What’s the Difference Between Osteo & Rheumatoid Arthritis? How Can Ayurveda Help? Plus: SPRING DETOX – Open Enrollment – your SV Ayurveda Newsletter March 16, 2023 – #10, Vol 12

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— you don’t have to live with it!


Dr Marianne Teitelbaum

Osteoarthritis is a very common condition which results from wear and tear on the joints, breaking down the cartilage in the joint, causing pain, inflammation and stiffness.

On the other hand, Rheumatoid Arthritis (RA), does not occur from wear and tear — it is a condition where the immune system mistakenly starts attacking the joints. Even children and babies are known to come down with this condition. In a minute we’ll discuss all the reasons why the immune system loses its intelligence and begins to mount its horrific assault on the joints.

But first, let’s learn a little interesting anatomy about the structure of our joints.

Inside our synovial joints is a layer of connective tissue called the synovial membrane. Synovial joints are movable joins that enable us to flex, extend, rotate, abduct and adduct the joint. The joint is made up of a sac-like fibrous joint capsule, a synovial cavity filled with synovial fluid and a layer of articular cartilage. 

The joint capsule is the capsule surrounding a synovial joint. It contains two layers — the first layer is a fibrous membrane that lies in the outer part of the capsule. It is made up mainly of ligaments, which is why it is so fibrous.

The second layer, which is the inner layer of the joint capsule, is the synovial membrane. This membrane is made up of two layers: an outer layer of connective tissue and the inner layer is made up of two types of cells: fibroblasts and macrophage-like cells.

Let’s focus our attention on the fibroblasts. The fibroblasts secrete synovial fluid which is a clear viscous fluid that functions by lubricating the joints. It contains protein and hyaluronic acid and serves as a lubricant to the joint cartilage surfaces. It also supplies nutrients and oxygen to the joints and removes toxins away from the joints. Some types of fibroblasts make collagen and even cartilage.

So the main function of the fibroblast is to protect the joint. But in Rheumatoid Arthritis the synovial fibroblasts become abnormal, aggressive and destructive. 

One theory is that our genetics could predispose us to RA but we have to dig a little deeper and look at the situation from the perspective of epigenetics.

So what this means is that, yes you may contain the gene for RA, but that doesn’t necessarily mean you will come down with RA just because you have the gene for it. But it does mean that your behaviors and environment will determine whether the gene will wake up and express itself or not. So it is epigenetics that can determine if the gene is turned on or off. Things which turn on the gene are a processed diet, obesity, physical activity or trauma, cigarette smoking, alcohol consumption, environmental pollutants, exposure to air pollution or heavy metals, psychological and emotional stress and working the night shift.

So for example, we could line up 100 people who have the RA gene. Those who might actually come down with RA would be those that make these “mistakes” and drink alcohol or maybe they smoke cigarettes, or are eating an unhealthy fast food diet, or are exposed to heavy metals and pesticides.

These mistakes turn on the gene and then you can come down with RA. So having the gene for RA just means that the gene will be quiet, and you will never even know you had that gene. But then if you make any of the mistakes I just mentioned, then in your case you trend towards developing RA. Someone else might make similar mistakes you are making, but their gene expresses itself as something else, such as ulcerative colitis or scleroderma, or diabetes. It just depends on the genes you inherited.

So let’s say you have the gene, and you are making some of these mistakes. Then the gene’s switch is turned on and now the body begins making destructive fibroblasts. These are called Rheumatoid Arthritis Synovial Fibroblasts or RASF’s. So these “evil RASF’s” have an increased capacity to migrate, they can leave the joint and spread through the bloodstream and implant in another joint. 

The regular intelligent fibroblasts stay in the same joint and never leave the area. But these evil fibroblasts can travel and implant into a different joint – much like cancer metastasizes. 

Then the RASF’s produce pro-inflammatory cytokines which trigger an inflammatory response in the joints. And to make matters worse, the RASF’s can produce enzymes which break down the joints in contrast to the normal fibroblasts which build up and protect the joints.

Rheumatoid arthritis can eventually even damage the skin, the heart, blood vessels and ravage the whole body. 

But remember though: your genes have both and on and an off switch. All you need to do is to stop making the mistakes, clean up your diet, go to bed early, stop smoking cigarettes and drinking alcohol, and avoid exposure to chemicals and pharmaceuticals which disturb your immune system. By doing this and learning how to pull out the toxins which are disturbing your immune system and joints, the gene will settle down and the RA symptoms will start to dissipate as your immune system regains its intelligence and stops launching its attacks on the joints.

If you’ve been listening to any of my other videos by now you know that the immune system is intelligent and knows not to attack your own body. But the immune system basically consists of 3 major parts: the friendly bacteria in the gut, the liver and the bone marrow.

What you CAN Do! 

So first and foremost, you want to avoid medications which destroy your friendly bacteria. Medications such as antibiotics, birth control pills, acid reflux medicines, steroids and immunizations. If you have a history of taking any of these you must regrow your friendly bacteria or you could suffer the consequences of your immune system spiraling out of control since your gut micro biome, or the friendly bacteria in the gut, stabilize your immune system and keep it from attacking you. The use of these pharmaceuticals in modern times is responsible for many of the epidemics of autoimmune diseases we are seeing nowadays. 

Next you must keep your liver clean and cool. Too many toxins in a highly processed diet combined with too many pharmaceuticals heat up the liver as they course through it. Once the liver heats up, it provokes the immune system to go in the attack mode, and you could develop RA if you have the gene for it. So you must cool the liver, clean it out and regenerate liver cells, especially if you have been raised on vegetable oils which form a poison once heated and damage the liver cells. Of course, you should contact an Ayurvedic physician who is well trained in repairing and cleaning the liver. Don’t try to do this on your own or you run the risk of pushing yourself further into an autoimmune crisis if you take remedies which could heat up the liver even more. Remedies such as milk thistle, garlic capsules, MSM, flax seeds, turmeric and garlic capsules, shilajit, and ashwagandha, to name a few. Notice that many of these remedies are recommended incorrectly for people with RA.

Third, you must clean the bone marrow since modern toxins such as pesticides, air pollution, heavy metals, immunizations and many other pharmaceuticals wind up in the bone marrow on a regular basis. And the bone marrow is where the immune system cells are born, so if toxins reach this very deep tissue autoimmune diseases may result.

Once you balance out all three parts of the immune system you must change your diet to a healthy one — also, work with your Ayurvedic physician on this. And you must learn to do correct detox, always making sure your body’s physical channels are well lubricated since it is these channels that have to carry out these very hot nasty toxins into the bowel movement, urine and sweat. If you pull out the toxins too quickly and if the channels aren’t well lubricated you run the risk of rupturing the channels, and the toxins are free to roam throughout the whole body and you are now in even bigger trouble since you can’t get to them anymore. Yet another reason to contact an Ayurvedic physician who is familiar with this problem.

Then you must use herbs to calm down your hyper immune system which will allow the inflammation to go down and then of course the herbs to heal the cartilage, synovial fluid and collagen formation. Yes, believe it or not, we have a whole arsenal of herbs and other remedies which can heal the joints and the cartilage. And we even have herbs that work exactly like steroids, but without the side effects, so you can stay on them longterm until the autoimmune tendency and inflammation goes away.

Current treatments for RA involve shutting down the immune system in order to stop the attacks on your joints. While this approach may work it is a scary notion to be walking around with a turned off immune system. The approach we take is to modulate the immune system, or gently bring the hyper-reactive immune system back down to normal. And as a side note here: if you have RA, or any other autoimmune disease for that matter, you definitely don’t want to take any herbal formulas which “boost” your immune system. Occasionally I run into a patient who is doing just that, and I make sure I take them off the remedy since their immune system is already too boosted. What we need to do is to calm it down so it stops hyper-reacting and attacking the body.

And one other thing: we might study the body as if it is made up of various components, such as the endocrine system, the nervous or digestive system, the immune system. But the real truth is that anything can affect anything, due to the various connections made on the inside of the body which pulls all the systems together as one. So if one area goes out of balance it could affect many other systems and processes in the body, even if they seem unrelated. That’s why we often see thyroid involvement with rheumatoid arthritis, for example. So in these cases you have to see all the reasons which are disrupting the thyroid gland and support it since a weak thyroid contributes to joint pain.

And of course, in Ayurveda we also evaluate the state of Vata, Pitta and Kapha since imbalances in each of these principles which govern all aspects of the physiology can create joint pain — Vata can dry out the joints and cause severe pain, pitta can create heat and inflammation in the joints and kapha can create stiffness in the joints, especially if digestion is sluggish and you are creating ama (partially digested food) which can accumulate in the joints. So in these cases we have to teach the patient how to keep all three in balance as they go through their life. 

And finally, our emotional states can also cause autoimmune reactions in the body because if you are angry, stressed, or grieving your digestion can be impaired to the point where you could be making ama visha from your food. Ama visha is a very hot reactive toxin which gets produced by anything which could interfere with the normal digestion of the food. When food is only partially digested it forms what is called ama, or a residue of undigested food which clogs the digestive channel. But then once the initial channel clogs, all subsequent channels in the body can clog, which could cause stiffness and pain, as I just mentioned.

But if the ama rots and ferments, an acidic more highly reactive version of itself forms, which is called ama visha. The word visha means poison. So ama visha is worse than ama because this hot acidic toxin can pave the way for autoimmune diseases due to its hot tendency which can quickly push the immune system into highly inflammatory autoimmune reactions. But when there is emotional stress, the food turns into ama visha immediately, which means it doesn’t have to first form ama, and then rot into ama visha. That’s why imbalanced emotional states can adversely affect the body immediately.

Fortunately, we have herbs and many other treatments to help you deal with your emotional challenges and effective ways of ridding the body of ama visha. For example, regular ama is cold and clogging, so it needs to be burnt out of the channels using hot spices and herbs. However, ama visha is already hot, reactive and inflammatory, so clearing this from the channels requires an artful approach so as not to inadvertently create more heat which will push the immune system into more autoimmune reactions.

So now you know if you suffer from Rheumatoid Arthritis there is another alternative for you. First, it involves determining what mistakes you are making so you can reverse the bad habits, and then work on recalibrating your immune system by eating healthy and doing the necessary detox so that your immune system can once and for all get back on track so those evil RASF’s can fade away, allowing the normal fibroblasts to do their work in protecting your joints for your whole life.

Thank you,

Dr. Marianne Teitelbaum

Cinnaminson, New Jersey



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