Posted on 11/01/13
A 36-year-old woman initially presented to her rheumatologist with active bilateral synovitis in her hands, wrists, and ankles, and nodules on her left elbow. Her laboratory results were as follows:
- C-reactive protein (CRP) = 5.7 mg/dL (normal: 0.1–0.9 mg/dL)
- Erythrocyte sedimentation rate (ESR) = 38 mm/h (normal: 0–15 mm/h)
- Rheumatoid factor (RF) = 344 (normal: 0–29 IU/mL)
- Cyclic citrullinated peptide (CCP) = 90 (normal: 0–20)
- Other parameters within normal limits
A radiography revealed small erosions in both feet. She was subsequently diagnosed with moderate rheumatoid arthritis (RA) and started on methotrexate (MTX) at 10 mg/week, which was then increased to 15 mg/week. At her next visit, she reported some symptomatic relief after a few weeks of treatment. After 3 months, however, she visited her rheumatologist, presenting with stiffness, pain, and swelling in her wrists. Her sedimentation rate was elevated, and she complained that she could not be fully productive at work because of joint pain.
Questions to consider:
- Can this patient be considered refractory to MTX?
- How should this patient’s treatment regimen be modified?
According to Centers for Disease Control and Prevention (CDC) statistics, approximately 1.5 million US adults have RA, a chronic, autoimmune inflammatory disorder.1 The disease is characterized by synovial inflammation that causes stiffness and tenderness and can eventually lead to cartilage damage, bone erosions, and joint destruction. When inadequately treated, RA is associated with significant activity limitations and disability.2
In recent years, the primary therapeutic goals for patients with RA have shifted from relieving symptoms to reducing disease activity and progression.3 Many rheumatologists view remission as an attainable goal for their patients with RA. Regarding management strategies, research evidence and clinical experience support 2 key themes:
- Treating early and aggressively with disease-modifying antirheumatic drug (DMARD) monotherapy or combination therapy
- <span style="Times New Roman" "="">Tight control, or treating to the targets of low disease activity or remission
According to the updated 2012 guidelines of the American College of Rheumatology (ACR), patients recently diagnosed with RA (disease duration of less than 6 months) characterized by low disease activity should be treated with synthetic (nonbiologic) DMARD monotherapy.4 The standard first-line therapy is MTX (10-25 mg weekly), administered orally or subcutaneously. MTX acts by inhibiting the proinflammatory activity of autoreactive T cells, which play a key role in RA immunopathogenesis. Among other proposed mechanisms of action, methotrexate stimulates T-cell apoptosis.5 For patients with moderate disease activity and features of poor prognosis, methotrexate may be prescribed with other synthetic DMARDs, including sulfasalazine, leflunomide, or hydroxychloroquine.4
For patients recently diagnosed with moderately to severely active RA, or for patients with established RA (disease duration over 6 months) who do not respond to a synthetic DMARD, ACR guidelines recommend a tumor necrosis factor alpha (TNF-α) inhibitor, either alone or added to methotrexate.4 TNF-α inhibitors are biologic agents that bind soluble and membrane-bound TNF-α, a cytokine that causes joint inflammation and degeneration through various mechanisms. To date, 5 TNF-α inhibitors are approved by the FDA for treating moderate to severe RA: etanercept, infliximab, adalimumab, certolizumab pegol, and golimumab. Clinical trials have consistently demonstrated that, compared with methotrexate alone, the addition of a TNF-α inhibitor is associated with significantly better clinical, radiologic, and functional outcomes.6 Adverse events associated with TNF-α inhibitors include injection- or infusion-site infections, tuberculosis, and opportunistic infections. Severe adverse events include malignancies, hepatitis B and C reactivation, hematologic abnormalities, and exacerbation of congestive heart failure.7
For patients with moderate to severe disease activity who do not respond to a TNF-α inhibitor, the ACR guidelines recommend the combination of methotrexate and a biologic agent that acts through mechanisms other than blocking the effects of TNF-α.8 These biologics include:
- Rituximab, which depletes B cells and thereby inhibits their pro-inflammatory effects in RA
- Abatacept, which inhibits the activation and harmful effects of autoreactive T cells
- Tocilizumab, which blocks interleukin-6 (IL-6) signal transduction and thereby reduces the pro-inflammatory and degenerative effects of IL-6 on joint tissue
In clinical trials, patients treated with a biologic agent plus methotrexate have experienced significantly better clinical and radiologic outcomes compared with patients treated with methotrexate alone.6 Like TNF-α inhibitors, the addition of these biologics poses risks of injection- or infusion-site reactions, and patients are more susceptible to infections, especially opportunistic infections. In addition, these agents have been associated with exacerbations of chronic obstructive pulmonary disease (abatacept); rare cases of progressive multifocal leukoencephalopathy (rituximab); and elevated liver enzymes and lipids, neutropenia, and GI perforations (tocilizumab).8
As revealed through head-to-head comparison studies and meta-analyses, efficacy outcomes are generally similar for RA patients treated with different synthetic DMARDS and biologic agents, respectively.9 The Agency for Healthcare Research and Quality (AHRQ) commissioned a comprehensive analysis of new research findings, and in April 2012, published a systematic review, “Comparative Effectiveness of Drug Therapy for Rheumatoid Arthritis in Adults - Update.” The review was conducted by investigators at the RTI International University of North Carolina Evidence-Based Practice Center. The comparative effectiveness review is available at no charge on AHRQ's Effective Health Care Program website (http://www.effectivehealthcare.ahrq.gov/ehc/products/203/1044/CER55_Drugtherapies-rheumatoidarthritis_FinalReport_20120419.pdf).
In conclusion, experts in rheumatology emphasize that optimal patient outcomes depend on compliance with the evidence-based and consensus therapeutic strategies of early, aggressive treatment and tight control. The ultimate patient-centered goals of therapy are to inhibit progressive structural damage, reduce comorbidity and mortality risks, restore function and quality of life, and achieve remission.4
1. Arthritis-Related Statistics. Center for Disease Control and Prevention. August 2011. www.cdc.gov/arthritis/data_statistics/arthritis_related_stats.htm#1.
2. Lee DM, Weinblatt ME. Rheumatoid arthritis. Lancet. 2001;358(9285):903-911
3. Mease PJ. Improving the routine management of rheumatoid arthritis: the value of tight control. J Rheumatol. 2010;37(8)1570-1578.
4. Singh JA, Furst DE, Bharat A, et al. 2012 Update of the 2008 American College of Rheumatology Recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. Arthritis Care Res. 2012;64(5):625-639.
5. Segal R, Yaron M, Tartakovsky B. Methotrexate: mechanism of action in rheumatoid arthritis. Semin Arthritis Rheum. 1990;20(3):190-200.
6. McIness IB, O’Dell JR. State of the art: rheumatoid arthritis. Ann Rheum Dis. 2010;69:1898-1906.
7. Thalayasingam N, Issacs JD. Anti-TNF therapy. Best Pract Res Clin Rheumatol. 2011;25(4):549-567.
8. Agarwal SK. Biologic agents in rheumatoid arthritis: an update for managed care professionals. J Manag Care Pharm. 2011;17(9 Suppl.B):S14-18.
9. Donahue KE, Jonas DE, Hansen RA, et al. Comparative effectiveness of drug therapy for rheumatoid arthritis in adults – update. Comparative effectiveness review No. 55. Agency for Healthcare Research and Quality. AHRQ publication no.12-EHC025-EF. April 2012. http://www.effectivehealthcare.ahrq.gov/ehc/products/203/1044/CER55_Drugtherapies-rheumatoidarthritis_FinalReport_20120419.pdf.
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24 Arthritis and Rheumatism Case Studies
from The Goldberg Clinic
Systemic arthritic disorders cause great suffering. Pain, disability, fatigue, loss of work and social life are all problems patients must endure, in addition to numerous side effects that are caused by utilizing medical pharmaceuticals. Patients with rheumatoid diseases suffer not only with inflammatory joint and muscle pain but also with systemic complaints such as chronic fatigue, depression, gastrointestinal dysfunction, etc.,
The patients whose cases are presented here had been to medical physicians and under drug therapy which failed to bring about improvement in the their condition and generally resulted in a further decline in the patient's state of health.
A serious error made by both medical and many “alternative/complementary” practitioners is to address the patient's disease name rather than the individual nature of the patient themself . Even where two patients have the same medical diagnosis (e.g. rheumatoid arthritis) it is important to analyze each person as an individual to see what is occurring in their case.
To reverse rheumatoid diseases requires hard work by doctor and patient. These are conditions in which no part of the patient's family and medical history, lifestyle or biochemistry can be overlooked. These conditions generally take an extended amount of time to evolve into and usually take an extended amount of time to evolve out of. How encouraging for the patient, however, is the new attitude and reality that reversing these condition can occur and a life of continuing disability and endless suffering need not be the case.
The medical perspective on rheumatic disorders is a bleak one of progressive disability, reduced mobility and a lifetime of suffering. One need only visit a Medical Rheumatologist's office to see the legions of patients with arthritis and rheumatism taking toxic medications, suffering ongoing side effects and getting continually worse year after year.Little thought is given to the individual needs of the patient, and causal factors are left untouched. The patient becomes a pawn in their own sad state of affairs going back visit after visit for drugs that draw the patient deeper and deeper into a state of imbalance and toxicity. The following examples from our files illustrate that this tragic scenario need not be the case if causes of ill health are removed and the essentials of health are supplied.
Found in people of all ages, this is the best known and most feared of the rheumatoid diseases. The medical perspective on rheumatoid arthritis is a gloomy one, stating that its causal factors are unknown and that medical treatments can serve only to lessen discomforts and perhaps slow down disease progression but not halt or reverse it.
Rheumatoid Arthritis is found more commonly in females than males with more than two million people in the U.S. having been labeled with this condition. Many become severely disabled with significant disability.
Medical diagnosis is based upon the patient's symptoms and the results of blood tests. Patients are informed that their disease is incurable and given a variety of anti-inflammatory drugs, steroids, and immunosuppressants all with toxic side effects.
As with the other rheumatoid diseases, careful investigation followed by hard work is required to obtain favorable results. The earlier the patient proceeds with a Biological/Hygienic Program of care and the less drugs that have been involved, the greater are the chances for success. Once favorable results have been obtained a return to former habits or excessive levels of stress is likely to cause a resumption of disease activity so the patient must understand the need to be disciplined in taking proper care of themselves on an ongoing basis.
Case Number One : Rheumatoid Arthritis
Patient: Mr. David Murphy
December 13, 1999
Dear Dr. Goldberg:
I want to express my sincerest gratitude for your guidance in restoring my health. I hope that your future patients can findencouragement and inspiration in what you have been able to do for me.
As an active 27-year-old man, I exercised daily: lifting weights in the gym four nights a week, running on weekends and playing softball in my company's league. I studied martial arts. I loved playing guitar and riding my motorcycle. All of this stopped because of a disease.
In the early spring, I began experiencing pain in my wrists when exercising and typing on my computer. I started taking ibuprofen to kill the pain, but eventually the ibuprofen was less effective masking the pain and I was consuming several times the recommended dosage.
After a month of enduring the pain I went to a medical doctor. After less than a minute's examination the doctor said it was "probably tendinitis". The doctor prescribed me an anti-inflammatory drug and told me to ice my wrists.
Two months later I returned to the doctor with considerably more pain in my wrists and by that point a couple of my fingers had become so swollen I could not bend them. After examination of my x-rays the doctor changed his diagnosis to "arthritis" later classifying it as "rheumatoid arthritis". The doctor said there is no way of knowing why or how our bodies develop this disease and there was not a cure. His treatment was a higher strength anti-inflammatory drug. He said my body would develop a tolerance to the drugs I was taking and I would eventually move on to more powerful anti-inflammatory drugs.
As the weeks went by I watched more fingers swell with tremendous pain. Then my elbows began stiffening. Each day I was horrified to see my body deteriorating as the disease spread to my shoulders then to my feet, knees, and hips. I no longer was able to enjoy playing sports or exercising. My muscle mass and body weight began to decrease dramatically. My body degraded to a point where I struggled just to walk. I became depressed and very unpleasant to be around.
During this time of treatment by my medical doctor I was following a routine of chiropractic treatment also. My chiropractor had witnessed the progression of my symptoms over the period of several months. He recommended I seek treatment from Dr. Goldberg, saying if his mother was suffering from this disease the only person he would trust treating her would be Doctor Goldberg!
I drove four hours to Atlanta to see Dr. Goldberg. From the very beginning there was a noticeable difference. Where my medical doctor was concerned with identifying and treating my symptoms and hurrying to the next patient, Dr. Goldberg took a significant amount of time to interview me and perform a detailed analysis of my entire lifestyle including diet, sleep patterns, and areas of stress.
After several laboratory tests, Dr. Goldberg not only explained how my body was reacting to the disease but also how it started. He then prescribed a method of treatment without any use of drugs!
In just a few weeks of changing my diet and other areas of my lifestyle based on Dr. Goldberg's recommendations, I experienced a significant decrease in the severity of pain and swelling. After continued visits to Dr. Goldberg the disease has withdrawn from my feet, knees, hips, shoulders, and elbows. I do not have problems walking. My strength has begun to increase again.
There have been many amazing side effects from implementing the changes recommended by Dr. Goldberg. Since childhood I have had asthma. After the initial changes to my diet I noticed a decrease in the frequency and severity of attacks. I have since stopped using my steroid based inhalers that I have used four times a day for years to control the asthma.
I used to become very tired and anxious if I did not eat something every couple of hours. I would experience mood swings because of these dramatic fluctuations in energy levels. Since changing my diet my energy has remained constant and my disposition has been very calm.
I can not thank Dr. Goldberg enough for my returning health and the education I have received during my treatment. I have a much greater awareness of my diet and my responsibility to maintain a balanced lifestyle or continued health.
The following is an analysis of Mr. Murphy's case:
Presentation / history: Mr. Murphy came to see our clinic in the late summer of 1999. As he describes in his letter, he had gone from being an active young man of 27 to a partially disabled person who felt considerably older than his years. Like many patients, his symptoms had started out slowly taking some time before the diagnosis of rheumatoid arthritis was made. Increasingly powerful anti-inflammatory drugs were employed by his medical physician and a negative outlook for the future was forecast. In addition to the joint and muscle discomforts the patient complained of significant fatigue.
Examination/Laboratory Analysis: The patient had obvious signs of discomfort including inflammation in his wrists, fingers, elbows, knees and other joints causing him to move with discomfort. The joints were stiff and slightly swollen. The sedimentation rate was modestly elevated. Dietary analysis showed a high intake of refined carbohydrates. Allergy testing revealed a number of foods the patient had a high titer to. There was evidence of imbalance of the patients blood sugar which coincided with the patient's high intake of soft drinks.
Program of Care: The patient was placed on a short liquid diet followed by nutritional reform specific to his needs. Specific nutrient supplementation was reccomended. The patient's condition began to improve in less than thirty days.
Comments: This patient is a clear example of how problems such as allergies, blood sugar imbalances, and dietary inadequacies can, in susceptible people, cause serious symptoms that are medically interpreted as rheumatoid arthritis.Under medical care, patients with this diagnosis are told to expect to get worse. Mr. Murphy's reversal was quicker than most due to this youth, positive attitude and compliance with the program. It is tragic to realize how many people could be helped if these problems were addressed from an etiological basis rather than a pharmaceutical one.
Case Number Two:
Patient: Ms. Linda Shore
February 23, 1995
Dear Dr. Goldberg:
This letter has been a while in coming. Forgive me for not writing sooner after you did so very much for me. I am a new person.My fatigue and joint pains are gone better than 99% of the time and when I have them, they are now very mild and very temporary. I sometimes forget that I had Rheumatoid Arthritis for over eight incredibly painful years.
I saw my Rheumatologist just to see what he would have to say. He told me he thought that the things we did together in reconstructing my health during the five months you worked with me had nothing to do with my feeling better. He says it is just coincidence, that I am probably only having a temporary remission of the Rheumatoid Arthritis, that diet, good digestion, nutrients, allergies, etc., have nothing to do with arthritis. So what does? I asked him. He said it is all genetics.
He is a fool. I was sick with the arthritis for over eight years. I was under his care for over seven of them during which time I only got sicker and more deformed. I only felt bad and worse, never any real signs of improvement while under him, while being poisoned with all the steroids, methotrexate and gold. Now I am consistently well for over six months and he says it is just a "coincidence." He cannot admit that he failed where you succeeded. What pride!!! You know what else? I never saw any of his patients get real improvement nor any of my friends who have serious arthritis get any better under medical care... they just go on suffering and taking drugs and suffering and get worse and worse!
Your ability to figure out for each patient what is best for them and teach them at the same time how to stay well are what I admire most about the way you practice. Thank-God I had the good sense to stay with the program and do what was needed rather than give up and stay in a sick condition on drugs and lead a miserable life. The difference between you and all the other medical doctors and chiropractors I went to, is like night and day. You made me work (and work hard I must say!!!!) to get well and gave me the tools to stay well. Thank-God I am now free of the Rheumatoid Arthritis that made life a living hell for me.
I hope you know how much I appreciate you!!!
Case History of Ms. Shore:
Presentation/History: The patient, a forty-one year old female presented with a diagnosis of rheumatoid arthritis from her rheumatologist seven years prior to being seen at our office. She complained of joint pains throughout her body, most severely in her hands, wrists, and knees.
Examination: The patient was significantly underweight at five feet five inches tall and 95 pounds. She found it difficult to gain weight due to poor digestion. She was pale and depressed looking. The blood pressure was low at 96 over 62 and the pulse was rapid at 86 beats per minute. The tongue was bright red and had patchy smooth areas. The sedimentation rate was elevated at 68 mm. per hour. A number of abnormal stool flora was identified including the presence of Klebsiella pneumonia.
Program of Care: The patient was placed on a reduced carbohydrate diet centered primarily around lean proteins and non-starchy vegetables. Steps were taken to normalize the bowel flora. Extra rest and sleep were advised. Spinal adjustments were given along with massage to help ease the patient's discomforts and to encourage healing.
Comments: The Rheumatologist's remarks regarding her recovery are unfortunately all too common. It is unfortunate that he did not show more interest in her recovery and give her encouragement rather than take a “sour grapes” attitude about her improvements.
Case Number Three: Rheumatoid Arthritis
Patient : Ms. Bea Shaffer
Dear Dr. Goldberg,
I'm writing to let you know of the great improvement in my condition of rheumatoid arthritis.
I got off all medication in mid November of 94. I had a CBC and a Sed rate 12/5/94 and everything was just about in the normal range, and the Sed. Rate was 7 ! That's the first time things have been normal in nearly three years. I had a Sed Rate run again 1/3/95 and it was 20, but it was back up to 45 2/7/95.
I had been doing very well on my diet, but since the holidays I've been having white flour and sugar products occasionally. I still have not had any chocolate, alcohol, or caffeine.
The results of the Sed Rate tells me I must get back to a very strict diet, though, as I made such great improvement.
My fingers and wrists are still swollen and bother me a lot, but all the other swelling is practically gone. Dr. Shaffer got a wrist brace for me that has special support to improve and prevent Ulnar Deviation, and it is helping. I've been very active and the swelling in my feet, ankles and knees is still practically gone. Since last summer I've been riding an exercise bike and lifting one pound weights. I'm up to four miles per day and lift weights about another 10 minutes. I've developed a lot of muscle; as a matter of fact, I think that's one reason I started putting on weight. I'm also able to walk up and down stairs now, one foot right after the other (slow, but I can do it).
I've made great progress in conquering this illness, and I owe a lot of it to you, Dr. Goldberg. Thanks you for your care and guidance on good nutrition, (which enabled me to get off the damaging drugs). With patience, time and faith, the natural healing route has and will continue to pay off.
Thanks again for everything, Dr. Goldberg.
Ms. Shaffer had undergone a hard time for a number of years with medically diagnosed rheumatoid arthritis. A very pleasant lady in her forties it was painful to watch her walk as each step required much effort and suffering. We did not have easy nor quick results, but fortunately Bea persevered in what was a difficult case. She underwent repeated fasts, liquid diets, and dietary programs along with other biological reforms. Despite her pain she remained optimistic and pleasant throughout her care. While she was not able to obtain total reversal of her condition, she nonetheless had significant improvement as her letter states. Bea was not only a patient, she also was a teacher as I learned a good deal about perseverance, optimism and determination from Bea who exhibited all these admirable traits.
Case Number Four : Rheumatoid Arthritis
Patient : Ms. Charlotte Kiley
FEBRUARY 16, 1996
TO WHOM IT MAY CONCERN:
I am writing this letter to say thank-you to Dr. Goldberg for helping me feel rejuvenated.
My first encounter with Dr. Goldberg was when my daughter brought a friend home and he noticed my counter top filled with pills. He happened to be attending the School of Chiropractic in Atlanta. He started to question me about the drugs and I told him that I have arthritis and was presently taking:
Lodine an anti-inflammatory 400 mg three X daily
Methotrexate 3 weekly
Prednisone 2 daily
Darvocet for pain
He then proceeded to tell me about Dr. Goldberg and gave me the telephone number. I decided that it was worth a try since I was feeling miserable all the time and could not see my future getting any better.
I went to see Dr. Goldberg in September and he informed me of his program. He told me it would not be easy for the first few weeks and he was right. I left feeling very skeptical but would try; after all how could any program make me feel better when for the last six years I have been suffering, and doctors told me that you have to learn to live with the pain and depression of this disease.
I never went through anything so difficult and was ready to give up after the first week but kept in mind that this was my only chance to try and have a normal life, so I kept going with the encouragement of Dr. Goldberg. As time went on, I started giving up the drugs little my little and started feeling better.
At present, I am only taking 2.5 mg of Prednisone every 2nd day and have given up all the rest and will give up this one soon.
I feel better, look better and have more energy than before. My arthritis is still there but only noticeable at times and much more tolerable.
I want to thank Dr. Goldberg and recommend any one to give his program a chance and you will come out a winner in the end.
Panama City, Florida
Comments: Ms. Kiley presented originally in an understandably depressed state over her condition. She made repeated trips to our clinic which was a six hour drive for her and followed directions to the letter. Her determination paid off allowing her not only to rid herself of the severe arthritic pains but also allowing her to have more energy and look years younger than when she had started. She was also fortunate in having a very supportive husband. Having a spouse or other person that is helpful and supportive is of great value in the recovery process.
Case Number Five: Rheumatoid Arthritis
Patient: Ms. Rachel Sharon
April 23, 1999
Dr. Paul Goldberg
2480 Windy Hill Road
Marietta, Ga. 30067
Dear Dr. Goldberg:
I came to your office about eleven months ago with severe rheumatoid arthritis that was complicated by an overweight condition, lousy digestion, and much fatigue.
My troubles began when I was 29 years old and I began to get very stiff after even just a small bit of exertion. This got worse and worse until one morning I woke up to find my wrists and ankles swollen and red. The hell was just beginning. The pains spread from joint to joint and were with me all the time not allowing me to rest or know any peace. I consulted with both my family chiropractor and my family medical doctor both of whom I had gone to for many years for care. My medical doctor did some lab tests and said I had rheumatoid arthritis and sent me to a rheumatologist who said my family doctor was correct. I was first put on prednisone which at first gave me a little relief, but soon caused me to gain weight and I also experienced severe depression while on it. After a few weeks my face began to swell and the pains started to hurt very badly again anyway. I was then put on a number of other drugs including plaquinel which bothered my stomach and did not afford me much relief.
My Chiropractor whom I have always trusted tried his best to adjust my bones but I was so stiff he had a hard time doing so and it was painful. He finally said he could not help me and sent me to another Chiropractor who adjusted my top spinal bone twice a week for ten weeks but it did not help either and I continued to worsen. Both of the chiropractors were nice men, but they did not seem able to help a serious problem like rheumatoid arthritis, but at least I did not get sicker from drugs from them like I did from the medical rheumatologist.
In time I could not lift my arms more than a few inches without excruciating pains and my knees had to have the fluid drained off them continuously. I had only been married for a little over a year at the time and this was very hard on my husband. I gave up hope of being able to have children although the rheumatologist said I might want to have a couple babies as it would likely make the pains better while I was pregnant.
I grew disappointed with the rheumatologist and went to see another one who wanted to give me the same drugs and add some drug that would suppress my immune system he said. I tried it and it made me nauseated, so I went back to the first rheumatologist to get monitored, but he did not do me any good for all the years I saw him. I just got worse and worse. I then went to see another chiropractor who said she did nutrition and called herself a “nutritionist” and she gave me a bunch of herbs and vitamin pills and told me to eat lots of fruit each day to clean out my intestines. All I got from all that was a good case of gas and after spending a lot of money and seeing her about ten times I quit her care.
At thirty five years old, six years after the problem got severe I heard of you through a friend whose son's wife went to you with lupus and she did very well. I was skeptical after already having been to a number of doctors and I did not think anybody could help me. My friend encouraged me however, and I had my husband drive me to see you. I was impressed that you actually listened to all my complaints and were understanding, or as you said “it takes one to know one.”
After you ran a number of tests I came back a month later from Kentucky and was under your care for a period of five weeks. The five weeks I was in Atlanta were the best decision I made in my life. You put me on a water diet for five days at first, followed by a few days on juices. I had tried fasting myself once before but did not know how to do it properly nor for how long, nor what to do while I was fasting, nor how to monitor myself, nor how to break it, etc. I must say that speaking to other patients at your clinic that were also under special care plans including diet reforms and fasting was helpful. You then had me eat a special diet for five days followed by a few more days on water. During this time you had me rest extensively and occasionally do some very light exercises. It took about three weeks before I noted any significant improvement and during that time I wondered if I was doing the right thing. The next two weeks gave me more improvement and when I went back home to Kentucky (with a special diet and supplement plan as well as with counseling for healthier living and special exercises) I was more than 33% better than when I had come down. For the first time in years I had real hope!
The next several months gave me more improvement although there were some ups and downs....and I was drug free!!!
Today, almost a year later I am more than 75% better and am able to take fairly long walks without significant discomfort, swim freely, have much better digestion, and thank God I am enjoying my life again. I know, as you have encouraged me, that I will continue to improve more as time goes on. What a miracle, however, that I am not only not getting worse with time anymore but am actually getting better with time!
You are right you know, your having been sick for so many years yourself is undoubtedly what makes you so knowledgeable and caring. All that garbage they teach doctors in colleges does nothing to help one at all and makes you lose faith.
By the way, my original chiropractor thinks you are great! He says he can now adjust my back easily again, although I find I don't need his services much anymore. He has been encouraging, however, of me to continue to follow your advice but I don't need encouragement with such wonderful results.
I spoke once with the rheumatologist I first went to. He says that I am simply in a “remission” and that diet, and digestion, and nutrients and toxins have nothing to do with any type of arthritis!. A remission? How strange that I never had a “remission” anytime for all the years I saw him and just kept getting worse, and then I came to see you, and went into “remission” in just a few weeks and continue to be in “remission” and getting better now almost a year later! How strange that when I went to see him I continued to have poor digestion, be overweight and fatigued and full of pain, and now I am 50 pounds lighter, almost free of all pain and stiffness, energetic, have better laboratory results, am optimistic, and have good digestion. What a coincidence!!!
Please give my best to your family.
Comments: The patient's improvements were due to improvements in her overall health, not due to the treatment of her “rheumatoid arthritis.” We can expect that as digestion improves and vitality increases that there will be a corresponding improvement in the patient's joint and muscle pains.
Case Number Six : Rheumatoid Arthritis, headache, irritable bowel, chronic fatigue, hypercholestermia
Patient : Ms. May Wilkins
June 25, 2001
Dear Dr. Goldberg:
My deepest thanks to you for bringing me “back to life”. As you know I had received a number of medical diagnoses prior to coming to you including:
2) Rheumatoid Arthritis
3) Irritable Bowel Syndrome
4) Chronic Fatigue Syndrome
I accepted these diagnoses blindly never stopping to think that none of them told me anything about what was causing my problems. I remember getting my diagnosis of rheumatoid arthritis for example and being scared out of my gourd and yet thankful to the medical rheumatologist that he had discovered “what was wrong with me”. It was not till years later that it finally got through my thick head that his diagnosis was based only on my signs and symptoms and not on causal factors. My treatments for all the above were drugs which did nothing to improve my health. How could they? All were based on suppression of symptoms and nothing to do with whatever was causing my problems.
After five years of drug treatments for all the above during which I continued to worsen with the arthritic pains throughout my hands, feet, neck, knees, shoulders, and hips being worse and having to rely on a walker and having to have my husband assist me just about everywhere I went (at 34 years of age), I get fed up. I was getting worse and worse, I was sick all the time, increasingly crippled up, my bowels were a mess, my marriage was about at an end, and I was tired of running from medical physician to physician for ongoing drugs with numerous side effects.
I was referred to you by Jane Cooper who also had bad bowel problems, fatigue, and joint pains along with psoriasis for years and had a wonderful recovery under your care. I asked her how you had treated her and she said you had not treated any of her symptoms but had worked with her to uncover the underlying problems and then worked to remove those problems while increasing her vitality.
My husband who has a Ph.D. in Chemistry was impressed with you and your extensive knowledge of Internal Medicine and Clinical Nutrition (he had at first tried to dissuade me from going to you based on you having a Chiropractic Degree) and I was impressed with the amount of time you spent with me and the thoroughness with which you went over my case on my first visit with you. (Your medical technician Linda is also very good at drawing blood and is very kind).
The three months I worked intensively with you were much easier than I had thought they might be. Amazingly my overall health began to improve after the first three weeks of care (those were a little hard as I had to give up a lot of foods I used to be addicted to as well as get over my dependency on a lot of toxic medications) as my energy climbed, my joints became more flexible, my muscle pains melted away, and my plumbing became normal again (I know you must get sick of people telling you about their beautiful bowel movements after they begin to work under your care). I did not feel like I was your patient as much as I felt like you were my teacher as I learned to address the factors that had made me ill and to understand how to stay healthy without being dependent on doctors of any kind.
The blood tests showed what I already could feel...the joint and muscle inflammation died down (my sed rate went from 84 down to 24 within the first five weeks!) and my cholesterol went from 220 (on medication before )to 140 (now off all medication).
My hair took on a new gloss and my fingernails now grow long and strong (I know, I know, you did not treat my fingernails or my hair) and I am taking long walks with my husband and our relationship is much better now that I am out of pain and not such a pain anymore to be around.
The move to Ohio, which I dreaded, with the heavy lifting was a breeze and I like our new house.
Joseph sends his best.
Post Script: I did see my old rheumatologist before I left. The same one who told me that Rheumatoid Arthritis would only get worse as I got older and that it was “incurable”. He says I must be in “remission”. Its now been a year of “remission” drug free with the symptoms only trying to return when I don't follow your directions.
Comments: Note how all the medical diagnoses were inter-related and yet were being treated (unsuccessfully) as separate entities by her medical physicians.
OTHER RHEUMATIC DISEASE CONDITIONS
There are over a hundred different medical diagnoses of rheumatoid disease that involve joint and muscle pains among other symptoms. Many of these are as severe and disabling as rheumatoid arthritis can be. Medically the same general types of drugs are used for all these conditions.
Case Number Seven: Mixed Arthritis, skin disease, chronic fatigue, & shortness of breath.
Patient: Ms. Pat Nichols
September 30, 1998
Dear Dr. Goldberg:
I want to thank you for giving me back my health.
When I first came to you five and half weeks ago I was in terrible shape. My skin was broken out with a rash; all my joints and muscles ached. I could hardly walk upstairs due to my aching joints and shortness of breath. I had been to many doctors looking for help over the past ten years with no improvement. The past one and half years it has been hard for me to work. In the nine months before coming to see you, I had missed over five weeks of work. I was feeling hopeless.
I went to see Dr. Lisa Williams who recommended that I see you. My whole life has changed since walking into your office ....... among other things I have a positive outlook now because I feel so good! I no longer have joint and muscle pains. I can run up steps with no shortness of breath, my skin has healed, no rash or cracks that bleed... I feel like a new person. All my family is very excited over the changes.
Today I am retiring and I will be 66 years old in December. I am so excited about feeling good enough to travel and have fun in my retirement. Had I not found Dr. Goldberg, I am afraid I would have been unable to enjoy the rest of my life.
Thank you so very much.
Comments: Ms. Nichols had worked hard for many years and was facing a well earned retirement with severe pain and fatigue limiting any hope that she would be able to enjoy it. Medical physicians had given her pain killers of various kinds to mask her symptoms. Rather than “treat” her individual symptoms, a program was undertaken to address her general health and vitality. As her health, vitality and resistance improved her symptoms of pains, fatigue, shortness of breath, skin problems, etc.,went away. The removal of causes and the development of anindividualized program of health always serves patients best and allows them to take control of their own health destiny.
Case Number Eight: Arthritis & Severe Fatigue
Patient: Christina Kupper
February 12, 2002
FROM : CHRISTINA KUPPER
TO: ANYONE DIAGNOSED WITH RHEUMATOID ARTHRITIS, UNKNOWN DISEASE, OR “INCURABLE” DISEASE”
I am 27 years old and a new person!!
About 2 years ago I started noticing a lack of energy. This progressed until I was always tired, had developed joint pains in my wrist and was having chronic abdominal cramps. I discounted all of this thinking that I had “overdone it”.
Last year it all got worse. My joint pain was now accompanied by muscles spasms. It got to the point where it was difficult to perform simple tasks like brushing my teeth, opening jars and even lifting a gallon of milk. I went to my primary doctor who tested me for everything under the sun with no results. I was beginning to think that he thought I was crazy. He wanted me to take anti-depressants, antiinflammatory drugs, & a slew of others. Finally he referred me to a Rheumatologist who barely listened & also made me think it was all in my head. But, she wanted to add six new drugs for me to take - the side effects alone were worse than anything I'd been through.
Last November I came to see Dr. Goldberg. At this point, I was having difficulty doing most daily / routine tasks and the joint pain had spread all over. Sometimes it was difficult to walk. The pain was always there - sometimes it was just annoying and others it would bring me to tears.
Since being under Dr. Goldberg's care and following the recommendations he gave me I have improved 85% already (in less than two months). I spent 10 days on a liquid diet, followed by a number of specific changes for my particular case. Now the mild pain I get is only intermittent and I have more energy than I have had in years.Although the changes have to be made consistently (this is a lifestyle change), I am certain that within a few months I will be completely pain free - so long as I stick to the plan that Dr. Goldberg made for me.
I can't thank Dr. Goldberg enough for everything he has helped me get through.
Thank you Dr. Goldberg!
Comments: There are many patients like Ms. Kupper who go to a number of doctors and get different medical diagnoses. Rather than arrive at the right name for the disease it is far more important to arrive at what are the causes of the disease.
By definition ankylosing spondylitis primarily involves the spine, sacroiliac joints, with other large joints of the body being affected depending on the individual. Some cases are mild while others are very severe and result in fusion of the vertebra and with disability as the ligaments calcify. The entire body can be affected including involvement of the chest and lungs.
There is significant scientific evidence to support the observation that there is significant involvement of the gastrointestinal tract and its immune components in the development of this condition in many people. Frequently inflammatory changes can be detected in the small and/or large intestine. There is evidence that bacteria such as Klebsiella Pneumonia may provoke inflammatory responses in people with the right genetic predisposition.
It is important to investigate gastrointestinal functioning carefully and take appropriate measures to improve its efficiency. In many cases specific nutritional changes can create an environment in the gastrointestinal tract that discourages the growth of intestinal bacteria that may trigger the immune system and promote the ankylosing spondylitis condition.
Dietetic, allergic, immunological, gastrointestinal, endocrine and lifestyle factors require careful examination so that a course of effective action may be developed. This includes the necessary effort by the patient. Some cases respond more quickly and more completely than others. Ongoing specific exercises, particularly swimming and Hatha Yoga are often of benefit to complement the individual's program. Hard work, patience and perseverance are required by the patient. Those expecting a quick fix will be disappointed.
Case Number Nine: Ankylosing Spondylitis
Patient: Mr. Mark Padfield
Dear Fellow Patient:
I am writing to describe my experience to date under the care of Dr. Goldberg. Hopefully, you may find some similarities with your own symptoms that may give you reason to try some of the behavioral and dietary changes that Dr. Goldberg suggests that may improve your health
About 18 months ago, I began to experience severe middle and lower back pain. The pain was particularly bad early in the morning. It gradually worsened until it felt like my entire chest and spinal area were inflamed. It hurt to breath deeply. A sneeze caused excruciating pain. I developed a soreness in the area just below my left knee which ultimately prevented me from running and playing tennis. The top of my right foot even became inflamed and it hurt to walk. At night, at first I was unable to sleep on my stomach as the back pain would wake me. Then later, even on my side, I would be waken up with back inflammation. I would start in bed, but after only 2-3 hours of sleep, I would be forced to try and sleep in a chair sitting up. It was the only way I found the pain subside enough for me to sleep.
Of course I went to a "doctor" (a standard MD). After several tests, I was sent to a rheumatologist. There, after several other tests, I was definitively diagnosed as having ankylosing spondylitis (which means arthritis of the spine). There's a scale (the sedimentation rate) which they measure the level of inflammation in your body. The normal range is 0-10. Mine was 56.
I was immediately put on anti-inflammatories. Alter a couple of weeks, I began to experience severe stomach aches associated with the drugs. Two more types of anti-inflammatories were tried with similar results. Finally, I was able to obtain some arthritic relief with minimal stomach pain with Trilisate (an aspirin like drug). However, I was taking a high dosage and the prospects of long term damage to the kidneys were present with this drug.
At this point, I decided to give Dr. Goldberg a "try". I had heard he had once had the same disease as me and had found certain dietary changes, which dramatically improved his condition. My first visit to Dr. Goldberg was 6 months ago.
Under Dr. Goldberg's care I have made substantial changes in my diet and other behaviors.
My diet was probably very typical of most Americans when I initially came to Dr. Goldberg. I ate a large variety of foods, but I am sure it consisted of too high a percentage of meats, dairy items, and sugars.
Under his care, I initially started with an 11 day fast and then gradually added back certain vegetables and fruits. This was done to give my digestive system a chance to heal.
Today, I am eating lots of vegetables, nuts, whole grains, fish and chicken. Every once in a while I will eat a portion of red meat. I take in very little sugar, and have avoided almost all desserts. I have also avoided most dairy products and "white" flour and rice. I now drink water almost exclusively. I do not drink milk or sodas, and rarely have fruit juice. I have also avoided almost all alcohol, although occasionally I will have a glass of wine.
The results have been fairly dramatic improvement. My back pain has gradually subsided. The inflammation in my chest has disappeared. My foot is healed and even the pain below my knee is much better (although still present). I am playing tennis again and it feels wonderful. I am not cured however. I still wake up with some morning back stiffness (which stretching exercises helps to overcome).I also have a tender spot (to the touch) on my middle back which remains with me constantly. However, each of these symptoms is minor compared to the pain at the height of my illness. I should add that I am no longer taking any anti-inflammatories. In addition to the improvement with respect to pain, I am clinically in better health as well (as the various blood tests can attest). For example, my cholesterol dropped from 226 to under 150 during the last six months.
My new diet does take quite a bit of discipline and will power. Others around you are constantly eating and offering those delicious desserts. The availability of soft drinks and rich food abounds. It is not easy. However, it is better than the alternative, which for me was debilitating pain. I am convinced that a person's diet does have a lot to do with their overall health. In a way it seems so obvious. What you take into your body does affect how you feel in a very real way. For me, changing what I ate and drank on a regular basis was far more effective than any drug I could take in helping to improve my health. Of course, it has only been 6 months, but so far, so good.
I hope this letter can be of help to you or someone you know in a similar circumstance.
Comments: Each case of ankylosing spondylitis is different. Mr. Padfield's case was in the early stages when he began care which helped make his rapid improvement possible.
Psoriasis, like Rheumatoid Arthritis, is classified as an autoimmune condition. In psoriasis the superficial layers of the skin multiply at an excessive rate leading to an ongoing flurry of scales that can prove both uncomfortable physically and socially to the patient. A small percentage of patients with psoriasis (perhaps 10% to 15%) will develop joint disease associated with psoriasis termed Psoriatic Arthritis. The severity of the skin problems has little to do with the severity of the joint disease. In those that do have joint symptoms, however, the arthritis can be severe and disabling. Joint symptoms are often similar to those seen in ankylosing spondylitis with typical involvement of the sacroiliac joints and spine along with secondary involvement of the knees, shoulders and other joints. Psoriatic Arthritis is treated medically much like other rheumatoid diseases with steroids, immunosuppressants, anti-inflammatory drugs, and skin ointments. These are toxic and do not improve the patient's overall health.
Case Number Ten: Psoriatic Arthritis
Patient: Ms. Brandy Bethune
August 30, 1999
Dear Dr. Goldberg:
I wanted to let you know how much I appreciate everything you have taught me. My life has drastically changed because of you. When I was 14 years of age, I was having a great deal of trouble walking, my first days of high school. I went to multiple bone specialists, and they all told my parents I was just having growing pains. Pain yes, growing no! The pain proceeded and someone finally suggested that I had arthritis. My parents were referred to an arthritis specialist in Chattanooga, Tenn. and they made me an appointment. We went to an appointment and at 14 years old I, was diagnosed with Psoriatic Arthritis. The doctors gave me so many medicines that made me sicker by the day. The doctor would drain my knees with huge needles to get the fluid off of them. Soon it spread to every joint in my body. The doctor told me there was no cure, that it was a chronic illness and I would have it forever. I was prescribed some anti-inflammatory medicine to prevent the swelling. When we left the office I did not know what to say, I had a disease that will never get better and would only get worse. I took the medicine which was prescribed and followed the other orders I had been given.
Time progressed and my condition only got worse. The arthritis became worse and soon was in my elbows, hips, spine, and ankles. The next problem that arose was weight gain, I began to gain until I had went from 140 to 206 lbs. All of my symptoms only got worse and the medication made me nauseous. I began to not sleep at night because the pain was so bad. I was no longer able to do the things I enjoyed with my friends because I could barely walk. So one day my mom heard of Dr. Goldberg from a friend. Her friend told her that the doctor had really helped him, so my Mom contacted the office and made me a appointment.
My mom went with me on the first visit, I met Dr. Goldberg and he talked about really getting better. He ran several tests on me, I found out I was allergic to several things that only making my arthritis worse. My cholesterol was a grand total of 289. (I was a major junk food addict.) I had lost my self-esteem from all the weight I had gained. Dr. Goldberg put me on a special diet and gave me some nutrition supplements. I went home and had to totally adjust everything I did. I had to exercise, I now walk a mile every day. The results started to show within three weeks. I began to lose weight, sleep better, regaining my self-esteem and energy. The constant pain has disappeared, I would have never known these things could get this good after the pain I had.
I owe my good health and happiness to Dr. Goldberg and his help to show me how I could get well and live a better life. If I could give any advice to anyone with the same health problems to allow Dr. Goldberg to help them it would be the best help they could ever receive. Also I thank my mom and dad and my mom's friend for taking me to find Dr. Goldberg so I could get well. Thank You!
Comment: Ms. Bethune's history was typical. No effort had been made to identify the causes of her symptoms. A medical diagnosis was made and drugs were given for that medical diagnosis. The disease was being “treated” but not the patient.
By addressing Ms. Bethunes overall health status she not only was able to get rid of the symptoms of her disabling disorder and avoid the ongoing progression of disability, but also able to lose excess weight, improve her ability to sleep, improve her appearance, gain new energy, and in her own words, regain her self esteem. When we address the health of the patient rather than just the disease symptoms the whole body benefits.
Case Number Eleven: Psoriatic Arthritis
Patient: Mr. Robert Chapman
To Whom it May Concern:
My name is Robert Chapman. I am twenty-six years old and live in Lefaytette, Indiana. I have had psoriasis for ten years and Psoriatic Arthritis for about a year. My condition finally got to the point that I had to try a new treatment. The drugs and creams were not working. I heard of Dr. Goldberg from my sister and decided to give him a try. Well, I'm glad that I did. I have been under his care for a month and most of the pain and swelling from the arthritis has gone. I also have seen a remarkable improvement in the psoriasis. I have great faith and respect for Dr. Goldberg's method of healing and would recommend that anyone that has health problems of any kind could benefit from his treatment. I feel that I owe Dr. Goldberg for my new life.
Case history and Comments:
Patient Presentation: A twenty seven year old male, Mr. Robert Chapman presented with severe psoriatic arthritis with profuse scaling of the skin over more than eighty percent of the body. Accompanying the psoriasis was severe joint pain (sacroiliac joints, knees, elbows, fingers, and toes.) Radiographic studies revealed spondylosis (degeneration) of the neck with arthritic changes. There was moderate joint destruction of the toes. The patient was depressed, having consulted both Medical and Chiropractic Doctors for the past three years without success. He had been on numerous anti-inflammatory drugs which had caused gastrointestinal distress.
Laboratory tests: The patient's sedimentation rate was elevated. Multiple food allergies and increased intestinal permeability were found. Blood studies revealed yeast overgrowth. The diet included junk foods and alcohol.
Program of Care: The patient was briefly fasted to rest and desensitize the G.I tract. He obtained fresh air and natural sunlight daily along with an individualized natural foods diet (eliminating all allergens) with nutrient supplements and materials to reduce yeast growth.
Outcome: Within three weeks the joint pains disappeared, other than some minimal residual discomfort in the cervical spine. The psoriasis reduced by 70% by the fourth week with the remainder being less severe.
Discussion: Dermatological problems often originate in the gastrointestinal tract. A simultaneous occurrence of both skin and musculoskeletal problems is common. Imbalance of the G.I. tract caused by poor diet, allergen exposure, emotional stress, etc., can lead to both conditions. By correction of gastrointestinal problems, arthritic & Dermatological complaints are often corrected simultaneously.
Gout is a metabolic disorder that can produce severe pain and joint destruction. Rather than address the causes of the problem and the overall health of the patient, medically these patients are given drugs to disperse accumulations of uric acid. While this relieves some symptoms it does not address the overall health of the patient.
Case Number Twelve: Gout
Patient: Mr. Michael Lebhaft
July 22, 1994
Dear Dr. Goldberg:
I have promised this testimonial concerning why, when and how. This story starts 40 years ago but I had no real control then. I was always having problems with weight control, ear and sinus infections, high cholesterol, bad blood work indicating future heart and arterial problems, digestive disorders, fatigue, zero energy, blood pressure problems and the one main reason why I sought Dr. Goldberg's help, which was severe joint pains that I was having and getting worse by the day. I received treatment from every type of doctor and specialist. My condition still got worse even after taking medication. The medication had side affects that was going to kill me. My liver, stomach and other organs that I can't even begin to tell how, but I knew my health was doing down hill at age 40. My job was on the line also, because I am required to pass a flight exam every six months so I may act as a pilot......The testing Dr. Goldberg wanted to do was different and I had never heard of it. After it was completed the results were analyzed by him and we went over all of them in detail. He then gave me a plan of action. The responsibility was then on me to follow through.
I had to first detoxify my body. Boy was this tough. I was in pain before I started this but within a week or two it got even worse. Dr. Goldberg warned me that in my case this might happen. After a period of a several weeks the pain began to get better. After the cleansing was over my healing began. I began to lose weight without trying. My joint pains got better, my blood work showed an improvement. I did everything I was told to do.....It has now been six months since I started. I have lost 55+ pounds and my joints are much better. I have stopped any and all medications. My blood pressure is normal. My blood work is perfect. Dr. Goldberg has given me the tools to live a healthy life. I could go on and on about how this has changed my life and the way I feel about myself. I will close by stating, It is wonderful to have someone dedicated to help people achieve good health as Dr. Goldberg has helped me.
History and Presentation: A forty one year old male, Mr. Michael Lebhaft presented with severe gout. It was painful and difficult for him to walk. The condition was getting worse despite drugs given by his medical physician. He was also troubled by fatigue, high blood pressure, an overweight condition, digestive disorders, and ear and sinus infections.
Laboratory Testing: Laboratory testing revealed elevated uric acid, cholesterol and triglyceride levels. The patient's food allergy test showed numerous allergies. Mineral imbalances were noted.
Program of Care: The patient was placed on a liquid diet lasting 21 days. His symptoms initially worsened, and the blood uric acid level increased. By the tenth day the pain began to subside as did the uric acid, cholesterol, and triglyceride levels. He was later placed on an elimination diet along with nutrient supplementation based upon his condition and blood work.
Outcome: In forty days the patient lost thirty pounds. His cholesterol dropped from 258 to 165 and triglyceride levels dropped to 80. Blood pressure normalized. The patient reported feeling very well with no more joint pain and with increased energy. He give up all high blood pressure and gout medications. At last contact three years later, the patient had maintained excellent health. His ear and sinus infections were no longer present.
Case Number Thirteen : Systemic Lupus
Patient: Ms. Amanda Nash
August 14, 2002
Before I came to see Dr. Goldberg I had experienced years of bouts with medications and surgeries. When I was seventeen I was diagnosed with lupus. Heart complications, achy joints, and kidney problems are just a few of the symptoms I was facing. I was seventeen and until I was twenty-one I thought this was how I would spend the rest of my life. I had trouble leading a normal life and being sick was a focus.
Then I met Dr. Goldberg. We did tests and though I may not always have enjoyed his treatments.... they worked! Within months I had minimal problems and now after two years I feel as though I can carry on a normal and healthy life. Lupus is no longer a focus and I love that.
Thank you Dr. Goldberg for making me eat rice – and for making me do the things needed to get better. You have done what no medical doctor could do for me.
I will always be grateful.
Comments: Systemic Lupus Erythemetosis is an inflammatory connective tissue disorder of unknown (medically) etiology. Symptoms can be similar to rheumatoid arthritis due to the joint and muscular involvement. About 90% of cases occur in women. Medically the patients, as happened with Ms. Nash are put on anti-inflammatory drugs, steroids, and immune suppressants as with other rheumatoid diseases. Though Ms. Nash had a diet largely of hot dogs, soft drinks and other junk foods, her medical physician had made no inquiry as to her dietary habits and as is typical, started her immediately on pharmaceuticals. When I first saw her she was depressed looking, pale, underweight, and clearly in discomfort. She is now drug free, working, active, of normal weight and energy, and a bright, attractive, pleasant young lady.
Additional Case Studies On Arthritis and Rheumatism
The following are additional cases with clinical details involving Rheumatoid Diseases from the Goldberg Clinic without names concerning patients who wished to maintain anonymity. These cases have been presented professionally to practitioners as part of continuing education seminars.
Case Number Fourteen: Rheumatoid Arthritis
Presentation/History: A forty three year old female presented with complaints of fatigue, severe joint pain and swelling, and generalized stiffness. She had been under medical care for eight years with her condition continuing to worsen. Her medical physician administered repeated courses of steroids and other anti-inflammatory drugs along with gold and methotrexate. These drugs resulted in a number of side effects including liver inflammation, gastric bleeding, and facial swelling. She had received numerous Chiropractic Adjustments which gave partial temporary relief only. She was anxious over her deteriorating condition but did not know what to do. Examination of the patient revealed joint stiffness/pain/swelling in multiple areas including the knees, ankles, wrists, and low back. The patient frequently had indigestion.
Laboratory Studies: A blood chemistry, CBC/w. differential., rheumatoid panel, diet and mineral analysis, intestinal permeability study, food allergy profile and sedimentation rate were performed.
The sedimentation rate was over 60mm./hr (0- 20 normal for a female). The diet contained a great deal of refined carbohydrate.The mineral profile revealed several mineral toxicities including aluminum. There were multiple delayed (IGg4) type allergies to wheat, corn, milk, and beef. The patient had increased intestinal permeability, i.e. a "leaky gut" .
The patient was put on a detoxification program followed by a rotation diet with allergens being eliminated. Refined carbohydrates were eliminated. Steps were taken to reduce gut permeability and appropriate nutrient supplementation was given.
Outcome: The first two weeks of the program were difficult and the patient experienced an exacerbation of her symptoms. During the third week she noted improvement with reduced joint pain and improved vitality. By the fifth week joint swelling, redness and stiffness dissipated and the patient was able to take long walks with her husband. The sedimentation rate dropped from sixty to twelve. A follow up on the intestinal permeability showed it within normal limits.
Follow Up: Two years later the patient continues to be healthy and symptom free as long as she continues her diet, obtains adequate rest and observes other hygienic factors.
Case Number Fifteen: Rheumatoid Arthritis With Ulcerative Colitis
Patient Presentation: A forty year old female presented with complaints of ulcerative colitis over an eighteen year period, accompanied by severe arthritic complaints in the hands, elbows, shoulders and knees. Prior care included eighteen years under a gastroenterologist resulting in removal of fifty percent of the colon and ongoing antibiotics. She also saw a rheumatologist who placed her on prednisone. The patient had received Chiropractic Care for two years for low back pain which nonetheless persisted. The patient complained of chronic fatigue, ongoing bloody diarrhea, severe stiffness and pain, and depression. She described her condition as "desperate".
Laboratory: The patient was tested for intestinal permeability, mineral imbalances, and food allergies. Intestinal permeability was elevated. Mineral testing showed a pattern of general depletion and malabsorption. Food allergy testing was positive (mostly of the IgG4 variety). Foods the patient was allergic to such as egg, wheat products and dairy were the same foods reccomended to her by her gastroenterologist and medical dietitian to "sooth the colon". The patient had subluxations of the low back which her Chiropractor adjusted but could not get to hold.
Program Of Care: The patient was put on a hypo-allergenic liquid diet for a period of ten days followed by a diet of cooked vegetable foods and moderate amounts of proteins excluding all allergens. The patient was instructed on hygienic measures to take e.g. additional rest and sleep, fresh air, emotional poise, etc. The patient began to reduce the amounts of corticosteroid compounds prescribed for the colitis and arthritis. Appropriate natural anti-fungals and antibacterials accompanied by probiotics were employed to restore a healthy flora balance to the G.I. tract.
Outcome: During the first two weeks the patient went through a stormy period of discomfort. By the eighth day the bowels began to quiet. Joint pain subsided by the sixth week accompanied by an increase in the energy level. In three months the patient reported her stools were partially formed without blood and that joint pains had reduced by 80%. In her fourth month of care she went off her plan and ate a variety of foods she had been warned to avoid. Within ten days she was again passing bloody stools and experiencing severe joint and muscle pain. We gave her a program for resting the gastrointestinal tract and urged her to follow the entire health program carefully. She was soon feeling well again and reported she had "learned her lesson."
Follow up: The patient has continued well for four years without joint pain or colitis. Only mild looseness of stool (no blood or mucus) remained due to having had 50% of her colon removed. Had she come to us earlier this operation, I believe could have been avoided.