Can Complementary and Alternative Medicines be Beneficial in Treating Psoriatic Arthritis?

Can Complementary and Alternative Medicines be Beneficial in Treating Psoriatic Arthritis?


(uplifting music) – Hi, my name is Dr. Dana DiRenzo. It’s common for patients
with chronic diseases to want to try as many
therapies as possible, especially if they are in pain, whether they are prescription
therapies from their doctor of complimentary and alternative therapies available in the community
or over the internet. However, it is always important to talk to your treating physician about all the substances
and activities you may take and participate in for your arthritis. The American College of Rheumatology issued a position statement in 2012 recognizing the interest of
both patients and physicians in use of complimentary
and alternative medicines. Generally, in terms of
psoriatic arthritis, there are very little scientific studies regarding the effectiveness
of complimentary and alternative therapies. There is some evidence with
regards to herbs, supplements, creams, and mind/body practices
for relief of psoriasis. (uplifting music) Mahonia aquifolium, also
known as Oregon Grape. The most common side
effects of topical treatment include rash and a burning sensation when applied to the skin. Traditional Chinese herbal medicine. There is some evidence that using TCMs like Chinese foxglove,
red sage, purple gromwell in addition to traditionally
prescribed medications and light therapy may be more effective than conventional treatment alone. On the other hand, patients
call in all the time asking about coconut oil. In combination with UV light treatment, was not found to clear
psoriasis plaques faster in the only clinical
trial it was studied in. Side effects with combination therapy may include GI upset,
elevated liver enzymes, and elevated cholesterol. Patients frequently drink green tea, which contains caffeine, which
may improve mental alertness. However, there are no
clinical trials to date assessing the effectiveness of green tea for treating psoriasis
or psoriatic arthritis. Liver toxicity has been reported if you are drinking large
quantities of green tea but green tea is generally safe. Kombucha tea, this popular drink commonly sold in health stores is produced by fermenting the kombucha
mushroom in tea and sugar. However, there are no
scientific studies published with regards to proven health benefits in psoriasis or psoriatic arthritis. There are rare serious side effects from drinking large
quantities of this beverage including impaired liver function, especially for patients with
preexisting liver damage. Other effects include allergic reactions and nausea and vomiting. As a side note, if you are on medications that are processed through your
liver, such as methotrexate, it is always important to keep in mind herbs and supplements that
may affect your liver. Patients also frequently
ask about tumeric, ginger, cinnamon. There is very little evidence
that tumeric is effective for psoriasis specifically but it is known to have
antiinflammatory properties in other diseases. Patients should use
caution with long-term use and at high doses and this may
cause gastrointestinal upset. Ginger, also frequently used. Ginger has not been studied in psoriasis or psoriatic arthritis specifically, but has been shown to help with nausea that some patients may experience
while taking methotrexate. In terms of ginger,
caution should be noted with patients with gallstone disease as ginger may increase the flow of bile and for those on blood thinners. There is an unclear certainty
of drug interaction. Cinnamon is frequently asked about. There are no clinical
trials evaluating cinnamon for psoriasis specifically. There are a small number of trials in mice that have found
antiinflammatory properties of cinnamon, however. Cinnamon contains coumarin which may cause impaired liver function and should be used with caution, especially if you are prescribed
an arthritis medication that is metabolized in the liver. These medications not
only include methotrexate but also include leflunomide
and sulfasalazine. Other common supplements include
glucosamine and chondroitin and bovine collagen. There is one small published case series that reports improved plaque psoriasis after taking chondroitin supplements. There is no specific study
in psoriatic arthritis; however, we know from the
osteoarthritis literature that this has proven benefit, especially with patients with knee OA who are having moderate to severe pain. Other substances such as bovine collagen, which can be topical or oral, have very limited scientific backing. There has been some very serious allergic
reactions reported. A word of caution about
other potentially used herbs and supplements. St. John’s wort. Historically this has been
used to treat depression, anxiety, sleep disorders, and nerve pain. However, there is
potential drug interactions with immunosuppressant medications such as cyclosporine, which
is commonly used in psoriasis. Ginseng, particularly in Asian patients, ginseng may alter the ability of the body to metabolize certain drugs. Examples of these drugs include
tacrolimus and colchicine, other drugs that are commonly used in the rheumatology division. So in conclusion, remember
herbs and supplements, which are tried by nearly 50% of patients with psoriasis and psoriatic arthritis, are not bound by proven quality standards that all prescription medications
approved by the FDA have. Herbs and supplements may still contain very powerful ingredients that
can alter your immune system and the way your body
processes medications. Natural substances do not
necessarily mean safer substances or substances with less side effects. We are here to help and
are open to discussing all of the herbs and supplements
that you may be taking or are interested in. Complementary therapy should never be used in place of your prescription medications. It is also important for us to know about the herbs and
supplements you may take because they may interact with
your prescribed medications. Please talk to your doctor
about questions or concerns that you may have regarding
alternative therapies. A great resource for specific information on any herb or supplement can be found at the National Center for Complimentary and Integrative Health. (uplifting music)

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