A range of alternatives exist for the rheumatoid arthritis sufferer worried by the battery of toxic treatments from conventional medicine. Here are some of the main ones. Remember, though, as with all use of supplements, this sort of therapy should not be carried out without the guidance of an experienced, qualified nutritional therapist.

Diet

Clinical ecologists believe that arthritis is an allergic reaction to food, pesticides and the environment. Of the foods, dairy products, soy, wheat and the nightshade family (potato, peppers, tomatoes and tobacco) are often cited as the culprit (in one study 70 per cent of 5000 arthritis patients reported gradually increasing relief after elimination of nightshades J Int Acad Prev Med, November 1982). A specialist would need to test for your particular reactions.

A well known pioneer of this treatment is Dr Collin H Dong of San Francisco, an arthritis sufferer who adopted a "caveman diet" and was free of all symptoms within a few months. The diet excluded meat, fruits, dairy products, vinegar and other acids, peppers, hot spices, chocolate, dry roasted nuts, alcohol and soft drinks. The diet is high in fish and fish oils.

There is much anecdotal evidence to show that diet can alleviate the symptoms, but very few scientific studies exist. Those that do have produced impressive results. One of the biggest ever controlled trials took place at three centres in the US. The first element involved a water only fast of six days, at the end of which improvements were reported in the vast majority of cases. The second proved that wheat, corn and animal proteins caused a reaction in patients. (Jrnl of Clin Ecol II (3): 137-45 and II(4): 181-9).

Vitamins

Vitamin B: The vitamins B5 (pantothenic acid) and B3 (niacin) have been shown to be beneficial at doses of 25mg. They should be taken within a balanced B complex and should not be taken late at night.

Vitamins C, E and selenium: These are among the main anti oxidants. Selenium is a trace element and beneficial effects have been seen at 200mcg doses; vitamin C is necessary for the formation of cartilage and bone and daily dose can be 3000mg; vitamin E can reduce the risk of inflammation. Daily dose can be 400iu. (Dose levels as recommended by the Institute of Optimum Nutrition).

Copper

Probably the best known self help treatment for arthritis is the copper bracelet. According to one American survey (D Sobel and A Klein; Arthritis: What Works, St Martin's Press, New York 1991), the copper bracelet was shown to be useless. However, Patrick Holford (Say No to Arthritis, ION Press, 1993) says its efficacy depends on the level of copper in the body.

Fish oil

Unlike diet and vitamins, fish oil has been scientifically tested against drug therapy. One study, carried out by L Skoldtsam at Kalmar Hospital in Sweden, concluded that 10g of fish oil a day had similar anti inflammatory qualities as NSAIDs. Another, by C S Lau of Ninewells Hospital, Dundee, discovered in a double blind placebo study that patients on the fish oil could reduce their NSAID requirements without suffering any deterioration. However, it should be noted that high doses of fish oil can lead to changes in white blood cell counts and cause excess bleeding in the brain.