Psoriatic arthritis alternative treatment, herbs, vitamins, supplements, research by Ray Sahelian, M.D.

Psoriatic arthritis is a chronic disease characterized by inflammation of the skin (psoriasis) and joints (arthritis). Approximately 10 to 20% of patients who have psoriasis also develop an associated inflammation of their joints. Patients who have inflammatory arthritis and psoriasis are diagnosed as having psoriatic arthritis.

Natural treatment
I could only find one study. Vitamin D may be of benefit.

Subjective improvement in patients with psoriatic arthritis after short-term oral treatment with seal oil. A pilot study with double blind comparison to soy oil.
J Rheumatol. 2006. Section for Rheumatology and Gastroenterology, Institute of Medicine, University of Bergen, Norway.
To investigate effects of short-term oral treatment with seal oil in patients with psoriatic arthritis. Forty-three patients with polyarticular psoriatic arthritis were randomized to receive oral treatment for 2 weeks with either seal oil or soy oil in a double blind controlled trial. Patients were allowed to continue nonsteroidal antiinflammatory drugs (NSAID) and disease modifying antirheumatic drugs (DMARD) during the study. Forty patients completed the study, 20 in each treatment group. Patients in the seal oil group reported a significant improvement in global assessment of the disease 4 weeks post- treatment, and both groups showed a trend toward improvement in tender joint count, but the differences between the groups were not significant. There was a fall in the ratio of n-6 to n-3 fatty acids and in arachidonic acid (AA) to eicosapentaenoic acid (EPA) in serum after treatment with seal oil. Twenty-one percent of all patients had elevated values of calprotectin in feces suggestive of asymptomatic colitis. Treatment with seal oil was followed by a modest improvement in patient's global assessment of the disease and a trend towards a decrease in number of tender joints. There was a shift in fatty acid composition in serum toward a putative antiinflammatory profile. Oral treatment with seal oil may have NSAID-like effects in psoriatic arthritis.
   Comments: I wonder if fish oil, krill oil, or flaxseed oil would have similar benefits.

Symptoms and signs
Common symptoms and signs of psoriatic arthritis include:
Feeling fatigued, reduced range of motion in the joints and feeling stiff in the morning.
Joints that are swollen and painful along with back pain.
Pain and soreness where tendons attach to bone, such as at the heel.
Pitting or separation of nails from the nail bed.
Conjunctivitis with by redness and pain in tissues surrounding the eyes.

Psoriatic arthritis treatment
Mild skin and joint symptoms of psoriatic arthritis may be treated with topical agents, ultraviolet light therapy, and nonsteroidal anti-inflammatory drugs. More severe manifestations of the disease, including progressive peripheral joint damage, spine disease, enthesitis, dactylitis, and severe skin changes, require systemic therapy. Traditional systemic drugs include methotrexate, sulfasalazine, and cyclosporine. When these medications are not adequate or not tolerated, new biologic agents, particularly anti-tumor necrosis factor (TNF) compounds, have shown benefit.

Associated medical conditions
A significantly higher prevalence of thyroid autoimmunity (positive AbTPO, hyoechoic thyroid) findings in men and women with psoriatic arthritis and of subclinical hypothyroidism in women with psoriatic arthritis than in the general population. Therefore, thyroid function tests, an AbTPO assay, and thyroid ultrasound should be considered as part of the clinical evaluation, particularly in women with psoriatic arthritis.
   Overall, people who suffer from psoriatic arthritis do not have a higher risk of cancer compared to the general population. Patients with psoriatic arthritis have an increased risk of cardiovascular disease. Severe inflammation is a risk factor for the development of cardiovascular disease. This is similar to what has been shown for other inflammatory forms of arthritis such as rheumatoid arthritis.

Nail psoriasis
This is common in adult patients with psoriasis. Traditional treatment includes topical applications of corticosteroids, calcipotriol, retinoids, and 5-fluorouracil, but these treatments don't work too well. Systemic treatments include ciclosporin, methotrexate and acitretin, all of which have a serious toxicity. Early research suggests that psoriatic nail disease may improve with fumaric acid esters.

Questions
I am a doctor from the UK, and have psoriatic arthritis. I have tried a number of complementary therapies to try and overcome a hot, swollen knee including high dose fish oil, boswellia, curcumin, MSM, GLA, and Ginger, with little effect. Nothing seems to work as well as the NSAIDs. I was wondering if you could suggest anything else that may be worth trying.
   We have come across little research regarding the natural treatment for psoriatic arthritis. If you come across something, let us know and we will tell our readers. Perhaps eating a lot of fish, fresh vegetables and fruits, and reducing sugar, white bread, milk, and junk food could be helpful. Using more fish oil, salmon egg, seal oil, etc should be considered. It may be cautious to reduce the dose of the NSAIDs while using high doses of fish oil products.

My sister is suffering from psoriatic arthritis for the last 3 to 4 years and there is a treatment from Hosmat Hospital in Bangalore which cured her skin problem. But the pain in her joints of her feet fingers are still growing and it is getting worse day by day. Do you have a treatment for this which can cure this psoriatic arthritis decease. Please revert us if you need any further information on the symptoms or the treatments availability.
   At this time I don't have any knowledge of a natural treatment for psoriatic arthritis.

I am a 40 yr old male, wt: 150 lbs, ethnicity: Indian. I have suffered from psoriatic arthritis for almost 20 yrs. I have been on multiple NSAIDS. I was most recently on methotrexate po, and enbrel sq. Currently I am ONLY on methotrexate sq as I developed some side effects on enbrel. I am also taking a statin, a baby aspirin, flecainide (h/o lone AFib). I have added curcumin, sam-e, Co-Q10, omega 3 fish oil in the past year. I have read there can be interactions between curcumin and statins, arthritis meds and NSAIDs. I feel very disappointed as I was hoping to use nutraceuticals to actually help protect my liver and boost antioxidant protection as well as joint support. Would you advise I stop all the supplements for now. Of course as a physician I completely understand your information is limited by the lack of a complete history from me and as such you cannot take responsibility for the advice you dispense and the potential outcomes or side effects of what you tell me. I am just seeking some general guidance.