into the skin every 2 to 4 weeks by a doctor or nurse. Originally it was developed for control of moderate to severe asthma. However, subsequently physicians treated moderate to severe atopic dermatitis cases also. Biologics are very expensive. It depends on your insurance carrier whether or not it is affordable for you.

Rheumatoid arthritis

Another disease that is autoimmune is rheumatoid arthritis. This can lead to crippling deformities in the hands and feet. Two of the earlier biologics for RA were etanercept (Enbrel) and adalimumab (Humira). But there are a host of other biologics that are effective as well.  Generally speaking, the physician will start with conventional medicine, like Methotrexate. If Methotrexate does not sufficiently control the symptoms of rheumatoid arthritis, the physician usually adds biologics. Often patients need a combination of Methotrexate and biologics.

Different biologics affect different aspects of the autoimmune response. The first biologic for RA was a tumor necrosis factor (TNF)-antagonist, etanercept (Enbrel). Other TNF antagonists are infliximab (Remicade) and adalimumab (Humira). A different approach is an interleukin (IL)-1 inhibitor, called anakinra (Kineret). This biologic interrupts the inflammatory pathway of RA. Another biologic interrupts the T-cells or killer cells; it is called a T cell co-stimulation blocker, abatacept (Orencia). A different mechanism of action is the B-cell depleting agent, rituximab (Rituxan and Mabthera). This suppresses the formation of RA-autoantibodies from B cells.

The rheumatologist has a wide range of biologics from which to choose. The key is that the specialist individualizes the treatment protocol according to the response of each patient.

Crohn’s disease

Crohn’s disease and ulcerative colitis belong to the inflammatory bowel diseases (IBD). They are also autoimmune diseases where biologics can be useful.

There are three categories of treatment that are worth mentioning.

  • Anti-Tumor Necrosis Factor Agents

Adalimumab (Humira) was one of the first anti-tumor necrosis factor agents. The physician uses Humira in moderate to severe cases of Crohn’s disease and ulcerative colitis. It will calm down the symptoms of Crohn’s/ulcerative colitis and will maintain the disease in this symptom-free state. There are 8 other anti-tumor necrosis factor agents on the market.

  • Integrin Receptor Antagonists

These medications block a protein that coats the inflammatory cells. This arrests the cells, so they don’t move out into blood vessels and to tissues where they could cause tissue destruction. Examples are vedolizumab (Entyvio) and natalizumab (Tysabri). Unfortunately, natalizumab can have a serious side effect, a brain condition called progressive multifocal leukoencephalopathy (PML), This is caused by John Cunningham (JC) virus, which is a virus that 60% of the population carry. Natalizumab suppresses the immune system, which allows the JC virus to flare up and cause PML in the brain. Vedolizumab (Entyvio) is an alternative drug among the integrin receptor antagonists. Contrary to natalizumab it does not enter the brain. In a large clinical trial, it did not cause PML. This drug is infused over 30 minutes initially, then after 2 weeks, 6 weeks and every 8 weeks for maintenance.

  • Interleukin-12 and -23 Antagonist

Two inflammatory kinins, interleukin-12 and interleukin-23 are involved in causing inflammation in Crohn’s disease. They are proteins and the interleukin-12 and -23 antagonist helps to suppress the inflammation. The FDA approved ustekinumab (Stelara) for moderately or severe Crohn’s disease cases where conventional treatment did not show adequate responses. The physician administers the first treatment intravenously. The follow-up treatment occurs subcutaneously every 8 weeks by a nurse. Alternatively, the patient trains to self-inject the drug subcutaneously and administers the drug every 8 weeks.

The Use of Biologics for Treatment of Autoimmune Diseases

The Use of Biologics for Treatment of Autoimmune Diseases

Conclusion

Biologics have entered the treatment world of autoimmune diseases. Biologics can be monoclonal antibodies that inactivate part of an inflammatory cause, such as interleukins. Others may counter certain hyperactive immune cells. One of the side effects can be that the immune system is weakened. This allows latent viruses such as the John Cunningham (JC) virus to suddenly flare up. This is the case with progressive multifocal leukoencephalopathy (PML) following natalizumab (Tysabri) treatment for Crohn’s disease. Due to the development of new medications, this treatment is no longer the best option. Vedolizumab (Entyvio) is an alternative drug among the integrin receptor antagonists where PML does not develop.

Such varied conditions like rheumatoid arthritis, atopic dermatitis (eczema), Crohn’s disease and ulcerative colitis respond to biologics. In addition, nasal polyps from chronic allergic rhinitis and asthma also respond to these drugs. The physician has to carefully match the treatment option to the condition of the patient. The more specific the targets of biologics are the less immunosuppressive side effects they have.

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Nov
21
2020

Antibody Treatment for Rheumatoid Arthritis Was Superior

Researchers found that antibody treatment for rheumatoid arthritis was superior to conventional therapy. In particular, rheumatoid arthritis is an autoimmune disease where autoantibodies attack the synovial lining of joints. In this case, subsequently macrophages are activated, which attack joint surfaces. As an illustration, this process leads to crippling joint deformities.

The original study was published in June, 2019, but this is difficult to understand. The magazine Sciworthy published a review article on August 24, 2020 with more understandable language.

To emphasize, in mouse experiments the researchers found that only a small subfraction of activated macrophages caused symptoms of rheumatoid arthritis. They were folate receptor beta (FR-β) positive macrophages. It is important to realize that the researchers found them both in mice with rheumatoid arthritis and in man. The evidence in humans were the same findings in human tissue samples of people with autoimmune diseases.

Details of mouse experiments

Folate receptor beta (FR-β) positive macrophages are key in mouse model of RA

Explicitly, the researchers started experiments with a mouse model of rheumatoid arthritis, because it is easier to do than human research. They found that the key to developing rheumatoid arthritis was the presence of folate receptor beta (FR-β) positive macrophages. Chiefly, macrophages remove cell debris, bacteria or viruses from the blood. However, once they are activated and they carry FR-β receptors on their surface, they destroy joints. Certainly, in the mouse model monoclonal F3 antibodies were developed that kill activated macrophages. On the contrary, the human equivalent for the F3 antibodies is monoclonal antibodies with the name m909. They are directed at the FR-β receptors on the surface of activated macrophages. But first to the mouse experiments.

Inflammation from intraperitoneal injection of thioglycollate

In the first place, the researchers created an inflammatory condition by injecting thioglycollate into their peritoneal cavity. They could demonstrate that inflammation did occur. With this in mind they found macrophages in the peritoneal fluid. There were a lot of activated macrophages in it. Histological slides were analyzed with the help of F3 antibodies. In this case they visualized the activated macrophages. Subsequently the researchers treated mice with varying concentrations of monoclonal F3 antibodies. They found that the higher concentrations cured intraabdominal inflammation of the mice.

Researchers used monoclonal F3 antibodies to treat mouse model of RA

The researchers treated collagen-induced arthritis next in a number of experiments. Several concentrations of monoclonal F3 antibodies were given to these mice. Other experiments showed that monoclonal F3 antibodies specifically attacked only the activated macrophages and killed them. The killing of the activated macrophages in the mouse model of rheumatoid arthritis cured the arthritis. Fig. 5 shows this.

Mice treated with maximum concentrations of monoclonal F3 antibodies showed decrease in bone density

Next the researchers treated rheumatoid arthritis mice with maximum concentrations of monoclonal F3 antibodies to treat the arthritis. The swelling of their paws went down completely. CT scans of the bone in the paws showed decrease in bone density, while untreated controls showed significant loss of bone density. Monoclonal F3 antibodies were indeed a cure for RA in mice (Fig. 6).

Human experiments

Researchers confined human experiments to tissue samples from patients with various autoimmune diseases. Skin biopsies from patients with psoriasis, scleroderma, and sarcoidosis showed the distribution of FR-β-positive macrophages by special staining. This staining technique used human monoclonal antibodies (m909) against human FR-β receptors on activated macrophages. The publication depicts images that show abundant activity in all three autoimmune diseases (Fig. 1).

Researchers examined tissue samples from other autoimmune diseases with monoclonal antibodies (m909) against human FR-β receptors. The activated macrophages including rheumatoid arthritis, Crohn’s disease, ulcerative colitis and idiopathic pulmonary fibrosis lit up on fluorescence microscopy. In addition, nonspecific interstitial pneumonia, chronic obstructive pulmonary disease, systemic lupus erythematosus, psoriasis, and scleroderma tested positive as well.

Future therapy possibilities of rheumatoid arthritis with monoclonal antibodies

A series of experiments showed that two mechanisms can eliminate FR-β-positive macrophages: complement-dependent cytotoxicity and antibody-dependent cell cytotoxicity. It means that there is a strong possibility that autoimmune diseases may be treatable with monoclonal antibodies. Fig. 2 summarizes these experiments.

Conventional therapy for rheumatoid arthritis

To explain, the conventional treatment approach of rheumatoid arthritis is to induce a disease remission with drugs. To this effect doctors use anti-inflammatory drugs like ANSAIDs, disease modifying anti-rheumatic drugs (DMARDs). For example, drugs like methotrexate and sulfasalazine belong into this category. Unfortunately, the conventional drugs have many serious side effects that often make the rheumatoid arthritis patient’s condition worse.

In contrast, the integrative medicine approach to rheumatoid arthritis is to use dietary measures to reduce the inflammation. The fasting mimicking diet is able to reduce the severity of the inflammation in RA patients.

Other authors described the use of the Mediterranean diet to reduce inflammation. In addition, there are a number of regenerative methods that help improve the condition of RA patients. Research described here proved that antibody treatment for rheumatoid arthritis was superior to conventional therapy in a mouse model.

Discussion

Monoclonal antibodies (m909) against human FR-β receptors targeting activated macrophages opened up a new therapy method against rheumatoid arthritis. The equivalent F3 antibodies in mice were a useful tool to expedite research in this field. The publication that I reviewed here was able to combine mouse experiments and work on human tissue samples essentially showing the same results . Monoclonal antibodies (m909) against human FR-β receptors work potentially like a broad-spectrum anti-inflammatory drug. The monoclonal antibodies reduce the accumulation of inflammatory immune cells, which treats the cause of rheumatoid arthritis. This will likely be the future cure of rheumatoid arthritis and other autoimmune diseases. We urgently need clinical trials to prove in humans that the findings from a mouse model and human tissue samples are correct.

Antibody Treatment for Rheumatoid Arthritis Was Superior

Antibody Treatment for Rheumatoid Arthritis Was Superior

Conclusion

Researchers recently showed in a mouse model that a small portion of activated macrophages cause rheumatoid arthritis (RA). But they also examined many biopsies from patients with autoimmune diseases. The findings in human tissue samples were identical to the findings in a mouse model. Activated macrophages are sensitised to attack the linings of joints as is the case with rheumatoid arthritis. These macrophages develop special receptors, called folate receptor beta (FR-β), and the macrophages release cytokinins. The cytokinins (TNFα, IL-1, IL-6, IL-12 and others) cause inflammation and make the RA worse. They also recruit more neutral macrophages and convert them into activated macrophages. The research group found that monoclonal antibodies against human or mouse FR-β receptors killed the activated macrophages. This alleviated the arthritic symptoms and after enough antibody treatments cured the RA. There were no negative effects on the rest of the immune system.

Physicians will cure human autoimmune diseases with monoclonal antibodies in the future

Researchers demonstrated this mostly in a mouse model. But the authors have manufactured human monoclonal antibodies against the FR-β receptors of activated macrophages. This has set the stage for curing human autoimmune diseases with monoclonal antibodies as well. At this point there is a need for clinical trials with various autoimmune diseases including rheumatoid arthritis with monoclonal antibodies against activated macrophages.

Feb
15
2020

Rheumatoid Arthritis Treatment by Regenerative Medicine

Dr. David Lans gave a talk at a conference in Las Vegas about rheumatoid arthritis treatment by regenerative medicine. This was at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15th, 2019. The full title of his presentation was “Rheumatoid Arthritis, A Regenerative Medicine Approach”.

Dr. Lans is a rheumatologist and Assistant Clinical Professor of Medicine at the New York Presbyterian Lawrence Hospital, Bronxville, NY.

Introduction

Rheumatoid arthritis is a worldwide immune disorder. About 1% of the general population suffer of this illness with a female to male ratio of 3:1. Typically it can affect  the synovial membranes of all joints. To clarify, the presentation is usually symmetrical, but in 40% of all cases this systemic inflammatory disease can also involve other tissues and organs. 70% of cases have a positive rheumatoid factor (RF) in blood tests. However, a newer, more specific blood test for rheumatoid arthritis is anti-cyclic citrullinated peptide (anti-CCP). Symptoms of rheumatoid arthritis are anemia, fatigue, malaise, joint pain and joint stiffness. Inflammatory blood markers are positive.

Causes of rheumatoid arthritis

Genetic causes play an important role in the causation of rheumatoid arthritis. Over 100 genes  can increase due to genetics. Twin studies showed that the concordance rate to develop RA is only 15-20%. Certainly, this means that in order to develop RA you need a double hit: the genetic vulnerability for RA and also an environmental triggering factor. Meanwhile, here is a list of environmental risk factors:

  • Smoking
  • Gum disease (chronic gingivitis)
  • Any chronic infection
  • Dysbiosis in the gut
  • Environmental toxins
  • Heavy metal toxicity
  • Poor diet and nutrition

In other words, the common denominator to all of these environmental risk factors is the disruption of the mucosal integrity. In fact, this starts the process of chronic inflammation and autoantibodies (like RF and anti-CCP) resulting in chronic synovitis.

How inflammation travels from mucosal surfaces to the synovium of joints

Inflammation in gums, lungs or gut can travel via the blood and the lymphatic system into periarticular bone. This leads to bone and cartilage damage. Consequently, the bone destruction leads to chronic synovitis. To emphasize, Dr. Lans said that no patient with rheumatoid arthritis will develop symptoms of RA unless the autoantibodies have developed. In the same vein, there is a distinct preclinical period of RA with positive blood tests for RA, but absent clinical symptoms.

Prevention of synovitis through a preventative program

It is important to realize that because of this time relationship there is room for a preventative program where patients are taught the importance of dental hygiene. Another key point is that good health habits and nutrition are also important for prevention. When patients develop early-onset RA, the following measures often help to alleviate the development of symptoms: anti-inflammatory diet, stress management, intermittent fasting, a gut healing program, nutraceuticals like vitamin D3 and fish oil. Herbal therapies are also important like curcumin, Boswellia serrata, devil’s claw, ginger, Ashwagandha and others.

Conventional medicine approach versus the regenerative medical approach

To explain, the conventional treatment approach of rheumatoid arthritis is to induce a disease remission with drugs. To this effect doctors use anti-inflammatory drugs like ANSAIDs, disease modifying anti-rheumatic drugs (DMARDs). For example, drugs like methotrexate and sulfosalazine belong into this category. Unfortunately, the conventional drugs have many serious side effects that often make the rheumatoid arthritis patient’s condition worse.

In contrast, the integrative medicine approach to rheumatoid arthritis is to use dietary measures to reduce the inflammation. The fasting mimicking diet is able to reduce the severity of the inflammation in RA patients.

Other authors described the use of the Mediterranean diet to reduce inflammation. In addition, there are a number of regenerative methods that help improve the condition of RA patients.

Regenerative medical treatments for RA patients

Significantly, platelet rich plasma (PRP), peptides, stem cell therapy and exosomes are some of the modalities that show promise. (I’ll explain the meaning of exosomes later.) In addition, red light therapy and low-level laser therapy can help joint synovitis.

PRP provides growth factors to repair damaged tissues and is anti-inflammatory. Peptides consist of short chains of amino acids that have anti-inflammatory effects and promote healing of damaged tissues. Thymosin-alpha 1, Thymosin-beta 4, BPC-157, Melanotan II and FOXO4-DRI are examples of peptides used in patients. Special blood tests are used to monitor whether the treatment of RA is successful. These tests are: C-reactive protein, sedimentation rate (ESR) and Vectra. Vectra measures 12 protein markers that are important in RA.

More info about peptide therapy

Researchers noticed that peptides are very safe, but they are also very effective. HAP-1 seems to bind to synovial surfaces. RDG peptides work closely together with integrin-binding proteins. Together they have an anti-inflammatory effect in rheumatoid arthritis. They are capable of blocking both the inflammatory and autoimmune components of rheumatoid arthritis. Thymosin-alpha 1 is a peptide with powerful effects as an immune and inflammation modulator. Thymosin-beta 4 is promoting tissue healing. BPC-157 is a peptide with 15 amino acids. It helps with the regeneration of tissue after damage.

Melanotan II is a synthetic peptide derived from melanocortin, a pituitary hormone. It helps to suppress cytokine-meditated inflammation.

FOXO4-DRI is a peptide that stimulates the removal of senescent cells. Because of this it is called a senolytic. Researchers are still investigating FOXO4-DRI in humans and for the tissue repair effect in rheumatoid arthritis patients.

The use of stem cells in RA therapy

Another biological remedy for treating RA patients is the use of mesenchymal stem cells. In 2013 rheumatoid patients received umbilical cord stem cells to study the effect of stem cells. The clinical trial consisted of 172 patients. In the trial disease modifying anti-rheumatic drugs plus placebo were compared to disease modifying anti-rheumatic drugs plus umbilical cord stem cells (treatment group). In the treatment group inflammatory cytokines were reduced and regulatory T cells were increased. Improvement was assessed with objective clinical measures and blood tests. The improvement lasted between 3 and 6 months.

Exosome therapy from mesenchymal stem cells 

Many of the effects of stem cells are explainable by so-called exosomes. They are cell particles shed by stem cells. They contain signalling proteins (integrins), messenger RNA and many other healing substances. The bioactive effects are very diverse. Exosomes are bactericidal, antifungal, stimulate angiogenesis and stimulate tissue regeneration. They are also anti-apoptosis, anti-tumoral, anti-fibrosis, stimulate immunomodulation and cause chemoattraction.

What does that mean clinically? Exosomes suppress the release of inflammatory cytokines. Anti-inflammatory cytokines (like transforming growth factor beta or TGF-beta) are increased. Exosomes reduce the Th17 cells (T helper cells that produce the inflammatory cytokine IL-17). They also promote osteochondral regeneration, which is important for joint healing in the treatment of RA patients.

Treatment of RA using the integrative and regenerative medicine approach

  1. The physician assesses all affected joints and orders blood tests to check the inflammatory status.
  2. Identify the triggers that perpetuate the RA disease. Typically there are gut dysbiosis issues that need treatment. Sleep hygiene and stress issues require modification.
  3. Assess the need for disease modifying anti-rheumatic drugs (DMARDs); these are drugs like methotrexate, sulfosalazine and others.
  4. Peptide protocol: BPC-157: 300 micrograms once or twice daily IV; Thymosin alpha: 300 micrograms once or twice daily IV; Thymosin beta: 100 to 300 micrograms once daily IV, limit to 3-month cycle.
  5. Mesenchymal stem cell therapy and exosomes.
Rheumatoid Arthritis Treatment by Regenerative Medicine

Rheumatoid Arthritis Treatment by Regenerative Medicine

Conclusion

Rheumatoid arthritis is a common autoimmune disease, which leaves the patient disabled, if she receives no treatment for it. Conventional rheumatologist protocols treat the inflammation with various drugs, but they cause a lot of side effects.

There is an emergence of regenerative therapies that may be able to help treat the inflammation of the rheumatoid arthritis patient with less side effects. At the same time these treatments can also help to repair the damaged tissues. There is a great need for more clinical studies. Current human data are limited. Safe options to treat RA patients are mesenchymal stem cell therapy, exosome treatment and peptide therapies. The approach of the physician depends on the clinical stage the patient is in. It is common sense that early diagnosis and treatment will have better results. Also, an integrative approach has the best chance to help the patient with the least side-effects.

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Apr
04
2015

Stop Suffering From Arthritis

This article shows you how to stop suffering from arthritis. Arthritis is an illness of the joints, mostly in older people (osteoarthritis or degenerative arthritis). However, a subgroup of younger patients can also develop a severe form of arthritis, called rheumatoid arthritis where autoimmune antibodies play more of a role.

In the 1950’s Dan Dale Alexander wrote a book called “Arthritis and common sense”. The medical establishment did not accept that simple remedy and Dan Dale Alexander was classified as a “quack”. However, Dr. Mirkin describes a study from Berlin that later confirmed that Dan Dale Alexander’s observation was correct: an emulsion made by shaking orange juice with cod liver oil and taken three times per day on an empty stomach would indeed improve osteoarthritis.

Dan Dale Alexander’s emulsion of orange juice and cod liver oil

In 1966, when I was still a medical student, I suggested to my future mother-in-law to give Dan Dale Alexander’s book about arthritis a try. Despite the well-established osteoarthritic condition in her left knee the arthritis vanished within 6 months and stayed controlled. I could not explain to her why this remedy was effective, as researchers had not yet described higher doses of omega-3 fatty acids and higher doses of vitamin C to be of value for arthritis.

This all changed with the advent of orthomolecular medicine (Ref.1). On page 76 of this book Dr. Frederick Klenner describes that ascorbic acid (vitamin C) at mega doses of at least 10,000 mg daily, but better even between 15,000 and 25,000 mg daily does have healing effects for arthritis. He stated further that repair of collagenous tissue (the joint surfaces) would require adequate ascorbic acid. On page 240 of Ref.1 Dr. Abram Hoffer, the founder of modern orthomolecular medicine reviewed the history of the use of vitamins in higher doses, particularly the use of vitamin B3 (niacin). He also mentioned that Dr. William Kaufman had used mega doses of vitamin B3 for arthritis as far back as 1950.

Overview of arthritis

Dr. Hoffer explains in Ref.2 that arthritis belongs into a group of diseases that are related to faulty nutrition, which in turn lead to vitamin and mineral deficiencies and a pandeficiency disease. Other diseases that belong to that group are cardiovascular disease, multiple sclerosis, cancer, diabetes, schizophrenia, mood disorders, alcoholism and autism. Contributing factors can be poor diets with overemphasis on refined and processed foods and consumption of sugar, allergies, diseases of the gastrointestinal tract and viral infections. Arthritis belongs into this group of illnesses as well. Researchers found that niacin, vitamin B6 and zinc were useful to treat arthritis, but other vitamins and minerals are also necessary. Here is a list of what Dr. Hoffer would suggest to use (Ref. 2):

  1. Vitamin B3

Vitamin B3 from 100 mg to several thousand mg three times daily following meals. With niacin there can be skin flushing, which often goes away after the body gets used to the higher doses; but niacinamide could be used instead by those who are bothered by the flushing.

  1. B complex

B complex: this contains each of the major B vitamins including vitamin B6 (pyridoxine). Take 100 mg once per day with a meal. The dose for vitamin B6 is up to 500 mg per day or more.

  1. Vitamin C

The dosage for vitamin C is between 500 mg and several thousand mg three times per day after meals.

  1. Vitamin D3

To get adequate vitamin D3 levels the patient has to take 4000 IU per day in the summer months. In the winter months particularly populations who live far north require 6000 IU per day.

  1. Vitamin B1 (thiamine)

Vitamin B1 (thiamine): alcoholics and very high sugar consumers need thiamine at 100 to 500 mg three times per day.

  1. Folic acid at mega doses

Folic acid at mega doses (prescription needed) works as an antidepressant, which requires 25 to 50 mg. To lower homocysteine levels lower doses of folic acid are sufficient.

  1. Vitamin E

Vitamin E: usually 400 IU to 800 per day. Muscle wasting diseases, Huntington’s disease and amyotrophic lateral sclerosis (ALS) require much higher doses up to 4000 IU per day.

  1. Essential fatty acids (omega-3)

Essential fatty acids (omega-3): It is strongly recommended to use a molecularly distilled product, which is free of mercury and PBC’s at 1000 mg three times daily following meals.

  1. Selenium

Selenium: The required dosage is 200 to 600 micrograms once daily (with any meal). In areas where selenium is deficient, this is particularly important.

  1. Zinc

Zinc: 50 mg of zinc citrate or 220 mg of zinc sulfate once per day with a meal.

  1. Calcium and magnesium

Calcium and magnesium: Dr. Hoffer suggested 1000 mg of calcium with 500 mg of magnesium, although many experts now say that 1000 mg of calcium with 1000 mg of magnesium may be better.

Dr. Hoffer pointed out that this program is compatible with any medication and is non-toxic.

Thoughts on treating arthritis

 

 1. Conventional methods

The conventional approach to treatment of arthritis consists of anti-inflammatory medications like ANSAIDs. Unfortunately they have side effects like causing kidney damage after several years of use. Also, NSAIDs can lead to gastric bleeding from gastric erosions, which may require blood transfusions. Physiotherapy with reactivation and swimming have been found to be useful. Electro acupuncture can help for pain control.

2. Diet changes, multivitamins and minerals

As arthritis occurs mostly in civilized nations, physicians have long suspected dietary factors to be of importance. Dr. Hoffer pointed out that arthritis is a pandeficiency disease meaning that overconsumption of sugar and processed foods has lead to multiple vitamin and mineral deficits that interfere with the cartilage metabolism leading to premature breakdown of cartilage and causing inflammation. It is not good enough to just take the supplements listed above; this needs to be combined with a fundamental change in diet. Cut out sugar and starchy foods. Return to homemade foods. Keep it simple with lots of vegetables, salads and organic meats. Now that you are starting to turn around your metabolism by a sensible diet the supplements listed above have a chance to work.

You will notice that Dan Dale Alexander’s idea of omega-3 fatty acids and vitamin C (from the freshly pressed orange juice) is contained in the list of supplements above. Dr. Klenner’s mega doses of vitamin C are also listed and Dr. Kaufman’s mega doses of vitamin B3 is contained in this list as well.

This list may not have been formally researched with controlled clinical trials, because the food industry and the makers of NSAIDs (Big Pharma) have no interest in this. But thousands of patients have been empirically treated with this regimen and a network of orthomolecular physicians has established that this regimen works to control the inflammation of arthritis and at the same time has no toxic side-effects.

 3. Laser, platelet rich plasma (PRP) and stem cells

Blue and green lasers have anti-inflammatory properties and are suitable for interstitial and intra articular laser treatments of arthritis. Dr. Weber has extensive experience with this treatment modality in Germany. I have discussed this in another blog.

However, prolotherapy, PRP and stem cell treatments are also an option for more severe cases of arthritis, particularly in arthritis of the knees, which can avoid total knee replacement surgery.

Stop Suffering From Arthritis

Stop Suffering From Arthritis

Conclusion

I met Dr. Hoffer in the early 1980’s during a meeting in Vancouver, BC when he wanted to establish a local orthomolecular division for British Columbia. Although I found the ideas fascinating, I felt that the College of Physicians and Surgeons (the regulatory body for physicians in BC) would scrutinize the practice of any orthomolecular member. At that time I would risk losing my license to practice medicine, which I just had received in 1978. So I decided not to join. Interestingly enough later in the 1980’s a member of the orthomolecular society of BC lost his license because of the use of mega doses of intravenous vitamin C. At this time the College considered these infusions useless or hazardous. Nowadays, any naturopathic and orthomolecular physician uses these intravenous vitamin C treatments as standard therapies. It shows how times have changed.

Lifestyle issues important with causation of arthritis

What has not changed is the food industry that undermines our health every day with hidden sugar contained in processed foods. In social functions it is customary to have a drink or two, if not more, which uses up our thiamine faster than we can replace it. Pan deficiency disease is alive and well as it was many years ago. It is in front of our eyes, but can we see it? Depending on what your eating habits are, do you need to make changes in your diet and perhaps take some or all of the ingredients of the multivitamin and mineral list above? Start by adopting a Mediterranean type diet, then add some of the supplements listed above. It is time to take a thorough look at natural treatment modalities against arthritis in the interest of preserving your health!

References

Ref. 1: Andrew W. Saul, Ph.D.: “The Orthomolecular Treatment of Chronic Disease. 65 Experts on Therapeutic and Preventative Nutrition”, Basic Health Publications, Laguna Beach, CA, 2014.

Ref. 2: Chapter in Ref. 1 by Dr. Hoffer: “Pandeficiency Disease”, pages 24-30 (2014).

Feb
14
2015

Laser Therapy Going Beyond Skin Deep

There was an interesting workshop alongside of the A4M conference mid December 2014 organized by Jonathan Schwartz who gave an overview of the use of low-dose laser therapy for various clinical applications. It involved the use of the Dr. Michael Weber low-dose laser machine, which has a lot of versatility.

  1. First there are 5 laser light frequencies in the rainbow colors (infrared, red, yellow, green, blue) and the colors have very special characteristics as will be explained further below.
  2. There are a multitude of applicators like skin acupressure point applicators, a shower for hair loss applications, a head adapter, which looks like a crown. With this device red light will penetrate into the brain through the skull bone. There is also a mouth shower and various lengths needle applicators that can be used to access the body intravenously or interstitially (direct tissue approach). At the center of the equipment is the Weberneedle Compactlaser, which can be attached to the various applicators.

Laser characteristics

The blue laser penetrates about 1 cm (0.39 inch) under the skin, a green laser penetrates only 0.5 cm (0.19 inch); like the blue laser the yellow laser penetrates through the skin with a depth of 1 cm (0.39 inch). The red laser has a penetration depth of 2-3 cm (a bit more or less than 1 inch) and the infrared laser penetrates 5-7 cm (2 to 2 1/2 inches).

In addition the various lasers have different inherent qualities: The red laser is good for tissue regeneration, which lends itself for chronic pain. Green and blue lasers have anti-inflammatory effects, which helps in acute pain. The yellow laser can be used for detoxification, has antidepressant qualities and photosensitizes hypericin, a substance derived from St. John’s wort, which is known to have antidepressant qualities. The various types of laser mentioned can be used interstitially, intravenously and just on the skin surface over acupuncture points. Dr. Weber explained that detailed research has revealed that the low-dose energy beam sends out energy that is taken up by the surrounding tissues and cells. The mitochondria of the cells get activated to produce more ATP, which the cells use to heal themselves.

Meeting in Placentia

Forward to a meeting in Placentia, CA on Feb. 7, 2015 where Dr. Michael Weber and several other speakers gave presentations on the use of the Dr. Weber laser system. A number of local doctors who had an interest in learning more about the low-dose laser system were there as well. It was a daylong mini conference.

Three volunteers were used to demonstrate the use of the system. I was volunteering about a chronic left lower back pain that various chiropractors had problems adjusting in the past year. I have a strong family history of arthritis on my mother’s side and my maternal grandmother’s side as well. The health professionals thought that I likely have developed arthritis in the left sacro-iliac joint. Dr. Weber used the interstitial needle, which is 4 cm (1.57 inches) long. The skin was injected with a local anesthetic first, and then the needle was inserted, which I could hardly feel. Now he injected 5 cc of normal saline. This was used, so that the laser light would spreads more into the surrounding area. Dr. Weber explained that he was very close to the SI joint with the tip of the needle on the left. He attached a blue laser to it for 20 minutes and switched it to a green laser for another 20 minutes.

In the meantime the other two volunteers were treated.

One was a physician in the group who had a chronic planter’s fasciitis. He was treated with an intravenous laser application. First a special butterfly was inserted, through which a sterile laser probe could be threaded and then attached. He received a red laser.

The third volunteer had a chronic right knee problem from congenital Osgood Schlatter disease. In him Dr. Weber used an approach of intraarticular injection and he attached a blue laser for 20 minutes, followed by a yellow laser for another 20 minutes. A physician with a California license supervised all of these procedures.

I woke up the following day with no pain in my left lower back, but at the same time the lesser right lower back pain had also disappeared. I figure that due to the fact that my back mobility is back the untreated right side must have normalized as well. It is now 7 days following the procedure and I still have no back pain. Yesterday I saw my local chiropractor in Southern California and he confirmed that my back was much easier to adjust than the month before (Update April 12, 2015: my lower back is still pain free!).

Normally a case like mine would require 5 to 6 weekly treatments before the problem is resolved. Dr. Weber explained that more complicated problems like fibromyalgia would take 15 to 20 treatments in succession or more. The principal is always that you treat where the symptoms are; in the follow-up visit the healthcare practitioner treats the remaining symptoms until all of the symptoms have resolved.

The intriguing fact is that low-dose laser therapy seems to fit right into gap where conventional medicine has failed.

Clinical cases that respond to laser therapy

Dr. Weber has collected clinical cases that improve with laser treatments, such as diabetes, chronic liver diseases, chronic pain syndromes, rheumatoid arthritis, polyneuropathy, chronic inflammatory disease, cancer (with photodynamic therapy), fibromyalgia, high blood pressure, ringing in the ears (tinnitus), macular degeneration, multiple sclerosis, chronic fatigue syndrome, Lyme disease, allergies and eczema. This, however, is just a partial list.

Photodynamic cancer therapy is made possible by the fact that certain substances have absorption spectra that are activated by different wavelength. This amplifies the effect of the natural substance that is used by several folds. For instance Chlorin E6 absorbs a red laser (around 660 nm). A blue laser activates Curcumin. A yellow laser activates Hypericin. Here is a website that explains the principle of phototherapy.

Various cancers can be treated where conventional medicine has so far failed. Examples are lymph metastases from breast cancer, pancreatic cancer, and bladder cancer. I have blogged regarding a combination treatment for breast cancer before, where phototherapy with lasers and immunostimulation were combined. Esophageal cancer is treated through esophagoscopy combined with a laser that activates curcumin, which had been taken orally well before the procedure. Not all of the cases are successful, but the majority of them are.

Otherwise routine low-dose laser applications are used for tendinitis, tennis elbow, sprains and soft tissue injures.

Laser-Therapy-Going-Beyond-Skin-Deep

Laser-Therapy-Going-Beyond-Skin-Deep

You can combine the laser system with prolotherapy. Prolotherapy is done first by injecting hyperosmolar dextrose solution, which is a strong stimulator of stem cells. Using the same needle, but attaching the Weber low-level laser therapy will activate the stem cells and protect them from dying off.

Conclusion

Low dose laser therapy using the Weber Medical technology is a new treatment modality available to the interested physician. I think that it will cause a revolution within medicine. It is scientifically sound and it fits right into the difficult to treat patients; the patients that otherwise would be unlikely to respond. However, they will respond well to these new treatment modalities. Apart from musculoskeletal problems, various cancers will also respond to this. The Mayo clinic is starting a study on treating cancer using phototherapy and the Dr. Weber low-dose laser system.

Dec
07
2013

Slow Down Aging And Prevent Disabilities

You have seen it many times before: a man or a woman retires at age 65; for a while you see them around at social functions; then they are not seen any more and they return in a wheel chair only to die prematurely. You ask yourself: what can I do better to avoid this death trap?

There are several aspects to this equation: first, we would like to slow down the aging process. Part of this is to retain our physical functioning. In the following I am discussing the ingredients that are necessary to achieve the goal of aging in dignity, but avoiding disability.

It starts with a healthy mind set

You need to be optimistic and have a mindset of believing in yourself that you can do it. With a negative attitude, you will manage to find something to complain about, no matter how perfect the day has been. Negative thinking is rampant, and depression tends to be higher in the older population. If you suffer from depression or you had negative events such as accidents or abuse in the past, it is important to do some house cleaning. Do not be hesitant seeking professional help and counseling from a health professional to help you build up your self-esteem.

Regular exercise is important

A regular exercise program helps you to get your day organized. If you think that you are too busy to find the time to exercise, you are sacrificing your wellness and in fact you sabotage your health. It’s time to rethink your lifestyle! The reason you need exercise is to set the automatic pilot on staying healthy and active. If you are accustomed to sitting down in front of the computer or television set for hours, your muscles do not get the exercise they need. Fast-forward several decades and you will be one of those who rely on walkers, wheel chairs and assisted living establishments. Without training your muscles you are more prone to falls and injuries. Your balance organ is not getting the impulses it needs on an ongoing basis to prevent you from falls later in life. People in their 80’s are often stable up to the point where they trip and fall. I have seen many patients like this arrive in an ambulance where I was doing my shift as the emergency physician in a community hospital. When I summarize the fate of all of the people in their 80’s who had falls and broke their hips over the years, 50% of them made it through the surgery and went back home (often with a walker or in a wheel chair) or ended up in a nursing home; the other 50% died from complications of the surgery, often from heart attacks during the surgery or from clots in their pelvic veins or in the leg veins that dislodged and turned into pulmonary emboli. A fracture and in particular a hip fracture in your 80’s is a serious, potentially deadly accident. So, you need strong muscles and joints and you need strong bones. All of this comes free to you from years of regular exercise in your 60’s and 70’s.

Slow Down Aging And Prevent Disabilities

Slow Down Aging And Prevent Disabilities

You guessed right: good nutrition is important!

Eat right and your body will function right. This is where a lot of people are sent on the wrong path due to clever advertising from the Agro Industry, Big Pharma, the American Dietetic Association and the United States Department Of Agriculture. So they preach that wheat and wheat products are good for you, but the lab tests show that it induces hyperinsulinemia and leads to diabetes. The genetic changes of wheat (“accomplished” through forced chemical hybridization in the 1970’s) are responsible for the metabolically very active wheat belly (accumulation of visceral fat) that Ref. 1 has described in detail. But others have researched this topic as well. Ref. 2 for instance confirms that gliadin, the glue in wheat, which allows dough to stick and makes it easy to create bread, bagels and pasta, is responsible for neurological issues like numbness of fingers and feet (peripheral neuropathy), balance problems and cognitive decline all the way to Alzheimer’s disease. If you continue to eat wheat and wheat products (all contained in conveniently packaged “processed” foods), you may very well find that your balance and muscle control will deteriorate by the time you are in your eighties. This condition is not new: one of the lecturers I listened to at McMaster University in Hamilton, Ontario in 1977 referred to those unfortunate individuals who were severely disabled as the “tea and toasters”. The tea in this case was probably the lesser evil, but the wheat induced malabsorption and malnutrition was a reality already in the mid and late 1970’s.

However, if you start eating organic foods to avoid the chemicals and estrogen-like xenoestrogens from pesticides, and you cut out sugar, high-density carbs and wheat products, you will no longer have problems with weight control and you will maintain your muscle, brain and nerve function. This is not what you learn from the regular agencies mentioned at the beginning of this paragraph, but Ref. 1 and 2 will fill you in on the details. Essentially, I follow a Mediterranean diet without sugar, starchy foods and wheat or wheat products. Ref. 2 stressed the importance of enough saturated and healthy fat (omega-3 fatty acid rich oils) in a balanced diet consisting of 20% protein and low carbs. No specific numbers were given regarding the %-age of fat. I would say that a limit of about 25 to 35% for fat would be reasonable except for the Inuit who are used to a fat content in their diet of 80%. The new thinking is that healthy fats are good for your brain and heart. Healthy fats are omega-3 fatty acids (EPA and DHA) derived from fish oil as they are very protective (anti-inflammatory) oils, so is olive oil and coconut oil. These latter two are anti-inflammatory monounsaturated fatty acids. Keep in mind that you want to change the ratio of omega-3 to omega-6 fatty acids (the ratio in this link is cited as omega-6 to omega-3) more in the direction of omega-3 fatty acids, so that the ratio will be between 1:1 and 1:3. Most Americans are exposed to ratios of 1:8 to 1:16 (too many omega-6 fatty acids in fast food and processed foods), which leads to inflammation of the arteries as well. Omega-6 fatty acids, found in safflower oil, sun flower oil, grape seed oil and canola oil are bad for you when not balanced by enough omega-3’s (flax seed oil and fish oil) as they lead to inflammation through the arachidonic acid system in the body. It may be a surprise to you that saturated fats are OK: animal fat like butter, lard, cream, ghee (clarified butter), and other animal fats provided they come from clean (not antibiotic or bovine growth hormone treated) animals. Buy organic and buy organic meats as well such as grass fed beef and bison, chicken and turkey.

Here is an example of what a day would look like nutritionally in terms of a breakfast, lunch and dinner (recipes by Christina Schilling):

Breakfast:  Great Greens Omelet

(2 servings)

1 tablespoon olive oil or coconut oil

3 chopped green onions

3 cups spinach leaves or a mix of greens: kale, spinach, Swiss chard

1 red pepper cut into strips

3 eggs and 3 egg whites

2 tablespoons grated Parmigiano

In non-stick pan sauté green onion, greens and pepper strips in oil, stir eggs and egg whites and pour over the vegetables, sprinkle with Parmigiano. Cook on medium heat, till the egg mixture has started to set. Turn over and briefly let cook. Remove from pan, divide into two portions and sprinkle with a bit of salt (optional). Serve with salsa and guacamole.

Lunch: Oriental Salad

(2 portions)

1 small Sui choy cabbage (Napa cabbage)

2 cups mung bean sprouts

1 small daikon radish, shredded to yield 1 cup

1 red pepper, cut into thin slices

3 green onions, chopped

1 medium sized carrot, cut into matchstick size pieces

1 can sliced water chestnuts, rinsed.

Dressing: 2 tablespoons sesame oil,

2 tablespoons rice vinegar,(light balsamic vinegar works too)

1-tablespoon tamari soy sauce

1 tablespoon Thai sweet chilli sauce

1-teaspoon fresh grated ginger

3 tablespoons chopped fresh cilantro

Prepare all vegetables and put into salad bowl. Stir all dressing ingredients together and pour over vegetable mix. Stir gently, cover and refrigerate. This salad can be consumed immediately or kept refrigerted for a day. To complete the salad with a protein portion add your choice of 6 oz. cooked shrimp or the same quantity of cubed or sliced grilled chicken.

Dinner:  Florentine Chicken

(2 servings)

1 large boneless chicken breast

1 tablespoon of chopped fresh basil-alternatively use 1 teaspoon dried basil.

1 tablespoon grated Parmigiano

4 thin slices prosciutto

1 tablespoon olive oil

2 tomatoes- cut into halves

3 chopped green onions

2 cups baby spinach leaves

pinch of salt

Spread chicken breast flat and top it with the basil, Parmigiano and prosciutto slices. Fold into half an hold the stuffed chicken breast together at the edges with a toothpick or two. Heat olive oil in frying pan, add onion and tomato slices and put the chicken breast on top. Put lid on the pan, and cook at medium heat till the chicken is cooked through. If you test with a fork, the juices will be clear. Remove vegetables and chicken from pan, put on serving plate and keep warm. Remove toothpicks from meat, and cut chicken breast into two portions. Put spinach into pan and let the leaves wilt at medium heat (cover with lid). Put spinach on the side of the chicken and tomatoes, and sprinkle with a bit of salt.

Dessert after dinner: Berry Sorbet

(2 servings)

2 cups of deep frozen berries (strawberries, blueberries or a berry mix, no sugar added)

¾ cup of organic yogourt or goat’s milk yogurt

a few drops of liquid stevia or small amount of powdered stevia-to taste.

Put into blender and process till smooth. You will have to open the blender jar to stir the contents in between. Serve with a dollop of whipped cream,  if desired.

What about the “slow down” of menopause and andropause?

It is a fact that as we age, our hormone glands do not produce as much hormones as when we were in our 20’s and 30’s. But if you find a health care provider who is interested in anti-aging medicine (there are about 26,000 physicians, chiropractors and naturopaths who are members in the A4M), your hormones can be measured accurately from saliva and blood tests. This will tell whether you are hypothyroid, deficient in sex hormones and whether you should be supplemented with the missing hormones in adequate doses through bio-identical hormones. For instance, women are often deficient in progesterone in menopause and men deficient in testosterone. Treatment needs persistence and patience, as it often takes months for the patient to feel better and up to 2 years, to find the exact balance for you where the hormones are re-balanced and your symptoms of tiredness, insomnia, hot flushes etc. disappear. All our body cells have hormone receptors that require stimulation for the cells to function normally. Your health professional needs to pay attention to this and not just treat your symptoms symptomatically. When your hormones are in balance and you take a few supplements, your bones will be strong (no osteoporosis), your brain will be clear, your hearing perfect, and your balance great. You will be much less likely in your eighties to fall and break a bone and your mind will be clear and sharp.

Stress management

As the baby boomers age, they need to be aware of the stress in their lives. You may have been accustomed to having lots of energy when you were in your child rearing years or in your active professional career. Often we do not even notice that there may be stress in our lives. But your adrenal glands know. This is really a subpart of what I said of hormones: they need to be in balance. But cortisol, which is produced in your adrenal glands, is different from the menopause/andropause hormones. Corticotrophin-releasing hormone (CRH) from the hypothalamus and adrenocorticotrophin hormone (ACTH) from the pituitary gland are the rulers of the adrenal glands. And it is how you handle stress when you are in your 40’s, 50’s and 60’s which will determine whether you come down with adrenal fatigue, various degrees of adrenal insufficiency or not. Ref. 3 is a whole book that deals with this topic. Here I like to mention only that the best test to diagnose adrenal problems is a four-point saliva hormone test for cortisol. You connect the four points and get a curve where the cortisol level is expressed as a function of time. If this curve is below the lower normal range, which the laboratory provides for you, you need to be managed by a knowledgeable health care professional in order to build up the reserves of your adrenal glands. Yoga, meditation, deep prayer, self-hypnosis and enough regular sleep are all proven methods to overcome any stress related issues. Sometimes more effort is needed to rebuild the adrenals by specific herbs or porcine adrenal gland cortex extracts. Your health care provider can tell you more regarding this.

Useful supplements

1. On March 17, 2013 I wrote in a blog about prevention of osteoporosis the following summary:

“The best combination is 1000 mg (or 1200 mg as per National Osteoporosis Foundation recommendation) of calcium per day together with 400 to 800 IU of vitamin D3 (for cancer prevention you may want to take 4000 IU to 5000 IU of vitamin D3 per day instead monitored by a 25-hydroxyvitamin D blood level test through your physician) and 100 micrograms of vitamin K2 (also called MK-7). In the age group above 50 missing hormones such as bioidentical testosterone in men and bioidentical progesterone/estrogen combinations in women should be given as well. This works best, if you also watch your weight, cut down your alcohol consumption to a minimum (or better cut alcohol out altogether), exercise regularly (this builds up bone and muscle strength) and stick to a balanced diet resembling a Mediterranean or zone type diet (low-glycemic,  low fat, wheat free and no sugar).” I would add in view of Ref. 1 and 2 that “low fat” should now be replaced by “balanced fat diet”. With this I mean that nuts, almonds, olive oil, unsalted butter are allowed within reason. Lately there have been new insights that some cholesterol is needed for normal hormone production. What needs to be cut out are omega-6 fats and trans fats.

2. Omega-3-fatty acid supplements from molecularly distilled fish oil at a good dosage (3 to 6 capsules a day) will prevent chronic inflammation that often causes arthritis. Chicken cartilage (UC-II) from the health food store will desensitize your system in case you have rheumatoid arthritis or osteoarthritis. This will prevent crippling arthritic disease down the road.

3. Mitochondrial aging (the mitochondria are the energy packages in each body cell) is slowed down by the two supplements ubiquinol (=Co-Q-10, take 400 mg per day) and 20 mg of PQQ (=Pyrroloquinoline quinone). Co-Q-10 repairs DNA damage to your mitochondria and PQQ stimulates your healthy mitochondria to multiply. Between the two supplements you will have more energy.

4. Vitamin C 1000 to 2000 mg per day and a multivitamin supplement help to support the rest of your metabolism. Some may want to add PS (Phosphatylserine) 100 to 200 mg per day, which works together with vitamin D3 for Alzheimer’s prevention.

Conclusion

By now you noticed that nothing comes from ignoring the fact that we are aging. We need to pay attention to our body functions and think about what we can do to make us stronger. In the end we are our own caregivers. When we are in our eighties, we should still be active and our brains should function with a lot more experience than in our past. Our bones will be strong and our balance should prevent us from falling. I do not want to use assisted living and I do not like the confinement of a wheel chair. In the meantime I am going to carry on dancing.

More information on:

1. Fitness: http://nethealthbook.com/health-nutrition-and-fitness/fitness/

2. Nutrition: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/

3. Vitamins, minerals and supplements: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/vitamins-minerals-supplements/

References

1. William Davis, MD: “Wheat Belly. Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2011.

2. David Perlmutter, MD: “Grain Brain. The Surprising Truth About Wheat, Carbs, And Sugar-Your Brain’s Silent Killers.” Little, Brown and Company, New York, 2013.

3. James L. Wilson, ND, DC, PhD: “Adrenal Fatigue, the 21sty Century Stress Syndrome – what is it and how you can recover”; Second printing 2002 by Smart Publications, Petaluma, Ca, USA

Last edited Nov. 7, 2014

Sep
07
2013

Preserve Your Muscles And Joints

Our ancestors were hunters and gatherers, constantly on the go. They did not have to think too much about their muscle and joint health, they simply moved them. In our society this has changed a lot. At work we spend hours sitting at a desk, and then we use computers and watch television at home. Instead of walking to the neighborhood store, we use our car.

Here I will review what we can do to keep our joints and muscles in top shape until a ripe old age.

Brief intro regarding the anatomy of joints and muscles

Our joints are designed to give us full mobility. But the joints cannot do it alone. The muscles are designed to allow the joints to move in a full range. Without exercise the muscles will shrivel up (medical term “atrophy”) within only 2 to 3 weeks. So without regular exercise your joints won’t do you any good. Besides the joint capsules need regular stretching in full range exercises to produce the lubricating fluid (synovial fluid) that nourishes the joint surfaces and the menisci of the knees. Think of muscles and joints as being a functional unit designed to move you about.

Our joints have aerodynamic designs to do the most optimal job for our body. For instance the knees have more of a hinge design that includes menisci for shock absorption while the shoulders and hips have more of a ball and socket type construction.

Wear and tear with aging

It is usually thought that injuries and aging wear down the joints. But there are other factors such as the wide spread use of statins that can contribute to muscles weakness. Ironically statins are taken to protect the heart, but side effects can interfere with the ability to exercise your heart because of aching muscles and joints.

With optimal nutrition and avoidance of wheat and wheat products to prevent autoimmune arthritis (lupus, rheumatoid arthritis, dermatomyositis) your joints can stay young for much longer (explained further below). But your joints and muscles need to move through a full range of motion regularly to keep the blood circulation and nutrition of their tissues in top shape.

What causes joint deterioration?

Aging, weight gain, diabetes, smoking and lack of exercise all are known to cause a worsening of arthritis, particularly osteoarthritis, but also rheumatoid arthritis. The wrong diet with lots of sugar and starch and trans fats (hamburgers, pasta, sugar soda drinks) causes hyperinsulinemia (insulin overproduction, like in type 2 diabetes) and is almost guaranteed to make you sick with arthritis, obesity and diabetes.

There is also evidence that wheat causes inflammation and arthritis by stimulating your pancreas to produce too much insulin. This has been proven for dogs and for humans. A good diet book to follow is Dr. William Davis “Wheat Belly Cookbook” (Ref. 1) with 150 recipes. If you are overweight, these recipes will also help you to lose some weight effortlessly.

A caution to marathon runners: the constant pounding of prolonged jogging can cause osteoarthritis of hips and knees decades down the road. You may want to switch to different exercises before this happens.

Preserve Your Muscles And Joints

Preserve Your Muscles And Joints

What helps joints?

Molecularly distilled omega-3 fatty acid helps to prevent inflammation of your joints. Vitamin D3 will help your bones to be strong to support the tendons and ligaments. Chicken cartilage can build up joint cartilage within a few weeks! So, if you feel pain in your joints use 3 capsules of omega-3 (the strong, molecularly distilled ones) twice per day. This will help your joint inflammation within 3 to 4 weeks. If this alone is not enough add chicken cartilage from the health food store, which will help to build up the hyaline cartilage within your joints. For those who are questioning the effect of chicken cartilage, here is a 1993 chicken cartilage Harvard study proving it.

Below are more general steps that will help your joints, ligaments and muscles.

Maintaining health of joints and muscles

a)    It starts with good nutrition.

Hamburgers and deep fried French fries will not do the trick. Muscles require protein from meat, fish, poultry and dairy products. If you are a vegetarian you need to become knowledgeable on what essential amino acids are and what combination of vegetables will give you the amino acid composition to build up a full protein.

Joints need ingredients from cartilage, which you find in chicken cartilage (available in health food stores as fikzol (type II cartilage). I you prefer, chicken soup would also give you the ingredients to build up cartilage, but it would require a lot of regular chicken soup consumption to achieve this.

Sugar and starchy foods, which are broken down within half an hour after a meal into sugar in your blood, cause an insulin response from your pancreas. This in turn can cause inflammation in your joints and tendons. It is interesting to note that type 2 diabetes and arthritis are associated. A ketogenic, low sugar/starch diet will prevent arthritis and diabetes as it reduces the insulin level in the blood, which in turn turns off inflammation in the joints.

b)   Supplements:

Omega-3 fatty acids will help control any inflammation including the inflammation from arthritis (you need 3 capsules of the concentrated, molecularly distilled fish oil twice per day to achieve this).  DMSO gel, available in health food stores in the US, can also be used to rub onto inflamed joints. It will penetrate tissues rapidly, is nontoxic and helps control inflammation along with the omega-3 fatty acids. Regular anti-inflammatory pain relievers (NSAIDs) are harsh on your kidneys and can irritate the gastric lining causing bleeding gastric erosions, so definitely not recommendable.

Glucosamine, chondroitin sulfate, or a combination of both is available in the health food store and has been shown to help with osteoarthritis. I contributes to building up hyaline cartilage.

c)   Watch your weight:

It has been shown that the rate of degenerative arthritis (=osteoarthritis) in obese people is much higher when compared to slim people.

d)   Exercise:

You need to move your joints, ligaments and muscles every day to maintain their strength and range of motion. A daily workout at home or in a gym is best. I recommend 30 minutes of a treadmill or equivalent (jogging, Stairmaster etc.) as aerobic exercises. Then you need 30 minutes of isometric exercises like a circuit on exercise machines in the gym or dumbbells and expanders (resistance bands) at home. I consider this as the basic fitness routine every day.

Ballroom dancing and Latin dancing or Zumba is also a good combination exercise, which I would recommend on top of the basic exercise. Dancing helps to maintain your balance as well, which is something the older population tends to lose. In addition dancing stimulates your brain cells and makes you less vulnerable to develop dementia in old age.

Other aerobic exercises that can be recommended are walking (brisk walk) and/or intermittent jogging. Swimming has the advantage particularly for arthritis sufferers that you are floating. It allows you to exercise your leg and arm muscles, even if you have some arthritis pains.

e)  Pain relief: What could you do for pain relief? I do not like NSAIDs as this will damage your kidneys on the long-term and cause gastric erosions that can bleed massively. Electro acupuncture is very useful for muscle and joint pains and has no side effects. Physiotherapy treatments are useful to recondition your muscles and build up the range of motion of your joints. Chiropractic treatments for back and neck pain will also help. Instead of narcotics, why not try low dose Naltrexone (LDN). It has been shown to help with the pain of fibromyalgia.

Conclusion

In this brief review I have attempted to show you that your body is not on a one-way street in the direction of disability and death. There is a lot we can actively do to prevent this from happening prematurely. Just eat right, supplement (if you have symptoms), exercise and be active. Soon you will no longer be aware of your previously achy joints or muscles, as the pain tends to melt away when you are reconditioned.

More information on fitness: http://nethealthbook.com/health-nutrition-and-fitness/fitness/

References:

1. William Davis, MD: “Wheat Belly Cookbook. 150 Recipes to Help You Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2012.

Last edited Nov. 7, 2014

May
01
2008

Early Use of Immunosuppressive Drugs for Early Crohn’s Patients

So far the strategy of treating patients, who were newly diagnosed with Crohn’s disease, was the use of corticosteroids to control abdominal pain and bloody diarrhea. The conventional mode of treatment consisted of a “step-up” treatment: after corticosteroids the use of immunosuppressants and finally antibody treatment would follow to curb the inflammatory response. International data which were published in the Lancet (February 23 issue) points to a safer and more effective treatment protocol. It consists of a “top-down” approach rather than of the conventional “step-up” approach. Patients receive immunosuppression early in the form of azathioprine and also the antibody infliximab, known as Remicade. Another study examined patients who were on maintenance therapy with adalimumab (Humira). They experienced sustained improvements in the symptoms that are associated with Crohn’s disease. After 4 weeks of induction therapy with the medication patients with mild and severe depression had improved to such an extent that they returned to the normal range. They were also assessed regarding fatigue and after treatment they showed a significant improvement in their daily functioning. The two treatment protocols were compared in a trial involving 129 patients with Crohn’s disease who had no previous treatment. At the end of the trial the researcher found that 65% of the group that had received the “top-down” treatment was symptom free after 26 weeks of treatment. Contrary to this only 36% of the “step-up” patients went into remission during the same time.

Early Use of Immunosuppressive Drugs for Early Crohn's Patient

Crohn’s before and after immunosuppressive drugs

When the patients were examined after 1 year, 62% of the “top-down” group was still symptom free, but only 42% of the “step-up” group had no symptoms. Dr. Brian Feagan of the University of Western Ontario coordinated this trial involving international sites in Belgium, Holland and Germany. He points out that the newly diagnosed Crohn’s disease patient that has the worst prognostic signs will benefit from this form of treatment. The top-down modality also is safer, as it protects the patient from high exposure to steroids. Similar results were demonstrated in patients with rheumatoid arthritis. The results of these trials and Dr. Feagan’s research suggest that the top-down treatment option could also give the best chance to patients with other chronic autoimmune diseases such as ulcerative colitis.

More information about Crohn’s disease: http://nethealthbook.com/digestive-system-and-gastrointestinal-disorders/crohns-disease-crohns-disease/

Reference: The Medical Post, March 4, 2008, page 2; April 1, 2008, page 17

Last edited November 3, 2014

Jul
01
2006

Benefits Of Arthritis Drug Outweigh Cancer Risk

Any medication that is very effective in one area may also have side effects.
An analysis of randomized trial has confirmed, that rheumatoid arthritis patients who are treated with anti- tumor necrosis (TNF) antibodies, are at an increased risk for cancer. A study from the Mayo Clinic and other studies from institutions in the U.K. showed that patients who are treated with the monoclonal antibodies infliximab (Remicade) and adalimumab (Humira) are at a higher risk for serious infections.
This may sound like a blow to any patient with rheumatoid arthritis. Treatment with Monoclonal antibodies and anti-Tumor necrosis antibodies has revolutionized the care of these patients. The medications are highly effective and have made a difference for many affected with rheumatoid arthritis.
Dr. Eric Matteson, a study co-author and professor of medicine in the division of rheumatology at the Mayo Clinic points out, that the concerns about infection and malignancy are not new. They are already mentioned in the drug labeling. The risk for cancer was statistically significant only in the high-dose groups. It was also impossible to draw any conclusions about whether any type of malignancy occurred more often than another. He also emphasized, that doctors and patients have to be alert to signs of infection, and age-appropriate cancer screening is of great importance for the patient who takes these particular medications.
Dr. John Esdaile from the University of British Columbia mentions some additional points. These medications are not handed out freely to any patient with R.A. The treatment cost of about $18,000 per year does not make this a standard medication for anybody with R.A. Patients with severe disease who have failed to get relief from any conventional medications would be the ones who are considered for this treatment. Most patients would likely be receiving doses in the lower range of the spectrum, and patients usually know within 3 months, whether the medication is helping them. The medications do not work in everyone, but for 50% of the patients the effect is dramatically positive. The patient, whose joints were being destroyed by rheumatoid arthritis, can go from a state of terrible pain and disability to being able to return to a good quality of life.

Benefits Of Arthritis Drug Outweigh Cancer Risk

Benefits Of Arthritis Drug Outweigh Cancer Risk

The key is close screening of patients regarding the suitability of the therapy. The possible increased risk for malignancies and infection must be discussed with candidates for anti-TNF therapy. Finally close monitoring for infection and cancer screening is necessary.

More information about rheumatoid arthritis: http://nethealthbook.com/arthritis/rheumatoid-arthritis/

Reference: The Medical Post, June 2, 2006, page 1 and 7.

Last edited Nov. 1, 2014

Jan
01
2006

Combination Of Drugs Helps Rheumatoid Arthritis

Several treatment options have become available to patients suffering from rheumatoid arthritis, but side effects can be a problem. Corticosteroids are still needed, and methotrexate has been added. While anti-tumor-necrosis factor therapy (TNF alpha antibody) is a very beneficial form of treatment, there are patients who fail to respond or have toxicity to these therapy forms.
Dr. Stanley Cohen, a clinical professor of internal medicine at the University of Texas Southwestern Medical School in Dallas investigated 520 patients who had not adequately responded to methotrexate and anti-TNF therapy. The patients received the genetically engineered monoclonal antibody, rituximab (Rituxan), which so far has been used to treat Hodgkin’s lymphoma. It was found to be highly effective for active rheumatoid arthritis when given with methorexate in patients who experienced an inadequate response to anti-TNF therapies.
The patients were randomly selected and received either a single dose of 1000mg rituximab or placebo on days one and fifteen. All patients received a corticosteroid prior to the infusion. They also took a short course of oral corticosteroids between the two injections. For the patients on rituxmab, the medication proved beneficial. It was also well tolerated. Statistically 51% of the patients on rituximab had at least a 20% improvement on the swollen and painful joints and at least 20% improvement in 3 to 5 other criteria, like general well being, disability or laboratory tests of C-reactive protein.
Only 18% of the placebo group showed any improvement. It was also noted that the effects of this one-time treatment could last up to 15 months.
As good as the current medication is, there are treatment failures. Dr. David Karp, chief of Rheumatic diseases at the same university but not involved with this study finds the development very valuable.

Combination Of Drugs Helps Rheumatoid Arthritis

Combination Of Drugs Helps Rheumatoid Arthritis

He concludes that it becomes important in this area to personalize the treatment plan. The future is to look at the patients’ blood or gene makeup and prescribe specific therapies directed at their particular problem.

More information regarding treatment of rheumatoid arthritis: http://nethealthbook.com/arthritis/rheumatoid-arthritis/treatment-rheumatoid-arthritis/

Reference: The Medical Post, December 20, 2005, page 33

Last edited October 30, 2014