Rheumatoid Arthritis. Treating Inflammation. Sequoia Education Systems, Inc 1. How is RA Diagnosed?

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1 Rheumatoid Arthritis Causes, Assessment and Treatment How is RA Diagnosed? The following labs make up the basics of ruling in or out RA. Citrullinated Peptide (anti-ccp) Antibodies Rheumatoid factor Erythrocyte sedimentation rate C-reactive protein White Blood Cell Count Blood tests for anemia Citrullinated Peptide (anti-ccp) Antibodies in RA Important marker for diagnosis and prognosis As sensitive and more specific than IgM Rheumatoid Factors Marker of erosive disease May be detected in healthy individuals years before clinical onset of RA 1

2 Allopathic Approach to RA The primary objective of traditional medicine is temporary relief of pain and dysfunction via pharmaceutical agents: Disease modifying anti-rheumatic drugs (methotrexate, gold, sulfasalazine etc.) Corticosteroids The Logical Approach Patient Centered The Possible Causes of RA The following should be considered as potential causes of RA: Compromised Cortisol/DHEA/S IgA Increased Intestinal Permeability Bacterial, Parasitic Infections (mycoplasma) Hormonal Imbalance Fatty Acid Imbalance Nutritional and Amino Acid Co-factor Deficiencies Oxidative Stress 2

3 Cortisol/Inflammation Connection Eicosanoid Modulation Immune Regulation Inflammation control CHO Metabolism Cell Energetics Glycemic Control Detox Capacity Free Radical Removal Heavy Metal Removal Musculoskeletal Health Bone Turnover Muscle Integrity Collagen Turnover Cortisol/ DHEA Ratio Neural Tissue Health Neuronal Connectivity Memory & Learning Sleep & Mood Metabolism Fats & Proteins Weight Gain Protein Turnover Mucosal Integrity Endocrine Function Thyroid Function Pancreas - Insulin Ovarian Function 3

4 Intestinal Hypermeability 4

5 Patient Specific Treatments for RA Treat the Underlying Cause of RA Restore cortisol/dhea ratio Restore s IgA levels Treat the GI: The 4 R Approach Restore hormonal balance Replace EFAs Treat nutritional and amino acid deficiencies Reduce oxidative stress Put the fire out: treat the pain Restoring Cortisol/DHEA Ratio 5

6 Treat Low Cortisol Lifestyle changes Stress reduction Dietary changes: Balance blood sugar Nutritional supplements Herbal Support: Adaptogenic" herbs Miscellaneous herbs: Glandular Support Hormone replacement therapy Lifestyle changes: Stress reduction Treat High Cortisol Nutritional supplements: High-grade multi-vitamin/mineral. Additional Vitamin C, Vitamin B5, Vitamin B6 and zinc, as indicated. Phosphatidyl serine Herbal Support: Nervine and "calmative" herbs Low dose adaptogens Treat DHEA Imbalances Low DHEA: Consider lifestyle, dietary, and herbal options outlined under high cortisol. DHEA or pregnenolone supplementation may be warranted Consider measuring testosterone and/or estradiol levels and intervene if necessary High DHEA: Consider lifestyle, dietary and herbal options under low cortisol Consider measuring testosterone and/or estradiol levels and intervene if necessary 6

7 Treating The GI The 4 R Approach Remove mucosal Irritants Replace digestive supporting nutrients Re-inoculate with friendly flora Repair mucosal lining Marketing Tip 7

8 Summary 8