Rheumatoid Arthritis Nutrition and Hormones: Natural Endocrinology Meets Holistic Rheumatogy!

Dr. Nicole Sundene

Holistic Pain Doctor

Rheumatoid Arthritis is one of the most complicated conditions I treat as a Women’s Health Naturopathic Doctor. As someone with an Autoimmune disease, I understand just how painful and debilitating this condition is for many of my RA patients. So before I answer the most common questions my RA patients have, I want to explain how what I do for autoimmunity is a process and not just a prescription. 

Trust me, after eighteen years of living with my autoimmune disease if there was a “Magical Herb from the Rainforest” to make it all just go away, I would be on it and that is what I would be blogging about. Instead, what I do for RA is multifactorial, and is a process that every patient needs to go through because it is not the same for every patient. Some of the things that work for my autoimmune disease do not work for others. This is because we are all similar, yet unique like “Snowflakes.”

I am sure you would not be googling natural solutions to solve the chronic pain, swelling, and disfigurement of Rheumatoid Arthritis unless you were not getting lasting solutions that actually worked as I describe in my story about “Why I Became a Naturopathic Doctor.” 

I understand these painful autoimmune frustrations first hand, and exactly what it feels like to deal with callous uncaring doctors that cannot provide me with lasting solutions that actually work. 

Many Rheumatoid Arthritis patients have to pay a high amount of money in prescription drugs to maintain their pain. Often health conditions can quickly become expensive such as acne, eczema, psoriasis, ADHD, depression, anxiety, when we do not take the time to listen to the body and understand why the symptoms are present. 

I never want anyone to enroll as an autoimmune patient in my practice without first understanding what I will be doing as your “Natural Rheumatologist” that is quite different from taking steroids and immune suppressing drugs that can put Arizona autoimmune patients at higher risk for West Nile Virus and Valley Fever. Recently, I just had a patient with Rheumatoid Arthritis be discharged from the hospital after a bad case of Valley Fever Pneumonia. The ER doctors specifically said “You have to stop taking your immunosuppresants or the next time you end up here with pneumonia, you will die.”

Sadly, I had warned her about this many years ago, yet she did not want to do the nutrition changes that are realistically required to manage RA pain naturally. 

Let me take a minute to explain how I help my patients with Rheumatoid Arthritis achieve lasting solutions so that they do not have to rely on prescription drugs, or need the least amount possible. 

First off let’s discuss our failed American Medical Model: 

TAKE X Rheumatoid Arthritis DRUG FOR X Pain, Swelling, and Disfigurement

What I actually want to do as your “Natural Rheumatologist” To help you learn how to manage the pain naturally with less medication is the following: 

#1 Why to you have Rheumatoid Arthritis?

#2 What is the “Root Cause” or underlying causes of your RA? (Hint it is different for every woman) 

#3 Are you deficient in any vitamins, minerals, or nutrients needed to reduce inflammation and pain? 

#4 How can we better manage weight gain and chronic fatigue common in RA? 

#5 How can we improve insomnia and reduce stress so your joints can heal? 

#6 Is there an underlying chronic infection triggering your immune system? 

#7 Are your female hormones and thyroid in proper balance or is the imbalance actually spiking inflammation and causing more pain? (Common cause I find.)

#8 Teach Rheumatoid Arthritis patients to manage their weight, hormones, pain, and fatigue with my inflammation reducing Naturopathic meal plans and recipes. 

#9 Addressing the gut inflammation is often why my patients have RA inflammation and pain in the first place. Testing the microbiome, and ruling out dysbiosis is critical for many of my thyroid patients. 

#10 Remove individualized food triggers spiking pain and inflammation. 

#11 Screen for other autoimmune disease such a as Hashimoto's thyroiditis I commonly see occurring, often when we see one autoimmune disease, there may be two or three more not yet diagnosed.

Without understanding #1 and #2 on my list, I sadly have seen many RA patients fail to control their pain, swelling, weight gain, insomnia, and chronic fatigue naturally, or with less medication.  

Without a proper anti-inflammatory nutritional foundation, perfect hormones, and understanding that darn “Root Cause” (Hint it’s different for everyone) Natural Medicine will often fail. 

I want every woman with autoimmune disease in my practice to be a success story, because I live the pain and frustrations myself. I don’t want autoimmune patients that cannot work gradually through the above list to enroll into my practice because I know they will fail, and then I don’t get that “Joy of Fixing You” that I need to be happy as a doctor.

I also know that some days just surviving each pain flare can feel like completing an Ironman Triathlon. Patience runs very thin with women in pain and they desire a quick fix which Naturopathic Medicine sadly is not. Natural medicine takes several months for the average autoimmune patient to improve. And yes, I do recommend staying on full doses of Rheumatology drugs until we begin to notice improvement before we begin to taper them down. There is little sense in allowing your joints to be destroyed while we are working towards a better long term plan.

So please do treat yourself to a Naturopathic visit with me if you want real answers, want the right anti-inflammatory nutrition for your body, want to take herbal medicine, and want me to fix the underlying hormone imbalance that is most often triggering worse swelling and pain in RA. Which is why many women are diagnosed with RA in perimenopause and menopause.

While I love helping women with Rheumatoiod Arthritis, I also have been doing this job for over seventeen years as a Naturopathic Doctor and want every woman in pain to have realistic expectations with the type of medicine I practice. Simply visit my SCHEDULE page to treat yourself to a Naturopathic visit! I would be happy to help.

WHAT IS THE BEST NATURAL HOLISTIC TREATMENT FOR RHEUMATOID ARTHRITIS?

Rheumatoid arthritis is an autoimmune disease that responds very well to naturopathic treatments. Well researched natural treatments such as diet, herbs, vitamins, and other holistic therapies implemented early on can prevent the need for the overuse of harsh medications such as chemotherapeutic agents, corticosteroids, and drugs with a myriad of side effects such as hydroxychlorquine typically needed to aggressively manage symptoms.

Most of my MD colleagues are happy to refer patients with frustrating autoimmune conditions such as rheumatoid arthritis off to naturopaths, as a thorough diet and lifestyle cleanup typically works wonders for improving the disease course. Although this article is primarily discussing RA, the general treatment concept should be helpful for most cases of autoimmunity.

Please consult with your doctor or naturopathic physician to develop an individualized plan that is right for you, natural medicines may have interactions with your medications or other health conditions that should always be researched thoroughly before implementing.

WHAT ARE RHEUMATOID ARTHRITIS SYMPTOMS?

The symptoms of rheumatoid arthritis results from the autoimmune attack from the body’s own immune system. attacks the joints creating inflammation and the resultant symmetrical poly-arthritis typically affecting the wrists, knees, elbows, shoulders, ankles, and neck.

Swelling, heat, deformity of joints, morning stiffness and pain with passive motions are all hallmark symptoms. Seventy percent of patient’s exhibit radiologic signs of damage within three years of onset, so early aggressive preventative therapies are important to protect joint integrity.

Reversing joint damage is difficult. An “ounce of prevention” is truly “worth a pound of cure” in this case. Systemically patients additionally experience fatigue, depression, general malaise, loss of appetite, enlarged lymph nodes and spleen, and visual impairments.

WHAT ARE THE EARLY SYMPTOMS OF RHEUMATOID ARTHRITIS

What is the Cause of Rheumatoid Arthritis?

Since the etiology of RA is currently unknown, and all we know about RA in our current medical model is that “anti-body-complement complexes result in intra-articular inflammation” it is thus important that we eliminate all potential immune system aggravators, and ALWAYS address causes of health imbalance in the patient where applicable.

In layman’s terms, the immune system is reacting to something in the system, and those immune complexes are depositing in the joints, causing inflammation, the resultant inflammation is systematically destroying the joints. Until the cause of RA is further understood, as a biochemist and physician I think it is imperative that all food additives and other chemicals are removed from the diet and lifestyle. Something in the system is likely triggering the inflammatory autoimmune response, and it is better to error on the side of caution. Whole foods eating is the way to go.

All patients with RA will surely improve from a diet and lifestyle clean up, as from a sensible standpoint; a pure whole foods diet will only improve the total health of the patient while we investigate other potential causes of this frustrating and debilitating painful disease.

I have yet to see someone with an autoimmune disease that did not improve dramatically from healthier eating and living. If changing your diet and lifestyle seems overwhelming from reading this article, please consider your long term health, and make small goals to achieve systematically. Stay positive and don’t get caught by a potentially debilitating case of the “I cants”.

CAN NATURAL MEDICINE HELP RHEUMATOID ARTHRITIS?

Naturopathic Medicine can help reduce the side effects of medications, reduce symptom severity and frequency, and alleviate the need to take as much prescription medicine.

As with any modality naturopathic medicine also has its own set of limitations. Natural treatments take more time than prescription drugs. Keep in mind the immune system turns over a new supply of white blood cells about every 4 months. Joints are avascular meaning that they lack a blood supply and receive all their nutrients through simple diffusion. The natural treatment of joint problems therefore requires time, discipline, and dedication.

Patient compliance is typically an obstacle to cure when it comes to natural healing techniques for autoimmune disease. Be sure to work with a licensed naturopathic physician for the best holistic management of this complex condition, preferably one with a special interest in autoimmune conditions. Initially, frequent appointments should help you stay more motivated to make these changes.

WHAT IS THE BEST DIET FOR RHEUMATOID ARTHRITIS?

• Generally decrease animal fats and Omega 6 Fats (found in most vegetable sources) and increase Omega-3 oils (found almost only in Alaskan Wild salmon, flax seeds, and walnuts).
• Stop eating junk food. McInflammation is just pouring gasoline on the inflammatory fire of RA!
• A vegan, gluten free diet has been shown to be the most efficacious for those with RA.
• The Mediterranean Diet was also shown to be effective.
• Anti-inflammatory Diet. RA is an inflammatory condition. Eating an anti-inflammatory diet will prime your system to produce less prostaglandins and other inflammatory products. The ultimate goal is to reduce the total load of inflammation in your body, so that less prednisone, methotrexate, and other RA medications will need to be used. Improvement may be seen immediately but ultimate improvement will result after six months of this diet once most of the body’s cellular membranes have integrated the less inflammatory lipids in to their cellular structures.
• Allergy Elimination Diet: Most patients under naturopathic care reportedly improve with the elimination of foods they might be allergic to. Since 70% of our immune system surrounds our gut in the form of GALT (Gut Associated Lymphatic Tissue), most conditions of autoimmunity will respond to the reduction of foods that the patient is allergic or intolerant to. For instance, the current naturopathic theory with gluten in the diet purports that the protein sequence of gluten is similar to the protein sequence of healthy cells in our body, so the immune system becomes confused if it is reacting to gluten, and begins to see healthy cells in the body as a threatening antigen as well…attacking them and marking them for destruction. Most common allergen offenders are: wheat, dairy, peanuts, tomatoes, potatoes, beef, corn, soy, and the nightshades such as eggplant, tomatoes, and peppers.
• Whole Foods Diet to eliminate the toxic burden on the immune system. Research shows that pesticides in the diet affect the functioning of the immune system. Eat organic whenever possible.
• Eat sources of probiotics- if you have digestive problems in addition to RA, then eating probiotics such as acidophilus will help break down your food and make your immune system less reactive to it. Healthy gut flora is imperative to a healthy immune system!
• Absolutely eliminate aspartame! Let me re-emphasize the importance of this. ABSOLUTELY ELIMINATE ASPARTAME. After writing about aspartame in my post on “The Kitchen Table Villains”, many readers came forward with their various autoimmune issues with aspartame causing symptom flares. Elimination of food additives, chemicals, and the other “Kitchen Table Villains” have had many case reports of symptom improvement from the removal of these unnecessary additions to the diet. To error on the side of caution…get all chemicals out of your diet and eat a Whole Foods Diet.
• Eliminate arachidonic acid from the diet. This is the inflammatory component of fat found in animal products such as red meat and high fat dairy. Almost all prescription anti-inflammatory medications work to inhibit cycloxygenase at some point in the biochemical pathway of arachidonic acid metabolism. When we ingest arachidonic acid we make it easier for the body to make inflammation. Without ingesting arachidonic acid dietarily, the body will be forced to have to make its own supply, which takes time, and ultimately results in a slower inflammatory response, and less dramatic inflammatory flares.
• The good news is my Autoimmune Program puts all these diet factors together into simple 4 week meal plans and easy Naturopathic recipes.

LIFESTYLE CONSIDERATIONS FOR RHEUMATOID ARTHRITIS

• Quit smoking! Smoking is known to exacerbate the symptoms of RA. From a biochemical standpoint smoking creates more ROS (Reactive Oxygen Species) that attack normal healthy cells. The destructive process of these cells then adds to the total inflammatory load of the body. Our goal is to reduce inflammation; smoking is thus a major contributor to inflammation.
• Exercise moderately. Gentle exercise is shown to improve symptoms in some cases of RA, just don’t over do it! Avoid either extreme of excessive activity and inactivity. Find the level of activity that works for you.
• Manage stress. Stress and anxiety are the underlying causes of most chronic health conditions.

BEST VITAMINS AND MINERALS FOR RHEUMATOID ARTHRITIS?

• Vitamin E 1800 IU was shown to improve symptoms via its antioxidant capacity.
• Zinc and selenium may be effective, although studies conflict. This may just be due to their antioxidant characteristics, as antioxidants reduce inflammation in the body by reducing Reactive Oxygen Species that destroy healthy cells.

BEST HERBS FOR RHEUMATOID ARTHRITIS?

• Herbs are great for managing symptoms initially while we get the diet and lifestyle aspects of this disease under control. Anti-inflammatory herbs usually improve symptoms within a week.
• Anti-inflammatory Herbs: Turmeric, Ginger, Boswellia, and Quercetin (technically a bioflavonoid).
• Tripterygium wilfordii has been used successfully to manage RA symptoms. I would work with a naturopathic doctor if opting to use this herb though, as this is “big medicine” that is not intended for self treatment. However, I wanted to include it on this list as it has two rather decent research studies showing its efficacy.

NATURE CURE FOR RHEUMATOID ARTHRITIS

When all else fails with chronic disease, naturopathic medicine works wonders when we apply nature cure philosophies such as "Treat the Root Cause," “Remove the obstacles to cure” and “Treat the whole person" from a mind/body/spirit perspective.

Remove the Obstacles to Cure

Obstacles to cure are the things that are getting in the way of bringing your body in to a healthier state of balance. Anything listed above that you struggle to implement is therefore an “obstacle to cure”. Identify your challenges and work on overcoming them systematically. Start with the simplest obstacles to improve self efficacy, or tackle the hardest like quitting smoking to make the most significant impact in your health.

Treat the Whole Person

You are not a symptom. You are not a body. You are not inflammation. You are not pain. You are a complex being that is challenged by a painful case of arthritis. This is not just about your body, it is also about the mind and spirit that have to live in this body. The growing field of “psychoneuroimmunology” investigates how our minds affect our immune system. Nurture the mind and spirit connection to support your body.

Sample Naturopathic Treatment Plan for Rheumatoid Arthritis:

*PLEASE NOTE* Always check with your physician for drug interactions or medical contraindications before implementing any new treatments as this is not individualized care. Included for example only, preferably make an appointment with me for proper help:

• Vegan, Gluten free, Anti-inflammatory Diet
• Anti-inflammatory Smoothie: Eat 1 cup of frozen blueberries daily in “Dr. Nicole’s Smoothie Recipe” (be sure to include the L-glutamine to heal your gut and the flaxseeds for omega 3’s.)
• Quit smoking.
• Gentle exercise such as yoga, walking, and swimming.
• Acidophilus 1 capsule with each meal (three times daily) to restore healthy gut flora.
• Fish Oil 1 tablespoon twice daily with food (not to be used by those with bleeding disorders or on anti-coagulant medications, or by pregnant women due to vitamin A content).
• Anti-inflammatory herbs: Find a blend of turmeric, ginger, boswellia, and quercetin in capsules at a quality health food store and take as directed.
• Breathing Exercises for Stress. Being in constant pain that nobody understands is very stressful.
• Counseling. Addressing emotional components of our health and anxiety surrounding chronic disease is especially important for a good outcome. Anyone sick with a chronic disease deserves a safe place to discuss their fears and challenges surrounding pain and chronic illness. Address past emotional issues and work to let go of them. Forgive those that have hurt you or caused you upset.
• Work with a skilled Physical Therapist to retain mobility and function of painful joints.

Need my help reducing pain, swelling, and inflammation with Rheumatoid Arthritis? This is one of my favorite things to do. I would be happy to help! Simply visit my SCHEDULE page to treat yourself to a Naturopathic Hormone balancing visit!

Dr. Nicole Sundene, NMD

(480) 837-0900

Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert  in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy.