issue 4

July, 2014

Dr. Kurt Woellers

Rheumatoid Arthritis Help From Integrative Medicine

Including The Use of Low Dose Naltrexone & Minocycline
Kurt N. Woeller, D.O.
Rheumatoid Arthritis (RA) is a devastating disease leading to severe pain,
joint inflammation, and often crippling disability for millions of
individuals. Current statistics estimate that upwards of 1% of the U.S.
population is suffering from Rheumatoid Arthritis. In addition, there are
approximately 300,000 U.S. children with a similar disorder of Juvenile
Rheumatoid Arthritis. RA rates are approximately 3:1 in favor of females
to males acquiring the disease.
The causes are multifactorial with the
following being attributed to the onset of RA
for many individuals:
Stresschemical reactions to stressful events
such as physical or emotional trauma.

!Acute and chronic infections viruses and

bacteria may be triggers for the immune
system to attack joint structures.

!Intestinal imbalancesoften from chronic

bacterial infections, i.e. clostridia bacteria.
!Food reactionsthis is evidenced by improvements in RA with elimination
diets, i.e. gluten (wheat protein) avoidance.
!Intestinal imbalancesoften from chronic bacterial infections, i.e.
clostridia bacteria.
!Integrative medicine has much to offer for patients suffering from RA.

Much of this help comes in the form of the ability to recognize the role of
digestive infections and adverse food reactivity that triggers
inflammatory reactions which ultimately affect the joints.

In fact, independent research has shown that for many with RA, the
elimination of gluten proteins helps to improve their signs and symptoms

Clinical Pearl
There are many probiotics on
the market. In fact, many
probiotics contain a certain
bacteria called Streptococcus
thermophilus (St). (St) is
considered to be a beneficial
bacteria thought to help with
the digestion of lactose, and is
commonly used in the dairy
industry in the production of
yogurt. Even though
researchers have sequenced
the genomes of two common
Streptococcus thermophilus
strains, and found them to not
be dangerous (1), I personally
have observed in some children
with confirmed PANDAS
(Pediatric Autoimmune
Neuropsychiatric Disorders
associated with Streptococcal
Infections) or suspected
PANDAS that they react
negatively to this probiotic
bacteria. I have had numerous
reports over the years from
parents stating that their

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

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
be related to a reduction in immunoreactivity to food antigens
eliminated by the change in diet. Therefore, one useful test to
perform on ALL patients with RA is blood antibodies for Gliadin IgA, IgG,
Antitransglutaminase IgA, and Total IgA.

!Another area of integrative medicine investigation is digestive function,

particularly certain bacterial infections of clostridia. We know that

Clostridia difficle is a trigger for inflammatory bowel in the form of
pseudomembranous colitis (PC).
However, it
turns out that
there are other
forms of
clostridia
bacteria that
can contribute
to a toxic
burden on the
body. In
addition to PC,
Clostridia
difficle has
been reported
to initiate
inflammatory reactive arthritis in some individuals (2). One test I
recommend is the Organic Acid Test (OAT) from Great Plains Laboratory
www.greatplainslaboratory.com. It is a first morning urine test than
gives detailed information about various metabolic activities in the body
that are important for anyone with a serious illnessincluding RA. In
addition, it evaluates for toxins to candida and clostridia identifying two
bio-toxins
HPHPA and 4-cresol.

!Both HPHPA and 4-cresol are specific for clostridia bacteria. Clostridia

bacteria are anaerobic (oxygen avoiding) bacteria that are known to

trigger a wide variety of health problems (i.e. inflammatory bowel
disease). Clostridia bacteria have also been known to trigger an
inflammatory joint condition called Reactive Arthritis which has
similarities to RA. If HPHPA and/or 4-Cresol are elevated, it indicates
there is a clostridia bacteria present that should be treated. Two
antibioticsMetronidazole (Flagyl) and Vancomycin (Vancocin)-are both
effective in treating clostridia bacteria.

!A treatment option for clostridia bacteria is to use either one of these

antibiotics at a 40 mg/kg split dose three times daily for 10 days, then
initiating a treatment day every 3rd day for 3 weeks. This significantly
helps to eradicate the colonies of clostridia bacteria in my experience.

Clinical Pearl
(continued)

children have vocal tics or

motor tics when they consume
a probiotic with (St) in it, and
the problem resolves when it is
discontinued. Therefore, in my
practice I will avoid giving a
probiotic that contains this
bacteria strain to anyone with a
known or suspected case of
PANDAS.
(1) Streptococcus Thermophilus: A
Bacterium Which Is Harmless to Health."
International Research Associates. 14
Nov. 2006.

Visit any of Dr. Woeller's

websites for more information
on his specialities & services.
www.AutismActionPlan.com

!
!
!
!
!
!
!
!
!
!

www.AutismRecoveryBook.com
www.AutismRecoveryTreatment.com
www.MethylB12forAutism.com
www.RheumatoidArthritisRecovery.com
www.DrWoeller.com
www.MySunriseCenter.com
www.AutismSupplementsCenter.com
www.AutismSeminarsOnDemand.com
www.BiomedicineUniversity.com
www.LabTestsPlus.com

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

issue 4

July, 2014

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 nonsustained 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

!!
!

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.

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

Minocycline

issue 4

July, 2014

BIOM ED IC INE UNIV ERS ITY

I
N
!

T
H
E
!

N
E
W
S

In a study of nearly 1,000 mother-child

pairs, researchers found that prenatal
exposure to selective serotonin reuptake
inhibitors (SSRIs) was associated with
autism-spectrum disorder and
developmental delays particularly in boys
(1). This data comes from the University of
California at Davis MIND Institute based on
966 mother-child pairs from the Childhood
Autism Risks from Genetics and the
Environment (CHARGE) Study.
The data was broken into three groups those diagnosed with autism spectrum
disorder (ASD), those with developmental
delays (DD) and those with typical
development (TD). The children ranged in
ages two to five with the majority of the
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
study did include girls, but there was
substantially stronger affects in boys which
suggests possible gender difference in the
effect of prenatal SSRI exposure.
(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
Developmental Delay. Pediatrics, 2014

Practice
Marketing Tip
One of the best ways to promote
your practice is through short
information videos about various
health testing and therapies you
provide. These videos should be no
more than 2 to 3 minutes in
length. Videos have a better
chance of being highly ranked by
search engines like Google than
written material (which is still
important to do as well). You can
simply use a small camera to
record videos and then upload
them to a designated You Tube or
Vimeo Channel linked to your
office website. If you want some
ideas and examples on how to do
short videos go to You Tube and
search my name Dr. Kurt Woeller,
Autism or Dr. Woeller, B12.

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