Diet and Rheumatoid and Psoriatic Arthritis

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!

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.

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.

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

" 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.