Dr. Amy Nett: I like, yeah, both vitamin D and omega-3s. Oh, yeah, you’re giving me more ideas, systemic enzymes, okay, hold on. So vitamin D, I do like, but check her vitamin D level. Sorry, I’m just assuming it’s a she, since it’s rheumatoid arthritis, and it mostly occurs in women, so sorry if it’s a male, but check her vitamin D levels, and for a patient with an autoimmune condition, I do want to see vitamin D levels a little bit higher. So, If she has, you know, vitamin D levels somewhere around 35 or 40, think about adding vitamin D in there. You know, I think we’ve been talking about vitamin K, a couple times so far. I have a lot of patients on the Pure Encapsulations liquid vitamin D3, and then I’m using Thorne vitamin K2, and I was previously using Thorne vitamin D and K, but I think the D/K Drops has some K1 in it. So, switch to just using the straight Thorne K2. So you might want to consider it, because again, rheumatoid arthritis, I’m thinking there’s going to be an increased risk of osteopenia there, as well, so thinking about bone strength, so, if she’s running low on vitamin D, try getting the levels probably on the higher end of the spectrum, so I would say somewhere around 50 to 60 for vitamin D levels, serum vitamin D levels, and depending on how much, you know, Vitamin D you’re using, you could just use those vitamin K drops from Thorne, just use like one drop, I think that’s 1 milligram, something like that. So kind of just a maintenance dose, unless she already has osteopenia, then we might go up a little bit higher.
Omega-3s, I also like, but again, remember, Chris wrote the whole blog post for, you know, do we really want to be doing high dose, you know, fish oil or omega-3 supplementation routinely?
I don’t know. So omega-3s, little less certain that I would do a higher dose omega-3, for rheumatoid arthritis, but I think you could certainly do something like, you know, 1 gram, or 1 or 2 grams of omega-3. Hopefully she’s open to doing cod liver oil, because then you could get some omega-3, with the vitamin D and vitamin A in there, or you could just do like, you know, fish oil capsules. I often just have patients go to Vital Choice, and get the Wild Salmon Oil or Wild Salmon Oil Capsules, and I think it’s Pure Encapsulations also has like Eskimo PurEFA, something like that, fish oil capsules which are really nice. So, you could do a little bit of omega-3, I’m not sure, it depends on, you know, what the rest of the profile looks like, if there’s cardiovascular disease, or else something like that, sure, a little more comfortable with it, otherwise, maybe just like, 1 gram.
Systemic enzyme, for inflammation, so maybe you’re thinking Wobenzym, which is what I think of when you say systemic enzymes.
And that’s a great question. So, I do find that those are incredibly helpful with patients, and actually had a patient in yesterday, who has incredibly severe joint pain. So yeah, so she uses the Wobenzym, and that’s the only systemic enzyme formula that I know of, and there’s a fair amount of clinical research behind that one. So, I do think the Wobenzym is worth looking into and trying that as well.
So again, I would probably layer things in, sort of one at a time, if you can, so she gets a sense of what works and what doesn’t, but if it’s for a severe pain, you want to make the transition as easy as possible, then you might layer in quite a few things at once, but I would try the Wobenzym, that’s a great idea. So thanks for reminding me of that.