AUSTRALIAN NATUROPATHIC NETWORK
 Serving the community since 1998

The following case studies do not represent implemented treatment programs. They are protocols developed by students in the course of their studies, and should be taken as examples only.

Note - Anyone suffering from the conditions described below should seek advice from a primary health care practitioner. No responsibility is taken for any individual attempting to use the treatments described in these studies.

Woman 66 y.o.a suffers from osteoarthritis. She has broken her leg-lower 3 years ago and found it very difficult to do any exercise, yet she persevered with walking 4 times weekly until recently she developed back pain and great muscle soreness in her shoulders and arms. Her doctor has given a diagnosis of Ankylosisng Spondylitis, but is carrying out further tests. The anti-inflammatory drugs are paying havoc with her digestion. Her diet consists of meat and vegetables, heavily salted, 3-5 coffees, and 3-5 wines daily.

Definitions

Osteoarthritis is a degenerative joint disease often referred to as rheumatism¹. It is most often associated with joints subject to excessive wear and tear (eg the weight bearing joints of the knees, hip ankle and spine). A wearing and erosion of the protective cartilage is combined with inflammatory attack to lead to progressive breakdown of the joint, with pain and disability².

Ankylosing Spondylitis is a painful progressive rheumatoid disease involving the spine and sacro-illiac joints. The basic lesion is synovitis, leading to calcification of the spinal ligaments. It is more prevalent in men than woman¹.

Mitigating Factors – Ankylosing Spondylitis

• 10-20% of patients with inflammatory bowel disease get ankylosing spondylitis¹

• Concentrations of serum IgA and secretory IgA (presumably from bowel mucosal origin) are raise in spondylitis. This would suggest the presence of a sort of bowel inflammation¹

• Bowel infection are associated with reactive arthropathy which in turn can be complicated with inflammatory spinal disease¹

• The disease can be precipitated by certain micro-organisms that seemingly lie dormant in the individual. Klebsiella has been associated with the destruction of HLA-B27 positive lymphocytes of patients with ankylosing spondylitis¹

• Serum vitamin E levels were lower than normal in these patients. Supplementation resulted in the relief of pain. (Alpha and gamma tocopherol should be used.)¹

Treatment Goals

• Heal and seal the gut
• Treat infection by micro-organisms
• Encourage remineralisation of the bone
• Reduce pain
• Increase range of movement
• Excrete waste product
• Improve integrity of cartilage

Dietary Considerations

Dietary Supplements

Vitamins C, D, E, B9, B12, B5, B3

Minerals Copper Chelate topically¹

Probiotics to increase presence of bowel flora

Glucosamine (enhances cartilage repair)¹

Life Style

Low stress exercise – walking and especially swimming is possible.

As and when reduce intake of anti-inflammatory drugs these will slow down cartilage repair.

Herbal Protocol

I would probably proceed with a three formulas addressing the problem from a number of fronts:

1. enhance function of the gut addressing inflammation and infection;
2. address arthritis and spondylitis;
3. provide a night time brew to aid sleep and reduce pain at night.

Naturally I would consider the patients ability to afford the medication, and her likely compliance, before using so many mixtures. If this proved to be a problem, I would reduce the number of mixes by (at least) combining the gut mix with the arthritis/spondylitis mix. I might also consider the use of Boswellia serrata tablets.

Heal & Seal Mix

The classes I would use include:

Astringents – to heal the walls and lining of the GIT

Antimicrobials – to address GIT infection

Demulcents – to sooth and heal the gut wall

Gastric acid normaliser – to aid with digestion, pain, dyspepsia

Hepatic/Bitter – to normalise liver function/aid elimination/aid digestion

Antispasmodics – to reduce gut tension and aid in relaxation

Dosage – start low (2ml tds) to avoid over-addressing liver detox then build over the next few weeks to 5mls tds. Probably taken 30 minutes prior to meals.

Ulmus fulva (1 tablespoon in warm water) would also be suggested 30 minutes before meals.

Arthritis & Spondylitis Mix

The classes I would use include (care must be taken not to overdo the detoxification regime):

Alteratives – to aid in the elimination of toxins from the system

Antiinflammatory – to reduce inflammation as it occurs and relieve some pain

Analgesic – to relieve pain

Immunostimulants – to enhance the immune system and aid in elimination of infection

Circulatory Stimulants – to improve circulation to the affected areas and remove metabolic wastes

Antispasmodics – to reduce muscle tension around joints that could be contributing to the pain

(Possibly) Immuno-depressants – to normalise overactive parts of the immune system

Also may add Tylophera indica in drop doses as immuno-depressant.

Dosage – 5mls tds to be taken between meals when stomach acid at lowest.

Night time mix

To aid with sleep I would suggest the following prior to retiring:

Dosage – 5mls tds half an hour prior to retiring.

Also suggest use of external rubefacient rubs such as Ruta graveolens, and Capsicum annuum for pain relief.

Cautions and Contraindications³

General caution if patient is sensitive to salicylates.

References

1. Osiecki H, The Physician’s Handbook of Clinical Nutrition – 5^th Edition, Bioconcepts Publishing, Queensland, 1998.

2. Mills, S., The Complete Guide to Modern Herbalism, Thorsons, Great Britain, 1994.

3. McGuffin, M., Hobbs, C., Upton, R., Goldberg, A., American Herbal Products Association - Botanical Safety Handbook, CRC Press, 1997.