Susan Blum, MD, MPH, author of a new book on arthritis, outlines a three-step guide to treat joint pain.
Arthritis is the most common cause of disability in the United States, affecting as many as 37 percent of the nation’s adults. In her new book, Healing Arthritis: Your 3-Step Guide to Conquering Arthritis Naturally, Susan Blum, MD, MPH, outlines a protocol that helps readers address the root causes, rather than just assuaging the pain with pills. We caught up with her recently to talk about treating arthritis.
Experience Life | You write that the number of people with arthritis will skyrocket in coming years: Why is the incidence increasing?
Susan Blum | I believe the incidence is increasing for three main reasons:
- We have shifted to a processed-food diet that is inflammatory not just because of what is missing but also because of what is added — bad fats, sugars, animal foods from feedlot cows, etc.
- The world is moving faster with technology, and people are sleeping less, productivity is higher, and people are more stressed. This directly harms the immune system.
- Our gut microbiomes are a mess.
EL | Most people don’t associate gut problems with arthritic pain in the knees or hands. Can you explain this?
SB | Let’s start with the 100 trillion bacteria in the gut that have evolved through the history of humankind to keep our digestive tract healthy. They support our immune system and keep the intestinal lining strong. Having a healthy gut microbiome means you have lots of these good bacteria, and at the same time, you don’t have an overgrowth of harmful microbes such as yeast or harmful bacteria or parasites. When you have an overgrowth of harmful microbes, or not enough good bacteria, this is called dysbiosis, and it can damage your intestinal lining.
The intestinal lining provides a barrier, keeping what’s inside your digestive tract from leaking into your body. If the lining gets damaged, then the food and bacteria in the gut can “leak” into the body and trigger an immune reaction.
The immune system can react in many ways, all of which end up with the release of inflammation messengers and free radicals throughout the body. Studies have shown high levels of these compounds inside the joints of people with arthritis and that these compounds are the cause of the inflammation and damage.
EL | Many conventional doctors treat the symptoms of arthritis — the inflammation and pain — by prescribing drugs instead of addressing root causes. What are the problems with using these drugs?
SB | The first, big problem is that you are just treating symptoms and will rely on them forever unless you treat the underlying problem. The other main issue is that they have really bad side effects because they suppress or turn off your immune system, which makes you susceptible to getting sick from infections, not to mention digestive upset and fatigue.
But there’s no reason to suffer, and medication is often needed at the beginning when there is a lot of pain, or when it comes to rheumatoid arthritis and there is a need to do something quickly to quiet it down. But then we start working on treating the root cause of the pain at the same time. We work with food, stress, and healing the gut while people are on medication, and, as they feel better, the doctor who is prescribing the medication can help them taper it down and get off of it.
EL | Can you outline your three-step arthritis protocol?
SB | Food comes first. Do an elimination diet, eliminating gluten, dairy, soy, corn, eggs, sugar, processed food, and nightshades. Focus on eating the good stuff: antioxidants, polyphenols, fiber, whole foods, healthy fats. Take supplements to reduce inflammation: fish oil, vitamin D, curcumin, antioxidants, collagen.
Second, gut repair: two months of herbal gut cleansing supported by glutamine and probiotics.
Step 3 is the long-term plan: a Mediterranean-based diet; focus on trauma, stress, lifestyle, and sleep; gut support with food, probiotics, and glutamine.
EL | How long, on average, does it take to treat a leaky gut?
SB | To truly heal a leaky gut in someone with arthritis, first you have to treat the dysbiosis, which can take six months to a year, and then heal the intestinal lining, which can take an additional year. And for someone with severe RA (rheumatoid arthritis), they should expect to re-treat the gut with herbs to treat dysbiosis every six months or so for two years, all the while taking glutamine to heal the lining. Someone with OA (osteoarthritis) might only need to treat the gut once by following the Arthritis Protocol, and then heal the lining for an additional six months.
EL | In your book, you talk about using herbs to treat dysbiosis so that probiotics can be more effective. You write, “Think of this as weeding the garden before you plant the flowers.” Can you explain this?
SB | This is simple if you think about your garden in your yard and then your gut as an inner garden filled with flowers (good bacteria) and possible weeds (bad bacteria, yeast, parasites). You need to get rid of the weeds, which represent the harmful microbes. You need a weed killer, which are the herbs. You can’t just plant flowers (probiotics) and think that you can get rid of the weeds that way.
EL | Currently, fecal transplants are largely used only to treat C. diff, but what do you think about their possible efficacy in treating leaky gut overall?
SB | I think FMT (fecal microbial transplant) is something that will potentially be a great thing for people with chronic microbial imbalances that we just can’t get repaired with the standard gut-repair approaches. Right now, I don’t recommend it as a routine kind of treatment because I don’t think we really know enough about the effects of different strains and microbes that we are giving in the transplant.
EL | You outline three different types of arthritis that are common — inflammatory arthritis (a category that includes rheumatoid and psoriatic arthritis, among others), osteoarthritis, and arthritis arising from infection. Can your protocol be used to treat all three types?
SB | Inflammatory arthritis and osteoarthritis are the two most common chronic arthritis conditions and can be treated the same way, by following the program. Arthritis from infections is different — it’s important to make a diagnosis so that the infection can be treated. I explain how to do this in the book.
EL | In the book, you talk about your own experience with arthritis. Do you still have flare-ups from time to time? What do you do to address them?
SB | Actually, I don’t! If I go off the wagon with my food, or if my gut starts feeling off, I get right back on track before I have any arthritis symptoms.