Etiquette: Disease and Dating

No, no, no… this is not a nag about STD’s and dating today, people!

This is a guest post from my favorite Relationship Columnist, and dear friend, “Miss Matchmaker” herself.

She has worked as a social worker, therapist, and has been a professional Matchmaker for the largest Matchmaking company on the Gulf Coast for the past 13 years, and her advice is always spot on.

When I heard this story, I was baffled and asked her to share it at the kitchen table.

Frankly, your health condition is no one’s business but your own, and if you are privileged to be privy of someone’s health condition you should never gossip about it, nor scapegoat it.

Please respect confidentiality with the same professionalism that doctors, nurses and HCPs everywhere kindly maintain thanks to The Hippocratic Oath which I highly recommend everyone in need of a little inspiration reads. ~Dr. Nicole

“The Etiquette of Disease and Dating”

By Denise Paravate, Missmatchmaker

Disease is a very serious component in the life of anyone who must deal with it on a daily basis. We have doctors who dictate treatment and therapy, and sometimes there are people who step in to help with the emotional aspects of disease, but how often is there someone at your side explaining to you the social components of disease when it comes to dating?

Several months ago I was involved in a relationship in which I had kept my physical history private. I did so for several reasons. Number one, I don’t look sick. Number two, I didn’t want to scare him away. This being the most popular route for people in the same situation as myself, I felt it worthy of discussion.

After dating for 6 weeks and spending several nights under the same roof, the inevitable happened. We had been out with friends, and previous to our social engagement we had a bit of a tat, so to speak. After a few cocktails, he pipes up with “well at least I don’t have to drug myself down every night before bed.” In front of all of our mutual friends, I explained to him that I had been diagnosed with Rheumatoid Arthritis as a child, Fibromyalgia in college, and Peri-Menopause at the age of 35.

I explained that my evening cocktail of medications helps me to function as a “normal” person and that I was the kid who saw Disney for the first time in a wheel chair. I then went on to explain that I may not be able to ever have another child and that without my hormone pills, I would be the psycho woman throwing chairs out windows between hot flashes as I attempt to stand up from my wheelchair (of which I would be in because I didn’t take my RA meds) and I didn’t think that was a person he would enjoy meeting.

Lesson learned, maybe I should have told him sooner. People have preconceived notions about medications and what “sick” really is. As a matchmaker, I preach to my clients to always be honest with their dates, but at what point is too much information just too much information…

When it comes to dating I believe that yes, honesty is the best way, but “TMI” (too much information) can sometimes scare the potential suitor away. So what is the best policy? From my own experiences I must say that it is probably best to keep things on a need to know basis. I don’t necessarily believe that it is something that should be shared on a first or second date. When it gets to the point where you are seeing someone on a regular basis and they are learning your daily routine, then it may be time to fill them in.

I don’t like the idea of keeping secrets and that is not what I am trying to imply. All I am saying is that if you live with chronic disease, life is hard enough and if you plan on sharing your life with someone, they have the right to know just how hard it is. I think now looking back that the best way to handle the situation would be to talk about it first and educate the other person about your particular issues.

Some people may be scared to do so because they would not want to discourage a blooming relationship, but understand that if you try to keep it a secret, chances are it will blow up in your face at some point later anyway. If that person chooses to not be with you because of the challenges you face, then that just means it was not the person for you and maybe it is best you move on.

Dating is hard enough. Disease is even harder. Combining the two can be a challenge!

~Denise Paravate

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Best Glucosamine 2008

The Kitchen Table Award for best glucosamine is awarded to Biogenesis Glucosamine Sulfate!

When shopping for a high quality glucosamine be sure that it is “sulfate” and not glucosamine “HCL”. Most studies showing glucosamine efficacy for pain reduction and long term arthritis management have been done on glucosamine sulfate.

There are some extremely overpriced glucosamine blends out there and for those of you needing to take the recommended 500mg three times daily of glucosamine to prevent or treat arthritis can be easily overwhelmed by cost. Sometimes the highest priced glucosamine isn’t even the best brand anyways, and has a lot of hype attached to it.

When looking for a great glucosamine we want to avoid the most expensive brand as much as we want to avoid the cheapest brand. The best glucosamine is usually priced somewhere in between, and this one by Biogenesis happens to be on sale right now though HealtheGoods!

I like this glucosamine sulfate by Biogenesis because it comes in capsules and not tablets, and is a pure pharmaceutical grade product free of the typical excipients, additives, preservatives, and processing plant allergens.

I can always count on Biogenesis to make pure pharmaceutical grade products. The supplements we take on a daily basis should be the absolute purest. This supplement is priced extremely well considering it’s high quality.

Glucosamine benefits:

• Nutritionally supports joint health and function.
• Nutritive support for joint regeneration.
• Supports healthy range of motion.
• Helps reduce symptoms of pain and stiffness.
• Promotes relief from overworked joints.
• Treats the joint area – not the symptoms.
• No cortisone or other steroids.

For those with severe joint pain, I would recommend ArthroGenX over plain glucosamine, as this formula is designed to further reduce inflammation and pain in the joints. Just check with your doctor before combining with any prescription medications as there may be drug-herb interactions.

ArthroGenX may seem a bit pricey, but being in pain also has a high price to bear. This high quality glucosamine, chondroitin, anti-inflammatory formula is well worth the investment for those in chronic joint pain. When shopping for a joint formula look for something exactly like ArthroGenX.

Joints take time to repair as they are “avascular” meaning without any blood supply. I would give a good joint repair formula three solid months to work before trying something else. Most people will see results in a matter of weeks. Whether you decide to manage your arthritis pain naturally or with prescription means, daily glucosamine intake is important for the long term health of your joints. Take it in divided doses to prevent stomach upset and aim for a total glucosamine level of 1500mg daily.

If you do not notice improvement in your quality, quantity, and severity of pain after three months you may want to consider a different formula as I have discussed in my article “Glucosamine, MSM, or Chondroitin?” and Dr. Benjamin Lynch discusses in his article “Glucosamine vs NSAIDS.”

Biogenesis Glucosamine Sulfate and ArthroGenX are available through HealtheGoods or your local Naturopathic Physician.

Thank you to HealtheGoods for donating a portion of sales to our free publication and expert product reviews!

~Dr. Nicole Sundene
Naturopathic Physician

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Natural Treatments for Rheumatoid Arthritis and Autoimmune Disease in General

Q. What are the best natural treatments for rheumatoid arthritis?

A. 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 is Rheumatoid Arthritis?

Rheumatoid arthritis is an autoimmune condition in which 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 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”.

What can Naturopathic Medicine do for 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.

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.

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.

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.

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 (pictured above), Boswellia, and Quercetin (technically a bioflavonoid).
• Tripterygium wilfordii has been used successfully to manage RA symptoms. I would work with a naturopathic physician 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 “remove the obstacles to cure” and “treat the whole person”.

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.

• 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.
• 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.

Research for Rheumatoid Arthritis:

1. PMID: 11600749; A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens.Rheumatology (Oxford). 2001 Oct;40(10):1175-9.
2. PMID: 12594104; An experimental study of a Mediterranean diet intervention for patients with rheumatoid arthritis.Ann Rheum Dis. 2003 Mar;62(3):208-14.
3. PMID: 12548439; Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis. Rheumatol Int. 2003 Jan;23(1):27-36. Epub 2002 Sep 06.
4. PMID: 11890437; Effects of a very low-fat, vegan diet in subjects with rheumatoid arthritis. J Altern Complement Med. 2002 Feb;8(1):71-5.
5. PMID: 11154796; Antioxidants in vegan diet and rheumatic disorders. Toxicology. 2000 Nov 30;155(1-3):45-53.
6. PMID: 9117178; Faecal microbial flora and disease activity in rheumatoid arthritis during a vegan diet. Br J Rheumatol. 1997 Jan;36(1):64-8.
7. PMID: 15077267; Physical activity behavior in older women with rheumatoid arthritis. Arthritis Rheum. 2004 Apr 15;51(2):246-52.
8. PMID: 15513677; Aetiological factors of importance for the development of rheumatoid arthritis. Scand J Rheumatol. 2004;33(5):300-6.
9. PMID: 8912502; gamma-Linolenic acid treatment of rheumatoid arthritis. A randomized, placebo-controlled trial. Arthritis Rheum. 1996 Nov;39(11):1808-17.
10. PMID: 12069368; Effect of cod liver oil on symptoms of rheumatoid arthritis. Adv Ther. 2002 Mar-Apr;19(2):101-7.
11. PMID: 11708441; Fish oils are beneficial to patients with established rheumatoid arthritis. J Rheumatol. 2001 Nov;28(11):2563-5.
12. PMID: 12610802; A randomized double blind, placebo controlled trial of topical Tripterygium wilfordii in rheumatoid arthritis: reanalysis using logistic regression analysis. J Rheumatol. 2003 Mar;30(3):465-7.
13. PMID: 12124856; Benefit of an extract of Tripterygium Wilfordii Hook F in patients with rheumatoid arthritis: a double-blind, placebo-controlled study. Arthritis Rheum. 2002 Jul;46(7):1735-43.

For more support surrounding your diagnosis of rheumatoid arthritis, you can follow my friend Sandy’s Rheumatoid Arthritis Support Site.

Best of luck to you. Thanks for asking about natural treatments for RA. Diet and stress management are key for autoimmune conditions, if the changes are overwhelming, focus on one change at a time until you get it down. Give yourself a month for each important goal. Implement all the things that you can easily do now. Remind yourself that it is all about “progress and not perfection”.

If you have any additional questions or insight to share about RA please do so in the comments.

Thanks for stopping by my kitchen table!

~ Dr. Nicole Sundene

Naturopathic Physician
www.KitchenTableMedicine.com

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McInflammation: Are You Really “Loving It”?

Recently a friend reported over dinner that his inflammatory problem (and let’s just say almost all medical problems are caused by inflammation) was not much better.

He said he was diligently taking everything I had recommended, and had only noted minor improvement.

Although natural remedies take time, I was curious how the dietary recommendations were going….you know, the most important part of his prescription? To no surprise, he was struggling to make the necessary changes.

As I climbed in to his car to head to our next destination I noted the eight bags of fast food littering his car floor.

“Well here is the source of McInflammation in your diet right here!” Read more

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Fish Oil vs Flax Oil? The Great Debate

One of the greatest flaws in the Standard American Diet (SAD) is a lack of omega-3 fatty acids.

Repleting this deficiency typically improves memory and mental functioning as well as corrects a gamut of other annoying health problems.

The reason for this is that these essential oils are necessary for proper brain functioning, immune function, hormonal balance and skin integrity as they are the necessary building blocks for the cellular membrane of every single cell in our body. Wow just ONE thing for all SIXTY TRILLION cells in your body!

This must be pretty important then… Read more

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Anti-Inflammatory Diet

Who should be on the anti-inflammatory diet?  Well– just about everyone!

Anyone with arthritis, chronic pain, chronic disease, cancer, cardiovascular disease such as high cholesterol and high blood pressure, autoimmune conditions such as rheumatoid arthritis, lupus, or sjogrens, as well as those looking to slow the aging process and disease prevention will benefit from an anti-inflammatory eating plan. Eating healthy is the gift that keeps on giving!

My first day in Human Pathology class back in med school I learned about how inflammation led to cellular destruction and that cellular destruction was ultimately the root cause of disease. Little did I know at the time that it was just about everything I needed to know for treating disease. Many years later, as I watch most chronic disease clear up if not vastly improve just from the implementation of the anti-inflammatory diet, I am consistently reminded of the importance of treating the inflammatory load in the body.

To understand the detriments of inflammation on a cellular level, imagine that your body is a factory.

Now let’s pretend that the cells that make up all your tissues are simply the product of an assembly line in this factory. The factory is required to produce a certain quantity of functional cells every day, regardless if cells are destroyed or made improperly. Every time the factory loses cells, or makes dysfunctional cells, the assembly line will then need to speed up that much more in order to achieve that day’s production quota.

I’m sure you can quickly see that the faster the line speeds up the more room for error there then becomes.As the line speeds up to max capacity quality goes down and quantity of error goes up.

In order to manage the “factories” called our bodies properly we must learn how to keep the assembly line running at a nice steady consistent virtually error free rate.

So what causes these errors?

Arachidonic acid is the biochemical “mother of all evil” when discussing inflammation.

Most pharmaceutical medications as well as anti-inflammatory herbs work to inhibit the enzymes like cycloxygenase and lipoxygenase that convert this bad fat in to the inflammatory products that cause us pain, destroy our joints, and ultimately make us sick. Most physicians heavily rely on anti-inflammatory meds like “COX Inhibitors” also known as “NSAIDS” that are either prescription or over the counter pain relievers for treating a myriad of complaints. COX just stands for cycloxygenase. COX is the enzyme that converts arachidonic acid in to inflammatory products that cause us pain or make us sick.

Why depend on taking a daily drug to reduce inflammation when you can simply achieve the most of it through diet?

Arachidonic acid (AA) is the fat found primarily in animal fats. The body can still produce AA on it’s own from vegetable fats in the event that we do need some inflammation to help the healing and remodeling process that is necessary for short term illness and injury. However the body tends to REALLY overshoot when it comes to inflammation.Anyone that has had some very painful swelling from an injury can understand how unnecessary most of the inflammatory response actually is. When dealing with chronic inflammation however, we need to do the best that we can to tone down this overshooting of the inflammatory response.

Fried foods are just like throwing gasoline on the inflammatory fire.

The unstable molecules in the fried foods just contribute to the chaos.

• The best thing you can do for your long term health is to get fried foods out of your diet. Do not use butter or margarine.
• Please never use shortening!
• Olive oil should be used at all times unless cooking over 350F which then cold pressed canola or rapeseed oil should be used.
• Flax seed oil should not ever be used for cooking due to it’s low smoking point, but can be used as salad dressing, or drizzled over steamed veggies for a nutty flavor.

The other most important step is to reduce if not eliminate animal fat consumption. This is why many people do well on a vegan diet (no animal products at all). You should check with your doctor to determine if a vegan diet is the right choice for you, as it is not the easiest to follow and may not be recommended for your particular body type and metabolism. At the very least you can eliminate red meat from your diet, all processed meats like hot dogs and sausages should absolutely be avoided as the nitrates in them particularly increase inflammation, as well as the ridiculously high fat content. Eggs have a high AA content and thus are best to be avoided or consumed in moderation.

Remember: Animal fat=Inflammation.

Eat lean poultry, fish, and plenty of wild Alaskan salmon.www.ewg.org to find a list of low mercury content fish that are not endangered. Fat free organic dairy products may also be acceptable for those without severe disease.

Although consuming omega 3 fats in the form of Alaskan salmon is most optimal, I understand it is not always practical.Those with severe inflammation will benefit from adding cod liver oil or fish oil in to their diet. Check with your naturopathic doctor to determine the dose that is appropriate for you. Those with bleeding disorders and on anti-coagulant medications should not take fish oil. The reason that fish oil is so anti-inflammatory is that it competes with arachidonic acid for the same enzymes to produce opposing products.In the presence of fish oil, arachidonic acid has less raw materials to produce inflammatory products. The average daily dose of fish oil is about 1tsp to 1 tbl daily. Be sure to take it with food. I like the lemon flavored cod liver oil by Carlson in the green bottle. It can be found at any health food store.

Other substances in the diet aside from arachidonic acid can also lead to inflammation.Anytime you have food allergies or intolerances, you will have an increased level of inflammation in your body as your immune system is forced to work overtime.You can do an ALLERGY ELIMINATION DIET to determine which foods you are most sensitive to.Most patients are triggered by a favorite food. Not typically what anyone ever wants to hear, but that is why I get paid the big bucks to be the bad guy. Aside from favorite foods top inflammation offenders are: Wheat, dairy, soy, citrus, peanuts/nuts, corn, chocolate, alcohol, caffeinated beverages, bananas, and beef.

Now at this point after I recite such a list most patients will look at me and say “But Doc that is my entire diet!” which then I will be forced to respond “Well no wonder you are so sick…”It may seem tough at first, but giving up foods that make us sick means giving up disease, and ultimately being healthy is what makes us the most happy and productive. Nothing should be more important to you than your health.Especially not a silly little food! If you are having a difficult time with these changes, and demonstrating to yourself this level of care and self love, please work with a therapist to sort out the issues surrounding making the necessary health improvements.

Some patients will notice a marked improvement in their arthritis by avoiding the night shade family, some will not.

The “night shade” family is comprised of potatoes, eggplant, tomatoes, and peppers.The chemical solanine is thought to specifically cause pain in some individuals although it is not specifically researched.

You can try a 2 week elimination of the nightshade family with a re-introduction challenge as explained on the ALLERGY ELIMINATION DIET page and see if these foods are problematic or not. You will simply need to play around with all these foods that typically cause allergies and irritations and figure out which if any are causing you trouble. Typically after a week you should notice a marked improvement without that food in your diet, more severe disease may require two to three weeks without the food. Children respond faster and will typically resolve in 3 to 4 days.

Reducing sugar consumption is also key to reducing the inflammatory load.

Sugar basically “rusts” our system. Sugars in our system get stuck to healthy cells and basically “tags” them for destruction.A process called “glycosylation”.To prevent this inflammatory/aging process start with eliminating all white refined sugars and flour products like white breads, bagels, white rice, and other “evil white foods” from your diet.Find substitutes whenever possible, and enjoy your favorites judiciously. Follow the LOW GLYCEMIC INDEX DIET and learn how to appropriately pair high protein and high fiber foods with your carbohydrates to reduce the total glycemic load, which will stop your system from prematurely “rusting”.

Learn to eat more cleanly by adopting a WHOLE FOODS DIET.

Getting processed foods out of your diet is extremely important.So now that we have discussed the bad stuff in the diet that needs to go, let’s talk about the good foods that should be eaten liberally. Certain foods have magical anti-inflammatory properties. The more you can learn to use foods as medicine, the less medication you should inevitably be required to take.

Foods as medicine are great for people that already are on medications as they are less likely to have negative interactions than herbs and other natural supplements.

Please however always check with your doctor before making any changes to your health care routine.

My favorite anti-inflammatory food is BLUEBERRIES

I prescribe one cup of frozen blueberries daily to all my patients with inflammation, heart disease, or diabetes. Most people are happy to add such a delicious food in to their diet, but occasionally I will have a patient balk at the cost of eating so many blueberries each month.If you are already taking medications or other supplements, you are clearly paying quite a bit for your health already so adding a superfood in like blueberries is well worth the $30 a month. You could buy a bottle of some herbal product for that same price, or you could just enjoy eating blueberries.

• Blueberries are highly anti-inflammatory and their proanthocyanin behavior is fundamentally protective to our cardiovascular system.
• In my opinion there is not a more delicious, advantageous way to improve your health than by eating a cup of frozen blueberries a day.
• I like to enjoy them as an evening snack, and let them sit out and thaw about 20 minutes before eating.
• You can also add them to smoothies or your morning cereal.
• Cooking them does not destroy their important pigments, and the freezing process actually makes these proanthocyanins more bioavailable for absorption. A rare exception to the rule that fresh is best!

Green leafy vegetables should also become your new best friend as they are an important anti-inflammatory and anti-oxidant food.

Greens are chock full of magnesium a nutrient that most of us are typically deficient in anyways, eating as many servings of green vegetables daily as possible will serve you well. A diet of brown rice, vegetables, lean meats, non-citrus fruits, water and green tea is the ultimate goal to work towards.And honestly, it is the basis of nearly every “therapeutic diet” that we prescribe for just about every disease out there. No wonder treating inflammation is so fundamentally important!

If you add in some turmeric (found in curry spice), ginger, and green tea you should do really well with reducing your total inflammatory load.

Turmeric is a natural COX2 inhibitor and is a better anti-oxidant than vitamin E. Ginger is highly anti-inflammatory as it inhibits phosopholipase which then has the dual effect of inhibiting both COX and lipoxygenase .The catechins in green tea are shown to be anti-oxidant and inflammatory modulating. These can be enjoyed as foods or taken in supplements. Again if you are on any medications please check with your physician before using any herbs or making any changes to your health care routine.

Last but certainly not least is my plug on addressing your emotional state.

Toxic emotions such as anger, depression, and excessive worry or anxiety can lead the body out of balance. A new exciting research field on the forefront is “Psychoneuroimmunology” this is the study of how our emotional state affects our nervous system and how that in turn affects our immune system.The immune system is largely responsible for most inflammation.Having a positive mind set and letting go of past issues is as important as diet in experiencing optimal wellness!

So that is my simple anti-inflammatory formula for success.

Follow the recommendations in order systematically making one change at a time, or start with the changes that will be the most simple for you to build up your confidence and energy to deal with some of the tougher ones. If you are doing all of that and still noticing symptoms after some marked improvement you should continue to work with your Naturopathic Physician or other healthcare provider to determine what other dietary modifications or alternative medicines will benefit you.

Please do drop me a comment if you have any questions!

~Dr. Nicole Sundene
Naturopathic Physician
www.KitchenTableMedicine.com

REFERENCES

“Biochemistry” Fifth Edition by Berg, Tymockzko, and Stryer. “Herbal Medicine: From the Heart of the Earth” by Sharol Tilgner, N.D. “Medical Herbalism” by David HoffmanEastwood MA. Interaction of dietary antioxidants in vivo: how fruit and vegetables prevent disease. QJM 1000;92(9):527-530 Hidaka H, Ishiko T, Furuhashi T, et al. Curcumin inhibits interleukin 8 production and enhances interleukin 8 receptor expression on the cell surface: impact on human pancreatic carcinoma cell growth by autocrine regulation. Cancer. 2002;95(6):1206-1214John JH, Ziebland S, Yudkin P, et al. Effects of fruit and vegetable consumption on plasma antioxidant concentrations and blood pressure: a randomized controlled trial. Lancet. 2002;359(9322):1969-1974. Kremer JM. N-3 fatty acid supplements in rheumatoid arthritis. AM J Clin Nutr. 2000;71:348-351.McDougall J, Bruce B, Spiller G, et al. Effects of a very low-fat, vegan diet in subjects with rheumatoid arthritis. J Altern Complement Med. 2002;8(1):71-75Seaman DR. The diet induced proinflammatory state: a cause of chronic pain and other degenerative diseases? J Manipulative Physiol Ther. 2002;25(3):168-179.Stark AH, Madar Z. Olive Oil as a functional food: epidemiology and nutritional approaches. Nutr Rev. 2002;60(6): 170-176. Kawachi I, Sparrow D, Spiro A III, et al. A prospective study of anger and coronary heart disease. The Normative Aging Study. Circulation 1996;94(9):2090-2095Kawachi I, Sparrow D, Vokonas PS, et al. Symptoms of anxiety and risk of coronary heart disease. The normative aging study. Circulation 1994;90:2225-2229. Kiecolt-Glaser JK, McGuire L, Robles TF, Glaser R. Emotions, morbidity, and mortality: new perspectives from psychoneruoimmunology. Annu Rev Pschol. 2002;53:83-107

A user friendly book I recommend on this topic is “The Inflammation Cure” by William Joel Meggs, M.D., Ph.D. if you would like to read more on the biochemistry of what I have discussed here.

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