July 2018 Edition
Arthritis is the leading cause of disability in the United States with one in five (22%) adults in the United States that report having doctor diagnosed arthritis. (CDC)
Healing Rheumatoid Arthritis with Natural Medicine
People living with Rheumatoid Arthritis (RA) compare the pain and inflammation to a fire raging out of control. RA is a chronic, systemic autoimmune disease causing swelling, stiffness, and pain in the joints. It can result in joint deformity and damage to other organs, including the nerves, heart, and lungs.
Approximately 1.5 million Americans have Rheumatoid Arthritis: most are adults over age 40; about 12,000 children under age 16 have juvenile-onset RA.
Symptoms of RA (aggravated by stress and lack of sleep)
- Swollen, painful, hot and disfigured joints on both sides of the body
- Pain, stiffness and limited movement making daily activities difficult
- Fatigue, muscle aches, and fevers
The prevailing, conventional theory is that inflammation results from an “over-reaction” of the immune system that may include genetic factors. Doctors of natural medicine believe there is a deeper, root cause for this haywire immune system response. They theorize immune dysregulation originates in imbalances that involve a person’s genetics, lifestyle choices, nutritional status, gut health, stress, environmental triggers and emotional wellbeing.
Treatment of RA
Conventional treatment includes physical therapy and prescription medicines (steroids, painkillers, and immune suppressors) to treat pain and swelling. While these drugs may be necessary for some people, they have side effects including hair loss, liver damage, stress on the kidneys and heart, and risk for addiction, without correcting the underlying imbalance.
Natural medicine emphasizes identification and treatment of root causes. Holistic doctors use safe, natural therapies and interventions that stimulate the restoration of health without side effects. Here’s a sampling of holistic interventions that can make a huge impact in healing the root causes of RA.
An Anti-inflammatory Diet
Commit to a diet that includes: organic fruits and veggies; healthy fats such as olive, avocado, and coconut oils; whole grains; bone broth; wild-caught fish; and nuts/seeds. These foods provide natural antioxidants – cellular superheroes that gobble up the free radical cells that contribute to development of RA. There are many foods that are considered healthy in general, but may cause inflammation for some people, leading to immune dysregulation. Holistic doctors will test for food sensitivities, such as gluten, dairy, egg, or others, and work with a patient to create a diet with healthy alternatives when needed.
Movement is important for managing symptoms (including pain) and enhancing psychological wellbeing. Low impact exercise, such as cycling, walking, water aerobics and Tai Chi, are ideal. Symptoms can improve with strength training.
R & R: Rest, Relaxation & Pain Reduction
Massage therapy, acupuncture or acupressure, reflexology, yoga, deep breathing, and guided imagery provide protection against painful bouts of RA by helping improve body awareness, reduce muscle tension, enhance sleep, and decrease stress hormones.
Manage Symptoms, Naturally
Nutritional and herbal supplements can help reduce pain and inflammation. Vitamin D deficiency is associated with RA, so supplementing can be important. Extracts of ginger and turmeric, Omega-3 fish oil and digestive enzymes are some nutrients that help tame the fire of inflammation.
A natural medicine approach to healing RA will be unique to each person. Consult with your holistic physician for interventions that will work best for you.
Food for Thought. . .
“We see in order to move; we move in order to see.” – William Gibson
The Red Bell of the Ball!
Crisp, sweet red bell peppers are versatile and packed with nutrients. They’re loaded with the antioxidants Vitamin C and A, which support immunity and help the body fight free radicals – molecules implicated in inflammation and many disease processes. That beautiful red color is attributed to the nutrient lycopene, another antioxidant. Vitamin B6 and folate – nutrients that support red blood cells – are also found in these crimson beauties. Making red bells a regular part of your diet can help protect against chronic illnesses such as heart disease, joint disease, and cancer.
Red bells are actually the fully ripe version of green bell peppers. With the exception of very cold winters, they’re available year-round in most places. Choose peppers with deep color, taut skin, and fresh-looking stems. Peppers should be firm and heavy for their size (indicating they are well hydrated). They add flavor to sandwiches, stir-fry, salads, soups, stews, sauces, and are also delicious raw.
You may have heard that peppers are a part of the nightshade family of vegetables and aren’t a good food choice for some people. Nightshades (including potatoes, eggplant and tomatoes), are so named because they grow best in shady areas and some bloom at night. For most people, nightshades are a healthy choice, but for others, they can trigger a reaction similar to that seen with soy or dairy. If you’re concerned about this, consult a natural medicine practitioner for dietary testing and guidance.
Roasted Red Peppers Stuffed with Kale & Rice
Delight friends and family with this perfect summer picnic supper or lunch entree. The crimson flesh of red pepper gives bright contrast to kale’s deep green. Chopped onion and minced garlic combine with lemon and herbs to bring an aromatic flavor to the brown rice. Delicious, filling, and vegan friendly, too!
- 3 medium red bell peppers
- 1 tablespoon extra-virgin olive oil
- 1/4 teaspoon salt
- Freshly ground pepper, to taste
- 8 ounces kale, (6 cups lightly packed), trimmed
- 1 tablespoon extra-virgin olive oil
- 1 medium onion, chopped
- 1/2 cup chopped red bell pepper
- 2 cloves garlic, minced
- 3/4 cup cooked short-grain brown rice, (see Tip)
- 1/2 cup freshly grated Parmesan cheese (optional or use preferred substitute)
- 1/4 cup toasted pine nuts, divided (see Tip)
- 1 tablespoon lemon juice
- 1/4 teaspoon salt
- Freshly ground pepper, to taste
- To prepare peppers: Preheat oven to 400°F. Halve peppers lengthwise through the stems, leaving them attached. Remove the seeds. Lightly brush the peppers outside and inside with oil; sprinkle insides with salt and pepper. Place, cut-side down, in a 9-by-13-inch baking dish. Bake until just tender, 10 to 15 minutes. Let cool slightly. Turn cut-side up.
- To prepare filling: Bring 2 cups salted water to a boil in a large wide pan. Stir in kale, cover and cook until tender, 10 to 12 minutes. Drain, rinse under cold water; squeeze dry. Finely chop.
- Heat oil in a large nonstick skillet over medium heat. Add onion and chopped bell pepper; cook, stirring often, until onion is golden, 6 to 8 minutes. Add garlic and cook, stirring, for 30 seconds. Stir in the kale. Remove from the heat and let cool slightly. Stir in rice, Parmesan, 2 tablespoons pine nuts and lemon juice. Season with salt and pepper. Divide the filling among the pepper halves. Sprinkle with the remaining 2 tablespoons pine nuts.
- Add 2 tablespoons water to the baking dish. Cover the peppers with foil and bake until heated through, 15 to 20 minutes. Uncover and bake for 5 minutes more. Serve hot.
Time Saving Prep Tip: Follow Steps 1, 2 & 3. Cover and refrigerate up to 2 days.
Brown Rice Prep Tip: Place 1 cup brown rice, 2 1/2 cups water and a pinch of salt, if desired, in a medium saucepan; bring to a simmer. Cover; cook over low heat until rice is tender and most of the liquid has been absorbed, 45 to 50 minutes. Makes 3 cups.
For Toasted Pine Nuts: Heat a small dry skillet over medium-low heat. Add pine nuts and cook, stirring constantly, until golden and fragrant, 2 to 3 minutes. (Or spread in a small baking pan and bake at 400°F for about 5 minutes.)
Fight Joint Inflammation with Turmeric
Turmeric (Curcuma longa) is the golden-orange spice that gives curried foods pizzazz. In Traditional Chinese and Indian Medicine, turmeric is used to treat allergies, digestive ailments, and pain. The active chemical component of turmeric is curcumin, known for its anti-inflammatory properties. Today, research is focused on the role curcumin plays in diseases where the underlying factor is inflammation, such as in heart disease and arthritis.
Studies show that curcumin blocks inflammation at the cellular level. Some studies indicate that curcumin’s role in preventing joint inflammation surpasses its ability to reduce active joint inflammation. In clinical trials, standardized curcumin supplements helped improve pain and swelling in patients with RA. These promising results are being further investigated in long-term studies.
Including turmeric in your diet is easy to do and, oh, so flavorful. Add turmeric to soups and dressings; sprinkle over meats, veggies, and scrambled eggs; add it to plain yogurt or a smoothie.
While adding turmeric spice to your meals is a great first step, the amounts used in cooking do not provide the therapeutic levels needed to achieve its robust health effects. When considering the addition of turmeric to your health plan, work with your holistic health practitioner to determine if this is a good choice and which curcumin supplement is best for you. He or she can recommend the right form (capsule or powder) that will have the best bioavailability – meaning it’s easy for your body to process through the digestive tract – for your specific health needs.
The Anti-inflammatory Power of Cat’s Claw
Native to the Amazon rainforest, Cat’s Claw (Uncaria tomentosa) gets its name from the inch-long hooked thorns that allow this tropical climbing plant to anchor itself to trees and wind its way up 100 feet or more into the forest canopy. As they have for centuries, indigenous people and herbalists use the roots, leaves, and bark in preparations for asthmas, arthritis, rheumatism, urinary and kidney problems, and inflammation. In modern herbal medicine, Cat’s Claw is recommended for chronic illnesses such as fibromyalgia, chronic fatigue, mononucleosis, and arthritis.
A potent antioxidant and anti-inflammatory botanical, Cat’s Claw is used to treat joint problems that occur with osteoarthritis and rheumatoid arthritis. In a small clinical trial, Cat’s Claw was shown to decrease pain in patients with rheumatoid arthritis, as well as osteoarthritis of the knee. The medicinal benefits of Cat’s Claw come from chemicals called pentacyclic oxindole alkaloids, which boost the immune system and help temper inflammation.
The concentration of medicinally active chemicals in Cat’s Claw vary based on when and how the plant is harvested. A holistic health physician will be knowledgeable about a product’s purity and potency, as well as which form of Cat’s Claw supplement is best for you. For example, your physician may suggest tea, tincture, extract or capsule depending upon your health concerns. Some people experience upset stomach, headache or dizziness when using Cat’s Claw. Also, it is not recommended for women who are pregnant or nursing, or for children under age three.
Cold Laser Therapy for Pain Management
Cold Laser (CL) is a non-invasive therapy that helps reduce joint or muscle pain and swelling, while improving the rate of repair in the affected area. It’s used to treat injuries (e.g., sprains, tendinitis, muscle spasms) and joints affected by illness, including arthritis, fibromyalgia, neck and back pain, and nerve pain syndromes.
How does Cold Laser Work?
A low-level red or near-infrared light is emitted and absorbed by soft tissue, which leads to a change on the cellular level, giving damaged tissue a “boost” to promote regeneration. It helps the body rebuild connective tissue and release pain-relieving substances called endorphins. Applied by a doctor, therapist, or technician once or twice weekly, treatments take about 10 minutes. You’ll feel the device moving against your skin, but there is no sound or vibration.
Does CL Therapy Work for RA?
The experience of pain is highly variable among different people, including those living with RA. Studies using CL show promising results for reducing morning pain, stiffness, and swelling over 4-12 weeks, but more long-term research is needed.
Are there Side-effects?
CL Therapy is gentle and no side effects have been reported. It’s important to understand that results vary based on:
- symptoms treated and the underlying health condition
- extent of the person’s experience of pain
- duration of treatment
- type of device used and the experience of the technician applying treatment
Many types of Cold Laser (CL) devices are approved by the FDA and are sold online for use at home for the temporary relief of pain. This only means that the device is safe to use – it may not be effective for all conditions or symptoms. Consult with a health practitioner (ND, DC, PT or OT) who understands this treatment and can guide you in receiving this therapy or, if appropriate, educating you on purchasing the best device for use at home.
Prep Time:5 minutes
Cook Time:10 minutes
When it comes to fish, simple is best. This fish recipe only takes 10 minutes to cook, start to finish. I’ve used a combination of orange and lemon, capers, white wine and then finished it with a bit of butter.
4 fish fillets of your choice, patted very dry
salt and pepper
1 tablespoon olive oil
1 tablespoon capers (drained)
1/2 cup white wine
2 tablespoons butter
1. Cut the orange in half. Juice one half of the orange and slice the other half into thin half-moon slices. Repeat with the lemon.
2. Season the fish on both sides with salt and pepper. Heat a large skillet over medium heat. Swirl in the olive oil. When hot, add the fish fillets. Once the cooked edge has reach almost halfway up the fillet, flip the fish.
3. Add in the wine, orange juice, lemon juice, orange/lemon slices, capers and the butter. Season the sauce with a bit of salt and pepper. When the liquid begins bubbling, turn the heat to medium-low, cover and cook until the fish is cooked through, about 1-2 minutes depending on the thickness of your fillet. Serve immediately.
Krista Moyer, ND
Dermatology can be annoyingly difficult to navigate, since each condition can have so many different presentations. My goal in this article is to introduce you to the possibility that histamine intolerance may be the root cause of many cases of atopic dermatitis.
Histamine is a well-known cause of seasonal allergies and pruritic rashes; however, there is a whole other world of bodily functions that can be caused by histamine dysregulation (Table 1).
Histamine is a neurotransmitter that is a part of the immune system, and is released by mast cells. There are 2 main enzymes that break down histamine. The enzyme in the central nervous system is histamine N-methyltransferase (HMT), and the enzyme within the digestive system is diamine oxidase (DAO). This article will focus on dysfunction of the DAO enzyme.
Many patients seek out naturopathic doctors because of gastrointestinal (GI) dysfunction, estrogen dominance, anxiety, chronic urinary tract infections, and rashes. An imbalance in histamine can cause any of these to occur, either simultaneously or intermittently.
In a healthy person, a large production of histamine is normally produced within the GI system. However, impairments within the intestinal lining can cause the DAO enzyme to be produced in insufficient quantities by the enterocytes, resulting in excessive concentrations of histamine.
This elevated level of histamine will promote inflammation in the GI tract, and its most obvious outcome will be diarrhea. So, even if histamine is being secreted at an appropriate rate, once the DAO enzyme levels decrease, histamine remains elevated, causing further inflammatory damage to the lining. The same goes for the urinary tract, especially if there is a history of digestive complaints, as this will lower the DAO enzyme, further increasing the concentration of histamine in the urinary tract and resulting in inflammation and degradation of the tissue. Excessive histamine within the body can then advance to cause further systemic dysfunction.
Estrogen & Histamine
Estrogen is ubiquitous in today’s environment, and with the generally heavier load on the liver from our toxic world, it is important to decrease exposure whenever possible. Estrogen has an important and interesting relationship with histamine: High levels of estrogen will increase histamine, and high histamine levels will increase estrogen.1 Combine this with an inflammatory digestive disorder, where the DAO enzyme isn’t being produced in sufficient quantities, and both estrogen and histamine levels will rise further. During pregnancy, women generally notice a significant decrease in their symptoms from high histamine, as the placenta also produces the DAO enzyme.1 But once pregnancy is over, the symptoms return.
Medications & Histamine
Certain drugs can directly induce histamine release, while others can decrease the effectiveness of the DAO enzyme.1 Non-steroidal anti-inflammatory drugs (NSAIDS), aspirin, and some diuretics have been associated with decreased effectiveness of the DAO enzyme.1
Histidine is an amino acid that transforms into histamine by the enzyme histidine decarboxylase. Certain bowel bacteria can produce this enzyme, which would increase the production of histamine in the GI tract. The histamine can then pass through the intestinal wall, transferring to other areas of the body.
Foods highest in histidine are mostly animal source: meats, dairy, eggs. Consequently, consuming a diet high in protein can temporarily exacerbate symptoms in a person with histamine intolerance. Furthermore, the histidine content of protein foods slowly transforms into histamine the longer it sits,2raising histamine exposure in overly sensitive patients. This goes for both cooked or uncooked foods, but is particularly prevalent in meats and fish.
Diagnosing Histamine Dysfunction
So, how do you decide if histamine, rather than some other dysfunctional pathway in the body, is causing your patient’s issues? This is where being a good detective and taking a thorough case history is important. It is crucial to establish what types of treatments the patient has tried in the past.
If they have already had customary treatments for their condition that failed, those failures can help guide you toward a diagnosis of histamine intolerance. A classic example would be that the patient did IgG food sensitivity testing and removed all of the reactive foods for 3 months, but only experienced slight improvements. IgG testing is not necessarily going to reveal a reaction to all of the high-histamine foods, or histamine-liberating foods, or a deficiency of the DAO enzyme. In such a case, the patient could have removed an inflammatory component, but still have the majority of their pathology present.
TESTING FOR HISTAMINE DYSREGULATION
Testing your patients for histamine intolerance is not a matter of a simple blood test. You can test for the levels of the DAO enzyme, but the results may not be all that helpful. If the enzyme is low, it could be because histamine levels are not elevated. And if it is high, it could be that there is a greater level of histamine in the body, and the DAO enzyme is appropriately elevated at that time to degrade the extra histamine. You could also do genetic testing; however, it will not reveal a histamine intolerance. The patient would still need to find a practitioner who is trained in genetic mutations and able to interpret the raw data, as there is currently no simple test to demonstrate a defect in the gene that codes for the DAO enzyme.
Foods to Avoid
- High-Histamine Foods
These foods naturally contain high concentrations of histamine.
- Anything fermented
- Meat, poultry, fish (unless freshly caught, gutted, and cooked within 1 hour, or immediately frozen after processing)
- Canned foods
- Raw eggs (a moderate amount of cooked eggs, especially the yolks, can be tolerated)
- Any fermented dairy products (the longer the fermentation process, the higher the histamine level)
- Cured meats
- Dried fruit
- Citrus fruits
- Fermented soy
- Yeast products
- Nuts (especially peanuts, cashews, walnuts)
- Histamine-Liberating Foods
These foods can induce histamine release from mast cells, etc, independent of DAO.
- High Biologic Amine Foods
Other biogenic amines than histamine preferentially compete with DAO for degradation. As a result, a higher concentration of biogenic amines can cause a temporary decrease in histamine breakdown. Some of these amines (including medications such as H1 anti-histamines) are also capable of directly causing histamine-like symptoms.
- Legumes (beans, lentils, soy)
- Wheat germ
- DAO Enzyme-Blocking Foods
These foods slow the breakdown of histamine by inhibiting the DAO enzyme.
- Tea (both green and black)
- Energy drinks
DIET & SUPPLEMENTS
Long-term treatment of histamine intolerance involves limiting high-histamine foods, as well as histamine-liberating foods. Healing the gut is essential. Supplements that are helpful will depend on the patient’s symptoms. Examples include: quercetin, vitamin C, DAO, and vitamin B6 (required to make the DAO enzyme). During the initial treatment of histamine intolerance, these supplements will be needed at higher dosages, and can be decreased or even eliminated once the patient has stabilized. Even using an anti-histamine, such as loratidine, only during the initial stages of treatment, will help to greatly decrease the load of histamine in the body and alleviate the aggravating symptoms more quickly. Long-term use of an OTC anti-histamine is not advisable, as it will disrupt gastric acid production, potentially leading to a full host of digestive disturbances and further complications.
Treating patients with histamine intolerance is life-changing. Patients generally have gone to many doctors, and have tried many different medications, dietary changes, and creams to alleviate their atopic dermatitis, among their other possible conditions. Once the anti-histamine diet is initiated, you should know within 4-6 weeks whether they have histamine intolerance, as most, if not all, of their symptoms will have subsided significantly. And they will finally have achieved relief from years of aggravating symptoms, with you to thank!
Table 1. Histamine-Related Symptoms
|-dysmenorrhea-symptoms subside during pregnancy
-nausea & vomiting
|-chronic fatigue-foggy thinking
-chronic swollen lymph glands
-low blood pressure
||-chronic joint or body pain-difficulty exercising
-numbness & tingling in extremities
Krista Moyer, ND, attended the Boucher Institute of Naturopathic Medicine in New Westminster, British Columbia. Prior to this, she attended the University of Western Ontario, where she achieved an honors degree in kinesiology. When Dr Moyer is not in her clinic at Broadway Wellness in Vancouver, BC, she teaches advanced clinical nutrition, as well as supervises at the Boucher Institute. It is here where she continues to teach and immerse herself in the profession she loves. She continues to write and lecture in the community, to educate and promote the naturopathic profession.
- Maintz L, Novak N. Histamine and histamine intolerance. Am J Clin Nutr. 2007;85(5):1185-1196.
- Ganowiak Z, Gajewska R, Lipka E. [Histidine decarboxylase activity and free histidine and histamine levels in fish meat. Rocz Panstw Zakl Hig. 1990;41(1-2):50-57. [Article in Polish]
Dr. Dave Hamilton, 33, and Laura Denyes, 36, are a husband and wife team that moved to Charlotte in 2014. Together they operate Of the Earth Wellness, a wellness clinic, and live on a five-acre farm, Wish We Had Acres, located 12 miles from uptown. Their goal is to educate the public about natural foods and natural medicines.
Dr. Dave is a naturopathic physician with a focus on treating the whole person. He answers five questions for C5’s Entrepreneur Series:
Why is Charlotte a good place to start a business?
Charlotte is the tree city, named for its large, urban canopy of trees. This makes it a natural setting for plant medicine and natural products. Many folks who move to Charlotte have a deep connection to its trees… often these folks are also connected to nature. My practice as a naturopathic physician is inspired by and cultivates a relationship with nature to achieve health. We see food, herbs and the environment as something sacred and an invaluable part of the healing process.
The city at-large has a growing trend of support for local foods, local farms and local business. Increasingly folks want to find local alternatives for everything from produce to body care products to health care.
Who was your biggest influence and how did this person affect you and the way you do things?
My grandparents instilled a work ethic in me that has carried through into my adulthood: Making something from nothing and seeing the beauty in what others may see as garbage. Some of my fondest memories were helping my grandpa grow food in the garden and taking care of his many rabbits.
…I use these memories as inspiration to transform someone’s poor health into hope and empowerment. And like a garden, you must sometimes weed out some negatives, but you must get to the root, or else the weed will continue to grow. The same can be said for an individual’s health.
How do you begin each day?
Often I wake up taking care of the various critters on the farm… the dogs, goats and chickens. Then I have a hot cup of coffee or tea. Depending on the day or season I begin my day in the barn, milking the goats, gathering … eggs. Other days I’ll check the garden for fresh produce and pull weeds, some of which are harvested for medicine.
What do you see in your future?
We have begun the hunt for our next property. I hope to eventually prescribe veggies, fruits and herbs directly from the farm. If patients were unfamiliar with how to use a particular vegetable or herb, they could attend a medicine-making class or cooking class that would be offered at the farm.
Where do you go to chill?
When we do get time to relax, you can find us at one of the local breweries or eateries in town. Some of our favorites are OMB, Triple C, Birdsong, Heist (especially their brunch) and Free Range breweries. Sometimes we bring a goat or a dog with us.
Of the Earth: 10715 Shopton Rd W
Photos: James Robinson, Laura Denyes
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