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No. 66 - 1992
RHEUMATOID ARTHRITIS: A STORY OF TWO WOMEN
Jenny Sieversen is almost 70, softspoken, maybe too gentle for her own good. In her 40's the joints of her fingers first began getting hot, swollen and painful -- classic symptoms of rheumatoid arthritis (RA). For thirty years she's patiently accepted the best that orthodox treatment has to offer -- aspirin or other antiinflammatory drugs, steroids (cortisone or prednisone), injections of gold compounds, and so on. By now, her hands are permanently deformed. The disease also has affected her knees and ankles. Walking becomes a perilous adventure -- even her minor falls have caused fractures in bones weakened by many years, on and off, of steroid therapy. Lately, the doctors are using a powerful drug to suppress Jenny's immune system. Their rationale is that RA is an "autoimmune" disease -- one in which her raddled antibodies insist on attacking her joints. Unfortunately, the drug has nasty side effects. The quality of Jenny's life is not good.
Occasionally I send her clippings on new, usually nutritional, approaches to RA. Her response is always a polite, implied 'thanks but no thanks.' In the rare times when I've pressed her, she tells me, apologetically, her doctor said diet has little to do with RA. The medical texts I peruse stress this point. While the experts say they don't know what causes RA, they largely dismiss diet, as a factor. Typical statement: "Much has been written in the lay literature about diet and arthritis, and much of it is nonsense. Unfortunately, many arthritis patients are grasping at straws for help and may adopt dietary habits that are potentially dangerous." (Current Therapy, W. B. Saunders Co., 1986.)
I cannot accept that the nutrients we consume don't play a part in autoimmune disease. After all, our immune system itself is composed of tissues that have to be nourished before they can do a decent job of protecting us. Jenny, good docile soul, wouldn't think of challenging her doctors or exploring alternative approaches to her illness, even though her health is on a steady downhill slide. I received a letter a few months ago from a subscriber Who took the opposite tack. In 1975, at the age of 17, Celine Haugen developed the disease. "Naturally, my doctor put me on aspirin and Indocin immediately (6 aspirin a day and at least 2 Indocin). A year or two later he sent me to a rheumatologist, who put me on Feldene and Chloroquine. I thank God now that no steroids were included, although cortisone was injected into two tendons when I couldn't bend my fingers. A year after taking Chloroquine, the rheumatologist sent me to have my eyes looked at -- only then did he inform me of the possible side-effect of Chloroquine on the eyes! I was furious."
[Chloroquine, mainly classified as an anti-malarial drug, has lost favor as a treatment for RA. "The ocular toxicity of these drugs and the slow onset of beneficial effects are believed to outweigh the therapeutic merits of the drug," according to Principles of Medicinal Chemistry, 2nd ed., 1981. In Worst Pills, Best Pills, published by the Public Citizen Health Research Group in 1988, Indocin (indomethacin) and Feldene (piroxicam) both are in the DO NOT USE category because of unpleasant and dangerous side effects. Feldene is known to have caused many deaths.]
Celine Haugen says the permanent deformities in her wrists and toes occurred during those first few years when she was receiving the 'best' medical treatment. "I was given no advice on diet and nutrition." Fortunately, she is a fighter and questioner. Maybe her need to challenge arose because Celine is part of the generation strongly affected by the women's movement -- unlike Jenny's (and mine) which grew up acquiescing humbly to male, hence medical, authority! Perhaps it also has to do with her background. She was born in Rhodesia, then an English colony in southern Africa, of parents who had emigrated from Germany.
Rhodesia, after long political and armed struggle, in 1980 become the independent black African nation of Zimbabwe. "My siblings and I were born of a German family in an English colony in Africa, surrounded by African beauty!"
When the first few years of medical treatment proved largely ineffective, her family helped her to explore other paths. Her father sent her to a chiropractor who recommended supplements of calcium, zinc, magnesium, and vitamins, especially C. "He also sent me to a homeopath, who began talking about diet. And then I began reading, talking, etc. The best thing for me was that my brother began turning vegetarian. He was studying dentistry. Then my sister studied dietetics. I bought my first vegetarian cookbook and began experimenting, and enjoying the meals more and more, plus they were a lot cheaper (we were students living in South Africa on a limited budget)."
She has become a 'fish' vegetarian, giving up milk, wheat, alcohol, and coffee. Through the years, she has consulted doctors, homeopaths, and naturopaths. Not long ago in Berkeley she saw an Ayurvedic healer. Recently a cousin in Germany, who is a naturopath, "put me onto flax seeds (your favorite!) which I soak in good water in the evening and eat the slimy seeds and water with my muesli in the morning. (I eat the muesli with only a little water, no milk). We order spring water, don't drink tap water, something my dad was adamant about way back, and no drinking either side of meals....
"Also do reflexology on my feet and hands whenever I remember -- good while watching TV!"
She takes herbs, vitamins, kelp and spirulina. The odyssey in her struggle for health is complex and sometimes exotic, taking in, as it does, disciplines and therapies from Europe, Africa, Asia and the U.S. In her early thirties now, she and her husband live in a small California city where she is the economic development manager. Her health is good, she has "boundless energy," and the attacks of rheumatoid arthritis are infrequent and lighter each time. "I am under attack right now and not taking any medicine -- letting my own body do the fighting -- and am doing OK."
She eats as much fruit and fresh vegetables as possible, her muesli (wheatless) in the morning, fish once a week. No meat or dairy. "I knew I was supposed to give up sugar, but that was hard .... Ice cream is my favorite, but now I buy Rice Dream [a non-dairy dessert], which I love, and limit myself to one carob peanut cluster a day! Brave, brave!"
"Recently, the fluid in one of the discs in my lower back became inflamed (never had it before) and I took two Indocin ... Lo and behold, two of my finger joints flared up. Those chemicals only serve to weaken, not to strengthen ... a step backwards....
"Basically, I feel that stress is a major cause of autoimmune [ailments] and robs the body of its healing and fighting abilities. I need to work on this a lot more, i.e., stop worrying, being angry, or working too hard -- and spending more time on myself .... I also need more exercise now ... even if only a brisk walk around the block."
She says that in Europe, natural and "chemical" doctors work side by side, referring patients to each other, because both have their advantages. "In Asia, Africa and other parts of the World, natural methods are widely used. Why is it that here in the U.S.A, 'chemical' doctors are so utterly afraid of natural healers?" She thinks it is because doctors and pharmaceutical companies "are all in this game together," a money game.
Celine writes, "What I love about all this is that the more you learn, the more there is to learn; and the more you change your ways, the more rewarding it becomes. Above all, it is exciting."
I suspect most RA specialists here are simply unaware of scores of studies on ways in which crummy nutrition -- sometimes just one missing nutrient -- can torpedo the immune system. Fifteen years ago, Diane Wara, M.D. was involved in a case where four children in a family had no antibodies or other immune defenses. Three of the children died of infections, but ingenious research solved the mystery for the remaining youngster: she had inherited a family defect that caused a deficiency of one B-vitamin, biotin. All enzymatic activities depending on biotin were absent, and this alone was enough to inactivate her entire immune system! Miraculously, they saved her and restored her immune powers by giving her large amounts of biotin. "This was my first experience with the disastrous effects of a single deficiency," Dr. Wara said.
In RA, the body does the opposite, making too many antibodies that chew up its own tissues. But that, too, can have a nutrition connection. My beloved Omega-3 fatty acids again are coming up roses, because medical researchers currently are finding that giving Omega-3 fish oil to RA patients helps to keep their antibodies and other defense molecules from turning into enemy warriors. The result is fewer swollen and tender joints, less morning stiffness, and greater gripping strength in patients' hands (Joel M. Kremer, M.D., et al., Arthritis and Rheumatism, June 1990).
Others are getting good results with plant oils containing Omega-6 GLA (Peter Callegari, M.D. & Robert Zurier, M.D., Rheumatic Disease Clinics of North America, Vol. 17, No. 2, May 1991). GLA (in primrose seed oil), 540 milligrams a day for twelve months, allowed RA patients to reduce aspirin-type medications because of less pain. Callegari and Zurier in their own pilot study found that a higher dosage of GLA (1.1 gram per day in borage seed oil for 12 weeks) "resulted in significant relief from symptoms of RA in six of seven patients and a reduction in duration of morning stiffness and numbers of swollen and tender joints." Little or no side effects. They also suggest a combination of Omega-6 GLA and Omega-3 fish oil may be especially effective in combatting inflammation and promoting healing.
Here, worthy medicos are talking about simple food supplements, implying these may have value as an alternative therapy. They're suggesting, let's look into the ways natural fats control the disease process, instead of putting all our research efforts into the highpowered pharmaceuticals that may relieve inflammation and pain for a while, but do not heal, often interfering with the body's efforts to heal itself. In fact, as they state, "the detrimental effects of therapy occasionally can be more difficult to manage than the disease itself." (My own files are fat with items about best-seller arthritis drugs that turned out to be killers.)
Celine Haugen instinctively sensed that the drugs she was given ended up sabotaging her body's own defenses. The 'mildest' of them -- aspirin and aspirin-like medications -- relieve pain, etc. by suppressing production of damaging, irritating, inflammatory prostaglandins. But they also suppress the body's production of different, rescuing prostaglandins that curb inflammation and promote true healing. That could explain why, when she took Indocin recently for her sore back, she ended up with a rheumatic flare-up in her fingers!
Even the medical texts aren't all that jaunty about aspirin, Naprosyn, Indocin, ibuprofen, and all the other "nonsteroidal anti-inflammatory agents" (NSAIDs), routinely prescribed as the safest of the arthritis drugs. Not only is there a list of chilling side-effects, but my Principles of Medicinal Chemistry explains that NSAIDs stimulate production of collagenase, an enzyme that attacks and destroys collagen, the protein substance that reinforces our skeleton, connective tissue, and joints! It adds a little sadly: This finding May explain in part why nonsteroidal anti-inflammatory drugs relieve inflammation but do not prevent tissue damage in arthritic patients.
So, despite an impressive array of medications to deal with RA, none of my medical texts expresses jubilation about easy victories over the disease. They admit none of the drugs is curative, yet go on seeking a magic bullet for what is essentially an illness of the whole system. Meanwhile, they shove aside "diet" as if it were only incidental to the whole business of life and healing!
Omega-3 oils (fish oil, flaxseed oil, etc.) and Omega-6 GLA (from primrose seed oil, borage oil, black currant oil, and the blue-green algae Spirulina) are prime examples of the kinds of foodstuffs that nature abundantly provides to deal with inflammation and pain -- not just in rheumatoid but in osteoarthritis, heart disease, colitis, psoriasis, and kidney disease.. They enhance healing. They don't cause dangerous side effects.
They don't create huge profits for giant pharmaceutical houses, either! I expect all of them, not just primrose oil, may be banned by the FDA when the new Nutrition Labeling and Education Act goes into effect May 1993. ■
THE NUTRITION GESTAPO
It's funny, isn't it, how the FDA honchos are so dead set on protecting all of us from the perils of self-dosing with vitamin, mineral, and herbal supplements. Any time I've talked to FDA officials, they act as if they never met a supplement they didn't distrust! Yet about 40 percent of the U.S. public uses supplements more or less regularly, and most of them haven't dropped dead yet. Maybe those FDA guys suffer from a "vitamin complex"! (More likely a vitamin deficiency.)
Anyway, the bad news is the FDA is on the warpath again. We supplement users thought we were safe, once and for all, when after vigorous consumer pressure Congress in 1976 overwhelmingly passed the Proxmire Law, giving us the right to purchase supplements in the potencies we desire, without having to first get prescriptions from a physician. The FDA has gotten into the act -- well, actually, the Nutrition Labeling and Education Act (NLEA) -- because, alas!, it was given the job of developing regulations to enforce the act's provisions. NLEA is a law of worthy intent, namely to improve nutritional information on labels. It will go into effect May 1993. Enter the FDA! The regulations it created are so out of line with NLEA's intent, they would be ludicrous if they weren't so sinister. We now have an FDA-Frankenstein monster on our hands.
It's clear now the FDA planned from the start to sabotage the Proxmire Law. Its actions over the past few months bode ill for consumers, retailers, and manufacturers of supplements. The June issue of Let's Live describes the chilling raid on the Kent, Washington clinic of Jonathan Wright, M.D. by 20 uniformed officers from the King County Police Department and the FDA, who kicked the doors down just before the clinic opened on the morning of May 6 and burst in with guns drawn. They closed down the clinic and removed practically everything that wasn't nailed down, including supplements, literature, treatment equipment, patient files, and the computer hard drive.
The search warrant mentions "all quantities of any drugs labeled in a foreign language, or identified as of foreign origin..." Dr. Wright uses a number of European supplements, including a German injectable B-vitamin because it doesn't contain preservatives. He's been a member in good standing in the Washington medical community for 20 years, is the author of several outstanding books on nutritional therapy, and as of this writing (July 1992), has not been charged with a crime! The clinic is back in operation, but if that isn't harassment I'll eat my Merck Medical Manual.
Not long after the book I coauthored with Donald O. Rudin, M.D. on Omega-3's came out, the FDA cracked down on linseed (flaxseed) oil, pulling it off healthfood store shelves just as they had done with evening primrose oil. Because "health claims" were made for these oils, they would have to go on "drug status" and undergo years of testing, the FDA said. (One might reasonably ask: What about health claims of "regularity" for bran? Will bran be confiscated and have to be tested for ten years as a drug???) Now, with the authority given the FDA to "enforce" its newly minted regulations, the crackdowns, which have already started, will be swift and devastating. It was waiting for just this chance -- thinking, of course, only of the welfare of us consumers!
Our best bet at this time is the new Health Freedom Act of 1992. Orrin Hatch is not my favorite senator by a long shot, but his bill, S. 2835, clearly spells out the protection needed against unsuitable, vindictive actions by the FDA under the guise of enforcing NLEA. For instance, a vitamin or mineral supplement shall not be deemed a drug solely because its potency is greater than the RDA, or because its labeling or advertising contains health claims, provided these are truthful and not misleading and there is scientific evidence that provides a reasonable basis for these. Furthermore, claims will not have to wait to be approved by the FDA before they can appear on labels, advertising, etc.
The bill points out that if a labeling claim is false and misleading, or if a food or herbal supplement is unsafe or harmful, the PDA has ample authority under a number of existing laws to act appropriately to protect consumers.
When I called the senator's office this July, the political aide told me our best course of action is to contact our own senators and ask them to support or co-sponsor S. 2835. She didn't know when it was coming up for a vote, but felt everything depended on loud and clear messages to senators to support the bill.
Okay, sweet readers, it's telephone and postcard time! My politically savvy friends tell me the messages are truly heeded by the politicians. ■
FLAX, THE NEW DESIGNER FOOD!
When I first wrote to Dr. Jack Carter, president of the Flax Institute of the U.S., about the wonderful potential that flaxseed holds for human nutrition because of its high Omega-3 content, Dr. Carter, who is an Emeritus professor at North Dakota State University, said he was intrigued by my newsletter articles on flaxseed but, frankly, wasn't aware of any appreciable human use for it. That was less than six years ago, and the beginning of a valuable exchange. I smile when I think about it, because before me on my desk is the stack of scientific papers he sent -- proceedings of the 53rd and 54th Flax Institutes in 1991 and 1992 - and they are mostly about flaxseed in human nutrition! Until recently, all the papers would have been on industrial and agricultural uses of flax.
What a turnaround we've seen in just a few years! Nobody knew or cared anything about the Omega-3 fatty acids, medical research ignored them, and only the food oil industry was interested -- but just in finding ways to hydrogenate them out of existence! The swift, widespread acknowledgment by medical authorities of fish oil's benefits for heart disease led to a new curiosity about Omega-3 oils in general, and eventually to the best plant source, flaxseed.
Canadian and U.S. growers of flax perked up their ears. This was good news. Their market for linseed (flaxseed) oil in paint and linoleum had dwindled because of manmade petrochemical substitutes such as vinyl. The papers at the 1991 and 1992 Flax Institutes reflected a new, rich vein of research that's being enthusiastically tapped, here and in Canada. For instance:
- Flaxseed oil is approximately 60% alpha-linolenic acid (ALA), the essential Omega-3 fatty acid, making it the richest available plant source.
- Flaxseed oil and flaxmeal confer beneficial effects on blood fats, cholesterol, and blood pressure.
- Flaxseed is an exceptionally good source of a fiber, lignan, that shows anti-cancer effects in cancers of the breast and colon.
- Flaxmeal improves health, fertility and litter size in pigs.
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- Added to regular feed, flaxmeal produces chickens with more Omega-3s in their meat and eggs.
- The body converts some ALA from flaxseed into EPA and DHA -- 'fish oil' fats that benefit the heart, eyes, brain, complexion, kidneys, and immune system!
A Chinese scientist at the 53rd Institute reported that unlike western countries where flax oil is used mainly for industrial purposes, China values it primarily as a food oil, and has done so for perhaps 5000 years' He said his country is now the third largest flax grower in the world, surpassed only by India and USSR.
While flaxmeal can be stirred into juices and easily swilled down, some of the researchers decided to give their subjects muffins baked with specified amounts of flaxmeal added. This is in line with ancient Rome, where soldiers on the march got rations of bread baked with flaxmeal. In present-day Germany, over sixty thousand metric tons of flaxseed [1 metric ton equals 1.1 tons] are consumed in bread and buns each year! In a note accompanying the papers, Dr. Carter told me he is going to try "to get flax bread, muffins, etc. into 3 or 4 local bakeries, and ground flax into one supermarket -- many folks would like to have ground flax, ready to include in baked products," without having to grind it. He also sent me flaxseed recipes -- his own and some by Canadian flax farmers. Here's one I tried, and it's good. I like it also because folks who can't tolerate gluten or wheat can use rice flour without spoiling the recipe.
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CARROT MUFFINS
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1/4 cup butter
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1 cup shredded carrots
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1/4 c. brown sugar
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1 cup flour
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2 eggs
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2 tsp baking powder
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1 Tbsp lemon jce
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1/2 tsp salt
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1 Tbsp water
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1 Thsp flaxineal
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Beat butter and sugar until creamy. Add eggs and beat until light. Stir in water, lemon juice and carrots. Add remaining ingredients and stir enough to moisten. Bake 375 degrees F for 20 minutes.
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