Everyone with chronic pain can safely start the Anti-inflammatory diet – no sugar, alcohol, gluten, dairy, preservatives, & chemicals. The minimum supplements I recommend you should be taking are high amounts of EPA/DHA (EPA-DHA 720, three softgels up to three times daily with food), Vitamin D3 (IsoD3 5,000 i.u. daily) and digestive enzymes (Metazyme, one tablet during each meal). Order from Metagenics 800-692-9400.
Additional Supplements for chronic pain:
Quercetin (Resveratin Plus 12 capsules daily). Order from XYMOGEN 1-800-647-6100
UltraInflamX Plus 360 medical food is a shake that contains Turmeric, Ginger, Rosemary extract, as well as other vitamins and minerals plus 15 grams of protein. Two scoops in water or juice 1 – 2 times daily. Order from Metagenics 800-692-9400
Kaprex is for joint relief and contains hops, iso-alpha acids, Olive Leaf extract and Rosemary Leaf extract. Dose is two softgels three times daily. Order from Metagenics 800-692-9400.
Chronic pain depletes serotonin, GABA and dopamine and other catecholamines (which in turn amplify pain perception); so nutrients that address serotonin (such as Tryptophan, 5HTP, and vitamin D) and dopamine and catecholamines are useful. Trancor and Symphora (4 each per day). Order from Metagenics 800-692-9400
Acute Trauma: Traumeel tablets – take 1 tablet every 15 minutes for 3 hours then cut back to 1 every hour for day 1; 1 every 2 hours on day 2 and 1 3 per day until you come in for a visit. This is easily purchased in health food stores.
Peripheral neuropathy, including diabetic neuropathy:
Take Insinase which contains Alpha Lipoic Acid 540 mg BID and Acetyl-L-Carnitine HCL 400 mg BID. Order from Metagenics 800-692-9400.
Osteoarthrits & RA:
Combinations of Magnesium, Calcium, Valerian root and Hops are essential. See my list for chronic pain and include UltraInflamX 360.
Capsaicin (Capsicum frutescens) cream:
Capsaicin is the main component in hot chili peppers (also known as cayenne). Applied to the surface of the skin, it is believed to deplete stores of a substance that contributes to inflammation and pain in arthritis. Several studies have shown that capsaicin cream provided much better pain relief than a placebo but no improvement in joint swelling, grip strength, or function for people with OA. Pain reduction generally begins 3 to 7 days after applying the capsaicin cream to the skin. Apply the cream 4 times daily.
This is another topical pain reliever used in pain management. This is especially good for sore or strained muscles; shoulderand arm pain; neck, hip, and leg pain; back pain; arthritis pain; painful joints; diabetic neuropathy; tendonitis; and bursitis. Biofreeze needs to be applied 4 times daily.
KinesioTaping procedures are an invaluable aide in everything from chronic edema (swelling) reduction to reduction of muscle tension/pain.
My two favorite modalities for chronic pain continue to be the Deep Muscle Stimulator (DMS) and warm laser.
On his DVD How to Treat Multiple Sclerosis with Diet, Dr. Cordain thoroughly explains the dietary mechanisms of autoimmunity in MS which are almost the same for all autoimmune diseases, including RA. These include: increased intestinal permeability, increased passage of luminal antigens into peripheral circulation, molecular mimicry and genetic susceptibility (genes encoding for the HLA system), among other factors.
In recent years, new substances have been discovered which might be responsible for increased intestinal permeability – namely saponins – found in legumes, potatoes, soya, quinoa, amaranth, alfalfa sprouts or tomatoes. If you’ve seen Dr. Cordain’s scientific paper entitled “Modulation of immune function by dietary lectins in rheumatoid arthritis”, I am sure you are aware of the role lectins play in autoimmunity.
Adjuvants are used by immunologists in order to boost the immune system and induce immune response. It turns out that certain foods possess bioactive compounds that have adjuvant-like activity. This is the case for tomatoes or quillaja (a foaming agent used in beers and soft drinks).
Gliadin is a prolamine found in wheat which has been shown to increase intestinal permeability, and hence the risk of suffering from an autoimmune disease. While several clinical trials conducted have shown promising results, unfortunately they have used a gluten-free diet or vegan diet instead of a whole paleolithic diet, which is probably superior.
In the vegan diets, authors often claim that the benefits cited might be due to the lack of meat, but what if the positive effects relie on the lack of diary proteins and gluten. Meat has historically been seen as the “bad guy” of inflammation, but the data to support that notion is not sufficiently compelling.
Listed below are some references that may be helpful.
- Modulation of immune function by dietary lectins in rheumatoid arthritis. Cordain L, Toohey L, Smith MJ, Hickey MS. Brit J Nutr 2000, 83:207-217.
- Gluten-free vegan diet induces decreased LDL and oxidized LDL levels and raised atheroprotective natural antibodies against phosphorylcholine in patients with rheumatoid arthritis: a randomized study. Elkan AC, Sjöberg B, Kolsrud B, Ringertz B, Hafström I, Frostegård J. Arthritis Res Ther. 2008;10(2):R34. Epub 2008 Mar 18.
- A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Hafström I, Ringertz B, Spångberg A, von Zweigbergk L, Brannemark S, Nylander I, Rönnelid J, Laasonen L, Klareskog L. Rheumatology (Oxford). 2001 Oct;40(10):1175-9.
European Journal of Clinical Nutrition Published online ahead of print.
A daily dose of vitamin B-6 at the current upper tolerable levels may reduce amounts of inflammatory compounds in people suffering from rheumatoid arthritis, a new study says.
Levels of the pro-inflammatory compounds interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) significantly decreased following 12 weeks of supplementation with 100 mg of vitamin B-6, according to findings published in the European Journal of Clinical Nutrition.
However, scientists from Chung Shan Medical University in Taiwan said that no changes were observed for pyridoxal-5-phosphate (PLP), the active form of vitamin B-6, in relation to levels of C-reactive protein (CRP), another marker of inflammation.
After 12 weeks of supplementation with B6, significant decreases in levels of IL-6 and TNF-alpha were observed.
“A large dose of vitamin B-6 supplementation (100 mg per day) suppressed pro-inflammatory cytokines (that is, IL-6 and TNF-alpha) in patients with rheumatoid arthritis,” the researchers concluded.
Vitamin B-6, a water-soluble vitamin that exists as pyridoxine, pyridoxal and pyridoxamine is found in beans, meat, fish and some fruits and vegetables, like spinach and avocado. I recommended UltraInflamX medical shakes from Metagenics as a great source of B6 and other i,portant nutrients for RA and other inflammatory conditions. www.DrJeffreyTucker.meta-ehealth.com to purchase UltraInflamX.
June 30, 2010 — Cardiorespiratory aerobic exercise may be safe and modestly beneficial in patients with rheumatoid arthritis (RA), according to the results of a meta-analysis of randomized controlled trials (RCTs) reported in the July issue of Arthritis Care & Research.
“Several lines of evidence have emphasized an improvement in aerobic capacity and muscle strength after physical exercise programs in …RA patients,” write Athan Baillet, MS, from University of Grenoble Medical School in Grenoble, France, and colleagues.
Benefits associated with the exercise intervention included improved postintervention quality of life, better HAQ score, lower pain VAS scores and less radiologic damage.
“Cardiorespiratory aerobic conditioning in stable RA appears to be safe and improves some of the most important outcome measures,” the review authors write.
“Besides the positive effect of the intervention on patients’ psychological well-being, aerobic exercise should be considered as a safe therapy, the efficacy of which has been underestimated,” the review authors conclude.
Arthritis Care Res. 2010;62:984-992.
Dr. Tucker’s comment: In my experience in working with RA patients, the key to successful exercise therapy is training patients in low load body weight exercises – these are gentle repetitive movements. Proper training avoids overloading the joints and does not hurt. UltraInFlamX medical food shakes are part of the program when I work with RA patients.