Case study: rheumatoid arthritis and HRT

I have had rheumatoid arthritis for more than 10 years. When it was first diagnosed, I was given Indocid, a non-steroidal anti-inflammatory drug. When the pain became very bad, I was prescribed Indocid suppositories to use at night, in addition to the tablets.

Eventually I became very unwell and ended up being rushed into hospital with a perforated duodenal ulcer, which had complications. The hospital doctors said the Indocid had caused the ulcer and took me off the drug and said I should never take it again. Eventually a private specialist diagnosed a split in my lower bowel, which needed immediate surgery.I refused to go on any other arthritis drugs, even though my joints became very swollen and I had to use a wheelchair outside the house. I read as much as I could about alternative treatments, cut out a number of foods and began taking cod liver oil and vitamins. I was able to manage without drugs, except for occasional pain killers, for the last seven years.

I started HRT patches about four years ago and this did improve my condition as well as making me feel better generally.

We subsequently moved to a new area, and I think the stress of moving must have caused the arthritis to accelerate severely. One specialist has recommended a knee replacement and another NSAID plus sulphasalazine. Mrs J K, Isle of Whithorn.......

Before you submit to surgery, more NSAIDs (which are supposed to be off limits to those with a history of gastrointestinal bleeding) or other drugs, our advice would be to seek out a seasoned nutritional specialist experienced at treating arthritis as an allergy. The Institute of Optimum Nutrition in London can refer you to a local doctor (5 Jerdan Place, London SW6 1BE Tel: 071 385 7984). You might also consider coming off HRT, a known immunosuppressant, which could be the real cause of the sudden worsening of your condition.