I’m not an objective storyteller. None of us is, honestly.
As a teenager, I had moderate-to-severe Rheumatoid Arthritis. I had all kinds of support and braces on the outside of my body and drugs on the inside, and at the age of nineteen I walked with a cane. The RA was severe for ten years, despite conventional western medical treatment. I received gold shots in alternating butt cheeks years before self-administering the newest biologic injectables, took pills previously only prescribed for malaria, and enough prednisone to give me 8o-year-old bones by age forty.
Despite all this, I don’t dislike conventional medicine. I think it provides useful tools in many different situations. But when it comes to RA, and other chronic inflammatory disorders, I believe it misses the forest for the trees.
In my mid-twenties, I went rogue. I knew I could be healthier, and I knew I needed to adopt a new way for being in the world. I noticed that flare-ups occurred around stress, and the stomachache I’d had for twelve years could be part of the larger picture.
So I chose a path away from the medicine I grew up with and started meditating, studying yoga, movement therapy, stress reduction, journaling, reading so many PubMed studies, wondering.
I lived with pain for fifteen years. And now I don’t.
I spent years trying different methods and practices: I spent time sitting at the bedside in a Buddhist hospice, apprenticed with the inimitable Darlene Cohen– a Zen priest with RA who focused on managing chronic pain, and eventually went back to graduate school to receive a Masters in Holistic Health Education. After completing my degree, I began specific study in a five-year program in Classical Ayurveda Clinical Medicine at Vedika Global College of Ayurveda in Emeryville, CA where I became adjunct faculty. After working in Integrative Medicine alongside a Functional Medicine MD, it became clear that holistic medicine needs a larger megaphone.
All roads lead back to digestion
The symptoms of RA are accurately described in the 4000-year-old primary text of Ayurveda, Charaka Samhita: from the characterization of hot swollen joints to the pattern of jumping from joint to joint. Even more, it described the relationship of digestive discomfort to eventual symptoms of Rheumatoid Arthritis. This specifically peaked my interest.
I had stomachaches for years before ever having joint issues, as do many of us with RA. I lived with at least one of my hands pressed against my lower abdomen for warmth and relief in any moment I could get away with it. My stomach hurt a little bit all the time; I honestly can’t remember a day when it didn’t. And despite all the doctors and tests, the cause was never determined. Stress played a starring role, as did nutrition, but these were the days before there was any acknowledgement of how greatly these factors affect health.
Here’s where it’s going to get a little crazy for some of you. I want to briefly describe how Ayurveda understands RA, and I know it’s going to push some buttons as being “unscientific” because it doesn’t fit into the box of western pathology. I also know I am also a testament to its validity, as are my clients.
The name for rheumatoid arthritis in Sanskrit is “amavata”.
Ama is a form of microscopic, undigested food matter that migrates beyond the stomach, eventually obstructing the deeper tissues of the body.
Vata is the bioenergetic principle of space and air elements in the body. It is responsible for all motility in the body, from cell division to exhaling to uterine contractions.
Rheumatoid Arthritis (amavata) is, literally, the unholy union of ama plus vata.
According to Ayurvedic pathology, by the time the disease is diagnosed as Rheumatoid Arthritis, there will be three factors in place:
there is an over-accumulation of vata dosha circulating through the body, which has likely been throwing off generalized symptoms of pain, bloating, stiffness, fatigue, or compromised immunity;
low digestive capacity, often signaled by symptoms such as gas, pain after eating, and sluggishness, and
an underlying vulnerability in the joints that may have been initiated by genetics, past injury, illness, or lifestyle choices over time.
The diagnosis often arrives after a period of trauma or exertion (physical or emotional)
Don’t ignore the small signs
According to Ayurveda, the large majority of diseases originate in the gut. Since 80% of our immune cells are located in and around the intestines, this shouldn’t be surprising. Rheumatoid Arthritis begins as a digestive disorder before it shows the classic symptoms of RA: often-symmetrical heat, swelling, and pain that jumps from joint to joint.
This is not to scare anybody with digestive issues into thinking they’re developing RA, although if it prompts you to address your chronic bloating then I’m okay with that. Chronic low-capacity digestion is going to affect individuals differently, depending on lifestyle and health history.
Using food as medicine
Everything in the universe has inherent qualities. A chili pepper naturally contains heat, coffee beans have bitterness, and water naturally carries a quality of coolness.
Unsure about the water part? Tell me how much you love a 70 degree day and then how much you love a 70 degree swimming pool.
Ingredients matter, as does cooking procedure (a raw carrot is different from a steamed carrot is different from a carrot sautéed with cumin powder). Add to that how much you eat, what time you eat, what season it is, what you do while you’re eating… you get the picture.
It can’t be completely boiled down into a bunch of food lists.
You are what you eat. You are what you digest. And ultimately, you are what you don’t digest. And that part is causing a lot of problems.
Start with digestion
The initial focus in addressing rheumatoid arthritis with Ayurveda is increasing agni, or digestive fire. The quality, capacity, and regularity of digestion is imperative in both managing symptoms and addressing the root cause of the illness.
Ayurveda offers a list of ways to evaluate digestive strength along with ways to increase its efficiency. But the digestion in the stomach is only one level: there are ultimately seven tissues in the body that also have to receive nourishment. For this reason, herbal medicines are often combined with diet specifically to increase metabolism at the level of the deeper tissues, and to cleanse and nourish the bones, joints, and nervous system tissues.
Agni (digestive fire) determines whether or not your body creates ama, and agni determines whether or not vata is balanced. It is essential to self-management of the disease.
The mind affects digestion and inflammation
Everyone with RA knows that stress creates flare-ups. The mechanism is twofold: the stress response increases vata (the bioenergetic principle in the body governing mobility) AND stress reduces digestive capacity, leading to ama (undigested toxin) formation. This is why stress can create both an immediate and longer-term flare in symptoms.
If you suddenly realize you forgot to make an important phone call or missed a deadline just as you are about to eat, your previously raging hunger likely disappears quickly. If you are in a state of consistent low-grade anxiety, this is hampering your ability to metabolize anything you eat no matter how healthy it may appear. Doubly true if you’ve got a greasy double-bacon-burger and fries in front of you.
The individual matters
Ayurveda appreciates that half of the work of an Ayurvedic Practitioner is understanding the disease and half is understanding the person who has the disease.
Your immune system is ultimately the result of how you metabolize your life: from the food on your plate to how your mind and body responds to stimulus, and what comes in through your senses (this includes words whispered in your ear and media that scrolls across your phone).
Your health is reliant upon your mind and body’s ability to:
take in substances and impressions from the environment,
sort out what is beneficial and what is waste, and
efficiently get rid of what doesn’t serve you.
Learning how to do this on mental, emotional, and physical levels is what equates to a holistic treatment plan.
It’s not about right or wrong
I’m not getting into a spitting contest about whether the western approach is right or wrong. I work with plenty of people who are using both. I do believe the current western model is incomplete. I am also heartbroken at the number of MDs spreading the story that stress and diet play no role in disease progression, and number of patients they chastise for even asking the questions.
None of us has the whole story and we can do better. I know my story, and why my actions changed my body, because I followed that story back 4000 years to its roots. I don’t begrudge anyone living with pain to follow what their gut tells them. Especially not the gut.
Is this your path? Check out my offerings. I’ve been there and I’d love to help.