Borage-seed oil for rheumatoid arthritis
patients with active rheumatoid arthritis were randomly assigned
to receive, in double-blind fashion, 2.8 g/day of gamma-linolenic
acid (GLA; from a concentrate prepared from borage-seed oil)
or placebo (sunflower oil) for six months. Subsequently, all
patients received GLA, in single-blind fashion, for an additional
six months. After the first six months, the improvements in
the following parameters were significantly greater in the GLA
group than in the placebo group: swollen joint count, tender
joint count, tender joint score, pain, and Health Assessment
Questionnaire score. Meaningful clinical improvement (at least
25% improvement in four measures) occurred in fourteen (63.6%)
of twenty-two patients in the GLA group, compared with four
(21.1%) of nineteen patients in the placebo group (p = 0.015).
During the second six months, both groups showed improvement
in disease activity. Of the twenty-one patients who received
GLA for twelve months, sixteen (76.2%) showed meaningful improvement
at twelve months, compared with baseline. Adverse reactions
included belching (three in the GLA group, two in the placebo
group) and diarrhea (four in the GLA group, one in the placebo
This study demonstrates that borage-seed oil is a well-tolerated
and effective treatment for active rheumatoid arthritis. The
results of this study were similar to those from a previous
trial with a lower dose of borage-seed oil (1.4 g/day of GLA).
The additional finding in the present study was that continued
treatment beyond six months resulted in further improvement.
Although it is not known how borage-seed oil works against rheumatoid
arthritis, GLA is believed to stimulate the synthesis of prostaglandin
E1, which might, in turn, enhance the production of suppressor
RB, et al. Gamma-linolenic acid treatment of rheumatoid arthritis.
A randomized, placebo-controlled trial. Arthritis Rheum
pollution and autoimmune disease
prevalence and incidence of systemic lupus erythematosus (SLE)
was investigated in an African-American community in Gainesville,
Georgia, that had been exposed to industrial emissions for a
long period of time. The prevalence of SLE was 300 cases per
100,000 population, and the incidence was 63.7 cases per 100,000
person-years. These numbers were six-fold and nine-fold higher
than the highest previously reported prevalence and incidence,
respectively, of SLE.
Sixty years ago, SLE was an uncommon disorder, affecting an
estimated 3-4 individuals per 100,000. Today the estimated prevalence
of this disease has increased by about 4-15-fold. Some of this
increase may be due to more reliable diagnostic tests; however,
it is also possible that more people are developing the disease
today than in years past. The present study suggests that environmental
pollution plays an important role in the etiology of SLE. I
propose an intervention trial: we clean up the environment around
Gainesville, Georgia and then see what happens to the incidence
of SLE over the next thirty years. Better still, lets
do a multi-center trial and clean up the whole planet.
T, Frumkin H. Systemic lupus erythematosus in relation to environmental
pollution: an investigation in an African-American community
in North Georgia. Arch Environ Health 1997;52:85-90.
infections and rheumatoid disease
to the author, amoebae of the genus Naegleria have been demonstrated
in all human tissues, particularly in those taken from patients
with various types of rheumatoid disease. These organisms can
be killed in vitro by metronidazole, clotrimazole and
other nitroimidazole drugs. Treatment of active cases of rheumatoid
disease by any of these anti-amoebic drugs has resulted either
in cessation of the disease or a temporary exacerbation of symptoms,
followed by their lessening or disappearance (Herxheimer reaction).
It is generally accepted that protozoal infections can cause
reactive arthritis; however, the observations of
the late Dr. Wyburn-Mason have never been taken seriously by
conventional medicine. I have administered a course of metronidazole
to approximately 40 patients with various rheumatoid disease
(including rheumatoid arthritis, psoriatic arthritis, and ankylosing
spondylitis); nearly half of these patients experienced marked
and long-lasting benefit. The most impressive case was that
of a middle-aged man with a ten-year history of moderately severe
psoriatic arthritis that never fluctuated in intensity. Within
five days of starting metronidazole, the arthritic symptoms
disappeared and did not return over a five-year follow-up period.
The work of Wyburn-Mason was the basis for the formation of
the Rheumatoid Disease Foundation, now called Arthritis Trust,
PO Box 8949, Topeka, KS, 66608-8949.
R. The Naeglerial causation of rheumatoid disease and many human
cancers: a new concept in medicine. Med Hypotheses 1979;5:1237-1249.
lupus with witchcraft
28-year-old Phillipine-American female developed weakness, hepatomegaly,
lymphadenopathy, and albuminuria. Laboratory tests were diagnostic
of systemic lupus erythematosus (SLE). Around the same time
she developed hypothyroidism and was placed on L-thyroxine.
Although the patients SLE responded for awhile to prednisone
(which caused numerous side effects), she subsequently developed
lupus nephritis which failed to respond to a combination of
prednisone and azathioprine. A renal biopsy showed membranous
and focal glomerulonephritis and immune complex disease. When
high-dose, sustained prednisone and cyclophosphamide were recommended,
the patient chose instead to return to the remote Phillipine
village of her birth. Much to the surprise of her physicians,
she returned three weeks later without any clinical evidence
of SLE. She declined further treatment with prednisone or thyroid
hormone and refused further testing of blood and urine, as directed
by the village witch doctor, who had removed the curse placed
on her by a previous suitor. Two years later she remained well
and insisted that her SLE had been cured by removal of the evil
spirit that had caused her original symptoms.
According to the author of this report, it is unlikely that
this patients SLE burned out. The mechanism
by which an Asian medicine man can cure active lupus nephritis,
change myxedema into euthyroidism, and allow precipitous withdrawal
from corticosteroid treatment without triggering adrenal failure
RA. Witchcraft and lupus erythematosus. JAMA 1981;245:1937.
allergy and lupus
infant with recurrent upper respiratory symptoms and pulmonary
infiltrates was found to have LE cells, tart cells, and milk-precipitating
antibodies in serum. Symptoms resolved after elimination of
cows milk from the diet, but recurred on two occasions
after ingestion of milk. The appearance of tart cells (which
result from phagocytosis by polymorphonuclear leukocytes of
dead nuclei) appeared to be related to ingestion of milk and
to the change in milk antibody titers. This case is consistent
with a diagnosis of atypical SLE due to milk allergy.
The relationship between food allergy and autoimmune disease
has not been studied extensively, although there are some reports
of food allergy as a triggering factor for rheumatoid arthritis
(Lancet 1986;1:236-238.) and some other less common rheumatological
conditions. It has been demonstrated that antigenic macromolecules
from food can be absorbed intact from the gastrointestinal tract.
These molecules can trigger the production of antibodies which,
depending on a persons genetic makeup, might initiate
an autoimmune process. Although additional research is needed,
the clinical response to an allergy-elimination diet is often
JA, et al. Hyperreactivity to cow's milk in an infant with LE
and tart cell phenomenon. J Pediatr 1974;84:59-67.
of lupus with acupuncture
patients with systemic lupus erythematosus (SLE) were treated
with acupuncture. Ten of these patients had not received previous
glucocorticoid therapy and were treated with acupuncture alone.
The others, who had failed to respond to treatment with glucocorticoids
for at least five months, were treated with acupuncture and
gradually decreased their steroid dosages. A well-matched control
group was also followed for comparison. Acupuncture treatment
was associated with considerable improvements in symptoms, signs
and laboratory findings.
Because there was no placebo group in this study, one cannot
rule out the possibility that some of the reported benefit was
due to a placebo effect. Of course, acupuncture is a safe treatment
and SLE can be a serious disease, so patients have little to
lose by trying this treatment. One way to perform a double-blind
study of acupuncture is to randomly assign patients to receive
appropriate acupuncture or sham acupuncture and then have the
needles placed by someone who does not know whether the points
are real or sham.
F, et al. Treatment of systemic lupus erythematosus by acupuncture.
A preliminary report of 25 cases. Chin Med J 1985;98:171-176.
patients are reported with clinically and serologically quiescent
systemic lupus erythematosus (SLE) who experienced reactivation
of their disease in association with ingestion of alfalfa tablets.
One patient, whose disease had been inactive for at least four
years, had an exacerbation after ingesting 15 alfalfa tablets
per day for nine months. The other patient showed a progressive
exacerbation of her disease over an 18-month period; she had
been ingesting eight alfalfa tablets per day for 2.5 years.
Analysis of the alfalfa tablets revealed the presence of L-canavanine.
Administration of L-canavanine has been shown to exacerbate
the severity of kidney damage and to increase antinuclear antibody
titers in NZB and (NZB x NZW) F1 mice (animal models of SLE).
In addition, a lupus-like syndrome developed in monkeys fed
a diet containing 40% dried alfalfa sprouts. It is not known
whether ingesting small amounts of alfalfa sprouts could cause
problems in individuals with autoimmune disease. Alfalfa meal
(as opposed to the seeds) has not been found to contain L-canavanine
and has not been reported to be associated with autoimmune disease.
JL, et al. Exacerbation of SLE associated with alfalfa ingestion.
N Engl J Med 1983;308:1361.