About therapies to treat rheumatism

The gravity of rheumatic diseases vary conciderably and is not necessarily dependent of the type of diagnosis. A rheumatic disease can be just annoying or it can progress to an invalitating or even life-threatening condition.

Rheumatic conditions have allways been fifficult to treat, and conventional medicine still do not have any good remedy against these conditions. Conventional medicine may however effectively slow the progression of these diseaes and remedy damages done by such diseases, but often coupled by dangerous side effects.

Lifestyle improvements, diet improvement and natural approches also has the ability to slow the progression or halt the progress of these diseases, sometimes very effective and sometimes only as a useful contribution.

There is therefore no standard methods of treating these diseases that work optimally for everyone. Each case must be handled individually.

Most rheumatic conditions usually involve strong inflammation, often causwed by auto-immune reactions and also involve chronic pain. Anti-inflammatory therapy is therefore important treatment moularieties by rheumatism. Since rheumatic conditions also often cause stiffness and body deformities, therapies to counteract and corrct such deformities are also important.

Here is a general survey of both natural and conventional treatment for rheumatism:


A. Use of anti-inflammatory diet

Anti-inflammatory diet: A natural anti.inflammatory diet will nearly allways help to some extend. In such a diet all types of fat consumed must be natural and unaltered. It consists of ingredients with a good contenet of omega-3-fat as found in fish, seeafood and flax, oil and of mono-unsaturated fat as found in olive oil, almonds and rape oil. Such a diet sholuld avoid great amounts of omega-6 oils as found in soy and most other commonly used oil types. Also chemically manipulated fat should be avoided in such a diet. Such fat is often of the type trans-fat that cannot be utilized well in the body and cause a lot of disturbances. Such diet also contain much vegetables and fruit in a natural form.


B. Use of pharmacological and natural drugs to treat rheumatism

NSAIDS - Non-steroid anti-inflammatory drugs: These drugs have both the ability to reduce pain, reduce fever and slow down inflammations. They are often the maid pharmacotherapeutic approch used by rheumatism, They are prefered for these purposes because the side effects of these are less than other drugs against inflammation and because they are not narcotics.Examples of these drugs are aspirin, ibuprofen and naproxen. The main working mechanism of these drugs is inhibitation od prostaglandine syntesis. Prostaglandins acts as signal substances in inflammmatory processes.

Steroid drugs: - These are hormones or hormone-like drugs with a chemicalstructure resembling cholesterole or derived from cholesterole. They have strongt effect against inflammation. But they also give strong side effects if used uncritically and over longer time, like suppression of the immune responce, water retension and reduction of body tissues like muscles and skin tissues and delayed healing of damages. Steroid drugs act by hindering syntesis of many proteins, for example enzymes that help to produce signal substances that are in effect during inflammatory processes, They also increase production of some proteins.

Biological drugs: On the cellular level, the sub-processes in an inflammatory process are started or enforced by certain signal substances, like prostaglandines, cytokines or histamine. Biological drugs are a new type of drugs that can attach to specific substances of the kind, or the sites on the cells that these signal substances trigger. Many of these drugs, consist of anti-bodies towards these signal substances made by tissue cultures in the indutries producing them, for example the drug Remicade. There is a reluctance to use these drugs, partly becaue they are expensive, and partly because the attack on signal substances also can disturbe normal bodily functions controlled by these substance in some cases. They are most used as the last resort when other treatments have not worked well.

Antiinflammatory herbs: There are many herbs with good anti-inflammatory actions, for example Boswelia serrata, stinging nettle.


C. Physical therapies:

Stifness and deformation of limbs and body parts like the spine are common effects of rheumatic conditions. Physical theraoies have the purpose of counteract and remend such patological changes. Physical therapies work by mechanical streching effects, by warming and by muscular training effects.

Massage: Massage therapies include massaging along muscles, percussion on muscles and body areas and passive stretching. The massaging and will better the blood circulation and therby promote healing of damages in the tissues. Both massage and stretch will increase the flexibility of muscles and joints and thereby improve mobility. To some extend stretching can also correct deformities caused by the disease process.

Thermal therapies: Use of heat is an old and well-proven physical method against rheumatic condition. The heat can be admistered in several ways, like  Warm baths, use of warm pads and packings around body parts and use of microwave radiation. The warming of tissues mailnly help by a relaxing of blood vessels and by reducing cramps and stiffness cause by cramps.

Topical use of aromatic compound: Aromatic compound to be appied onto stiff and painful body areas can be effective against rheumatic pain and stiffness. The compunds can be masaged onto th eskin, blended into warm baths or soaked into warm packings used around body parts. The aromatic compound works by several principles. Some ofthe substance will immediately vaporize and cool the skin superficially, chich will help against pain. Many of the compunds will creep into the skin and stimulate nerve endings. The siitchy feelings cause by this wil concour against the pain impulses and make the pain felt less obvious. The compunds willl also increase the blood flow in the tissues and thereby stimulate elemination of wasts and promote healing.  Use of camphor dissolved in alcohol is a classical treatment of this kind.

Training regimens: Training regimens consist of stretching exercises to increase mobility and to counteractdeformities and of muscular training to make the muscles stronger.


D. Surgery to correct rheumatic deformities

By rheumatoid arthritis and other deforming rheumatic diseases, surgery is a commonly used intervention. Arthritis makes the membran inside joint capsules thicken and grow into nearby tissues. Often surgery is performed to take away such overgrown tissue. If there is not any more abnormalities present than overgrown tissue, surgery to a great extend heal the treated joints, because the empty space caused by the surgey will often be covered by new normal tissue that grows in and replace the sick tissue taken out.

If the patological process have destroyed cartilage, bone and tendons, the destroyed structures must often be reconstructed by replaceing tendon materials or bone to new places, by tranplanting bone or tendon material, by setting in artificial blocks, or even replace the whole inner bone structures of the joints by artificial construction



About some compound used in the natural supplements against rheumatism

Glucosamine

Glucosamine (C6H13NO5) is an amino sugar and a prominent precursor in the biochemical synthesis of glycosylated proteins and lipids. Glucosamine is commonly used as a treatment for osteoarthritis, although its acceptance as a medical therapy varies.

Oral glucosamine is commonly used for the treatment of osteoarthritis. Since glucosamine is a precursor for glycosaminoglycans, and glycosaminoglycans are a major component of joint cartilage, supplemental glucosamine may help to rebuild cartilage and treat arthritis. Its use as a therapy for osteoarthritis appears safe, but there is conflicting evidence as to its effectiveness.

A typical dosage of glucosamine salt is 1,500 mg per day. Glucosamine contains an amino group that is positively charged at physiological pH. The anion included in the salt may vary. Commonly sold forms of glucosamine are glucosamine sulfate and glucosamine hydrochloride. The amount of glucosamine present in 1500 mg of glucosamine salt will depend on which anion is present and whether additional salts are included in the manufacturer's calculation.[7] Glucosamine is often sold in combination with other supplements such as chondroitin sulfate and methylsulfonylmethane.

In the United States, glucosamine is not approved by the Food and Drug Administration for medical use in humans. Since glucosamine is classified as a dietary supplement, evidence of safety and efficacy is not required as long as it is not advertised as a treatment for a medical condition.[8] Nevertheless, glucosamine is a popular alternative medicine used by consumers for the treatment of osteoarthritis. Glucosamine is also extensively used in veterinary medicine as an unregulated but widely accepted supplement.[9]

In Europe, glucosamine is approved as a medical drug and is sold in the form of glucosamine sulfate.

Clinical studies of glucosamine have consistently reported that glucosamine appears safe. Since glucosamine is usually derived from shellfish, those allergic to shellfish or who have kosher concerns may wish to avoid it. However, since glucosamine is derived from the shells of these animals while the allergen is within the flesh of the animals, it is probably safe even for those with shellfish allergy. Alternative sources using fungal fermentation of corn are available. Another concern has been that the extra glucosamine could contribute to diabetes by interfering with the normal regulation of the hexosamine biosynthesis pathway,[4] but several investigations have found no evidence that this occurs. The U.S. National Institutes of Health is currently conducting a study of supplemental glucosamine in obese patients, since this population may be particularly sensitive to any effects of glucosamine on insulin resistance. Finally, in the United States, glucosamine is sold as a dietary supplement, so safety and formulation is solely the responsibility of the manufacturer.


Methylsulfonylmethane

Methylsulfonylmethane (MSM, or dimethylsulfone) is an organic sulfur compound belonging to a class of chemicals known as sulfones. It occurs naturally in some primitive plants and is present in small amounts in many foods and beverages.

MSM is also known as dimethylsulfone, or DMSO2, a name that reflects its close chemical relationship to dimethyl sulfoxide (DMSO), which differs only in the oxidation state of the sulfur atom. MSM is the primary metabolite of DMSO in humans, and it shares some of the properties of DMSO.

MSM is sold as a dietary supplement that is marketed with a variety of claims and is commonly used (often in combination with glucosamine and/or chondroitin) for helping to treat or prevent osteoarthritis. Retail sales of MSM as a single ingredient in dietary supplements amounted to $115 million in 2003. However, clinical research on the medical use of the chemical in people is limited to a few pilot studies that have suggested beneficial effects.

The effects of supplemental methylsulfonylmethane in biology and medicine are poorly understood. Several researchers have suggested that MSM has anti-inflammatory effects (Morton et al. 1986; Childs, 1994; Murav'ev et al., 1991). Any health effects of dimethyl sulfoxide (DMSO) may be mediated, at least in part, by MSM (Williams et al, 1966; Kocsis et al, 1975). Stanley W. Jacob, M.D., of the Oregon Health and Science University, claims to have used MSM to treat over 18,000 patients with a variety of ailments (Jacob & Appleton, 2003).

Clinical evidence for the usefulness of MSM is limited to animal studies and four published clinical studies in humans. These pilot studies of MSM have suggested some benefits, particularly for treatment of osteoarthritis. Further studies would be needed to test the usefulness of the chemical as a medical therapy.

Osteoarthritis:After several reports that MSM helped arthritis in animal models, a double-blind, placebo-controlled study suggested that 1500 mg per day MSM (alone or in combination with glucosamine sulfate) was helpful in relieving symptoms of knee osteoarthritis (Usha and Naidu 2004). Kim et al. then conducted a double-blind clinical trial of MSM for treatment of patients with osteoarthritis of the knee. Twenty-five patients took 6 g/day MSM and 25 patients took a placebo for 12 weeks. Ten patients did not complete the study, and intent-to-treat analysis was performed. Patients who took MSM had significantly reduced pain and improved physical functioning, without major adverse events (Kim et al). No evidence of a more general anti-inflammatory effect was found, as there were no significant changes in two measures of systemic inflammation: C-reactive protein level and erythrocyte sedimentation rate. The authors cautioned that this short pilot study did not address the long-term safety and usefulness of MSM. but suggested that physicians should consider its use for certain osteoarthritis patients, and that long-term studies should be conducted.

Seasonal Allergic Rhinitis: Barrager et al. evaluated the efficacy of MSM for hayfever (Barrager et al, 2002). Twenty-five subjects consumed 2,600 mg of MSM per day for 30 days, and a significant improvement in symptoms was observed compared to those taking a placebo. However, the study was not blinded. Also, no significant changes were observed in two indicators of inflammation (C-reactive protein and immunoglobulin E levels). The authors suggest that MSM is safe for short-term use and recommend that a larger, double-blind study be performed to establish its usefulness in treating symptoms of seasonal allergic rhinitis.

Interstitial cystitis: In 1978, the FDA approved dimethylsulfoxide (DMSO) for instillation into the bladder as a treatment for interstitial cystitis. Since DMSO is metabolized to MSM by the body, it is possible that MSM is the active ingredient in DMSO treatments (Childs 1994).


Boswellia

Boswellia is a genus of trees known for their fragrant resin which has many pharmacological uses particularly as anti-inflammatories. The Biblical incense frankincense was probably an extract from the resin of the tree, Boswellia sacra.

There are four main species of Boswellia which produce true Frankincense and each type of resin is available in various grades. The grades depend on the time of harvesting, and the resin is hand sorted for quality. Anyone interested in frankincense would be well advised to first obtain a small sample of each type from a reputable dealer in order to ascertain the difference between each resin.

Boswellia has long been used in Ayurvedic medicine. Recently, the boswellic acids that are a component of the resin it produces have shown some promise as a treatment for asthma and various inflammatory conditions (Gupta I, Gupta V, Parihar A, et al. Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-controlled, 6-week clinical study. European Journal of Herbal Medicine. In West Africa, the bark of Boswellia dalzielii is used to treat fever, rhumatism and gastro-intestinal problems (Arbonnier 2002. Arbres , arbustes et lianes des zones sèches de l'Afrique de l'Ouest)


Extracts of boswellia serrata have been clinically studied for osteoarthritis and joint function, particularly for osteoarthritis of the knee. A boswellia extract marketed under the name Wokvel has undergone human efficacy, comparative, pharmacokinetic studies.


Vitamin B3 - Nicotinic acid (niacin)

Niacin, also known as nicotinic acid or vitamin B3, is a water-soluble vitamin whose derivatives such as NADH, NAD, NAD+, and NADP play essential roles in energy metabolism in the living cell and DNA repair.[ The designation vitamin B3 also includes the corresponding amide nicotinamide, or niacinamide, whose chemical formula is C6H6N2O.

It also plays a role in removing toxic chemicals from the body.Severe lack of niacin causes the deficiency disease pellagra, whereas a mild deficiency slows down the metabolism decreasing cold tolerance.
Niacin plays an important role in the production of several sex and stress-related hormones, particularly those made by the adrenal gland.

Niacin, when taken in large doses, increases the level of high density lipoprotein (HDL) or "good" cholesterol in blood, and is sometimes prescribed for patients with low HDL, and at high risk of heart attack.. An extended release formulation of niacin for this indication is marketed by Abbott Laboratories under the trade name Niaspan. Niacin (but not niacinamide) is also used in the treatment of hyperlipidemia because it reduces very low density lipoprotein (VLDL), a precursor of low density lipoprotein (LDL) or "bad" cholesterol, secretion from the liver, and inhibits cholesterol synthesis.[11] The main problem with the clinical use of niacin for dyslipidemia is the occurrence of skin flushing, even with moderate doses. There are current attempts to create a prolonged-release formulation of the substance, to allow it to be used more often and more comfortably.

The dose used should however not be too large. Niacin taken in doses over 20 mg per day has seen to give unwanted symptoms. Over 20 mg per day may cause flushing of the skin, lasting for about 15-30 minutes, sometimes accompanied by prickly or itching sensation. It may cause headache or nausea. This reaction is common in first-time users of large doses is caused by the cells of the body releasing histamine, which results in vasodilation. When the body becomes used to the larger dose (usually over a period of days), these side effects may diminish or cease.

In very large doses, niacin can have life-threatening acute toxic reactions. One patient suffered vomiting after taking eleven 500-milligram niacin tablets over 36 hours, and another was unresponsive for several minutes after taking five 500-milligram tablets over two days. Extremely high doses of niacin can cause niacin maculopathy, a thickening of the macula and retina which leads to blurred vision and blindness.

High-dose niacin may also elevate blood sugar, thereby worsening diabetes mellitus. Hyperuricemia is another side effect of taking high-dose niacin; as such, it may worsen gout[citation.


These statements have not been evaluated by the Food and Drug Administration. This information is nutritional in nature and should not be construed as medical advice. This notice is required by the Federal Food, Drug and