Fighting Back
How Lifestyle Changes Can Help Significantly with Managing the Pain, Inflammation and Fatigue of Autoimmune Disease
BY Melissa Ott, RN, MS, NP-C, FNP
Carolina Arthritis Center in Greenville is committed to providing the best quality and most up-to-date care for their patients. Specializing in rheumatologic diseases including arthritis (joint pain and swelling), rheumatoid arthritis, gout, lupus, osteoarthritis and muscle diseases.
The single-specialty office offers patients the convenience of on-site labs for both routine and special testing; radiological services such as x-ray, bone density and musculoskeletal ultrasound; and infusion therapy for the treatment of arthritis and osteoporosis in a comfortable setting.
At Carolina Arthritis Center, we treat patients with osteoarthritis and many types of inflammatory autoimmune diseases such as lupus, scleroderma, rheumatoid arthritis, psoriatic arthritis, myositis, vasculitis and sarcoid disease among others. Many of our patients also suffer from fibromyalgia symptoms that further complicate their treatment. All of these diseases may cause fatigue, pain, stiffness and immobility of the joints and muscles.
Research now tells us that the risks of developing cancer, heart disease and stroke are intensified by chronic inflammation in the body. If you suffer from any of these diseases or other types of inflammatory illness, it is imperative that you understand that your diagnosis requires you learn to balance your lifestyle to minimize your pain and symptoms, and reduce the overall risks to your body of developing more serious complications or disease states. These are just a few ideas that can help you get started.
Food is medicine: If you eat junk food, you will feel junky. Americans eat a lot of junky foods and tend to exercise less than people from other countries for many reasons. Rates of Alzheimers disease, cancer and heart disease are higher in the US than in other countries. The US has the fifth highest number of cancer cases in the world, of course there are many variables involved. One variable is definitely the food that we consume. Packaged and frozen dinners, fast food, canned food (high in salt) and processed meats (salami, hot dogs, bologna, liverwurst) should be avoided most of the time. Try living by the “80/20 principle”, follow a healthy diet 80% of the time, and allow yourself small amounts of these foods no more than 20 % of the time. Better to avoid them altogether if you can. Nitrates in frozen and processed foods cause pain and inflammation, high blood pressure, and kidney disease. Learning to follow an anti-inflammatory diet is usually life altering for those that pursue this lifestyle, and really does not have to be boring or difficult.
The National Heart lung and Blood Institute developed the DASH diet years ago. DASH stands for Dietary Approaches to Stopping Hypertension (high blood pressure). You can find books written on this subject in the library or book store or on the internet. There are free DASH diet recipes available on the internet and a free PDF packet with a seven-day meal plan at the end to help to get you started. The DASH diet is an anti-inflammatory diet. Use of this way of eating can help you reduce inflammation in the body, improve your overall health status, energy levels and help you lose weight if you need to.
Use google and type the following: NHLBIDASHDIET. You will find multiple articles and tools including a free PDF packet that explains this dietary change and helps you add more foods to your daily intake that will help reduce inflammation in the diet. It’s not rocket science. The goal is to eat more foods that contain potassium and magnesium (fruits and vegetables!) if you take in more potassium and magnesium, then you will excrete more sodium through your urine and the result is lower blood pressure, less swelling and less inflammation in the body. This is a blood pressure diet created by the National Heart Lung and Blood Institute, but overall it is an anti-inflammatory diet. It promotes “getting the good foods in”, rather than being deprivation driven like other diets. Tell yourself you deserve better foods, your body deserves to feel better. Be positive toward yourself and make yourself a priority on your list of things to do.
Sleep: It is as important as food and water. If your provider has recommended you be evaluated with a sleep study, take it seriously and go through the process. Accept treatment if a disorder is diagnosed to gain more restful and restorative sleep. Your body needs this.
Sleep hygiene: Allow your body 8-9 hours for sleep every day. If you sacrifice sleep, your symptoms will flare and you will inevitably have more distressing symptoms. Make your bedroom a peaceful space, free of clutter. Turn off all screens, smartphones, TV’s, iPad, computers etc. one hour prior to bedtime. Set a sleep time and stick to it, set a wake time and stick to it. Don’t cut yourself short on sleep.
DRINK WATER, NOT SUGARY DRINKS: Sugar promotes more inflammation. Water helps flush out inflammatory proteins. Water intake is also critical to dissolving crystals of gout and pseudo gout.
Over the counter supplements that may be helpful for sleep.
Always consult your medical provider before you begin taking a supplement or make any changes to your existing medication and supplement routine. This is not medical advice, but it is information you can use as a conversation-starter with your medical provider at your next appointment.
Glycine is a non-essential amino acid responsible for aiding many functions in the body. Taking 1 gram at bedtime helps promote a more restful sleep, better memory, and helps reduce pain and inflammation. You should NOT take Glycine supplements if you are less than 18 years of age, are pregnant or breast feeding, have liver or kidney disease or are taking the medication Clozapine. All supplements can have side effects and interactions, rare side effects reported with Glycine supplements include stomach upset, nausea, vomiting and diarrhea.
Bragg Apple Cider Vinegar: 3 tsp in 4 ounces of unsweetened, organic apple juice or apple cider up to four times a day. Promotes more restful sleep, aids with reduction of inflammation in the body and improves overall energy level.
Melatonin 3-5 mg at bedtime, helps promote a more restful sleep. Melatonin is a naturally occurring hormone in the brain. Melatonin levels rise in the evening to aide with promoting sleep onset. Doses of melatonin that exceed 5 mg are known to cause night mares in some people. Children and adolescents should not take melatonin unless directed to by a qualified medical provider as it can bring on hormonal changes that could delay puberty and maturation.
Supplements that reduce inflammation:
Coenzyme Q10 200 mg daily: This is a naturally occurring enzyme in the body. In chronic inflammation the levels of this enzyme may already be decreased. Cholesterol lowering drugs called “statins” can further reduce Coenzyme Q-10 levels in the body causing pain in joints and extremities and muscle fatigue. Taking the supplement can reduce the potential side effects of the medication and is helpful in reducing inflammation in the body. If your medical provider has instructed you to take a daily statin for your cholesterol, it is important that you follow their instructions.
Vitamin C 500 mg daily: helps to reduce inflammation and improve immune function and is an antioxidant.
Turmeric capsules: It may be difficult to cook with enough turmeric to make a difference for someone who eats a typical American diet. Turmeric capsules can be taken to help reduce arthritic and inflammatory symptoms.
MSM: (Methylsulfonylmethane) 1000 mg daily with the vitamin C tablet. Helps with joint health. This is an important nutrient that the body uses to help create new cells and connective tissue. It is important to note that MSM can cause hot flashes or flushing, if you are struggling with these symptoms already, you may want to avoid MSM.
Vitamin B12 1000 to 1500 mg daily. Use the sublingual (under the tongue) drops or tabs. This helps fight fatigue and joint pain and helps you with brain energy, it can also help reduce neuropathy symptoms. The ideal serum level in your body should be over 550. A level “too high” is not to worry about, as it will be that way if you are taking the supplement and you will get rid of what you do not need in your urine as it is a water-soluble vitamin. Using acid blocking medications (omeprazole, pantoprazole etc.) on a regular basis will deplete your body of Vitamin B12. This is common in people with many arthritic conditions as the meds used for arthritis can cause acid reflux.
Vitamin D3 1000 to 2000 units every day unless directed otherwise by your medical provider. This is essential for your bone health. It also aids in reducing inflammation in the body. It is very common as we grow older to have a level that is too low. The ideal blood level is over 30. Your provider may actually prescribe a much higher dose if your level is very low. It is important when you finish that prescribed dosage to follow it with the daily dose to keep your blood level up or it will fall again. It is also very important to remember that this fat-soluble vitamin can accumulate in the body and cause harm to your kidneys, medical monitoring of this vitamin level is advised to prevent this.
Calcium 1200 mg daily. This is important for postmenopausal women who do not have issues with hypercalcemia, elevated parathyroid hormone or kidney stones. It helps prevent osteoporosis along with vitamin D and promotes normal functioning muscle contraction.
If you smoke: it is important that you work on quitting. Smoking causes break down of the bones, the joints and the spine. It is a huge factor in making your illness worse. Ask for help from your primary care provider if you need it. There are therapies that can help. Vaping nicotine may be helpful in weaning from nicotine addiction, but should not be considered a safe or permanent substitute for other nicotine products. There is new and emerging research indicating that vaping nicotine can cause lung disease.
Most importantly, as much as it hurts at times, make sure you move. It is true that, “if you don’t use it, you’ll lose it.” Find a method of exercise that fits your lifestyle and personality and stick to it. Even on bad days try to move. Do not take to the bed as it will increase your feelings of depression and joint stiffness and muscle spasm. Ask for help if you need it. Providers can often make recommendations of types of exercise that can help your condition. Physical and Occupational therapists can be recruited to help you learn to exercise and work to improve stability of the spine and joints to improve your ability to exercise more. Be sure to balance activity with your symptoms.
Take care of yourself! That is the most important take home message. Your diagnosis makes this more important than for others that are not struggling with your illness. No amount of medication or medical office visits will alleviate all of your symptoms alone, how you lead your life makes a big difference. I tell my patients that if they practice lifestyle changes such as those discussed in this article, they will not only feel better, but may not need to take as much medication as they would if they do not make these changes. Always discuss changes that you are considering with your medical providers as even natural over the counter supplements can interact with certain medications and cause problems in people with certain conditions. Fight back, feel better!
Carolina Arthritis Center is located at 2355 Hemby Lane in Greenville. For more information about services and to schedule a consultation, call 252.321.8474 or visit carolina-arthritis.com.