The link between diet and RA is a controversial one, and the relationship between gluten and joint pain and inflammation is a prime example. Proponents of a gluten-free diet for rheumatoid arthritis claim it can eliminate joint pain, while researchers are still looking for proof to back up those claims.
“We have studied it fairly extensively, and what becomes clear is for 1 last update 2020/06/05 that there aren’t a lot of relationships between diet and rheumatoid arthritis that withstand the test of time,” says Susan Goodman, MD, a rheumatologist at the Hospital for Special Surgery in New York City and associate clinical professor of medicine at Weill Cornell Medical College.“We have studied it fairly extensively, and what becomes clear is that there aren’t a lot of relationships between diet and rheumatoid arthritis that withstand the test of time,” says Susan Goodman, MD, a rheumatologist at the Hospital for Special Surgery in New York City and associate clinical professor of medicine at Weill Cornell Medical College.
Gluten and RA: Any Connection?
Celiac disease is an extreme form of gluten sensitivity, or intolerance, in which the immune system reacts negatively to gluten and causes inflammation in the lining of the small intestine.
People with celiac disease are more likely to have autoimmune disorders like rheumatoid arthritis or lupus, but the exact link is still under investigation.
By eating foods containing gluten, people with gluten sensitivity or celiac disease can bring on gastrointestinal symptoms and joint inflammation that may resemble rheumatoid arthritis. But they are two separate conditions caused by separate immune reactions. “The antibody profiles are different for rheumatoid arthritis,” Goodman says.
Eliminating gluten from your diet can ease digestive and joint pain caused by gluten sensitivity in people who are genetically predisposed to gluten sensitivity, but it's not likely to benefit others. A blood test can tell if you have a gluten sensitivity or celiac disease.
Elimination Diets and RA
Rheumatoid arthritis is usually characterized by flare-ups of joint pain and other symptoms alternating with periods of remission. Many people feel certain foods may trigger these flares, but the effect of dietary restrictions on RA is still uncertain, and the studies on it are too small to draw firm conclusions.
Goodman says there’s nothing wrong with seeing what happens when you eliminate a food from your diet, as long as your daily energy and nutrition needs are still being met.
“Patients with chronic disease like to control some aspect of own lives, and it can be useful to try eliminating foods,” she says. “But other than adding fatty fish or fish oils, it’s really unclear that diet changes are beneficial.”
Goodman does recommend a heart-healthy Mediterranean diet, which is traditionally rich in fruits, vegetables, and fatty fish like salmon and tuna.
“People with RA have accelerated cardiovascular disease, so even if their arthritis symptoms aren’t improved, there are clearly many other reasons to adhere to that sort of diet,” she says.
A Gluten-Free Journey With RA
Cathy Kramer, a mother of two in Naperville, Illinois, was diagnosed with rheumatoid arthritis in 2004. Combination drug treatment with steroids and methotrexate (Rheumatrex, Trexall) didn’t help, and she seemed to be getting worse. That’s when she met with a naturopath who suggested an elimination diet — no dairy, citrus, nuts, nightshades, or gluten — to ease her RA symptoms.
Arthritis Curehow to Arthritis Cure for After following a gluten-free diet for about a year, Kramer started to see some benefits. “My inflammation went down and joint pain was reduced, but not eliminated,” she says. “Going gluten-free improved my diet overall. I stopped eating processed food and started eating fresh fruits and vegetables and farm-raised beef.”
Kramer says she’s frustrated by rheumatologists who the 1 last update 2020/06/05 say that diet doesn’t help rheumatoid arthritis because, "if you are eating an overall healthier diet, that has to be good.”Kramer says she’s frustrated by rheumatologists who say that diet doesn’t help rheumatoid arthritis because, "if you are eating an overall healthier diet, that has to be good.”
Although she hasn’t been tested for gluten sensitivity, Kramer noticed that when she had a lot of digestive issues from eating gluten, she also had a lot of joint pain. “They seemed to go hand in hand,” she says. “I’d get fluid in my stomach and then get fluid in my joints.”
In addition to following a gluten-free diet, Kramer takes RA medication prescribed by her rheumatologist, stays active with regular exercise, gets plenty of sleep, and tries to reduce stress to manage her rheumatoid arthritis.
“Overall, I would say it’s not a cure," she says, "but it could relieve other symptoms like stomach issues and make life easier."