Jump to content
  • Sign Up
  • Join Our Community!

    Do you have questions about celiac disease or the gluten-free diet?

  • Scott Adams
    Scott Adams

    Arthritis and Celiac Disease


    Arthritis may be an allergic response to materials in the food supply. Diet revision may be helpful in reducing the activity of inflammatory arthritis and in some instances may halt the progression of the disease. There are many patterns of arthritis. A group of related joint and connective disorders have been called rheumatic diseases. All these diseases are immune-mediated, and all are expressions of inflammation in connective tissues. Inflammation damages joints and surrounding tissues resulting in loss of function and deformities. Variations in the patterns of these diseases reflect the many possibilities for immune damage to disturb and distort structure and function. Severity ranges from mildly painful, chronic activity to drastic, disabling disease. Rheumatoid arthritis, often severe and disabling, is the dominant rheumatic disease that can attack all joints in the body.

    Rheumatoid arthritis is often considered to be an autoimmune disease. Our idea is that no disease is just internally generated and must involve outside contributions. Arthritis is often associated with inflammatory bowel disease. The mechanisms of food allergy link abnormal Gastrointestinal Tract (GIT) function with immune attacks on connective tissue. In all arthritic patients, normal GIT function should be rigorously sought by adaptive dietary adjustments.

    Simple allergic arthritis is a definite entity that is often not recognized as a food allergy. Typically, a dramatic, acute, and painful swelling develops in one or more joints asymmetrically. Eating a food, either an unusual food eaten for the first time or sometimes a regular food eaten in excess usually brings on the joint inflammation. This presentation is similar to and often confused with gout. Any food can cause allergic arthritis. Staple foods such as milk, eggs, and wheat (rye, oats, barley), coffee, beef, pork, and food additives are the most common food triggers. Carinini and Brostroff reviewed the concepts of and evidence for food-induced arthritis. They stated:

    Despite an increasing interest in food allergy and the conviction of innumerable patients with joint disease that certain foods exacerbate their symptoms, relatively little scientific attention has been paid to this relationship. Abnormalities of the gastrointestinal tract are commonly found in rheumatic disease...Support for an intestinal origin of antigens comes from studies of patients whose joint symptoms have improved on the avoidance of certain foods antigens, and become worse on consuming them. These have included patients with both intermittent symptoms, palindromic rheumatism and more chronic disease.

    In another study, 33 of 45 patients with rheumatoid arthritis improved significantly on a hypoallergenic diet. The authors concluded: Increasing numbers of scientific studies suggest that dietary manipulation may help at least some rheumatoid patients and perhaps the greatest need now is for more careful and well-designed research so that preconceptions may be put aside and role of diet, as a specific or even a nonspecific adjunctive therapy, may be determined.

    Unfortunately, dairy products, wheat and its close relatives, oats, barley, and rye, have proved to be a major problem in the diets of our patients. There are many possible reasons for cereal grains to become pathogenic. Hypersensitivity mechanisms triggered by grain proteins, collectively called Gluten, are the likely cause of the illnesses related to intake of cereal grains. Gluten is a mixture of individual proteins classified in two groups, the Prolamines and the Glutelins. The prolamine fraction of gluten concerns us the most when grain intolerance is suspected. The prolamine, Gliadin, seems to be a problem in celiac disease; gliadin antibodies are commonly found in the immune complexes associated with this disease. Recently marketed grains, spelt and kamut, are wheat variants (despite claims to the contrary) and are likely to cause problems similar to other wheat varieties.

    A wheat gluten mechanism has been studied in rheumatoid arthritis patients. The clinical observation is that wheat ingestion is followed within hours by increased joint swelling and pain. Little and his colleagues studied the mechanism, as it developed sequentially following gluten ingestion. Dr. Parke and colleagues concurred with this explanation of the gut-arthritis link in their report of three patients with celiac disease and rheumatoid arthritis. The mechanism involves several stages:

    • GIT must be permeable to antigenic proteins or peptide fragments, derived from digested gluten.
    • The food antigens appear in the blood stream and are bound by a specific antibody (probably of IgA or IgG, not IgE class), forming an antigen-antibody complex, a circulating immune complex (CIC).
    • The antigen-antibody complex then activates the rest of the immune response, beginning with the release of mediators - serotonin is released from the blood platelets.
    • Serotonin release causes symptoms as it circulates in the blood stream and enhances the deposition of CICs in joint tissues.

    Once in the joint, the immune complexes activate complement, which in turn damages cells and activates inflammation. More inflammation results in more pain, swelling, stiffness, and loss of mobility.

    Arthritis is usually treated with salicylates or related anti-inflammatory drugs generally referred to as NSAIDs. These drugs alleviate the terrible pain of active arthritis but do not favorably affect the outcome of the disease. All anti-arthritic medication can produce asthma or chronic rhinitis and a variety of allergic skin rashes. Gastrointestinal surface irritation, bleeding, and ulceration are routine problems of anti-arthritic medication.

    The first attack of joint swelling and pain should be treated as an urgent problem to be solved. Inflammation may damage joints. Often NSAIDs and physiotherapy are the only treatments prescribed and inflammation is given every opportunity to ravage tissues. We have seen countless patients, just treated with NSAIDs, who progressed rapidly to a severe disabling disease, often with poor pain control. In unlucky patients, severe deformities of joints accumulate in the first few months of a severe attack. There is a trend to recommend more aggressive treatments, using drugs that impair the immune response. The best drug is prednisone, but it is seldom used because it has long-term side effects which scare both physicians and patients. Prednisone is often a magic drug that relieves terrible pain and suffering often in the first 48 hours of therapy. Beyond prednisone, there is a grab bag of immune suppressant drugs to treat arthritis-chloroquine, penicillamine, gold and methotrexate have emerged as the favored drug therapies. All these drugs have impressive side effects and great potential for toxicity.

    Our preference is to try to stop the inflammatory activity as soon as possible with diet revision. All inflammation is likened to a fire. You get out the fire-extinguishers and go to work. No matter what pattern the immune attack assumes, our standard defense can be tried first. The Core Program method of diet revision is used. Food is replaced with an elemental nutrient formula, ENFood, for a clearing period of 10 to 20 days. Prednisone and/or NSAIDs are drug options during the clearing period and then the dosage is reduced after pain and swelling have subsided. Improvement is followed by slow food reintroduction (see Core Program). Each returning food is carefully screened for arthritis- triggering effects. You hope that food allergy caused the problem and that food control can be successful controlling the disease in the long- term. Nothing is lost by taking this approach and complete control of the disease can sometimes be obtained. If strict food control proves to be inadequate, then other drug treatments can be instituted.

    End Notes/Sources:

    • Carinini C, Brostroff J. Gut and joint disease. Annals of Allergy 1985;55:624-625.
    • Darlington et al. Lancet Feb 1 1986;236-238.
    • Keiffer M et al. Wheat gliadin fractions and other cereal antigens reactive with antibodies in the sera of of celiac patients. Clin Exp Immunol 1982;50:651-60.
    • Little C, Stewart AG, Fennesy MR. Platelet serotonin release in rheumatoid arthritis: a study in food intolerant patients. Lancet 1983;297-9.
    • Parke AI et al. Celiac disease and rheumatoid arthritis.
    • Annals of Rheum Dis 1984;43:378-380.
    • Voorneveld CR, Rubin LA Disease-modifying antirheumatic drugs: early use is better. Medicine North Amer. Oct 1991 3177-3184.

    User Feedback

    Recommended Comments



    Anyone with passion cannot be ignored for a noble effort. You all will soon learn my name. Sheer genetic dietary evolution and genetic markers do not lie. The riddle is solved. My apologies if I offend the Vegans, but we are evolved carnivore. Not omnivore. We eat herbivore and fish. Without these accurate proteins, we as a species will suffer. This will no longer be hidden.With just the 2 markers of DQ2 and 8 make up nearly 40% of the USA. They now have at least 10 markers that are known gluten intolerant. DQ1 through 9 and a possible HLA A24. The only thing that can kill me is glutonite!Any nutritionist will tell you, mimic the diet of the bear, only add potato and rice! Follow the diet of your evolutionary origins. Paul R. Dierks. Proud celiac!

    Share this comment


    Link to comment
    Share on other sites

    I am finding that diet is such an important factor in solving health issues. I have become lactose intolerant in my middle years. I have found that my three children are all lactose sensitive. Two of my brother's children have been recently diagnosed with celiac disease. My sister who helped our family identify our lactose issues has gone gluten free. I am seeing that there may be more than dairy issues with me as I hit my funny bone in the summer and now 7 months later I still have 'tennis elbow'. After reading this article I will be watching carefully to see what happens to my elbow pain as I cut out the gluten.

    Share this comment


    Link to comment
    Share on other sites

    I was diagnosed with psoriatic arthritis two years ago. I was in so much pain and suffered for 18 months. I am was on Enbrel and Methrotrexate. They helped but did not do enough. I soon realized I also had Candida and went on a strict diet - no sugars, no gluten for 6 months. Alas, the pain went away, my chronic fatigue disappeared! I got my life back! In the past 3 months, I have added just a little bit of sugar back - mostly in the form of fructose. I also experimented with bringing back the gluten and every time I did the aches and the flair-ups came back. No doctor ever told me to consider eliminating gluten to help my arthritis during the first 18 months of misery! Cutting out the gluten and the night shade vegetables (which I did too) has been life changing! Anyone with arthritis needs to give it a try. This is a great article. I wish I had read it 2 years ago.

    Share this comment


    Link to comment
    Share on other sites

    Taking proteolytic enzymes, such as Wobenzym, or serrapeptase or nattokinase can also help eliminate unwanted protein fragments and circulating immune complexes. There has been quite a lot of research into this. People suffer less pain after taking proteolytic enzymes instead of NSAIDs for these conditions. I can testify to this from personal experience. I have a little arthritis in one hand and am now trying a bread-free experiment to see if this helps.

    Share this comment


    Link to comment
    Share on other sites

    Specific Carbohydrate Diet -- Check in out -- It works -- Whole food diet -- No gluten, no grains, no sugars, no starches. Eat whole, natural meats, vegetables and fruits.

    Share this comment


    Link to comment
    Share on other sites

    It was February since I came upon this article for my severe elbow pain. With in 3-4 days of changing my diet, my pain was 90% better.

    I had been suffering for 7 months and came upon this article in the night when I could not sleep because of the pain. I painted my daughter's room on President's Day and didn't think till the next day that my elbow didn't hurt. In addition I had what I called a brain fog where I was so scattered and forgetful that I thought I was in the early stages of memory loss. I was anxious and worried more than I use to be. Now I seem to have more clarity again. I did not test high on a blood test for celiac yet still had symptoms. The last thing I wanted to do was change my diet especially after being told by my sister that I might have some concerns. Her blood test was insignificant as well but had high numbers on a stool test. She changed her 4 year old son's diet as he had very aggressive behavior. He is now a pleasant yet still active child after finding additional corn, soy, sugar and additive triggers in addition to gluten and lactose.

    I know I keep going on but there is more. In March we found that I am pregnant! An unexpected blessing! I am 45 and our youngest is 7 years old. We have been relying on 'timing' for birth control and all of the sudden I change my diet and I'm pregnant. I do have a history of endometriosis, which is inflammatory. I have been sensitive to wheat in my previous pregnancies but never thought to exclude it from my diet. I usually vomit the first 3-4 months of pregnancy with a revisit to pukesville about every two weeks until delivery. I have not thrown up even once. Just lucky? I'm not going back to gluten to test it. It's not worth the health risks to me or the baby. I'm also interested to see if this baby will be a 10lb or 10lb + like my last two. Lots of speculation on my part but the results cannot be ignored.

    Share this comment


    Link to comment
    Share on other sites
    My daughter suffers from celiac and rheumatoid arthritis, and I read anything I can on this subject. She has recently changed rheumatologists, and this doctor suspects that her arthritis is food-related. When she was diagnosed 13 years ago, there was no information on this connection, so I'm grateful that this is being studied!

    was her RA food-related? i didn't even know that excisted. thank you.

    Share this comment


    Link to comment
    Share on other sites
    Taking proteolytic enzymes, such as Wobenzym, or serrapeptase or nattokinase can also help eliminate unwanted protein fragments and circulating immune complexes. There has been quite a lot of research into this. People suffer less pain after taking proteolytic enzymes instead of NSAIDs for these conditions. I can testify to this from personal experience. I have a little arthritis in one hand and am now trying a bread-free experiment to see if this helps.

    Did this regime help you? I have severe RA and now after being on Enbrel and Methotrexate for over a year am looking for another answer besides these toxic drugs. Also, I have had severe cramping the past 4 months and am trying an experiment today. Please let me know how it helped you.

    Share this comment


    Link to comment
    Share on other sites
    I was diagnosed with psoriatic arthritis two years ago. I was in so much pain and suffered for 18 months. I am was on Enbrel and Methrotrexate. They helped but did not do enough. I soon realized I also had Candida and went on a strict diet - no sugars, no gluten for 6 months. Alas, the pain went away, my chronic fatigue disappeared! I got my life back! In the past 3 months, I have added just a little bit of sugar back - mostly in the form of fructose. I also experimented with bringing back the gluten and every time I did the aches and the flair-ups came back. No doctor ever told me to consider eliminating gluten to help my arthritis during the first 18 months of misery! Cutting out the gluten and the night shade vegetables (which I did too) has been life changing! Anyone with arthritis needs to give it a try. This is a great article. I wish I had read it 2 years ago.

    Is the nightshade thing an absolute???

    Share this comment


    Link to comment
    Share on other sites
    Did this regime help you? I have severe RA and now after being on Enbrel and Methotrexate for over a year am looking for another answer besides these toxic drugs. Also, I have had severe cramping the past 4 months and am trying an experiment today. Please let me know how it helped you.

    I've had severe RA from the onset, nearly nine years ago. I've been on nearly every drug out there for RA, most recently a combo of Enbrel and Mobic, which worked amazingly. I'd been told repeatedly that stress contributes greatly to the severity of RA, but didn't really believe it much, till I switched jobs nearly a year ago. Since then I have been able to slowly go off of the Enbrel, while adding Omega-3's to help control the symptoms. It worked great until about a month ago (month 5 of no Enbrel). I have also had severe allergies most of my life, I broke out with a serious rash yesterday and have an appointment with my PCP later today. I'm planning to ask about a correlation with celiac or other food allergy. I have a good friend who was diagnosed with celiac about two years ago, and hadn't known about it before then, but after researching it have wondered if maybe that's been my problem all along. Does anyone know if an elevated SED rate is linked to celiac?

    Share this comment


    Link to comment
    Share on other sites

    I think this is a fine article. The notes mention an article by Gail Darlington, however I strongly recommend Darlington's book DIET AND ARTHRITIS: A COMPREHENSIVE GUIDE TO CONTROLLING ARTHRITIS THROUGH DIET. Darlington details the way in which to test your reactions to foods, and build a healthy individualized diet, a way that proved very successful for me.

    Share this comment


    Link to comment
    Share on other sites



    Join the conversation

    You are posting as a guest. If you have an account, sign in now to post with your account.
    Note: Your post will require moderator approval before it will be visible.

    Guest
    Add a comment...

    ×   Pasted as rich text.   Paste as plain text instead

      Only 75 emoji are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.


  • About Me

    In 1994 I was diagnosed with celiac disease, which led me to create Celiac.com in 1995. I created this site for a single purpose: To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives. Celiac.com was the first site on the Internet dedicated solely to celiac disease. In 1998 I founded The Gluten-Free Mall, Your Special Diet Superstore!, and I am the co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.

×
×
  • Create New...