Diet and Rheumatoid and Psoriatic Arthritis

Gabriel01342

Does anyone have experience please of reducing Auto immune type arthritis by following a strict gluten free and anti inflammatory diet. I ask as I once had some success in reducing symptoms using an elimination diet , a very restricted food diet . Many thanks

PeterJ

Hello @Gabriel01342 and welcome to the community. we are a friendly and supportive group and I hope that that will be your experience as well.

I understand that you have arthritis and are wondering if a gluten free diet would help. Our website is a good place to start and I would recommend having a look around it, to help I've put a couple of links in below.

https://www.versusarthritis.org/about-arthritis/your-experiences/your-questions-answered/your-questions-on-diet-and-arthritis/

https://www.versusarthritis.org/about-arthritis/your-experiences/your-questions-answered/your-questions-on-alternative-supplements/

You have also asked about methotrexate, so see the following information

https://www.versusarthritis.org/about-arthritis/treatments/drugs/methotrexate/

Please do keep posting and let us know how you are getting on and I am sure others will connect with you to share their support and experience as well

With very best wishes

Peter

frogmorton

Hi @Gabriel01342

Sounds like you have had success with elimination diets before. For me it's case of trial and error I am vegan (choice) and follow a vegan Mediterranean style diet as far as possible.

I am not 100% sure it helps all that much , but I know it's healthy and it helps to be actually doing something doesn't it?

Best of luck

Toni x

airwave

I have followed a whole meal type of diet for the last 25 years due to osteoporosis, no refined products, it’s difficult to say if it’s helped me but then I don’t suppose it’s harmed me which is important! Even before my diagnosis we tended to eat traditional foods which were freshly cooked. My diet has consisted of many whole grain products, meat, oily fish, fruit and nuts, I suppose I’d have to ask what sort of state I’d be in without these foods?

I’ve had a hiatus hernia since I was young so haven’t eaten anything which would upset me for a long long time.

its a grin, honest!

stickywicket

Many years ago I tried the Dr Colin Dong diet for RA. It's very restrictive. Basically, you can only eat whole grains, fish and fresh veg. I tried it twice for at least a month on both occasions and, on both occasions, got decidedly worse. I then gave up on diets and stuck to a broad, Mediterranean type of diet and have felt better ever since. I eat meat only in order to keep up my levels of iron. I prefer veg and fish.

In my view, anyone with a gluten intolerance will benefit from a gluten free diet and, as it's not particularly healthy, others might too but, RA? I don't see it helping much.

DRC99

Hello Gabriel01342,

I was interested in your discussion because it relates to a larger possible problem which I believe is not yet recognised within the NHS and which should be looked into much more to investigate the role of antibiotics and then develop diet- based methods of treatment. Even the Versus Arthritis folk seemed "sniffy" about this when I spoke to them.

I have identified various foods which cause flare- ups in my rheumatoid arthritis, such as wheat, gluten, alcohol, sugar and cheese and am taking treatment from a private clinic which is intended to alleviate the immune system inflammatory response to those foods, but I believe the real cause of my arthritis was a fungal infection of my intestines caused by an antibiotic I was prescribed.

(Lengthy account follows!)

You might be interested in how my condition came about as I was not always affected by these foods in the way that I am now. In 2019 my GP was treating me for a persistent mild cough and tried various antibiotics. The third antibiotic he prescribed was Azithromycin, which must have been quite a strong one because I took just one tablet for three days. After a couple of weeks I started to develop very odd but severe pains in my neck, feet, hands, fingers and wrists and these got worse over the next few months and then spread to my elbows, knees and ankles as well. I also felt very tired all the time. My GP eventually diagnosed rheumatoid arthritis. I asked him whether it could have been related to the antibiotic, and of course he said, without any hesitation, that it could not have been, despite the fact that it had first occurred just after he had prescribed the last antibiotic.

By this time, late 2019, the arthritis was seriously debilitating. My GP referred me to a consultant rheumatologist who recommended that I took up the usual steroid and methotrexate approach but I did not want to do this. As I said to the consultant, who has followed my treatment with interest, why on earth should my immune system wake up one day and suddenly decide to start attacking all my joints? There must be a cause. Interestingly the hospital tests revealed that the cough I had at the beginning was caused by bronchiectasis, which is another inflammatory condition related to rheumatoid arthritis.

I consulted a private clinic which specialises in allergies and sensitivities to food and other things. I went on an "elimination diet" for a couple of weeks during which I ate only about 20 foods which are usually not inflammatory, and my symptoms were significantly relieved, so we knew it was something to do with what I was eating. One of the first things the clinic did was to test me for Candida and found that I had very high levels in my system. Candida is a yeast which lives in the gut flora but is normally kept in check by the other gut flora. The specialist's opinion was that the Azithromycin killed off a lot of the good gut flora and allowed the candida to proliferate, helped by my sweet tooth, which meant they had lots of sugar to feed on. Candida itself causes rheumatoid arthritis in response to the toxins it creates, and the damage it can do to the wall of the intestine allows other substances to enter the blood stream which can also cause inflammatory reactions, so the effect is quite complex, with direct and indirect problems being caused by the Candida. I was prescribed an anti- fungal medicine, which cleared the Candida, and pro- biotics to restore the good gut flora. I was also tested to see what sort of foods I reacted to and then took up a course of immunotherapy intended to alleviate the responses to these foods.

I am not sure how effective this treatment actually was: what I can say is that since I took the anti- fungal medicine and got rid of the candida I have gradually got better, and can now do almost all the exercise, walking, work and gardening that I used to do. I used to run but have got out of the habit of it. I did some test runs in 2021 and they seemed to be OK. I have now recovered much of my old capability but am still left with irreversible residual damage to my fingers in particular. I have to watch my diet. The occasional croissant with sweet coffee, or wine or beer is OK but if I have a weekend of my favourite food and drink then I pay the price and have to de- tox for a few days.

I would be interested to hear from you or anyone who might have had a similar experience to mine.

Poppyjane

Hello @DRC99 welcome to the online community

It is good to meet you as you join in with the current discussion started by @Gabriel01342 . I can see that you have been part of a thorough investigation into the possible links between the use of antibiotics and inflammatory conditions. I am sure your story will be very interesting to our members and I hope you gain a good response from them.

I would point out to you the above links about diet and arthritis that can be found on the community information pages and hope that you have had a chance to look at them. I also add to those links about exercise and some members personal experiences of running and gardening.

https://www.versusarthritis.org/news/2022/march/what-are-the-links-between-sport-exercise-and-osteoarthritis/

https://www.versusarthritis.org/news/2022/april/tips-for-gardening-with-arthritis/

I do not however want to take you away from your main discussion which is related to inflammatory conditions and their relationship to medication and the relief you have found from following a careful diet. I hope your capability to do most of your former activities continues to improve and that you will join us again to update us on your progress.

Take care

Poppyjane

stickywicket

Please forgive a short reply. I'm pushed for time.

After 60+ years of RA I'm sure diet and exercise have big roles to play but only in the sense of sensible, broadly Mediterranean type with no junk food and sensible, helpful exercise - no heroics.

RA can often start as a result of an infection. Many people find that when they're on antibios, their RA is better. My guess is that the infection triggered yours not the ABs.

Good luck with whatever course you course you choose.

jamieA

https://community.versusarthritis.org/discussion/comment/697509#Comment_697509

Hi @DRC99

That's a really interesting story - not at all dissimilar to mine. I was a pretty healthy 64 year old retiree who had had skin psoriasis since aged 15. I took a series of chest infections starting March 2020. By May I was prescribed a 4th different antibiotic as I had had sinusitis and then hearing loss with the 1st and 3rd infections. I was then sent to a covid triage unit where the consultant was pretty certain I had had covid back in March. I continued to get chest infections through 2020 (I lost count at 10). By September my knee swelled and by October I was diagnosed with psoriatic arthritis. I then took 3 bouts of pneumonia from November 2020 - March 2021and the PsA worsened. At least a couple of rheumatologists I've seen have said that the PsA can be triggered by a virus and from what I've read about the role of cytokines in both PsA and covid I think that needs to be investigated further. There are a few medical papers published about covid inducing PsA or covid causing PsA flares. I've also read medical papers that state other respiratory infections can be a forerunner to inflammatory arthritis in a small percentage of cases.

stickywicket

Hello again @DRC99 . A little addendum and apology from me. You might find this interesting https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6685281/

jamieA

https://community.versusarthritis.org/discussion/comment/697566#Comment_697566

Hi @stickywicket and @DRC99

That's a really interesting article and it has made me think about the sequence of events I went through when I first started getting chest infections - and months before PsA symptoms appeared. I never took notice of the type of antibiotics I was prescribed initially for my chest infections back in early 2020 until the 3rd one. As I had lost the hearing in my ear as well this time, the GP prescribed a different antibiotic (amoxicillin) but this time I took what appeared to be an allergic reaction to it - my feet and ankles swelled and my feet and lower legs were covered in a rash. My GP immediately stopped the amoxicillin and changed it to another antibiotic. My father was allergic to penicillin, as is my daughter, but I've never in the past had a problem with it - or reaction to it. Five months after this reaction to amoxicillin my knee swelled and a month later I was diagnosed with PsA.

It's interesting what you say about candida. I've just read another article in the National Library of Medicine site that states that people with psoriatic disease (either psoriasis or PsA) have a far higher incidence of candida in their body.

DRC99

DRC99

@stickywicket

Thanks for that link to the BMC research, which does indeed seems to show that there are significant and interesting correlations between taking antibiotics, the onset of arthritis and other inflammatory conditions, and upper respiratory tract problems. All of these are relevant to my own case.

How did you find that research paper? What we need now is to find out about any medical research which might have taken this to the next stage and identified the causal mechanisms which create these correlations.

@jamieA

Thanks for your last post which also supports the above.

@Poppyjane

Does the VA Community have any established processes for identifying this sort of research?

When my problem began I checked the two medicines I had been prescribed, Lansoprazole (for the gastric reflux) and Azithromycin (for the cough), on the MHRA website. There were some joint problems with Lansoprazole but nothing significant for Azithromycin, so at first I thought that Lansoprazole was the most likely cause of the arthritis, and I submitted an MHRA report to that effect. In the light of subsequent events perhaos I shoud raise one for Azithromycin!

DRC99

stickywicket

" What we need now is to find out about any medical research which might have taken this to the next stage and identified the causal mechanisms which create these correlations."

Forgive me, @DRC99 . I'm smiling but in a kind way. Personally, I don't need to do anything. I've lived with RA for most of my 76 years. Whatever caused it is lost in the mists of time. I'm sure there are many causes. Certain antibiotics might be one but, equally certainly, some ABs can help. People had RA long before Lansoprazole (I've been on it for years since NSAIDS damaged my stomach and my RA has been pretty good in those years) and before ABs

We do know that there can be a genetic predisposition to autoimmune diseases which then requires a precipitating factor. I'd guess that the precipitating factors could be very many.

I shall leave the research to those who specialise in it. I found the article by - I think - googling 'Antibiotics and RA Pubmed' Pubmed articles are reliable. They're based on proper research. Another favourite site is Johns Hopkins, an excellent US medical university. And remember, Versus Arthritis was formed by the merger of Arthritis Research UK and Arthritis Care. Research is going on all the time.

Good luck but don't wear yourself out seeking sources. You'll need all your energy to deal with the disease while having a fun, enjoyable life.

simonsays

Diet is very important. Some good points made on this thread. I think going gluten free is one of the most important changes that people with arthritis can make. Leaky gut is one factor in developing arthritis and gluten doesn't help. I am personally on a sugar free and dairy free diet as well.

Ellen

Good Morning @simonsays

Welcome to the online Community.

You don't say which kind of Arthritis you have, but the subject of diet and it's links with Arthritis comes up fairly regularly here. This thread from earlier this year might be of interest to you:

https://community.versusarthritis.org/discussion/57256/diet-and-rheumatoid-and-psoriatic-arthritis

This article, particularly the section entitled 'Do any foods make arthritis worse' is certainly worth a read:

https://www.versusarthritis.org/about-arthritis/managing-symptoms/diet/

Please do join in wherever you feel comfortable it's great to have you on board.

Best wishes

Ellen.

simonsays

Thanks and looking forward to sharing, especially in regard to diet.

PS Ellen, you have just reposted the start of this thread again in your link?

Ellen

I have indeed @simonsays!! Ooops!

Ellen.