THE KEY - Examination of the Gastrointestinal Tract
Patients with autoimmune/rheumatoid syndromes have overall poor health. Digestive issues, fatigue, depression, skin problems, colitis, anxiety, depression, irritable colon, intolerance to cold etc., are all common accompanying problems. The patient's general health and resistance must be addressed along with specific factors, if the patient is to return to an improved state of vitality and comfort.
Early in my practice years I learned the importance of looking carefully into the function of the GI tract in rheumatoid patients. In the gastrointestinal tract over 70% of the immune system resides. The gastrointestinal tract and the factors influencing it is one of the most promising areas for uncovering answers to many patients' rheumatic disease problems.
It often surfaces that the patient suffers from some level of chronic indigestion. Until the causes of impaired gastrointestinal function have been corrected, good results will rarely be obtainable. Patients with ulcerative colitis, crohns disease and whipples disease all have a high incidence of arthritic syndromes illustrating the relationship between gastrointestinal function and the rheumatoid disorders.
Titles to Scare Patients With
There are many rheumatoid disease titles but most serve little use other than to terrify patients who often feel they have been handed a death sentence. This is understandable since under medical care Rheumatoid Disorders are typically chronic, painful, progressive and disabling. What other outcome should be expected when only the patient's symptoms are addressed and the causes remain untouched?
There are about a dozen common drugs employed for Rheumatoid Disease Patients by medical physicians at any point in time with frequent switching from one drug to the next as the patient's condition worsens or side effects appear from the drug's usage.
Pharmaceuticals used change over time. Steroids, whose side effects include severe osteoporosis, diabetes, mental instability, adrenal atrophy and progressive muscle wasting to Vioxx (taken off the market after much initial fanfare, for serious side effects) to Methotrexate (originally employed for cancer and infamous for producing liver damage) to the newer much touted "'Biological Drugs" e.g. Enbrel, Remicaide and Humira that disable a portion of the immune system from performing its tasks and carry risks including tuberculosis, other infectious diseases and cancer. No drug can build health and all drugs carry risks. We might categorize them by saying: Enjoy some symptom relief now (maybe) and pay like hell later.
As each new drug hits the market there is initial excitement at the "newest discovery" followed by the announcement of dreadful side effect(s) patients on the drug begin to exhibit. This is what happens when employing pharmaceutical agents to suppress symptoms without understanding the causes of those symptoms. The medical treatment of rheumatoid disease resembles a tortured man stumbling around a dark road without a ray of light to guide him. Ongoing disability, disappointment and pain with no hope of health restoration. This is the outcome of treating symptoms rather than addressing causes, improving function and taking the needed steps to restore health.
The Alternative Medicine Crowd
You might think that one so critical of the medical profession's approach to autoimmune/rheumatoid diseases would sing the praises of the "alternative" practitioners who avoid pharmaceuticals and advocate "natural" potions and therapies including Homeopathy, Herbology, Acupuncture, Naturopathy, Bach Flower Remedies, Orthomolecular therapy and legions of other "alternatives". This diverse hodge-podge of alternatives, (each one promising more than the last), are particularly prone to target those with rheumatoid issues. The alternative practitioner may have a medical, chiropractic, osteopathic, naturopathic, or other degree or none at all. They may claim to have special status because they have a medical degree from Harvard or studied under a guru in Tibet but it makes little difference if the causes of the patient's disease are not uncovered and addressed. To the extent the alternative practitioner might also suggest some diet reform, sunlight, increased sleep and encourage the patient to reduce their intake of drugs…to that extent something positive might be achieved. It must be emphasized, however, that the hawking of the latest potions, even when done with great fanfare using pseudo-science or pseudo- religion is a path best avoided. Patients are still grouped into broad categories as if they will all benefit from the same nostrums despite being vastly different from each other while the causal factors responsible for their conditions remain untouched.
What Is Needed
What is needed is neither Standard Medicine nor "Alternative Medicine", but a cause oriented, health-promoting, approach that identifies and addresses causal factors.The roots of such an approach were established by the works of Hippocrates and the School of Hygeia many hundreds of years ago in ancient Greece.
At the Goldberg Clinic we have built on the Hippocratic Tradition of seeking out the causes of ill health and developed a comprehensive approach we consider neither "standard medicine" nor "alternative medicine". The Goldberg Clinic Approach is based on my personal experience with the trials and tribulations of rheumatoid disease as a young man…as opposed to treating symptoms. I am no genius but have been given the opportunity to learn from the school of hard knocks and a wealth of experiences that over the years have opened my eyes to the need to take a causal approach to overcoming chronic illnesses and to focus on restoring good function and health as opposed to treating symptoms.
The Goldberg Clinic Approach
Roots out the core factors responsible for rheumatoid and other autoimmune disorders. This requires an ample amount of time and attention for each patient. This is essential to understanding each patient sufficiently to allow for the development of a successful program. No doctor can understand a patient, particularly one with rheumatoid disease, by giving him or her a few rushed minutes each visit.
Understands and approaches each patient as an individual knowing that even among patients with the same medical diagnosis the causes behind the person's disease differ widely one to the next.
Approaches the patient from the standpoint not of treating symptoms but of building solid health, utilizing hygiene, clinical epidemiology, nutritional biochemistry and disciplined living habits. We set a priority of addressing the causes of impaired health emphasizing both physical and mental aspects with a concerted focus on the interconnected workings of the immune, endocrine, nervous and gastrointestinal systems.
Specifically addresses the restoration of health. This includes improving the patient's health in such a manner as to allow the immune system to no longer need to over-respond as it does in typical autoimmune disease.
Identifying Causes… Addressing Those Causes… Building and Restoring Health
"Treating" rheumatoid diseases has proven to be a dangerous road to travel. Ask those who have suffered the side effects of steroids, Vioxx, Celebrex and the newer "Biological" agents that have resulted in serious infections and cancers. The great fanfare heralding drugs for patients with autoimmune disorders soon diminishes as the devastating side effects that occur with them become known. Rather than foolishly looking to pharmaceutical companies to be our salvation we must work to address and rebuild health in a disciplined, logical manner.
Those who continue to seek out drugs as their solution tragically learn in time that "all that glitters is not gold". The same is true for those who seek cures through "alternative medicine" with treatments that also fail to address causal factors.
Questions & Answers
Q: How do you treat rheumatoid and other autoimmune disorders?
A: Key to our approach and success is that we do not "treat" diseases. This is a serious error made in both medical and "alternative practices". We do not "treat" any rheumatoid or other autoimmune problem. We work with the patient to remove the causes of poor health and improve their body's functioning to attain a high level of vitality. When health and vitality return, symptoms go away. This includes improving endocrine, gastrointestinal, neurological and immunological function. If a patient wants temporary symptomatic relief at the expense exacted by taking drugs then medical treatments are appropriately chosen. They can expect that under such circumstances long term improvements in their health will be rare and that side effects from such treatment are common.
We address the patient's health issues through a detailed interview, examination and personalized, functional, laboratory testing. The initial office visit takes one to two hours. We take into account the unique traits making up each person and develop an individualized program for him or her to follow.
Our patients find that not only are their disease issues addressed but that they experience health renewal with increased energy, better mood, more youthful appearance, normalization of weight and vastly improved resistance against cancer, heart disease, diabetes, autoimmune diseases and other common health problems we are plagued with in the United States.
Q: What specific skill areas do you commonly employ with autoimmune patients?
A: Clinical epidemiology to help uncover the causes of an individual's problems along with nutritional biochemistry, biological medicine and functional medicine. My background in Chronic Disease Control, Clinical Nutrition, Preventive Medicine, Natural Hygiene and my clinical experience over 35 years are all integrated into the practice.
Q: Are there other ways in which your practice differs from standard medical and alternative practices?
A: We differ in a number of ways. First, I have a special empathy with chronically ill people due to my own experience. Secondly, I strongly encourage patients to become very involved with their care and make the effort to get well. Some patients refer to our office as "Dr.Goldberg's Boot Camp" as I encourage them to exert discipline to bring about good results. Our office also differs in the large amount of time and attention we give each patient.
The Goldberg Clinic is based upon good science, Hippocratic Principles, Clinical Epidemiology, science based Clinical Nutrition and thirty-five years of experience…not the latest fads that many alternative practitioners get hooked into nor the same old stay on dangerous drugs the rest of your life scenario used in standard medical offices.
Q: Your practice is based on Hippocratic/Hygienic Principles. Does that mean you do not believe there has been anything new that is of any value?
A: Modern science, particularly chronic disease epidemiology and clinical nutrition have helped us understand a great deal more about the origins of many chronic health problems including the Rheumatoid Diseases. There is much value in keeping current with new findings and interacting with other professionals. With the changing nature of our environment and new stressors, keeping current with advances in toxicology, clinical ecology, functional gastroenterology and functional endocrinology among other disciplines is important for our patient's welfare. Part of the reason I continue to lecture to physician groups is because it keeps me on my toes and aware of new developments in the health care field including issues involving autoimmune disorders.
Q: What do you think of taking enemas, colonics, shark cartilage, colloidal minerals, apple cider vinegar and honey, bee sting therapy, herbal products, DMSO, Acupuncture, Vega Testing, Homeopathy, Spirulina, Blue Green Algae, etc.?
A: There are innumerable potions and remedies on the market and they change each year. Until the real causes of a patient's problems are addressed any benefits obtained will be minimal. Looking for quick fixes delays finding the causes for our problems. Rheumatoid and other autoimmune issues do not occur due to a lack of shark cartilage, blue green algae or any other product. We must orient ourselves to look for the causes of our problems rather than shopping the "quick cure train".
Q: Is there such a thing as a "leaky gut" and if so what is its importance?
A: Research supports the notion that Rheumatoid/Autoimmune Syndromes can be precipitated when the intestines become excessively permeable, i.e. the "leaky gut" syndrome. When I first began lecturing about this topic 25 years ago it was thought strange yet I was not the first to explore this possibility. Today we commonly hear the phrase "leaky gut" being tossed about in both lay and professional circles. We cannot, however, simply "treat" a leaky gut, we must learn about the patient to know why this is occurring whether it is due to allergies, poor diet, parasites, bacterial and yeast overgrowth, excessive stressors in daily living, nutrient depletion or other factors. It is those causal factors that must be addressed rather than the outcome i.e. the "leaky gut."
Q: Is it necessary for patients to sometimes adopt a new ways of living if they are to recover?
A: Yes. Real health reform is often required. If the home or work atmosphere is filled with strife, if the person hates their job, if the environment is not health promoting, then change is mandatory.
Once the patient has had a comprehensive workup performed and understands the changes needed, they must dedicate themselves to enthusiastically establishing the right habits of living. Early to bed and early to rise, giving up toxic habits of mind and body, avoidance of low quality foods, allergen avoidance in some cases and perseverance to achieve the good health we seek.
Q: Once a patient has recovered can they have a relapse?
A: Yes. Some patients return to old habits and find themselves back where they started. Fortunately nature is kind and we can usually recover when we get back on track. If the causes of the disease are set back in motion then disease will follow. If we follow the correct path of health, improved health will follow. It is a simple matter of cause and effect.
Q: What are the factors that make recovery most difficult?
A: Lack of determination and persistence are the greatest threats to success. If the patient does not take an active role in their recovery, if they lack the motivation and/or are unwilling to endure temporary discomforts during the early periods of their recovery program, it is unlikely that improvement will be obtained. In terms of the clinical picture, long term steroid or other immunosuppressant drug usage such as methotrexate or the newer "biologicals" such as Enbrel, Remicaide, etc., or surgical loss of organs and glands make recovery more difficult though not impossible. Discipline in following instructions is essential.
Q: Is age a factor in recovering?
A: Age is not so much a factor as is our will power and energy reserves. Some middle age and older persons have more energy reserves than some younger people. In any person who has burnt the candle at both ends, which is often true with patients having autoimmune disorders, much rest may be required for some time.
Q: What is the single most important dietetic factor in causing Rheumatic Disease?
A: Multiple dietary factors can contribute to autoimmune and rheumatoid diseases. If I had to pick one factor it would be overeating. An excess of even natural foods can be a potent contributing factor in disease causation. Certain types of food allergies may also contribute. Some patients have eaten excess carbohydrates to such a degree that they have thrown off their insulin/glucagon balance leading to an imbalance of eicosanoids lowering immunity and increasing inflammatory responses.
Q: Vegetarians do not get arthritis do they?
A: Yes, they do. While excess meat eating can contribute to Rheumatic Disease, Vegetarians are not immune. One who is vegetarian is not necessarily eating healthfully just because they don't eat meat. Some people do better by eating a modest amount of animal products in the diet. Not everyone is cut out to be a vegetarian and not all vegetarians are healthy. Excessive intake of animal flesh, however, is common in our country and this excess is a potent contributor to many health problems. Animal foods when utilized should be used in a modest fashion…much less than consumed by the average American.
Q: I read in a popular health book that cows milk is the cause of all arthritis. Is that true?
A: There is no single factor that causes all rheumatoid or autoimmune issues. Cows milk is a common allergen and can contribute to autoimmune conditions in some people.
Q: Would some patients benefit from an extended rest/vacation initially as part of their care?
A: Yes! An extended rest with dietetic reform (or fasting in some cases) is often essential for the Rheumatic Disease Patient. It should be somewhere that the patient can get unlimited rest and sleep, be in a clean environment, be monitored as to their needs and be away from the enervating influences of modern society. Many patients are not able to recover from Rheumatic Disease unless they initially take a much-needed rest.
Q: Do all patients need to fast?
A: No, not all patients should or need to fast but for some it can be very beneficial. Some of our patients are placed on short fasts of three to ten days and respond very well with significant improvements.
I must add, however, that I have had patients come to us for help who had gone to other places and taken very long fasts that left them greatly weakened and severely depleted. Fasting is not appropriate for everyone and always needs to be individualized to each patient. Experienced supervision is essential.
The Goldberg Clinic has a facility for resting and/or fasting in South Florida, by the ocean, available specifically for our patients.
Q: Can severe or prolonged emotional stress contribute to Rheumatoid and other Autoimmune Diseases?
A: Yes. In a person predisposed to Autoimmune Disease, extensive emotional stress can trigger the disease process, particularly when added to other stressors. Unrelenting emotional stress adversely influences the immune, endocrine, nervous, and gastrointestinal systems particularly hard, which in turn influences the health of the joints and surrounding tissues.
Q: What is the length of time needed for recovery from Rheumatic Disease?
A: This is highly variable and depends on the amount of energy reserves the patient has, the amount and kinds of drugs taken, the extent of the disease process, the expertise of the practitioner and the determination to adhere to a program on the part of the patient. Some patients recover more quickly while others take more time. Generally the more accurate the program is at addressing the patient's needs and the more effort the patient makes in following the program, the quicker good results can occur.
Q: You sound optimistic. Is there really reason for people with rheumatoid and other autoimmune diseases to have hope?
A: What I have said is based on my experiences with patients, as a former afflicted sufferer myself, as a Professor and Researcher and from learning from my own teachers over many years. I know the enormous suffering and agony that is experienced by Rheumatoid and other Autoimmune Disease Patients and I do not take it lightly.
Be of good cheer! With the right guidance, effort and time, recovery and good health are possible. It has been true for many hundreds of my patients and myself and it can be true for you as well.