“Gut health plays a role in RA” sounds like the title of an episode of Dr. Oz. In fact, an episode discussing just that caused an uproar in online communities for people with rheumatoid arthritis (RA) and its counterpart, juvenile idiopathic arthritis. But strange as it seems, it could be true.
Leaky gut syndrome and other gastrointestinal problems could trigger flare-ups in diseases like RA, lupus, and multiple sclerosis. So achieving microbial balance in the gastrointestinal tract could be just what the doctor ordered when it comes to managing RA symptoms.
In fact, the gut microbiome has been linked to arthritis in various animal studies. Researchers are exploring whether the same is true in humans. A 2013 study by rheumatologists at New York University found that patients with RA were more likely to have the bacteria Prevotella copri in their intestinal tracts than patients without the disease. The findings suggest that this bacterium may somehow trigger the autoimmune response that leads to joint inflammation. However, more research needs to be done to examine the link.
The study also showed that the presence of P. copri corresponded with a loss of healthy microbes in the gut. The loss of these microbes could contribute to other symptoms or related health conditions.
Scientists are beginning to tease out just how the microbes that naturally live in our guts help prepare our immune systems to fend off invaders. Some of the microbes secrete chemicals that can destroy threats directly. The theory goes that an unbalanced community of microbes leads to a misguided immune response.
"Your microbiome plays a major role in your immune system, constantly providing protection from illness of which many of us are unaware. Autoimmune disorders, including rheumatoid arthritis and lupus, occupy a prominent position among diseases that have long been thought to have a genetic component that is triggered by microorganisms … Specifically, increased levels of the bacterium Prevotella copri is correlated with the reduction of beneficial microbes such as Bacteroides, leading to inflammation in the body," said Kathleen DiChiara, an author and functional diagnostic nutrition practitioner.
So, What’s a Microbe?
Though microbes are small, they are very important for our overall health. The human body harbors trillions of viruses, bacteria, and other little bugs, collectively called the human microbiome. The microbes that make up the microbiome outnumber human cells 10 to 1, and they contribute nearly 8 million genes to us.
Most of these microbes live in the gut. In fact, the gut has about 100 billion bacteria for every 1 gram of intestinal matter. Keeping the gut balanced and healthy could play a crucial role in managing not only RA, but also many other diseases.
Dr. B. Robert Mozayeni, a rheumatologist and researcher in Bethesda, Maryland, has said for years that there’s a link between bacteria and conditions like RA.
In a 2012 study, Mozayeni and his colleagues found that RA patients had a higher-than-normal prevalence of Bartonella antibodies.
While the researchers can’t definitively link RA to the microbiome just yet, the study results suggest that there is a strong link between Bartonella and RA that should be investigated further.
How Can Patients Apply This in Everyday Life?
Some people agree that gut health seems to play a role in managing symptoms of autoimmune and rheumatic diseases. A healthy diet and the incorporation of probiotics and prebiotics can improve gut health on a day-to-day basis.
“I have had rheumatoid arthritis for years and notice that I feel better whenever I eat healthfully and take my probiotic supplements,” said patient Nicole Smith of Baltimore.
Regarding RA symptoms and gut health, certified holistic health coach Cary Kelly of Long Beach, California, suggests a healthy diet that includes going gluten-free for a while.
“In order to stop exacerbating the propensity for flare-ups, we must balance gut flora with probiotics and perhaps try going gluten-free for a few weeks as a trial,” she said.
The jury is still out on whether (and how much) probiotic supplements help with gut issues. However, there are naturally probiotic foods like yogurt and fermented teas that can provide many beneficial bacteria at a lower price point.
Member of the American Association of Drugless Practitioners and health coach Sarah Lawrence, CHHC, of Mont Vernon, New Hampshire, said, “For autoimmune arthritis I work with a protocol of high dose probiotics, fermented foods, and gut supportive supplements like coconut oil and l-glutamine, in addition to an anti-inflammatory diet that's rich in fiber and prebiotics. Look for probiotics that contain S. salivarius and B. coagulans, since they have been shown to have great immunomodulating effects.”
While it isn’t certain whether gut health is tied to RA, researchers are working hard to find out. In the meantime, adopting a healthy diet and adding probiotics into your routine couldn’t hurt. In fact, it just might make you hurt less.