by Fred Harvey, MD

 

Last month was National Arthritis Awareness Month, and May 20 was Inflammatory Arthritis Day. There are two types of arthritis—degenerative and inflammatory. In this article, I will focus on inflammatory arthritis because its effects are systemic and devastating.

Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, lupus and scleroderma are all forms of inflammatory arthritis. These are also called auto-immune diseases because the body’s immune system attacks parts that cause destruction and impaired function.

Synovitis, or inflammation of the capsule surrounding the joint, is often seen in these diseases. There is a genetic predisposition for all of these, but genetics do not necessarily result in the disease. It seems that certain triggers must be experienced in order to develop the inflammatory problem. Some triggers could be infectious. For example, certain bacteria, when present in the intestines, can trigger an abnormal response in susceptible individuals which results in a flare of inflammation in ankylosing spondylitis, rheumatoid and psoriatic arthritis.

Lyme disease presents with synovitis like rheumatoid arthritis in some people. Lupus arthritis can be triggered by salmonella biofilm in the intestinal tract. Biofilm is a matrix of proteins and other products of the bacteria in which they live and thrive. It also seems that food can trigger flares. The lectin family of proteins is irritating to the digestive system. Lectins occur in grains, beans and other vegetables to a lesser extent. These are not food allergies, but are direct chemical irritants of the intestinal lining and the immune system. Many of our favorite foods like bread, pasta, beans and rice can all be culprits in these destructive processes.

A number of authors have written on this topic recently, and much has been published in the conservative medical peer-reviewed literature, but often ignored by conventional rheumatologists because their goal is to end inflammation immediately with immune modulating medication. This is an appropriate goal, but there could be a parallel treatment regimen.

Dietary changes like the Autoimmune Protocol Diet, which eliminates grains, dairy, beans and nuts, has been effective in reducing inflammation. Analysis of the digestive tract microbiome can help to direct therapy at specific bacteria irritating the immune system.

The addition of cannabidiol CBD has been shown to effectively reduce inflammatory markers, both in clinical studies and in my own patients. These interventions can work alongside powerful medications or as foundational stand-alone therapies. Our goal either way is to prevent joint destruction and retain optimal function.

 

Dr. Harvey is an internist, geriatric, functional and holistic physician.  He has over 30 years of practice experience, including 20 years in functional and holistic medicine at The Harvey Center for Integrative Medicine. For more information or to schedule a consultation, call 941-929-9355.