issue 4 July, 2014

Dr. Kurt Woellers

Rheumatoid Arthritis Help From Integrative Medicine

Including The Use of Low Dose Naltrexone & Minocycline Clinical Pearl
Kurt N. Woeller, D.O.
There are many probiotics on
Rheumatoid Arthritis (RA) is a devastating disease leading to severe pain,
the market. In fact, many
joint inflammation, and often crippling disability for millions of
individuals. Current statistics estimate that upwards of 1% of the U.S. probiotics contain a certain
population is suffering from Rheumatoid Arthritis. In addition, there are bacteria called Streptococcus
approximately 300,000 U.S. children with a similar disorder of Juvenile thermophilus (St). (St) is
Rheumatoid Arthritis. RA rates are approximately 3:1 in favor of females
considered to be a beneficial
to males acquiring the disease.
bacteria thought to help with
The causes are multifactorial with the the digestion of lactose, and is
following being attributed to the onset of RA commonly used in the dairy
for many individuals:
industry in the production of
Stresschemical reactions to stressful events yogurt. Even though
such as physical or emotional trauma.
!Acute and chronic infections viruses and researchers have sequenced
the genomes of two common
bacteria may be triggers for the immune Streptococcus thermophilus
system to attack joint structures. strains, and found them to not
!Intestinal imbalancesoften from chronic be dangerous (1), I personally
bacterial infections, i.e. clostridia bacteria. have observed in some children
!Food reactionsthis is evidenced by improvements in RA with elimination with confirmed PANDAS
(Pediatric Autoimmune
diets, i.e. gluten (wheat protein) avoidance.
!Intestinal imbalancesoften from chronic bacterial infections, i.e. Neuropsychiatric Disorders
associated with Streptococcal
clostridia bacteria. Infections) or suspected
!Integrative medicine has much to offer for patients suffering from RA. PANDAS that they react
negatively to this probiotic
Much of this help comes in the form of the ability to recognize the role of
bacteria. I have had numerous
digestive infections and adverse food reactivity that triggers
inflammatory reactions which ultimately affect the joints. reports over the years from
parents stating that their
In fact, independent research has shown that for many with RA, the
elimination of gluten proteins helps to improve their signs and symptoms

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issue 4 July, 2014

BI OM ED IC INE UNIV ERS ITY

significantly. As reported in the journal Rheumatology (1) the authors
concluded the data provides evidence that dietary modification may
be of clinical benefit for certain RA patients, and that this benefit may
Clinical Pearl
(continued)
be related to a reduction in immunoreactivity to food antigens
eliminated by the change in diet. Therefore, one useful test to children have vocal tics or
perform on ALL patients with RA is blood antibodies for Gliadin IgA, IgG, motor tics when they consume
Antitransglutaminase IgA, and Total IgA.
!Another area of integrative medicine investigation is digestive function, a probiotic with (St) in it, and
the problem resolves when it is
particularly certain bacterial infections of clostridia. We know that discontinued. Therefore, in my
Clostridia difficle is a trigger for inflammatory bowel in the form of practice I will avoid giving a
pseudomembranous colitis (PC). probiotic that contains this
However, it
turns out that bacteria strain to anyone with a
there are other known or suspected case of
forms of PANDAS.
clostridia
bacteria that (1) Streptococcus Thermophilus: A
can contribute Bacterium Which Is Harmless to Health."
International Research Associates. 14
to a toxic
burden on the Nov. 2006.

body. In
addition to PC,
Clostridia
difficle has Visit any of Dr. Woeller's
been reported websites for more information
to initiate
inflammatory reactive arthritis in some individuals (2). One test I on his specialities & services.
recommend is the Organic Acid Test (OAT) from Great Plains Laboratory
www.greatplainslaboratory.com. It is a first morning urine test than www.AutismActionPlan.com
gives detailed information about various metabolic activities in the body
that are important for anyone with a serious illnessincluding RA. In
!
www.AutismRecoveryBook.com
addition, it evaluates for toxins to candida and clostridia identifying two !
www.AutismRecoveryTreatment.com
bio-toxins
HPHPA and 4-cresol. !
!Both HPHPA and 4-cresol are specific for clostridia bacteria. Clostridia www.MethylB12forAutism.com
!
www.RheumatoidArthritisRecovery.com
bacteria are anaerobic (oxygen avoiding) bacteria that are known to
trigger a wide variety of health problems (i.e. inflammatory bowel
!
www.DrWoeller.com
disease). Clostridia bacteria have also been known to trigger an
inflammatory joint condition called Reactive Arthritis which has
!
www.MySunriseCenter.com
similarities to RA. If HPHPA and/or 4-Cresol are elevated, it indicates
there is a clostridia bacteria present that should be treated. Two
!
www.AutismSupplementsCenter.com
antibioticsMetronidazole (Flagyl) and Vancomycin (Vancocin)-are both !
www.AutismSeminarsOnDemand.com
effective in treating clostridia bacteria.
!A treatment option for clostridia bacteria is to use either one of these !
www.BiomedicineUniversity.com
antibiotics at a 40 mg/kg split dose three times daily for 10 days, then
!
www.LabTestsPlus.com
initiating a treatment day every 3rd day for 3 weeks. This significantly
helps to eradicate the colonies of clostridia bacteria in my experience.

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issue 4
BI OM ED IC INE UNIV ERS ITY
Two Additional Therapies That Absolutely Should Considered For Patients With
Rheumatoid Arthritis Low Dose Naltrexone and Minocycline
Low Dose Naltrexone
Low dose naltrexone has been a helpful therapy for
many with autoimmune diseases, particularly
Rheumatoid Arthritis. The basic function of LDN is
the ability to regulate aspects of the immune
system that are locked in a pathway of
autoimmunity. Much of the original research for
LDNs influence on autoimmune disorders was
highlighted by the late Dr. Bernard Bihari (a board
certified Psychiatrist and Neurologist) from New
York State (curriculum vitae - http://
lowdosenaltrexone.org/bbihari_cv.htm). What Dr. Bihari
and others found was many individuals with disorders
such as Multiple Sclerosis, Ankylosing Spondylitis, Lupus,
Rheumatoid Arthritis, and a host of other diseases
including cancer benefitted greatly by LDN. You can
research more about LDN at www.lowdosenaltrexone.org.
I too have seen RA patients respond quite favorably to
LDN taken once in the evening at a low dose of 4.5 mg in
a non-sustained release
capsule.
!The standard dose for
an adult is 4.5 mg.
However, this dosage
can be modified by
giving less to
begin if needed for
sensitive patients (i.e.
1 mg to 1.5 mg) and
then working up slowly
every few days to a 4.5
mg dose. Some
individuals with autoimmune disorders need to start
slower with LDN dosing (because of an initial
exacerbation of their symptoms, such as fatigue or
weakness as the immune system alters its function), but
Ive not seen this to be necessary for patients with RA. An
easy way to start at a lower dose is to have your chosen
compounding pharmacy prepare 1.5 mg capsules of non-
sustained released LDN. This way, if necessary, you can
start your patient with 1.5 mg in the evening and then
add a second and third capsule of 1.5 mg LDN every 5 to
7 days until a 4.5 mg dose is achieved. Ive had some
patients who benefitted so greatly from LDN at 3.0 mg,
that they didnt need to go to a 4.5 mg dose
!!
!
www.BiomedicineUniversity.com All Rights Reserved. Copyright 2014 Dr. Kurt N. Woeller
Minocycline
July, 2014
Thomas McPherson Brown, M.D. was a
pioneering Rheumatologist who treated
thousands of patients with a variety of
autoimmune disorders of mixed connective
origin, including RA, with the antibiotic
Tetracycline. It was Dr. Browns theory that
the vast majority of autoimmune diseases,
such as RA, Lupus, Scleroderma, etc. where
caused by a chronic infection (bacteria).
Through the use of Tetracycline, he
achieved miraculous results with a multitude of patients.
Ive seen great success in using antibiotic therapy for RA,
namely using Minocycline. The idea behind Minocycline
(and Tetracycline) use is to implement it in a cyclical
dosing pattern that helps maintain bacterial suppression
and allow for the immune system to regulate itself. In
doing so, many individuals gain significant improvement
in joint mobility, reduced inflammation and pain, and
sometimes complete remission of their disease. A
common dosing schedule that Ive found successful is as
follows:
!Minocycline (aka. Minocin) 100 mg twice daily for 10
days, then
Minocycline (aka. Minocin) 100 mg twice daily every
Monday, Wednesday, Friday
!This treatment course may take a few months to see
optimal results. In some people, the treatment regimen
may need to be maintained for years to keep the disease
in remission.
!For more information on these protocols, as well as
additional information for RA patients (as well as your
integrative medicine practice), including testing
recommendations, have a book titled 5 Things You
MUST Do Right Now To Treat Your Rheumatoid
Arthritis This ebook is available for immediate
download at www.rheumatoidarthritisrecovery.com.
! (1) Rheumatology (Oxford). 2001 Oct;40(10):1175-9. A vegan diet free of
gluten improves the signs and symptoms of rheumatoid arthritis: the
effects on arthritis correlate with a reduction in antibodies to food
antigen
(2) Semin Arthritis Rheum. 1993 Jun;22(6):420-6. Reactive arthritis
associated with Clostridium difficile pseudomembranous colitis.
!
issue 4 July, 2014

BIOM ED IC INE UNIV ERS ITY

I In a study of nearly 1,000 mother-child

pairs, researchers found that prenatal
exposure to selective serotonin reuptake
Practice
Marketing Tip
N inhibitors (SSRIs) was associated with
autism-spectrum disorder and
developmental delays particularly in boys One of the best ways to promote
! (1). This data comes from the University of
California at Davis MIND Institute based on
your practice is through short
information videos about various
T 966 mother-child pairs from the Childhood
Autism Risks from Genetics and the
Environment (CHARGE) Study.
health testing and therapies you
provide. These videos should be no
H The data was broken into three groups -
more than 2 to 3 minutes in
length. Videos have a better
E those diagnosed with autism spectrum
disorder (ASD), those with developmental
delays (DD) and those with typical
chance of being highly ranked by
search engines like Google than
written material (which is still
! development (TD). The children ranged in
ages two to five with the majority of the
important to do as well). You can
simply use a small camera to
N children being boys: 82.5% in the ASD group
were boys, 65.6% in the DD group were
boys, and 85.6% in the TD were boys. The
record videos and then upload
them to a designated You Tube or
E study did include girls, but there was
substantially stronger affects in boys which
Vimeo Channel linked to your
office website. If you want some
W suggests possible gender difference in the
effect of prenatal SSRI exposure.
ideas and examples on how to do
short videos go to You Tube and
S (1) R. A. Harrington, L.-C. Lee, R. M. Crum, A. W.
Zimmerman, I. Hertz-Picciotto. Prenatal SSRI Use
and Offspring With Autism Spectrum Disorder or
search my name Dr. Kurt Woeller,
Autism or Dr. Woeller, B12.
Developmental Delay. Pediatrics, 2014

A PERSONALIZED WEBSITE IS THE SINGLE MOST IMPORTANT ELEMENT OF YOUR SUCCESS!

To be competitive, you have to market yourself.
Patients are smart, self-educated information starved
consumers, and you are SELLING a service. The Yellow
Pages are a thing of the past. Consumers are taking
their health care into their own hands and choosing their
doctor by speciality. Think outside the box--if you
specialize in a certain type of treatment that isn't
readily available in other areas of the city, country or
even the world, you can do consults with clients via the
phone or Skype. Don't leave your future, and your
practice, in anyone else's hands. Think about how you
can extend your marketshare through the internet.
TIP: Work with a company that understands Search
Engine Optimization (SEO) and will set your website up
so that the search engines, like Google and Yahoo, will
index it. This isn't a "build it and they will come"
proposition. Your internet presence is an ongoing
commitment that requires your attention (or an
employee's attention) everyday. Don't forget about the
importance of social media as well.

www.BiomedicineUniversity.com All Rights Reserved. Copyright 2014 Dr. Kurt N. Woeller