Gold therapy was previously the gold standard for treating rheumatoid arthritis. Though still available today, this treatment option is much less common due to its side effects and newer medications.
Rheumatoid arthritis (RA) is a chronic autoimmune condition that affects the joints of the body. With RA, the immune system attacks itself and leads to inflammation along with pain, swelling, and stiffness of varying degrees.
Here’s what you need to know about gold therapy, how it works, and what side effects you may experience.
Gold therapy (also known as chrysotherapy/aurotherapy) uses gold salts that are either injected into the muscle or taken as an oral tablet. In 1929, French internist Jacques Forestier discovered that gold compounds could ease joint pain for people dealing with RA. In some cases, the gold even led to remission.
Gold therapy has been used to treat RA as well as psoriatic arthritis, lupus, and Sjogren’s disease. This therapy was widely used until the 1990s when more effective, less toxic medications like methotrexate became the treatment of choice.
Gold salts have anti-inflammatory properties. This means that the gold may stop the cells from making chemicals (histamines) that attack the immune system and harm the tissues.
Beyond that, researchers do not fully understand why this treatment is effective for RA.
Auranofin (Ridaura) is available by prescription. Tablets contain 3 milligrams of the gold compound. Treatment involves taking two pills each day for the first 2–3 months. The dosage may be increased as needed. Tablets should be taken with food.
Injectable gold therapy — aurothiomalate (Myochrysine) and aurothioglucose (Solganal) — was discontinued in 2019 due to a shortage of an active ingredient.
The most common side effects include:
- skin rashes
- mouth ulcers
- metallic taste in the mouth (dysgeusia)
- other digestive issues
- dizziness or fainting (syncope)
Rare side effects include:
- digestive issues: damage to the intestines (enterocolitis)
- kidney issues: protein in the urine (proteinuria), inflammation (nephritis), kidney failure
- bone marrow issues: excess white blood cells (hypereosinophilia), low platelet count (thrombocytopenia), low neutrophil count (neutropenia), aplastic anemia
- respiratory issues: bronchitis, interstitial fibrosis
- circulatory issues: heart attack, stroke
- nervous system symptoms:
- liver issues: cholestatic hepatitis, jaundice
Potentially irreversible side effects include a blue or gray discoloration of the skin and/or a golden ring around the cornea of the eye.
According to the manufacturer’s website, you should not take gold therapy if you have:
- necrotizing enterocolitis
- pulmonary fibrosis
- exfoliative dermatitis
- progressive renal disease
- severe hepatological disorders
Ridaura should not be prescribed to people who are pregnant or nursing. Those who are looking to become pregnant should wait 6 months after stopping the medication as it takes time for the gold to leave the body.
You should also not take gold therapy if you’re allergic to gold or if you have had a reaction to previous gold therapy.
Research shows that gold therapy is effective for 70–75% of people. It may take 3–4 months to see your symptoms respond. If you haven’t noticed improvement after 6 months, speak with your rheumatologist or healthcare professional.
When treatment is discontinued, the therapeutic effects gradually diminish over time.
Injectable gold therapy is not currently manufactured.
What you pay will depend on your medical insurance and what pharmacy you use. Reach out to your insurance provider for more information.
What other therapies are available for RA?
Other common treatments for RA include:
- Biological treatments:
I am allergic to gold jewelry, does that mean I’m allergic to gold therapy?
There’s no preparation for gold therapy, but it’s a good idea to speak with your doctor or healthcare professional about starting gold therapy if you have concerns.
Though it’s not commonly used to treat RA now because there are safer, more targeted medications on the market, if you do take this therapy, the first few months of treatment involve building up your dose and tolerance. After you notice a decrease in your symptoms, the frequency can be tapered to meet your needs.
Do lifestyle changes help with RA?
Gold therapy has a long track record of effectiveness for people with RA. While side effects and newer medications have put this treatment on the back burner, it may still be worth investigating if other treatments haven’t given you relief.
Your rheumatologist or healthcare professional can discuss the pros and cons of gold therapy and whether or not it’s an appropriate choice for you.