Integrative Recommendations for Autoimmune Conditions

autoimmune disease

By Georgia Tetlow, MD

An integrative approach to autoimmune illness, including rheumatoid arthritis, can incorporate  general measures to reduce inflammation in the body. Finding the root causes is essential to help you feel better. Simultaneously, reducing stress and improving stress management can help improve your quality of life as well as  your healing response to help reduce flares, because stress is expressed as inflammation in the body. Join Dr. Tetlow in August for a FREE class at Cabrini University to learn more about the root causes of autoimmune conditions and a comprehensive integrative approach!

A Place to Start: Mind-Body Medicine

Meditation is highly recommended for all patients with generalized inflammation. Consider enrolling in a Mindfulness Based Stress Reduction program--there are well over 550 academic programs nationally--just google MBSR and your zip code or visit Jefferson’s Mindfulness Institute or Penn’s Center for Stress Management. Mindfulness has been shown in multiple research trials  to measurably reduce salivary cortisol and plasma DHEA-S.

Many patients also explore relaxation techniques, Tai Chi, Yoga, or a any body-based meditative practice.

Reflective or disclosure journaling has been proven to be helpful, particularly if you write about emotionally charged events in your life.

Removing Toxins

Once you’re ready, reduce coffee and eliminate tobacco.  Make alcohol are rare treat, if at all. Consider eliminating foods that cause inflammatory reactions like stomach aches, itching, rashes or loose stools, or come into the office to get help to determine if particular foods are playing a role. Dairy, wheat, citrus, and nuts can be common culprits.  Total elimination of suspected foods from your diet for three weeks followed by reintroduction of each food separately can be revealing.

Shift to an organic-based diet, and visit the Environmental Working Group to learn which foods are more important to get organic. Some research suggests a substantial improvement in some people with rheumatoid arthritis who trial a vegan diet, with improvement only after several months.


Increase omega-3 fatty acid intake by eating more cold water fish, adding ground flaxseeds, or fish oil.  See for information to help you avoid excessive mercury exposure. Consider the recommendations of the anti-inflammatory diet and gradually incorporate as many of these as make sense to you.


A personalized well balanced exercise program has huge benefits.


Acupuncture is helpful for many people with rheumatoid arthritis; and is not as likely to be beneficial for those taking corticosteroids such as prednisone--but it can still help.


Avoid herbal supplements that stimulate the immune system, such as Echinacea, Astragalus, Alfalfa Sprouts, Iron (unless prescribed by your provider) or St. Johns Wort. Alfalfa sprouts contain the amino acid L-canavanine, which can stimulate the immune system in people with lupus and increase inflammation. Other legumes are safe to eat as they have a much lower concentration of L-canavanine.  It’s probably best to also avoid iron unless you are anemic and iron deficient. St. John’s Wort can cause many other medicines to be less effective.

Frequently recommended supplements:

  • Fish oil supplements are highly recommended, from environmentally friendly and non-toxic brands such as Nordic Naturals.  Determine your dose not by the total amount shown on the front of the bottle, but with the sum content of DHA plus EPA.  Start with a daily dose of 1000 mg of DHA + EPA, and increase every five days or so until you take a total of 25 mg DHA and 15 mg EPA / lb of body weight, or at least 3 g/day, ideally split between morning and evening doses, with food.

  • GLA (Gamma Linolenic Acid), as GLA 1.4-2.8 gm/day) or Evening Primrose Oil (12-22 gm/day). GLA is particularly helpful for reducing inflammation that has a hormonal component.

  • Vitamin D with MK-7 or MK-& and Vitamin A as indicated by testing. Choose a safe and non-toxic brand, such as Da Vinci.

  • Calcium Citrate has been studied for certain autoimmune conditions.

  • Magnesium Buffered Chelate – titrated to 1-2 formed bowel movements daily

  • Selenium 200 mcg and less if you eat many nuts (one brazil nut provides an average of 100 micrograms of selenium.)

  • Consider Vitamin C 250 mg twice daily.

  • Botanicals: (each are included in the supplement Zyflamend). Ginger, starting with 1 gm twice daily, increasing weekly up to total of 2 gm twice daily. Turmeric, ½ gm twice daily, increasing to 1 gm twice daily: to absorb it systemically, it must be cooked in oil.

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As discussed during your integrative appointment or as recommended by your rheumatologist.

PIM wants to hear from you! Do you have an experience with managing an autoimmune condition? Do you find this article helpful? Share your thoughts in the comments below!

Interested in connecting with PIM? Register for one of our upcoming events - Deep Dive Classes with Dr. Tetlow at Cabrini College. Deep Dive offers intensive, interactive, life transforming experiences that include honest self-assessments and multiple keys to help you be and feel different.

If you or your loved one has ongoing stress, mood or hormone imbalance, or they are suffering from a chronic illness, please consider scheduling a 20 minute free consultation or an appointment with Annmarie McManus, MMSc, PA-C, PT, IFMCP.