How does western medicine work for arthritis?

[wushijiao]

Anecdotes are meaningless.

I must be in a bad mood this morning, but I'm getting really upset at people that promise hope to desperate sick people just to gain fame and fortune, and deliver nothing but disappointment.

I agree anecdotes are meaningless, except for their ability to inspire. Perhaps I shouldn't have used them. However, if you want to take drugs the attack the body's immune response system and are shown to increase the risks of cancer in many studies, I think you're making a big mistake when you could deal with the root of the problem: not giving cells enough nutrients at the cellular level to detoxify.

Studies with raw vegan/plant based diets and arthritis?

http://www.ncbi.nlm.nih.gov/pubmed/11242480?dopt=Abstract

The effects of a strict uncooked vegan diet on serum lipid and sterol concentrations were studied in patients with rheumatoid arthritis. The subjects were randomized into a vegan diet group (n 16), who consumed a vegan diet for 2-3 months, or into a control group (n 13), who continued their usual omnivorous diets. Serum total and LDL-cholesterol and -phospholipid concentrations were significantly decreased by the vegan diet. The levels of serum cholestanol and lathosterol also decreased, but serum cholestanol:total cholesterol and lathosterol:total cholesterol did not change. The effect of a vegan diet on serum plant sterols was divergent as the concentration of campesterol decreased while that of sitosterol increased. This effect resulted in a significantly greater sitosterol:campesterol value in the vegan diet group than in the control group (1.48 (SD 0.39) v. 0.72 (SD 0.14); P < 0.001). A higher concentration of campesterol compared with sitosterol is normal in omnivorous subjects and can be explained by lower absorption and esterification rates of sitosterol. Our results suggest that a strict uncooked vegan diet changes the relative absorption rates of these sterols and/or their biliary clearance.

http://www.ncbi.nlm.nih.gov/pubmed/11602026?dopt=Abstract

BACKGROUND: Fibromyalgia engulfs patients in a downward, reinforcing cycle of unrestorative sleep, chronic pain, fatigue, inactivity, and depression. In this study we tested whether a mostly raw vegetarian diet would significantly improve fibromyalgia symptoms. METHODS: Thirty people participated in a dietary intervention using a mostly raw, pure vegetarian diet. The diet consisted of raw fruits, salads, carrot juice, tubers, grain products, nuts, seeds, and a dehydrated barley grass juice product. Outcomes measured were dietary intake, the fibromyalgia impact questionnaire (FIQ), SF-36 health survey, a quality of life survey (QOLS), and physical performance measurements. RESULTS: Twenty-six subjects returned dietary surveys at 2 months; 20 subjects returned surveys at the beginning, end, and at either 2 or 4 months of intervention; 3 subjects were lost to follow-up. The mean FIQ score (n = 20) was reduced 46% from 51 to 28. Seven of the 8 SF-36 subscales, bodily pain being the exception, showed significant improvement (n = 20, all P for trend < 0.01). The QOLS, scaled from 0 to 7, rose from 3.9 initially to 4.9 at 7 months (n = 20, P for trend 0.000001). Significant improvements (n = 18, P < 0.03, paired t-test) were seen in shoulder pain at rest and after motion, abduction range of motion of shoulder, flexibility, chair test, and 6-minute walk. 19 of 30 subjects were classified as responders, with significant improvement on all measured outcomes, compared to no improvement among non-responders. At 7 months responders' SF-36 scores for all scales except bodily pain were no longer statistically different from norms for women ages 45-54. CONCLUSION: This dietary intervention shows that many fibromyalgia subjects can be helped by a mostly raw vegetarian diet.

http://www.ncbi.nlm.nih.gov/pubmed/11093597?dopt=Abstract

The effect of a strict, low-salt, uncooked vegan diet rich in lactobacteria on symptoms in 18 fibromyalgia patients during and after a 3-month intervention period in an open, non-randomized controlled study was evaluated. As control 15 patients continued their omnivorous diet. The groups did not differ significantly from each other in the beginning of the study in any other parameters except in pain and urine sodium. The results revealed significant improvements in Visual analogue scale of pain (VAS) (p=0.005), joint stiffness (p=0.001), quality of sleep (p=0.0001), Health assessment questionnaire (HAQ) (p=0.031), General health questionnaire (GHQ) (p=0.021), and a rheumatologist's own questionnaire (p=0.038). The majority of patients were overweight to some extent at the beginning of the study and shifting to a vegan food caused a significant reduction in body mass index (BMI) (p=0.0001). Total serum cholesterol showed a statistically significant lowering (p=0.003). Urine sodium dropped to 1/3 of the beginning values (p=0.0001) indicating good diet compliance. It can be concluded that vegan diet had beneficial effects on fibromyalgia symptoms at least in the short run.

http://www.ncbi.nlm.nih.gov/pubmed/9117178?dopt=Abstract

Full study PDF in British Journal of Rheumetology:

http://rheumatology.oxfordjournals.org/cgi/reprint/37/3/274

Studies on curing heart disease? Take a look at Caldwell Esselstyn's work (had he has over 150 published journal articles). He's one of the most respected surgeon's in the US at the Cleveland Clinic, and a former Olympian.

Heart disease remains the leading cause of death in the United States for men and women. But, as Dr. Caldwell B. Esselstyn, Jr., a former internationally known surgeon, researcher and clinician at the Cleveland Clinic, explains in this book it can be prevented, reversed, and even abolished. Dr. Esselstyn argues that conventional cardiology has failed patients by developing treatments that focus only on the symptoms of heart disease, not the cause.

Based on the groundbreaking results of his 20-year nutritional study—the longest study of its kind ever conducted—this book explains, with irrefutable scientific evidence, how we can end the heart disease epidemic in this country forever by changing what we eat. Here, Dr. Esselstyn convincingly argues that a plant-based, oil-free diet cannot only prevent and stop the progression of heart disease, but also reverse its effects.

Studies

The China study has over 8,000 statistically significant associations between various dietary factors and disease.

Also, regarding hear disease, take a look at Ornish's work. Again, with over 30 years of studies to back it up. The Ornish eating plan:

In 1990, Dr. Ornish and his colleagues at the University of California at San Francisco School of Medicine published the results of a one-year study called The Lifestyle Heart Trial. This study was the first randomized, controlled clinical trial conducted to determine whether people with heart disease could be motivated to make and sustain comprehensive lifestyle changes and if so, whether regression of coronary atherosclersosis (hardening and narrowing of the arteries) could result from these lifestyle changes alone.

In this study, 28 patients followed the Ornish program (as described in the Principles section above), while a control group of 20 patients followed conventional dietary guidelines for heart disease (including restriction of fat intake to 30% of calories and cholesterol intake to 200-300 mg per day). After one year, the patients in the Ornish program showed a significant overall regression of coronary atherosclerosis (as measured by quantitative coronary arteriography), while, in the control group, atherosclerosis progressed. Patients in the Ornish group reported near complete relief from angina (chest pain), a likely result of increased blood flow to the heart. (Ornish, 1990) Studies published in 1992 and 1995, which used different diagnostic procedures for measuring the progression and regression of atherosclerosis than those used in the original Lifestyle Heart Trial, also showed the effectiveness of the Ornish Program (Gould and Ornish, 1992 and 1995). It is interesting to note that in each of the studies mentioned above, the amount of regression of atherosclerosis experienced by patients in the Ornish group was associated with the extent of lifestyle change, indicating that although small changes in lifestyle may slow the progression of heart disease, a complete change in lifestyle is required to reverse or halt the disease process.

Veganism and diabetes? (although here there is tons of annedotal evidence from tons of people that you can get off meds with days to weeks).

http://www.ncbi.nlm.nih.gov/pubmed/20425575

Again, I don't want to sound like a quack, but I strongly believe that there is a ton of scientific evidence, accumulated over the last 40 years, to support the positions outlined here. I wouldn't want to raise hopes unnecessarily, since some diseases will never be cured under the most ideal conditions. Obviously, there are many other factors to disease: stress, genetics, environmental pollution, bad luck...etc. But there is significant evidence that nutrition is one of the major causes and solutions to many of the chronic illnesses that affect us today. Obviously, if you think of the 2-8 pounds of food that we eat per day, and billions of chemical reactions that they subsequently produce afterwards, this shouldn't be surprising. As Hippocrates said, "let food be thy medicine". This, hopefully, should be a reason for happiness.

Edited May 4, 2010 at 04:58 AM by wushijiao

[xiaocai]

Yes for sure a well-planned diet can be beneficiary to many chronic diseases. As a matter of fact, we will always advise our patients to stick to certain modified diets when they are diagnosed with RA and refer them to dieticians if necessary. But the thing is, is diet alone able to produce remission? I read through the abstracts and the full article, but it seemed to me that the subjects didn't stop their active treatments while changing over to a healthier eating habit.

Of course it would be ideal that one can manage his/her condition without having to take any medicines. But in many cases, especially severe flare-ups, we often need something strong to bring down the inflammation and the subsequent joint destruction, because it is usually irreversible as far as most people believe.

Many people are scared of the side effects of immunosuppressants such as methotrexate (probably the most notorious among them all), but for RA only very small doses are needed and many people only need take one tablet a week, which significantly reduce the chances of getting those side effects. And as you can see in the full article that only a few patients were taking gold (another one that associated with numerous side effects) but all most all of them where on NSAID (e.g. Mobic and Celebrex), doctors need to assess the severity of the disease and only put the patients on those potent meds when the benefits justify the risks.

And the other interesting thing to notice is that some of the participants dropped out during the study in the full article simply because they were not able to stick to the diet. So how much effort do you think normal people have to make to strictly eat no animal protein and drink no alcohol (let alone the "unprocessed" bit)? Some of them may become vegans on the spot you ask them, but some may have to try really very hard, and some will just give up. And also, how much the cost is going to be if you are going to keep taking if for the rest of your life? Are there any long term effect of this diet plan that have been studied? On the other hand, methotrexate may have nasty side effects and may even shorten your life expectancy,but it is usually very effective and very cheap as well. And you can still enjoy normal most meals with your family, of course, in moderation.

And I didn't see any case of reversal of the existing damages in the studies.

The reason we are told RA along with many other autoimmune diseases are not curable is because it is supported by many previous studies. Not only hundreds, thousands but millions experiments and researches have been done to support this conclusion. Food restriction is indeed important to people suffer from autoimmune diseases along with medical treatment. But we can't just rely on some sporadic cases and say that certain dietary regimen can fully replace medical treatments with virtually no side effects or decease in quality of life. Of course I am hoping that one day we will be approved wrong, but these evidences you have given only are not strong and consistent enough, yet.

[wushijiao]

And I didn't see any case of reversal of the existing damages in the studies.

Neither did I. And, I should have been more careful in summing up and presenting the research, since some advanced cases and in certain individuals, natural approaches may have limited effects.

But, all of those studies were relatively short (3 months to a year).

And the other interesting thing to notice is that some of the participants dropped out during the study in the full article simply because they were not able to stick to the diet. So how much effort do you think normal people have to make to strictly eat no animal protein and drink no alcohol (let alone the "unprocessed" bit)? Some of them may become vegans on the spot you ask them, but some may have to try really very hard, and some will just give up. On the other hand, methotrexate may have nasty side effects and may even shorten your life expectancy,but it is usually very effective and very cheap as well. And you can still enjoy normal most meals with your family, of course, in moderation.

Very good point. And I wouldn't want to give the impression that even if one were trying a natural approach, doctor supervision, and medicines wouldn't be necessary. However, if you would allow for the sake of argument that certain people can reverse their disease or reduce symptoms through a primarily raw vegan approach, then why wouldn't doctors generally tell people this, even if a certain percentage don't want to follow it or can't? Do doctors, or other authorities, have a duty to be transparent when explaining options? (I say this mainly as a reflection on some of my friends from high school who are now doctors, who are now generally overweight (some even obese), eat poorly, and generally have no interest in pursuing research about whether diet can solve chronic health issues).

Furthermore, it could be (I can't say for sure), but many people suffer terrible detox when they go raw (ie. their body gets out years of toxins at one time, which can be painful and overwhelming). Detoxing, of course, is a issue of huge debate and concern, and different people have different approaches. Personally, I'd advise people to make the changes more slowly (say over a month or two), rather than just setting up two randomized groups, and expecting one group to make a radical eating change (with many emotional and psychological issues intertwined in their food relationships) with (most likely) little help or emotional support, or means to understand detox symptoms. That could be one reason why people quite the trial. Other may simply hate vegetables and miss meat.

The reason we are told RA along with many other autoimmune diseases are not curable is because it is supported by many previous studies. Not only hundreds, thousands but millions experiments and researches have been done to support this conclusion.

Can you prove this statement? I personally know people who have cured their auto-immune diseases through nutrition. To be honest, I'm not a health professional, but I'd be happy to do the research to show that diet have a very positive effect.

Here's more from Furhman's site:

Working with patients with autoimmune diseases such as connective tissue diseases, myositis, rheumatoid arthritis, and lupus is very rewarding. These patients had been convinced they could never get well and are usually eternally grateful to be healthy again and not require medication.

An aggressive nutritional approach to autoimmune illnesses should always be tried first when the disease is in its infancy. Logically, the more advanced the disease is, and the more damage that has been done by the disease, the less likely the patient will respond. My experience with inflammatory diseases such as rheumatoid arthritis is that some patients are more dietary-sensitive than others and that some patients have very high levels of inflammation that are difficult to curtail with natural therapy. Nevertheless, the majority benefit—and since the conventional drugs used to treat these types of illnesses are so toxic and have so many risky side effects, the dietary method should be tried first. Modern drugs often contribute to the disability and misery of patients with an autoimmune illness and increase cancer risk. Studies show that the long-term outcome is poor after twenty years of taking such medication.1 A recent study in the British Journal of Rheumatology showed the major drugs to treat rheumatoid arthritis, such as azathioprine, cyclophosphamide, chlorambucil, and methotrexate, increase ethe likelihood that the person will die of cancer.2

Patients who use drugs that suppress the immune system forgo some protection that the immune system offers against infection and cancer. These individuals need a superior diet, even if they can’t stop all medication.

So many of the patients I see, especially the ones who have made recoveries, are angry at their former physicians who did not even suggest nutrition before starting them on medication. These individuals are usually so “sick of being sick,” they will do anything to get well. They don’t find the diet restrictive and show enthusiasm and determination to recover their health. It is terrifically exciting to see such patients make recoveries and eliminate the need for medication.

Edit (5.15.2010):

Please take a look at Dr. John McDougall's website as well He has been helping people with arthritis for over 30 years:

http://www.drmcdougall.com/med_hot_arthritis.html

This article in particular shed a lot of light on the link between arthritis and diet, and includes many scholarly references.

Edited May 14, 2010 at 05:19 AM by wushijiao