Friday, September 23, 2011

New Drugs Cause Life-Threatening Infections

The FDA announced (9.7.11) a new warning for all tumor necrosis factor alpha (TNF-alpha) inhibitors to include a warning about the risk of “…serious and sometimes fatal infections from two bacterial pathogens Legionella and Listeria.

TNF-alpha blockers (e.g., Humira, Enbrel, and Remicade) are used to treat many autoimmune disorders such as rheumatoid arthritis, Crohn’s disease, ulcerative colitis, psoriatic arthritis, and juvenile arthritis. How could these drugs predispose a patient to becoming ill with a life-threatening infection? This question is not a hard question to answer. One only needs to look at the mechanism of action of TNF-alpha drugs and realize that their use is bound to cause an increased risk of infection.

Patients do not become ill with an autoimmune disorder due to producing too much TNF-alpha. TNF-alpha is a molecule produced in the inflammatory cascade. Inflammation is associated with pain. For example, if you sprain your ankle, the ankle becomes swollen and red. The swelling and red color are both signs of inflammation. In the case of an ankle sprain, the inflammatory response recruits white blood cells and other healing cells to the area of injury in order to start the healing process. Without this inflammatory response, a sprained ankle would not be repaired.

In the case of an inflammatory autoimmune disorder such as rheumatoid arthritis, my clinical experience has shown that the inflammation of the joints is often the body’s response to an infectious agent. I discuss this concept in detail in my book, Overcoming Arthritis. Treating the infectious agent can eliminate the cause of the inflammation and allow the body to repair the damage. The worst thing you can do in this situation is to shut off the body’s inflammatory response with a drug like a TNF-alpha blocker. In the case of an underlying infection, blocking the production of TNF-alpha is bound to cause a dysfunction of the immune system. The end result is a lack of the immune system’s ability to fight or control an infection.

Yes, blocking TNF-alpha can treat the symptoms of arthritis, but keep in mind, these drugs do not treat the underlying cause of the illness. In fact their long-term use is bound to cause problems with the immune system including the development of potentially life-threatening infections.

What can you do if you have an inflammatory disorder? The first step is to ascertain the underlying cause(s) of the disorder. Eliminating inflammatory-provoking foods such as dairy and gluten can help. Furthermore, removing refined sugar is a must. Eating a healthy, whole-food based diet provides the body with nutrients that not only aid the immune system but provide the body with the raw materials needed to promote healing. Next, drinking adequate amounts of water helps the body overcome illness. Finally, correcting nutrient imbalances can further aid the body’s capability to overcome arthritis.

There is a time and a place to use drugs like Remicade and Humira as TNF-alpha drugs can provide symptomatic relief from painful conditions. However, their use should be limited to patients who have failed all other therapies and for those in dire need of relief from pain. Adopting a holistic approach, as outlined above, can minimize or many times eliminate the need for these drugs. TNF-alpha drugs should be used with utmost caution and for the shortest period of time possible.


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