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Getting to the Root of (and Relief from) Rheumatoid Arthritis

February 18, 2024 | 7 Comments | SAFM Team

Congratulations, Amanda! Check out this week’s video to learn more about her client’s success in getting relief from rheumatoid arthritis. This is one of a series of videos celebrating success stories from our AFMC-certified students’ practices.

There are several common infectious triggers for rheumatoid arthritis. The immune system being constantly challenged with an infection can also promote a cross-reactive immune hypervigilance toward self tissue based on molecular mimicry. You may learn more about the Yersinia/RA connection here, here, here, and here. Gut dysfunction and enhanced intestinal permeability can also become a gateway that facilitates disease progression, especially if there is a high load of lipopolysaccharide (LPS), bacterial debris in the gut.

Keep in mind from clinical tips shared earlier that having ample bile flow and function is key to breaking down LPS in the GI tract, so it is less available to wreak havoc elsewhere in the body. Besides stool test data, elevated alkaline phosphatase (ALP) in everyday bloodwork (part of a CMP, typically) can be a sign of congested bile flow (yes, even if within range; look for values >100 IU/L) which might be a breeding ground for this dynamic. Catch it early, and you can often get in front of this brewing disease dynamic! This client’s ALP had been creeping up across four sets of labwork and was 106, a progression her primary care provider didn’t catch. More evidence of this fascinating interconnectedness? Those with RA are significantly more likely (50%!) to have gallstones or have had their gallbladder removed.

This is a fun one to geek out on. We are so proud of our practitioner community – a rich, diverse group who are deeply committed to this study and changing the lives of those they serve. I hope this clinical tip serves you and your patients and clients!

Warmly,

P.S. If you are passionate about transforming healthcare through the power of functional medicine, we encourage you to learn more about SAFM’s practitioner training programs. Enrollment for our next cohort is now open!

To receive weekly clinical tips for practitioners – like this one – right to your inbox, register here.

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3

SAFM Team says:

October 15, 2019 at 10:01 am

Which herbal remedies could be used for yersinia-infections? This is what I found: Berberine, black walnut, caprylic acid, oil of oregano, uva ursi, grapefruit seed extract and silver for 4 weeks, then re-test.

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  SAFM Team says:
  
  October 30, 2019 at 9:33 am
  
  There are 11 species of Yersinia, three of which are important human pathogens associated with zoonotic infections and each one has slightly different anti-microbial sensitivity. The botanical anti-microbials that you mention are broad-spectrum and in combination could be helpful in battling Yersinia infections. Here are a couple of research studies that support the use of berberine and oil of oregano specifically:
  https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0028-1088381
  https://www.ncbi.nlm.nih.gov/pubmed/18044446
  Hope this is helpful to you.
  
  Reply
2

Feres says:

May 15, 2019 at 8:12 pm

Is it possible that Yersinia can be present with no symptoms?

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  SAFM Team says:
  
  May 31, 2019 at 3:02 pm
  
  Yes, it is possible. Opportunistic bacterial species such as Yersinia can be tolerated quite well for some time before any dysregulation happens due to stress, poor diet choices or influx of toxicity. This is a great reminder that even when an opportunistic bacteria or a potential pathogen shows up on a results list of a test like GI-Map or another stool test, we still need to ask “who is the person who has these results” as that will really dictate the course of action based on the findings.
  
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1

Barbara Montgomery says:

October 30, 2017 at 12:39 pm

Hi have Peripheral Neuropathy. (Idiopathic). It has just recently flared up…like in the last month or so, it has gotten worse (seems like since the Neurologist conducted nerve testing…) It is now spreading to my hands. I’m ‘always’ active, but lately, my energy is slowing up as well. Any suggestions? Gluten free is one suggestion I’ve had. Dr.’s as you know have ‘no’ answer for this painful and debilitating disease.

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  SAFM Team says:
  
  October 31, 2017 at 8:11 pm
  
  This question is off-topic, but I am happy to answer it here (outside of the context of arthritis). Nerves can be aggravated or inflamed by a number of things….e.g. chronically elevated blood sugar, other causes of high oxidative stress (toxicity), extended active viral infection (e.g. EBV), mitochondrial dysfunction. What I have seen work best for peripheral neuropathy (PN) is a combination of (1) addressing suboptimal levels of B12 and/or B6 (realize that serum data doesn’t necessarily indicate this accurately; organic acid markers can be quite helpful, and a practitioner educated in functional medicine science can help you with this) and (2) ramping up slowly to 600mg of alpha lipoic acid (ALA) twice daily. The combination may take several weeks to show notable results. And of course, you want to be working with a skilled practitioner to address the other true Root Causes of your unique case of PN at the same time.
  1. The nerves fundamentally require these key B vitamins, and ALA is a very potent agent for reducing oxidative stress via its role in recycling glutathione. Ideally we use organic acids data to check true sufficiency of B12 and B6. Just make sure you are supplementing with the methylcobalamin form of B12 (perhaps 1000mcg/day) and the pyridoxal-5-phosphate form of B6 (perhaps staring with just ~10mg/day). This may be interesting (and the links contained within): https://schoolafm.com/ws_clinical_know/what-i-really-want-to-know-is-how-in-the-hell-did-my-doctor-miss-that%e2%80%8f/ .
  2. I always recommend ramping doses of ALA slowly, starting with 50-100mg/dose once daily and monitoring carefully for a few days. If it is well-tolerated, you might ramp up over 2-3 weeks. One important caution is regarding another function of alpha lipoic acid which is a chelator of heavy metals, including mercury which can also be at play in PN (I have a beloved family member who has wrestled with it actually). If you have mercury amalgam fillings in your mouth or a suspicion of heavy metal toxicity, be cautious with using alpha lipoic acid, as it may promote redistribution of toxins to the brain. It is important to pursue a paced, methodical approach to heavy metal detoxification with a skilled practitioner to minimize potentially debilitating side effects.
  
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  SAFM Team says:
  
  November 1, 2017 at 10:53 am
  
  One more thought for you: consider your homocysteine level. If it’s low (4 or less), this might be a contributor to your PN? This may be of interest: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566450/pdf/8-14.pdf . We focus so much on *high* homocysteine and its possible contribution to CVD risk, but it’s important to remember that homocysteine (like cholesterol) is a powerfully important substance that needs to be balanced; too low levels can be just as harmful as too high.
  
  Reply