The disease first struck when he was 26 after a nasty blow to his elbow when he fell from his bicycle. It isn't uncommon for rheumatoid arthritis to flare up in this way after a sudden traumatic injury to a joint, although medical experts aren't sure why it happens.
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John Pickering"It's been a battle that has made me stronger"
His artist goddaughter Rebecca Ivatts is showing some of her work alongside his. They are oil paintings of John's hands, gnarled and twisted, themselves sculpted into strange shapes by the rheumatoid arthritis he has suffered from all his adult life. "People do wonder how it's possible for me to work when I have a condition like this," says John.
After graduating in Modern Languages from Oxford University, Rebecca studied Drawing and Painting at the Slade School of Art and Anatomy at the Princes Drawing School. The human figure – as a subject of great power, strength and dynamism – has always been central to her work. |
She has produced a Series of Oils that depict the Rheumatoid Arthritic hands of her Godfather, the Sculptor, John Pickering.Despite suffering with Rheumatoid Arthritis for over forty eight years, he works creatively to build some truly magical forms. |
"The operations did help a bit. I think I was among the first sufferers who were also treated with steroids in the late Fifties and early Sixties to reduce the swelling of the joints. Like most treatments for rheumatoid arthritis there's an improvement to begin with and then the benefit gets less and less as your body gets used to the medication. Most of the joints in my hands are now dislocated because of the damage done to them by the arthritis. I don't let it stop me doing what I want to do" John is equally pragmatic about the fact that his art has never earned him a penny. . John went to Birmingham's college of art to study classical art and life drawing. "I found work as a stone mason but after the arthritis in my hands made that impossible I went to work as a technical assistant at my old art college. Art was something I did in my own time, for my own satisfaction." Yet despite shunning the limelight, eminent artists and engineers, including Sir Norman Foster's prestigious design team, have beaten a path to his door wanting to find out how John uses an obscure branch of geometry called the inversion principle to create his beautiful sculptures. "My arthritis has been a battle which has made me stronger. When you have to cope with some kind of adversity it helps you to develop self-discipline and know yourself " these are qualities that an artist needs to get to the heart of the work they ought to be doing." Read more
NSAID
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Slow acting anti rheumatic drugs
(SAARD)
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Cortiocosteriods
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immunosuppressant
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How Do You Pronounce Hydroxyquinoline: www.howtopronounce.com/hydroxyquinoline
Dr. Oz Asks Another Physician If He Would Want To Be Treated With Hydroxyquinoline.
detroit.cbslocal.com/video/4490979-dr-oz-asks-another-physician-if-he-would-want-to-be-treated-with-hydroxyquinoline/
Dr. Oz Asks Another Physician If He Would Want To Be Treated With Hydroxyquinoline.
detroit.cbslocal.com/video/4490979-dr-oz-asks-another-physician-if-he-would-want-to-be-treated-with-hydroxyquinoline/
quinoline
8-Hydroxyquinoline-2-Carboxanilides as Antiviral Agents Against Avian Influenza Virus Dr. Jiri Kos, et al. Effect of selected 8-hydroxyquinoline-2-carboxanilides on viability and sulfate metabolism of Desulfovibrio pigerI Kushkevych, What is Desulfovibrio piger? High and low values | Lab results explained., April 24, 2019. |
Hydroxyquinoline VS Hydroxychloroquine
Hydroxychloroquine, a potentially lethal drugC. Merino Argumánez,, et al., Medicina Intensiva (English Edition) > 2017 > 41 > 4 > 257-259 |
chloroquine
Cardiovascular risks of hydroxychloroquine in treatment and prophylaxis of COVID-19 patients: A scientific statement from the Indian Heart Rhythm Society Hydroxychloroquine neuromyotoxicity Stein M1, Bell MJ, Ang LCA The Journal of Rheumatology, 01 Dec 2000, 27(12):2927-2931 Experience with hydroxychloroquine and azithromycin in the coronavirus disease 2019 pandemic: implications for QT interval monitoring
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Desulfovibrio piger is part of a group called Sulfate-reducing bacteria (=SRB). SRBs are normal inhabitants of the intestine in humans. This group of bacteria can “breathe” sulfate rather than oxygen. SRBs have been suspected to contribute to gastrointestinal disease due to the production of hydrogen sulfide, which can be considered toxic to the gut epithelium. Desulfovibrio piger is an SRB from the Proteobacterium phylum (deltaproteobacterium) and formerly known as Desulfomonas pigra, is a Gram-negative, nonmotile, rod-shaped bacterium 0.8 to 1.3 μm ×1.2 to 5 μm in size. Possible treatment: – Avoid food high in fat and simple sugars.
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Desulfovibrio piger
Source: https://blog.healthmatters.io/.../what-is-desulfovibrio.../
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AbstractHydroxychloroquine (HCQ) is commonly prescribed for treatment of inflammatory arthritis. The most frequently observed serious side effect is retinal toxicity; however, case reports have described HCQ induced neuromyotoxicity. We describe a case of HCQ neuromyotoxicity and a literature review from 1965 to September 1998 using Medline and Embase. Including our patient, there are 10 reported cases of HCQ neuromyotoxicity. Muscle biopsy consistently reveals curvilinear bodies and muscle fiber atrophy with vacuolar changes. Most cases manifest as insidious onset proximal myopathy that may be associated with peripheral neuropathy and cardiac myotoxicity. Resolution of symptoms is slow after discontinuation of therapy and may be incomplete. Possible predisposing factors include Caucasian race and concomitant renal failure. Patients treated with HCQ who develop a proximal myopathy, cardiomyopathy, or neuropathy, especially in the setting of worsening renal function, should be evaluated for possible HCQ neuromyotoxicity.
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Please let's just forget about this drug, It's absolutely useless in the treatment of COVID-19
5 Most Common Mistakes in Treating COVID-19 https://www.youtube.com/watch?v=4JFepeRK_sM Dec 30, 2021 |
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Methotrexate (MTX), Bottled Death
Antidote for MTX: Leucovorin
Folinic acid, also known as leucovorin, is a medication used to decrease the toxic effects of methotrexate and pyrimethamine. It is also used in combination with 5-fluorouracil to treat colorectal cancer, may be used to treat folate deficiency that results in anemia, and methanol poisoning. Source: https://scholar.google.ca/scholar…
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1. Bone marrow suppression
Bone marrow suppression also known as myelotoxicity or myelosuppression, is the decrease in production of cells responsible for providing immunity, carrying oxygen, and/or those responsible for normal blood clotting. Bone marrow suppression is a serious side effect of chemotherapy and certain drugs affecting the immune system such as azathioprine. The risk is especially high in cytotoxic chemotherapy for leukemia. 2. With gastro-intestinal mucositis damage occurs to the mucosal membrane of the entire gastro-intestinal tract. The patient may experience nausea, passage problems, stomach discomfort, intestinal cramping, bloating, loose stools or decreased urgency with loss of mucus. (https://www.oncoline.nl/index.php…) 3. Acute liver failure is the appearance of severe complications rapidly after the first signs of liver disease, and indicates that the liver has sustained severe damage. The complications are hepatic encephalopathy and impaired protein synthesis. Symptoms: Jaundice, excessive bleeding, altered state of consciousness, hyperdynamic circulation, hepatocellular necrosis, low blood pressure Diagnostic method:Prothrombin time measurement, complete blood count Treatment:Liver transplant ....................... PPIs can delay clearance and prolong halflife of MTX Proton Pump Inhibitors (PPIs) - About GERD What are the long term side effects of proton pump inhibitors? The most common side effects reported include headache, diarrhea, nausea, and vomiting. Reports of more serious side effects include kidney disease, fractures, infections and vitamin deficiencies, but these are very rare and are generally associated with long-term use (using these products for more than a year) Source: 1. https://www.aboutgerd.org/…/proton-pump-inhibitors-ppis.html 2. https://www.uspharmacist.com/…/proton-pump-inhibitors-consi… ......................... dialysis if Methotrexate levels continue to be elevated after leucovorin and there is a significant risk of Methotrexate toxicity, dialysis may be able to remove 50% of Methotrexate. Image: C.Andrea Solario - Mary Magdalen - Walters .................................... |
Leflunomide an alternative in chronic sarcoidosis patients who cannot tolerate methotrexate Leflunomide (Arava) is a cytotoxic drug
Mitochondrial enzyme dihydroorotate dehydrogenase (DHODH), which plays a key role in the de novo synthesis of the pyrimidine ribonucleotide uridine monophosphate (rUMP). The inhibition of human DHODH by A77 1726, the active metabolite of leflunomide, occurs at levels (approximately 600 nM) that are achieved during treatment of RA. We propose that leflunomide prevents the expansion of activated and autoimmune lymphocytes by interfering with the cell cycle progression due to inadequate production of rUMP and utilizing mechanisms involving p53. The relative lack of toxicity of A77 1726 on nonlymphoid cells may be due to the ability of these cells to fulfill their ribonucleotide requirements by use of salvage pyrimidine pathway, which makes them less dependent on de novo synthesis.
Mechanism of Action for Leflunomide in Rheumatoid Arthritis Robert I.Fox, et al. Clinical Immunology. Volume 93, Issue 3, December 1999, Pages 198-208 https://www.sciencedirect.com/science/article/abs/pii/S1521661699947770
7. Adverse Drug Reactions Comparing leflunomide treatment with placebo or another DMARD, the most common adverse effects were gastrointestinal (diarrhoea, dyspepsia, nausea/vomiting, abdominal pain, oral ulcers), abnormal liver function tests (LFTs), drug eruptions, alopecia, infections, weight loss and hypertension, headache, hepatotoxicity and hair loss, as well as predisposition to infection and peripheral neuropathy. The incidence of gastrointestinal adverse effects for leflunomide is similar to sulfasalazine but higher than those seen with methotrexate. S
Significant drawbacks include leflunomide’s adverse effect profile, teratogenicity and long half-life. 15–18 days,
Benefit-Risk Assessment of Leflunomide An Appraisal of Leflunomide in Rheumatoid Arthritis 10 Years After Licensing Nicola Alcorn, Sarah Saunders and Rajan Madhok
Drug safety, ; 32 (12): 1123-1134 2009 - Springer (https://link.springer.com/content/pdf/10.2165/11316650-000000000-00000.pdf)
Mitochondrial enzyme dihydroorotate dehydrogenase (DHODH), which plays a key role in the de novo synthesis of the pyrimidine ribonucleotide uridine monophosphate (rUMP). The inhibition of human DHODH by A77 1726, the active metabolite of leflunomide, occurs at levels (approximately 600 nM) that are achieved during treatment of RA. We propose that leflunomide prevents the expansion of activated and autoimmune lymphocytes by interfering with the cell cycle progression due to inadequate production of rUMP and utilizing mechanisms involving p53. The relative lack of toxicity of A77 1726 on nonlymphoid cells may be due to the ability of these cells to fulfill their ribonucleotide requirements by use of salvage pyrimidine pathway, which makes them less dependent on de novo synthesis.
Mechanism of Action for Leflunomide in Rheumatoid Arthritis Robert I.Fox, et al. Clinical Immunology. Volume 93, Issue 3, December 1999, Pages 198-208 https://www.sciencedirect.com/science/article/abs/pii/S1521661699947770
7. Adverse Drug Reactions Comparing leflunomide treatment with placebo or another DMARD, the most common adverse effects were gastrointestinal (diarrhoea, dyspepsia, nausea/vomiting, abdominal pain, oral ulcers), abnormal liver function tests (LFTs), drug eruptions, alopecia, infections, weight loss and hypertension, headache, hepatotoxicity and hair loss, as well as predisposition to infection and peripheral neuropathy. The incidence of gastrointestinal adverse effects for leflunomide is similar to sulfasalazine but higher than those seen with methotrexate. S
Significant drawbacks include leflunomide’s adverse effect profile, teratogenicity and long half-life. 15–18 days,
Benefit-Risk Assessment of Leflunomide An Appraisal of Leflunomide in Rheumatoid Arthritis 10 Years After Licensing Nicola Alcorn, Sarah Saunders and Rajan Madhok
Drug safety, ; 32 (12): 1123-1134 2009 - Springer (https://link.springer.com/content/pdf/10.2165/11316650-000000000-00000.pdf)
Aspirin drug
long-term low-dose aspirin use was more likely to lead to complications, such as increased bleeding, than to significantly lower disease risk, particularly in the case of cardiovascular disease. Many patients were also found to be taking aspirin regularly without a physician’s recommendation, increasing the chance of harm in high-risk individuals.Aspirin acts by inhibiting the production of prostaglandins, body chemicals that are necessary for blood clotting and are noted for sensitizing nerve endings to pain. The use of aspirin has been known to cause allergic reaction and gastrointestinal problems in some people. It has also been linked to the development in children (primarily those 2 to 16 years old) of Reye syndrome, an acute disorder of the liver and central nervous system that may follow viral infections such as influenza and chickenpox, and to the development of age-related macular degeneration (a blinding disorder) in some persons who use the drug regularly over many years. Like almost all drugs, aspirin is to be avoided during pregnancy. Compare acetaminophen; ibuprofen.
Source: https://www.britannica.com/science/aspirin
Source: https://www.britannica.com/science/aspirin
SERONEGATIVE ARTHRITIS
Paracelsus stated:
"The dose determines the poison" Paracelsus, born Theophrastus von Hohenheim, was a Swiss physician, alchemist, and astrologer of the German Renaissance. He was a pioneer in several aspects of the "medical revolution" of the Renaissance, emphasizing the value of observation in combination with received wisdom.
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QUESTION #2
A 45yo woman presents with swelling, stiffness, and pain involving multiple joints, especially in her hands. Symptoms began 6-7 months prior and have led to significant restriction of her daily activities. She experiences prolonged morning stiffness and generalized fatigue. Tylenol and ibuprofen have provided only minimal relief. Which of the following drugs would provide most rapid and complete relief of her symptoms? a. Colchicine- for acute gout b. Methotrexate- preferred in moderate or severe RA but takes weeks c. Prednisone-corticosteroid d. Sulfasalazine-for mild, early seronegative RA e. Minocycline- for mild, early seronegative RA |
Neurological Involvement in Rheumatoid Arthritis
Safaa Ali. Mahran, 2019. Rheumatol Arthritic Dis 4(1): 1-7.
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Non-steroidal anti-inflammatory drugs can cause intestinal damage, an issue not addressed by prescribing physicians, and if the symptoms are ignored long enough can cause, will cause, kidney damage, skin damage, cardiovascular damage, gastrointestinal damage. Anti-inflammatories are not easily prescribed so much anymore as they challenge your liver, your kidneys, your lungs, your heart so were going to be looking at alternatives.
Drug-drug interaction may be a pharmacodynamic interaction or a pharmacokinetic interaction. Creative Biolabs has established a full portfolio of assay systems to provide our customers overall information concerning the DDI potential of investigated compounds. Creative Biolabs is a leading biological company specialized in new drug research and development and offers global clients with toxicology services to assess drug safety. Image: 04:54 When the liver breaks down a drug like acetaminophen, or Tylenol, a lot of free radicals are generated and this could cause massive damage to the liver. Source: Free radical damage - causes, symptoms, diagnosis, treatment, pathology https://www.youtube.com/watch?v=2ZRAUO51Wf8 |
DMSO
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DIMETHYLSULFOXIDE or DMSO
Calcinosis cutis
is the deposition of calcium in the skin and subcutaneous tissues. |
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Honey
It has broad spectrum anti-biotic, anti-viral and anti-fungal activities. Honey prevents and kills microbes through different mechanism such as elevated pH and enzyme activities. Till now, no synthetic compound that works as anti-bacterial, anti-viral and anti-fungal drugs has been reported in honey yet it works against bacteria, viruses and fungi while no anti-protozoal activity has been reported.
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Honey
Honey: Single food stuff comprises many drugs
Saudi Journal of Biological SciencesVolume 25, Issue 2, February 2018, Pages 320-325 Chemically, honey is a complex blend of many organic and inorganic compounds such as sugars, proteins, organic acids, pigments, minerals, and many other elements. Honey use as a therapeutic agent is as old as human civilization itself. Prior to the appearance of present day drugs, honey was conventionally used for treating many diseases. This article reviews physico-chemical properties, traditional use of honey as medicine and mechanism of action of honey in the light of modern scientific medicinal knowledge. |
Potent anti-oxidant, anti-inflammatory and anti-cancerous activities of honey have been reported. Honey is not only significant as anti-inflammatory drug that relieve inflammation but also protect liver by degenerative effects of synthetic anti-inflammatory drugs.
Lysozyme
A lysozyme is a hydrolytic enzyme that is present in body fluids such as serum, saliva, gastric juice, milk, and airway mucus secretions; From: Enzymes in Food Biotechnology, 2019 https://www.sciencedirect.com/topics/earth-and-planetary-sciences/lysozyme |
The Chiropractic Approach to
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Graston Technique
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Rheumatoid ArthritisThe Chiropractic Approach to: Rheumatoid Arthritis
https://www.youtube.com/watch?v=6sh0rlTFou8 |
firocoxib (an NSAID) and diclofenac sodium, available in a topical cream. In addition:
Stem cell therapy is also possible, although a more costly alternative. |
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Homeopathic Medicine
1. https://www.homeopathicmedicine.info/en?s=bone+
2. https://www.homeopathicmedicine.info/en/homeopathic-remedies-for-arthritis-gout-joint-pains/?fbclid=IwAR3EriZkqBpgmNpiz6wQVO6Rs-XF8LaSeGMWCm7xu4urnz_4elBRRlo2mf4
1. https://www.homeopathicmedicine.info/en?s=bone+
2. https://www.homeopathicmedicine.info/en/homeopathic-remedies-for-arthritis-gout-joint-pains/?fbclid=IwAR3EriZkqBpgmNpiz6wQVO6Rs-XF8LaSeGMWCm7xu4urnz_4elBRRlo2mf4
In some instances, your doctor may suggest injecting an inflammation-reducing corticosteroid into the painful joint. This therapy has limits, since too-frequent injections can actually worsen the breakdown of cartilage in an arthritic joint..
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General treatment methods for RA
General treatment methods for RA
Relief of pain & stiffness Reduction of inflammation Maintain mm strength & joint function Minimize drug side effects Maintain as normal of a lifestyle as possible Promote normal growth & development in juvenile onset cases |
RA Drug Therapy
Early, aggressive drug therapies are advocated
In first 2 yrs of disease...much of articular damage is often reversible No interventions are curative, but are anti-inflammatory and immunosuppressive to combat the effects of the inflammatory process Palliative...to relieve signs & symptoms including pain |
Six primary types of pharmaceuticals used
1. Disease Modifying Anti-rheumatic Drugs (DMARDS) 2. Cytotoxics (Immunosuppressants) 3. Non-Steroidal Anti-Inflammatories (NSAIDS) 4. Corticosteroids 5. Analgesic Drugs - pain relieving narcotics 6. Gold Salts |
Genetic traits
cytokines
HLA-
the role of different alleles of human leukocyte antigen (HLA) in rheumatoid arthritis (RA) patients is studied in many populations and geographical areas. |
[PDF] Intercellular adhesion molecule 1 (ICAM-1) gene polymorphisms in Italian patients with
rheumatoid arthritis Influence of HLA-DR Alleles on Rheumatoid Arthritis: Susceptibility and Severity in Argentine Patients https://www.researchgate.net/profile/Jose_Maldonado-Cocco/publication/11873885_Influence_of_HLA-DR_alleles_on_rheumatoid_arthritis_Susceptibility_and_severity_in_Argentine_patients/links/553ab6c30cf245bdd7644887.pdf Frequency of HLA-DRB1 alleles in rheumatoid arthritis patients in Zahedan, southeast Iran, The data suggest that the DRB1*10 allele is a risk factor and DRB1*03 is protective for RA in this population. Most African-American patients with rheumatoid arthritis do not have the rheumatoid antigenic determinant (epitope) DO McDaniel, GS Alarcon, PW Pratt… - Annals of internal …, 1995 - Am Coll Physicians Tumour necrosis factor microsatellites and HLA-DRB1*, HLA-DQA1*, and HLA-DQB1* alleles in Peruvian patients with rheumatoid arthritis. This study shows for the first time that TNF gene polymorphism is associated with susceptibility to RA in a non-white population. TNFα6 and HLA-DRB1*1402 independently conferred significantly increased risk in Peruvian mestizo patients.https://ard.bmj.com/content/60/8/791.short Tumor necrosis factor α 5′‐flanking region, tumor necrosis factor receptor II, and HLA–DRB1 polymorphisms in Japanese patients with rheumatoid arthritis . T Shibue, N Tsuchiya, T Komata… -. |
IL‐6 genotypes
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IL‐6 promoter polymorphism in patients with rheumatoid arthritis. https://www.tandfonline.com/doi/abs/10.1080/03009740510026373
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monocyte chemoattractant protein‐1 (MCP‐1)
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Allelic frequency of the MCP‐1 promoter −2518 polymorphism in the Korean population and in Korean patients with rheumatoid arthritis, systemic lupus erythematosus and adult‐onset Still's disease. https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2370.2002.00346.x
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Drug Interactions are Important to Consider in the Clinical Management of RA patients
TNF alfa inhibitors
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TNF-alfa (alpha) inhibitors (TNF-alpha) are a group of medicines that suppress the body's natural response to tumor necrosis factor (TNF), a protein produced by white blood cells that is involved in early inflammatory events.
List of TNF alfa inhibitors (tnf inhibitors) - Drugs.com https://www.drugs.com › drug-class › tnf-alfa-inhibitors A post-marketing report from US Food and Drug Administration (FDA) showed 15 patients developing GuillainBarre Syndrome (GBS) after TNF-α inhibitor treatment [36]. Neurological Involvement in Rheumatoid Arthritis Safaa Ali. Mahran, 2019 Lymphoma in rheumatoid arthritis: The effect of methotrexate and anti–tumor necrosis factor therapy in 18,572 patients Frederick Wolfe, Kaleb Michaud The increased lymphoma rates observed with anti‐TNF therapy may reflect channeling bias, whereby patients with the highest risk of lymphoma preferentially receive anti‐TNF therapy. |
Glucocorticoids
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Glucocorticoids have been widely used in RA to acutely control pain and inflammation associated with RA flares. However, the beneficial anti-inflammatory effects of glucocorticoids, which can improve mobility, are also accompanied by adverse effects, including increasing CV risk factors and worsening heart disease outcomes. Glucocorticoid use is associated with carotid plaque and arterial stiffness, decreased insulin sensitivity, elevated lipid levels, and hypertension (Dessein PH, et al., 2004 and Hafstrom I., et al., 2007)
Patients treated with high dose steroids (>7.5mg/day prednisone) appear to have twice the risk of heart disease compared with those who do not receive steroids (Davis JM, et al., 2007). Examples of glucocorticoid drugs include: beclomethasone , betamethasone, budesonide, cortisone, dexamethasone, hydrocortisone, methylprednisolone prednisolone triamcinolone |
Iatrogenic
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Iatrogenic (from the Greek for "brought forth by the healer") refers to any effect on a person, resulting from any activity of person(s) acting as healthcare professionals or promoting products or services as beneficial to health, which does not support a goal of the person affected
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Enbrell
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Disease Modifying Antirheumatic Drugs (DMARDs) is injected & has shown dramatic improvement
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Biologic |
Side Effects of Biologic MedicationsJanuary 12, 2016 By VICTORIA RUFFING, RN
https://www.hopkinsarthritis.org/arthritis-news/side-effects-of-biologic-medications/ |
Cytotoxins
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(immunosuppressants) Considered aggressive treatment
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NSAIDs
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Non-steroidal Anti-Inflammatories (NSAIDs)
Salicylates (aspirin), Ibuprofen, Naproxen (aleve)...less toxic. High risk of GI bleed. |
drug interactions will be important to consider in the clinical management of patients with RA.
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Corticosteroids
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Cortisone, prednisone. Side effects are multiple, Weight gain, edema, increased BP, decreased wound healing, mood swings, depression, brain fog, ...Injections are local & do not have the same side effects
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Analgesic drugs
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For pain narcotics such as oxycodone, vicodin
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Gold salts
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Contains chemical compound of gold...taken weekly for 3-5 months, then dose decreased.
- Decreases inflammation and slows progression of disease - Used for RA, inflammatory bowel disease, psoriatic arthritis, lupus, and others - Side effects: decreased appetite, hair thinning, nausea, kidney issues, rashy skin |
Statins
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Statins appear to reduce vascular inflammation
Atorvastatin treatment resulted in a small reduction in RA disease activity compared with placebo, suggesting that statins may reduce inflammation directly (McCarey DW et al.,2004). Small studies in patients with RA have also shown improvements in arterial stiffness and endothelial dysfunction with atorvastatin (Van Doornum S, et al., 2004 and Hermann F, et al., 2005). Statin discontinuation for ≥3 months in patients with RA resulted in a 2% increased risk of acute MI for each month of discontinuation (De Vera MA, et. al, 2011). Statin therapy has also been found to impair the effectiveness of rituximab (Arts EE, et al., 2011). |
Tocilizumab
Effective Treatment of Severe COVID-19 Patients with Tocilizumab
....Among them, GM-CSF and IL-6 are the key chinaXiv:202003.00026v1 3 cytokines leading to inflammatory storm which may result in increased alveolar-capillary blood-gas exchange dysfunction, especially impaired oxygen diffusion, and eventually lead to pulmonary fibrosis and organ failure...
...Tocilizumab can specifically bind sIL-6R and mIL-6R and inhibit signal transduction. It is currently used mainly for rheumatoid arthritis.
..Therefore, tocilizumab can effectively treat severe patients of COVID-19, which might be explained by the blocking of IL-6-associated febrile and inflammatory storm response.
Source:
Effective Treatment of Severe COVID-19 Patients with Tocilizumab
https://www.ser.es/wp-content/…/2020/03/TCZ-and-COVID-19.pdf
.......................................
IL - Interleukins
IL6: along with TGFbeta, it'll activate TH17, pro-inflammatory cytokine
Th17 cells, by virtue of their production of IL-17 and IL-17F, are generally thought to be pro-inflammatory and play an important role in host defense against infection, by recruiting neutrophils and macrophages to infected tissues.
IL17: Main cytokine produced by TH17, stim fibroblasts, endo cells, and epi cells to produce IL1, IL6, TNFalpha, G-CSF and CXCL8 for inflammation, along with IL22 stim keratinocytes to produce AMPs, implicated in Autoimmune Diseases of chronic inflammation, stim myeloid and stromal cells to produce G-CSF for neutro production in BM, act stromal cell to make chemokines to attract neutros.
....................................................................................
Tocilizumab
Interleukin (IL)-6 plays essential roles not only in the immune response, but also in haematopoiesis and the central nervous system. Unregulated production of IL-6 has been found in chronic inflammatory autoimmune diseases, such as rheumatoid arthritis (RA), systemic onset juvenile idiopathic arthritis (soJIA), Crohn's disease (CD), systemic lupus erythematosus (SLE) and vasculitis. Furthermore, IL-6 activities can explain many symptoms of these diseases. More importantly, serum levels of IL-6 are correlated with disease activity. Tocilizumab binds specifically to both soluble and membrane-bound IL-6 receptors (sIL-6R and mIL-6R), and has been shown to inhibit IL-6-mediated signaling through these receptors.
Important Information: (https://www.drugs.com/mtm/tocilizumab.html)
Tocilizumab affects your immune system. You may get infections more easily, even serious or fatal infections. Call your doctor if you have a fever, chills, aches, tiredness, cough, skin sores, diarrhea, weight loss, or burning when you urinate.
Tocilizumab may also cause a perforation (a hole or tear) in your stomach or intestines. Tell your doctor if you have a fever and stomach pain with a change in your bowel habits.
Tocilizumab may also cause liver problems. Tell your doctor right away if you have right-sided stomach pain, vomiting, loss of appetite, tiredness, dark urine, clay-colored stools, or yellowing of your skin or eyes.
Read More on Tocilizumab:
1. https://scholar.google.ca/scholar…
2. ...On the other hand, the growing knowledge about the pathogenesis of SARS-CoV-2 infection is leading to the introduction of drugs commonly used for the treatment of rheumatoid arthritis (RA) even for the management of more complex cases of COVID-19. Chloroquine and hydroxychloroquine have now been permanently included, alongside antiviral drugs, in protocols for the treatment of COVID-19 pneumonia [10]. In addition, the use of interleukin 6 (IL-6) blockers seems to be very promising for the management of the massive cytokine storm associated to the development of the typical lung damage and the consequent ARDS occurring in the most aggressive patterns of SARS-CoV infection [11].
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102591/
....Among them, GM-CSF and IL-6 are the key chinaXiv:202003.00026v1 3 cytokines leading to inflammatory storm which may result in increased alveolar-capillary blood-gas exchange dysfunction, especially impaired oxygen diffusion, and eventually lead to pulmonary fibrosis and organ failure...
...Tocilizumab can specifically bind sIL-6R and mIL-6R and inhibit signal transduction. It is currently used mainly for rheumatoid arthritis.
..Therefore, tocilizumab can effectively treat severe patients of COVID-19, which might be explained by the blocking of IL-6-associated febrile and inflammatory storm response.
Source:
Effective Treatment of Severe COVID-19 Patients with Tocilizumab
https://www.ser.es/wp-content/…/2020/03/TCZ-and-COVID-19.pdf
.......................................
IL - Interleukins
IL6: along with TGFbeta, it'll activate TH17, pro-inflammatory cytokine
Th17 cells, by virtue of their production of IL-17 and IL-17F, are generally thought to be pro-inflammatory and play an important role in host defense against infection, by recruiting neutrophils and macrophages to infected tissues.
IL17: Main cytokine produced by TH17, stim fibroblasts, endo cells, and epi cells to produce IL1, IL6, TNFalpha, G-CSF and CXCL8 for inflammation, along with IL22 stim keratinocytes to produce AMPs, implicated in Autoimmune Diseases of chronic inflammation, stim myeloid and stromal cells to produce G-CSF for neutro production in BM, act stromal cell to make chemokines to attract neutros.
....................................................................................
Tocilizumab
Interleukin (IL)-6 plays essential roles not only in the immune response, but also in haematopoiesis and the central nervous system. Unregulated production of IL-6 has been found in chronic inflammatory autoimmune diseases, such as rheumatoid arthritis (RA), systemic onset juvenile idiopathic arthritis (soJIA), Crohn's disease (CD), systemic lupus erythematosus (SLE) and vasculitis. Furthermore, IL-6 activities can explain many symptoms of these diseases. More importantly, serum levels of IL-6 are correlated with disease activity. Tocilizumab binds specifically to both soluble and membrane-bound IL-6 receptors (sIL-6R and mIL-6R), and has been shown to inhibit IL-6-mediated signaling through these receptors.
Important Information: (https://www.drugs.com/mtm/tocilizumab.html)
Tocilizumab affects your immune system. You may get infections more easily, even serious or fatal infections. Call your doctor if you have a fever, chills, aches, tiredness, cough, skin sores, diarrhea, weight loss, or burning when you urinate.
Tocilizumab may also cause a perforation (a hole or tear) in your stomach or intestines. Tell your doctor if you have a fever and stomach pain with a change in your bowel habits.
Tocilizumab may also cause liver problems. Tell your doctor right away if you have right-sided stomach pain, vomiting, loss of appetite, tiredness, dark urine, clay-colored stools, or yellowing of your skin or eyes.
Read More on Tocilizumab:
1. https://scholar.google.ca/scholar…
2. ...On the other hand, the growing knowledge about the pathogenesis of SARS-CoV-2 infection is leading to the introduction of drugs commonly used for the treatment of rheumatoid arthritis (RA) even for the management of more complex cases of COVID-19. Chloroquine and hydroxychloroquine have now been permanently included, alongside antiviral drugs, in protocols for the treatment of COVID-19 pneumonia [10]. In addition, the use of interleukin 6 (IL-6) blockers seems to be very promising for the management of the massive cytokine storm associated to the development of the typical lung damage and the consequent ARDS occurring in the most aggressive patterns of SARS-CoV infection [11].
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102591/
tripterygium wilfordii Tripterygium wilfordii, or léi gōng téng (Mandarin) (Chinese:雷公藤, Japanese: raikōtō), sometimes called thunder god vinebut more properly translated thunder duke vine, is a vine used in traditional Chinese medicine.
Tripterygium wilfordii has been promoted for use in rheumatoid arthritis and psoriasis; however, due to safety concerns this use is not recommended.[1] |
“Millions of RA patients are treated with TNFα inhibiting agents, but these expensive biologicals are effective in only 30 to 40 percent of patients,” explained Hueseyin Firat, President & CEO of Firalis. “We believe our BIOPRED assay will identify patients who will not successfully respond to such therapies. This Agreement is expected to, among other things, bring to market a product and services to improve clinical decision‑making, improve health outcomes for RA patients, and contribute to cost reduction and sustainability of the health care system in the multibillion dollar global RA drug market.”
PUBLIC LAW 114–255—DEC. 13, 2016
An Act: To accelerate the discovery, development, and delivery of 21st century cures, and for other purposes.
https://www.govinfo.gov/content/pkg/PLAW-114publ255/pdf/PLAW-114publ255.pdf
Oxidative stress reflects an imbalance between the systemic manifestation of reactive oxygen species and a biological system's ability to readily detoxify the reactive intermediates or to repair the resulting damage.
Oxidative damage and RA
The functional medicine approach offered at The Epigenetics Healing Center emphasizes the importance of improving your health in an effort to reduce the risk of or reverse chronic disease.
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Moringa Documentary - the 'miracle' tree
https://www.youtube.com/watch?v=L9tdLn_Zk1M |
For a healthy T1 response you need healthy gut flora, so this means the gut the microbiome inside of your intestinal tract.
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The Law of Life Energy states that for life to exist, the body must have life energy.
The intention of energy medicine or energy therapy is to keep the energy flowing through these systems. Any type of block to energy flow can cause discomfort and disease. Some symptoms of energy flow disruptions are: 1. Fatigue 2. Lack of vitality or zest for life 3. Negative, unbalanced or distorted thinking 4. Negative, unbalanced or distorted emotions 5. Negative, unbalanced or distorted behavior 6. Feeling disconnected from others 7. Feeling disconnected from Spirit 8. Feeling disconnected from nature 9. Panic attacks that can be caused by holes in our auras There are many types of energy medicine practices. Some are very similar to others. They always involve intention and many involve "hands on" healing. Some have been developed as recently as the 20th century and others can be as old as shamanism that originated over 10,000 years ago. |
Changing Your Diet to Boost Your Energy
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Some common types of energy therapies:
Acupressure
Acupuncture Alexander Technique Anthroposophy Applied Kinesiology Aromatherapy Autogenic Training Ayurvedic Medicine Bach Flower Remedies Biodynamic Massage Chi Kung Chiropractic Color Therapy / Light Therapy Cranio-Sacral Therapy |
Crystal Healing
Distant Healing Dowsing Eurythmy Feldenkrais Method Feng Shui Five Rhythms Dance Healing Touch Herbalism Homeopathy Hypnotherapy Johrei Jungian Psychoanalysis |
Magnetic Therapy
Massage Naturapathy Neurolinguistic Programming (NLP) Ortho-Bionomy Osteopathy Polarity Therapy Pranic Healing / Pranayama Prayer Psychic Healing Qi Gong / Chi Kung Rebirthing Reevaluation Training Reflexology |
Reiki
Rolfing Rosen Therapy Shamanistic Healing Shiatsu Sound Therapy Spiritual Healing Tai Chi Talismans Therapeutic Touch Trance Dance Yoga Zero Balancing |
Rheumatoid Arthritis and its Treatment with Chinese Medicine
By Professor Yan Xiao Ping
Chinese medicine does not have a specific term for what is defined in Western medicine as rheumatoid arthritis, but ancient medical texts describe a similar disorder known as Bi Bing 痹病, or “Obstruction Disease”. The ancient texts further classified Bi Bing as Xing Bi 行痹or Travelling obstruction, Tong Bi 痛痹or Painful Obstruction, Zhuo Bi 着痹and Re Bi 热痹or Heat Obstruction, all of which are characterised by joint deformity causing pain and limited mobility. Other terms are Gu Bi 骨痹 or Bone Obstruction, Shen Bi 肾痹or Kidney Obstruction, Wan Bi 顽痹or Stubborn Obstruction, Gui Bei 龟背or Tortoise Back, Li Jie Feng 历节风, Gu Chui Feng 骨槌风or Bone Mallet Wind, and He Xi Feng 鹤膝风or Crane Knee Wind.
Chinese medicine does not have a specific term for what is defined in Western medicine as rheumatoid arthritis, but ancient medical texts describe a similar disorder known as Bi Bing 痹病, or “Obstruction Disease”. The ancient texts further classified Bi Bing as Xing Bi 行痹or Travelling obstruction, Tong Bi 痛痹or Painful Obstruction, Zhuo Bi 着痹and Re Bi 热痹or Heat Obstruction, all of which are characterised by joint deformity causing pain and limited mobility. Other terms are Gu Bi 骨痹 or Bone Obstruction, Shen Bi 肾痹or Kidney Obstruction, Wan Bi 顽痹or Stubborn Obstruction, Gui Bei 龟背or Tortoise Back, Li Jie Feng 历节风, Gu Chui Feng 骨槌风or Bone Mallet Wind, and He Xi Feng 鹤膝风or Crane Knee Wind.
Professor Jiao Shu De , the renowned TCM rheumatologist followed the teachings of Zhang Zhong Jing who created the name Wang Bi” 尪痹 for “arthralgia in all joints of the extremities characterised by swelling, pain and fatigue …”. This describes the disease today known as rheumatoid arthritis, which is characterised by joint deformity, damage to sclerotin, contraction of ligaments, stiffness and restriction of movement. The name “Wang Bi” was officially confirmed as the Chinese medical term in December 1981. It is defined by four patterns:
(1) Exuberant kidney deficiency cold pattern as indicated by Bu Shen Qu Han Zhi Wang Tang (Tonify the Kidney and dispersing coldness Decoction); (2) Kidney deficiency with superficial mild heat pattern as indicated by Jia Jian Bu Shen Zhi Wang Tang (Modified Tonify the Kidney Decoction); (3) Kidney deficiency with superficial Heat Excess pattern as indicated by Bu Shen Qing Re Zhi Wang Tang (Tonify the kidney and dispel heat Decoction); (4) Damp-heat with damage to kidney pattern as indicated by Bu Shen Qing Hua Zhi Wang Tang (Tonify the kidney and clear heat decoction). In 1994, Wang Bi was finally incorporated as an official disease name into the “People’s Republic of China Pharmaceutical and Disease Pattern Diagnosis Standards” to refer to the Western disease known as rheumatoid arthritis. |
Shenyinxu (Kidney Yin Deficient)
腎陰虛 by: Joe Hing Kwok Chu 'yin deficiency' of the kidney - suggested treatment apart from massage and acupuncture for Viral arthritis of the right ankle can be a 'yin deficiency' of the kidney/bladder. A term used in Traditional Chinese Medicine (TCM) in describing certain condition of the body. When the condition of yin deficiency exist in shenxu (kidney deficient) it is called shenyinxu. Although shen means kidney, do not confuse with the anatomy term "kidney." Shenyinxu patients can have: - high levels of cAMP - relatively low levels of cGMP - normal to high levels of adrenocortical hormone - relatively high levels of epinephrine & norepinephrine - low levels of electrolyte - over active sympathetic nervous system - under active parasympathetic nervous system - retaining sodium and expelling potassium See yin enhancing herbs See: Food high in potassium The other extreme condition is shenyangxu. Note: cAMP is the abbreviation for cyclic adenosine mono phosphate, a cyclic nucleotide of adenosine that acts at the cellular level to regulate various metabolic processes and mediate the effects of many hormones; so it is also known as second messenger where hormones are the first messengers. Herb Therapy: liu wei di huang wan is commonly prescribed (+ info) |
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Experience of Professor Huang Jiyong in Treating the Type of Blood Stasis Stagnating Orifice in Rheumatoid Arthritis by Houxue-Tongbi Recipe刘靖晗孙柯罗慧佳黄继勇
浙江中医药大学附属第二医院
Abstract:Based on the analysis of Pro. Huang Jiyong ’s understanding of the etiology and pathogenesis of the type of blood stasis stagnating orificen in RA and the thought of syndrome differentiation and treatment,summrizing Pro. Huang Jiyong ’s experience in the treatment with the type of blood stasis stagnating orifice in RA by Huoxue-Tongbi recipe,supported by a medical record. Pro.Huang Jiyong adopted the treatment principle of absorbing clots,eliminating pathogenic factors and adjusting Ying and Wei,and self-made Huoxue-Tongbi recipe to treat this disease. The prescription drugs grasp the etiology and pathogenesis of the type of blood stasis stagnating orifice in RA,which not only absorb clots,eliminating pathogenic factors,but also restore the deficiency without hurting the body. The self-made Huoxue-Tongbi has a prominent effect,which is worthy of reference and promotion. (1)
2. Are Kidney-Tonifying and Blood-Activating Medicinal Herbs Better than NSAIDs for Knee Osteoarthritis? A Systematic Review and Meta-Analysis
https://www.hindawi.com/journals/ecam/2019/9094515/
浙江中医药大学附属第二医院
Abstract:Based on the analysis of Pro. Huang Jiyong ’s understanding of the etiology and pathogenesis of the type of blood stasis stagnating orificen in RA and the thought of syndrome differentiation and treatment,summrizing Pro. Huang Jiyong ’s experience in the treatment with the type of blood stasis stagnating orifice in RA by Huoxue-Tongbi recipe,supported by a medical record. Pro.Huang Jiyong adopted the treatment principle of absorbing clots,eliminating pathogenic factors and adjusting Ying and Wei,and self-made Huoxue-Tongbi recipe to treat this disease. The prescription drugs grasp the etiology and pathogenesis of the type of blood stasis stagnating orifice in RA,which not only absorb clots,eliminating pathogenic factors,but also restore the deficiency without hurting the body. The self-made Huoxue-Tongbi has a prominent effect,which is worthy of reference and promotion. (1)
2. Are Kidney-Tonifying and Blood-Activating Medicinal Herbs Better than NSAIDs for Knee Osteoarthritis? A Systematic Review and Meta-Analysis
https://www.hindawi.com/journals/ecam/2019/9094515/
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