Rheumatoid Arthritis: Making the Best Treatment Decisions

If you’ve recently been diagnosed with rheumatoid arthritis, then you have some important treatment decisions to make along with your healthcare team and immediate family. There are a number of traditional and holistic treatment options available to you, and it’s beneficial to explore these options so that you can make the best treatment decisions moving forward. Rheumatoid arthritis can be a painful and debilitating disease; therefore most healthcare providers agree that early, aggressive treatment is the best way to reduce long-term complications and joint or organ damage.

Making the best treatment decisions is not just about the kind of medications you’ll take. It’s also about establishing your goals, building a team of healthcare providers you can trust to help you reach those goals, and finding a balance between traditional and holistic approaches to enhance and maintain your quality of life.

Communicating with Your Healthcare Team

Your rheumatologist surely has your best interest at heart, but all doctors, namely specialists, have a lot on their plate. There’s always the possibility that what’s best for YOU can get lost in the routine or standard approach to RA treatment. It will be up to you and your healthcare advocate – perhaps a knowledgeable family member or a holistic practitioner of some sort – to make sure that your unique needs are consistently taken into consideration.

Functional medicine doctor, Mark Hyman, encourages his patients to “listen to the best doctor in the room, which is your body.” As you embark on your RA treatment journey, it’s important that you persistently bring awareness to your unique experiences, needs, and values. An important first step in building your treatment plan is defining those needs and values, and then discussing them with your healthcare team and immediate family. Building a team of healthcare providers you can trust and communicate with is one of the best treatment decisions you can make.

You should be at-ease with asking your doctor to delve deeper into the side-effects of a particular medication, to provide you with a list of alternative treatment options, or to help you gain clarity in any other aspect of your treatment plan. No decision should be made without full understanding on your part, or because you were made to feel that you had no other choice.

Your healthcare team works for you, so keep in mind that you have options. Perhaps you were referred to your rheumatologist by your primary care provider or insurance company, and you’re concerned that s(he) is not the best fit for you. Maybe you’ve started to feel uncomfortable with the level of care and interaction you’re receiving from your current provider. In that case, it’s your right to search for a new specialist with whom you can establish a more collaborative effort.

Written Communication

Submitting your personal goals, concerns, and values in a written format will communicate that you’re a present and active participant in your treatment and healing. Communicating with your doctor in writing often proves to be more effective than talking at a rushed appointment and expecting that s(he) will remember all you’ve discussed moving forward. All written documents are placed in your file for your doctor and his or her staff to review as needed.

It’s also beneficial to keep a document with a current list the medications, treatment methods, and contact information for other members of your healthcare team. Update this document frequently or have a family member do it for you. You can then email or fax this document to all new healthcare providers before your initial appointment, giving them the opportunity to view your entire picture before making decisions about your treatment.

Overview of RA Treatment Methods

The primary focuses of rheumatoid arthritis (RA) treatments are to:

• Stop inflammation and put the disease in remission as quickly as possible.
• Prevent joint and organ damage.
• Relieve symptoms.
• Improve or maintain mental and physical well-being and quality of life.

Moving through the RA treatment process puts a lot of stress on your mental and physical well-being. During RA treatment, you can actively manage your symptoms and support your body’s natural healing abilities with homeopathic therapies, lifestyle changes, and self-care practices. Your RA recovery is heavily influenced by your willingness to commit to lifestyle changes. Talk to your doctor about actively reducing your need for medication through diet, exercise, and holistic practices.

Keep in mind that your rheumatologist and primary care provider are not experts in holistic treatment methods. Therefore, it may be wise to consult with a qualified holistic practitioner about alternative treatment and support methods. It’s vital that you connect with experts who can educate and encourage you in these arenas. For example, a practitioner with an in-depth knowledge of holistic RA treatments and adaptogens can add massive value during your treatment.

Most of the medications used to treat RA come with their risks and complications, thus your doctor’s goal will be to make an expansive impact with the smallest doses of medication over the shortest period. You should have an idea about how you’d like to approach your RA treatment and use it as your guiding light when making decisions.

Remember that written document with your personal goals, needs, and concerns? Consider stating that you’d like to keep your use of medications to a minimum for as long as possible and remind your doctor of this regularly. Again, specialists see a lot of patients, and you don’t want to find yourself on “the standard” cluster of RA medications if they are not vital to your unique situation.

NSAIDs and Steroids

Nonsteroidal anti-inflammatory drugs (NSAIDs) are most commonly prescribed to reduce pain and inflammation. NSAIDs do not stop or slow down the progression of RA. All NSAIDs contribute to an increased risk of heart attack and stroke, and they can also raise blood pressure and cause digestive complications such as ulcers, bleeding, and an imbalanced microbiome.

Steroids are commonly used to reduce pain and inflammation during RA “flare ups.” Some patients must use steroids to treat RA symptoms on an ongoing basis. Long-term side effects may include high blood pressure, osteoporosis, and diabetes.

DMARDs and Biologics

Disease-modifying antirheumatic drugs (DMARDs) are prescribed to slow or stop the progression of RA. An overactive immune system is found at the root of RA and DMARDs essentially shut down your body’s immune response. Unfortunately, DMARDs curb your entire immune system leaving you vulnerable to infections. If DMARDS are ineffective, then your doctor might prescribe biologics, genetically engineered proteins that block your immune response, thus slowing or stopping the progression of RA.

Both of these treatment methods suppress your body’s immune system and leave you defenseless against infections. If you’re prescribed DMARDs or biologics, it would be wise to consult a holistic practitioner about probiotics, adaptogens, and other methods of healing and supporting your body during treatment.
It’s important to minimize your need for medications by adopting an anti-inflammatory lifestyle and diet. Medication may become necessary, but be careful not to load up on prescriptions that aren’t vital to your unique situation.

Lifestyle practices that may reduce the need for RA medications

• Explore alternative methods of pain management such as acupuncture, CBD oil/medical marijuana, herbal tinctures, and physical therapy or massage if it’s fitting.
• Consume plenty of omega-3 fatty acids or take a fish oil supplement. Wild caught salmon, mackerel, herring, tuna, flax oil, chia seeds, pecans, leafy greens, and beans are great sources of omega-3 fatty acids.
• Add plenty of antioxidant-rich foods. This includes fresh berries, nuts and seeds, green tea, raw cacao, and virtually all fresh fruits and green vegetables.
• A diet rich in fiber has been shown to reduce the amount of C-reactive protein (a marker of inflammation) in the blood. The key here is to focus on fiber from vegetables and ancient grains, like quinoa or amaranth, as opposed to wheat and corn products. Foods that contain wheat and gluten are known to promote inflammation within the body.
• Adopt the Paleo lifestyle. A quick Google search for “rheumatoid arthritis + Paleo diet” will reveal testimonies of those who have “healed” RA by adhering to the Paleo way of eating.
• Take turmeric and tart cherry juice consistently. Turmeric is one of the most powerful anti-inflammatory foods known to man, and tart cherry juice is a close runner up often touted for its effectiveness with arthritis patients.
• Avoid trigger foods. It’s in your best interest to minimize or completely remove processed foods, gluten, dairy, processed meats, refined sugars, and caffeinated beverages such as coffee or energy drinks from your diet.