Rheumatoid arthritis (RA) is a chronic, systemic, polyarticular autoimmune inflammatory disease that destroys the capsule and synovial lining of joints. Antirheumatic treatment reduces disease activity and inflammation, but not all patients respond to treatment. Naturopathy is claimed to be effective, but there is little data on the effect on inflammation and disease activity in RA. The objective of this study was therefore to explore the effect of 12 weeks of integrated naturopathy interventions on disease-specific inflammatory markers and quality of life in RA patients.
A total of 100 RA patients were randomized into two groups:
- the naturopathy group (integrated naturopathy interventions with routine medical therapy),
- the control group (only with routine medical therapy).
Blood samples were collected pre- and post-intervention for primary outcome measurements of systemic inflammatory markers (ESR, CRP, and IL-6). Disease activity score (DAS-28) and quality of life were used to assess disease activity and functional status using SF-36, respectively, at pre- and post-intervention time points.
The results show a notable decrease in disease activity after 12 weeks of naturopathy intervention. As such, a significant decrease was found in levels of systemic inflammatory markers such as ESR (p = 0.003) and IL-6 (p < 0.001), RA disease activity score (DAS-28) (p = 0.02), and most of the components of health-related quality of life (SF 36 scores) (p < 0.05) except in vitality (p = 0.06).
The authors conclused that the findings of the present study suggest that integrated naturopathy treatments may have the ability to control persistent inflammation, maintain immune homeostasis, and lower disease activity.
The naturopathic treatments included:
- acupuncture,
- hot and cold-water application to the painful joints,
- sauna baths,
- enemas,
- fasting,
- mud therapy,
- massage therapy.
The study was designed as an A+B versus B trial. Therefore, it is hardly surprising that subjective endpoints improved. A little more baffling are the changes in objective parameters. These could easily be due to the fasing interventions – there is reasonably sound evidence for such effects. Take this review, for instance:
Fasting is an act of restricting, for a certain length of time, food intake or intake of particular foods, and has been part of religious rituals for centuries. Religions such as Christianity and Islam use this practice as a form of sacrifice, self-discipline, and gratitude. However, in the past decade, fasting has penetrated the mainstream as a diet trend. There are several ways of fasting; existing fast mimicking eating methods promise accelerated weight loss, and many more benefits: lower cholesterol, prevention of type 2 diabetes and a longer lifespan. Even more, it has been proposed that fasting can downregulate the inflammatory process and potentially be used as a treatment regimen for several diseases. Here, we review the effects of fasting on immune and inflammatory pathways. Also, we present current knowledge about the role of fasting in the activity of inflammatory arthritides with a focus on rheumatoid arthritis.
What I am trying to say is this: some modalities used in naturopathy might well be effective in treating certain conditions. In my view, this is, however, no reason for condoning or recommening naturopathy as a whole. Or – to put it bluntly – naturopathy is a weird mixture of pure nonsense and some possibly reasonable interventions.
9 Responses to Effect of Naturopathy on Systemic Inflammatory Markers and Quality of Life in Rheumatoid Arthritis
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Anyone could set himself or herself up as a “Naturopath”, and simply by instructing every patient (if operating in the Western world) to avoid dairy and wheat, could see genuine improvement in inflammatory conditions in a certain percentage.
As I understand it (having, like Barbara O’Neill and Dana Ullman, no medical qualifications whatever), it tends to be the foodstuffs we ingest most of, that we develop either IgE allergies or some other specific chemical sensitivity to. In the far east, the same might work for rice, but they don’t consume nearly as much wheat or dairy protein.
When I used to read about this stuff years ago, in the USA a “lamb and pears” diet was written about as a low allergy diet as lamb isn’t the most popular meat there, nor pears the mass-consumption fruit.
It’s a shame that such a poorly thought-out ‘study’ as the one above, gets the credence of being published anywhere.
“IgE allergies”
Are you sure?
My experience is that quacks often recommend bogus IgG tests for allergies and/or intolerances.
Well, I’m dredging up stuff I’ve not read up on in some years, but here goes with my understanding:
The true, narrow, and restricted meaning of “allergy” (not actually that old a word) is an inflammatory response arising from raised levels of Immunoglobulin E (IgE) produced as an unwanted reaction to a specific protein. This is possibly due to a skewed TH1/TH2 lymphocyte balance. The test for raised IgE levels in response to specific proteins is called the RadioAllergoSorbent Test, or RAST. It requires a blood sample. It is not as reliable in young infants, giving false negative and false positive results.
It has been suggested that Immunoglobulin G (IgG) responses to proteins may play a role in some inflammatory reactions, and companies like York Laboratories offer IgG tests. While the tests are accurate in reliably identifying IgG responses to specific proteins, evidence is sketchy, so far as I understand, as to whether such raised IgG levels have a role in producing actual symptoms.
See also:
ASA Adjudication: YORKTEST Laboratories Ltd.
https://quackwatch.org/allergy/tests/yorktest/
You’ve said what I said, but with references!
The word “allergy” in the strictest medical sense, is an IgE mediated antibody response to specific proteins.
RAST tests (a tautology, I know) would generally be arranged by a hospital Consultant (I only know about the UK). A blood sample would be taken and sent for analysis to detect the presence of raised levels of IgE antibodies to specific proteins. IgE responses are definitely implicated in inflammatory physiological responses.
IgG antibodies, although they can be reliably detected, have not been shown to cause definite physiological responses, and even if they were, the responses would not be “allergies” since “allergy” in the correct narrow definition refers only to symptoms caused by IgE antibody responses.
The lay public, however, may not appreciate properly the accurate definition of “allergy”, and may ascribe that term to other specific chemical sensitivities, maybe not even involving protein-mediated responses. People find a vague general idea of “allergy tests” attractive. Thus the prevalence for a while in the UK some years ago of “VEGA tests” on the high street. And thus the niche market exploited by York Laboratories to sell IgG tests. And thus, I suppose, “applied kinesiology”.
I hope I have got this right, off the top of my head. Otherwise, I will need to go away and look up, the books!
I suggest that you stop referring to the wrong companies.
“I suggest that you stop referring to the wrong companies.”
I apologise.
Perhaps I may be permitted to explain whence my terminological infelicty arose:
In 2001 I took an IgG test sold by a company called York Nutritional Laboratories. That name tended to be shortened to York Laboratories in online and print media discussions. I still have the report from York Nutritional Laboratories.
The website of York Nutritional Laboratories is offline; I don’t know when that happened.
Yorktest Laboratories according to Companies House was incorporated on 27th May 1998, so there is overlap with York Nutritional Laboratories. One name who was a Director of York Nutritional Laboratories is a Director of Yorktest Laboratories Ltd.
I am sorry for any misunderstanding that may have arisen from my carelessness in this matter. I did indicate that I was writing “off the top of my head”. I guess it’s not a good idea to do that.
As for the results of the York Nutritional Laboratories IgG test that I took, and any further observations on the uselessness (other than placebo) of such tests in managing any health conditions, that can wait for another post, if desired.
Naturopaths confuse allergy with food intolerance. Not everyone has Crohn’s disease. I am genuinely gluten intolerant, been lactose intolerant since weaning. Neither involve the immune system. For eg I had a nasty allergic reaction to an egg raised flu vaccine back in the Noughties. It closed my throat but only on one side. I am also allergic to bananas but only if I eat them. That is, so far, restricted to itchiness, tingling in the throat and hives. I’m not about to find out what comes next. I’m wary of yellow gluten free cupcakes on flights now. Tasted of lemon, no label. I had hives go hands, forearms, upper arms over three days. It was the only thing might have caused it.
BTW I can eat eggs just fine. Was working in a lab going through 70-80 dozen fertile hen eggs a week. There were so many chicken allergens floating about. I was fine in it but having them injected is obviously another level.
It’s interesting to see eating 3-4 times a day, with some calorie restriction, classified as fasting. Two points that might be worth clarifying. 1. The naturopath interventions only lasted 10 days, but results were sustained. 2. The control group became more consistent at taking their medications after education (maybe by naturopaths). This might mean the 10-day intervention was even more successful than it appears.