Hello 😀🌸 This is my first post, I've just followed prior to this. I have inflammatory osteoarthritis and have recently had to stop sulfasalazine as it made me quite poorly. I'm still getting back on my feet and thought I would go down the diet route. I've been on a sugar free diet for the last ten days, together with no dairy (dairy intolerant.) I have been having more fruit and soya milk than usual, but my pain levels have risen. Does anyone have any ideas please? Am I eating too much fruit, is it the soya milk, or just a coincidence? Thank you 🌸
Anti inflammatory diet: Hello 😀🌸 This is my first... - NRAS
If you want to evaluate an anti-inflammatory diet, I wonder if you might be well-advised to pick a particular plan and follow it because different ones have different emphases? And then you might be able to narrow down specific things that work for you?
Some people do well with an entirely plant-based diet with negligible fat (neither added, nor any foods that contain relatively high levels of fat such as nuts and seeds). Others have made good reports of ketogenic diets (high fat, very low levels of carbohydrate). Still more praise a grain-free diet with no dairy or added sugar.
Some people report reductions in inflammation from excluding particular groups such as 'nightshades'.
What is anti-inflammatory for one person might not be for others - or just might not be sustainable.
Even going down the diet route, your starting point must be to consult your doctor / rheumy about the sulflasalazine and either get the dosage changed or move to another dmard. This is your best option for halting progress of your osteoarthritis. I would make that appointment with your doctor straight away because reversing damage joint damage is not going to be easy.
Removing dairy I fully approve of. However depending on your personal history both fruit and soya could be triggers and sadly may be causing you more pain! I would especially be careful of any and all fruit juice right now. Eating whole fruit is much better since the fibre helps slow down absorption and so reduces any sugar rush. But it all depends on the state of your gut and that depends on your medication, dietary and stress history etc that are not the purpose of this forum.
My belief - and experience - is that your gut is very much part of the problem that is causing your struggles. If you also feel this way then you have to find out what the arthritis triggers are for your body, and that means, in my eyes going through a comprehensive elimination diet. This is not just some haphazard process, because you need to ensure through that process you get complete and great nutrition from beginning to end.
As you go through the elimination process you also need to know as definitively as you can which foods really are causing your gut problems in its current state.
If you google diet and arthritis you will see advocacy for paleo/aip which includes high quality meats and fish as one dietary solution. The other main route is one I followed. This is the whole-food plant based approach as promoted by Clint Paddison. Both routes advocate many many more plants in your diet.
If you are determined to go down the dietary route then you will need 100% commitment. Reasons include
- some people on this forum have tried various dietary solutions and failed
- there people on this forum who think diet does not work
- there others who think (rightly in many cases) that there are people out there who are just after your money
- NRAS themselves recommend a only Mediterranean diet, following NICE guidelines
- if you discuss diet both your doctor and rheumy are likely to say "diet has no effect" probably for similar reasons.
- going through a good elimination process is not easy. My own process stalled and I was so confused. My wife even suggested the dietary approach was not working for me anymore. After taking advice I eventually stopped consuming oils such as olive and coconut and kept nuts to a minimum. Then progress started again and from that day my health never stopped improving.
Briefly, my own story is that I have had arthritis for 40+ years but it was May2015 when RA hit my body and brought my life to a complete halt. A year later Apr2016 I was hardly able to walk and in a wheelchair. I then started the paddison program, as it is called and by Sep2016 I was able to walk. Because my body was in such very bad shape physically I started yoga in Oct2016. I have done Bikram Yoga every weekday ever since and that has been a totally essential part of my recovery and I cannot recommend it highly enough.
And that's the other thing. Diet can get you so far, but for my money as and when you can do it good, indeed very good RA-friendly cardio-vascular exercise daily is a must. NRAS are themselves promoting good exercise, but I am not sure they would advocate the intensity of Bikram Yoga, which some yogis describe as 90 minutes of hell. But in my mind, if you can afford it and get to a studio, it is the best exercise, bar none for someone with arthritis.
Right now I would get your meds sorted to your satisfaction asap. Then do more and more research, deciding what next steps and approach to solving your dietary issues are right for you. Do whatever exercise you can that does not damage your joints.
If you want any more advice from me then click on my name and send me a message.
Thanks for your reply Andy. My gp and rheumy nurse advised me to stop the sulfa and have a break until I see the rheumatologist in July. I'm on a low maintenance dose of prednisolone. When you say added sugar is fruit ok? I've been making fruit and veg smoothies. I will try almond milk and see how that goes before changing anything else.
Fruit and veg smoothies can work esp banana but until you have definitive results from your own body...
I love almond milk. My wife has the sweetened and I the unsweetened, but when I cut out oils out went even almond milk, mostly used in porridge.
If you are OK within fruit your best to try are pineapple papaya cherries blueberrries and blackcurrants. All can be beneficial.
My concern about the sulfa... break is if you then rely on NSAID drugs. That's what I was advised and ended up with escalating crp levels at the same time as my liver went to pot.
I don't think it's entirely fair to say "you will need 100% commitment because people have tried and failed". I didn't fail on the dietary approach, instead the diet failed to control the RA. You make it sound as if it will always work if you are committed enough, which I don't believe is true. It may work for some people with some types of disease, but not all.
Quite possibly as a result of my diet, which is still heavily plant based, I have extremely low inflammatory markers usually with an ESR of 2. However I need the drugs to control the RA, without them life is painful misery.
helixhelix, you are right some people may need to take drugs for the rest of their life. I am reducing my medication right now and so far so good.
Without large scale research into the benefits of effective dietary changes we will never know. It would be good to find an organisation willing to take an interest in such research.
Andy, although there may not be huge research devoted yet to a diet connection for auto immune diseases if you look hard enough you'll find that there are some out there.
Just so you see that not all scientifically minded researchers are ignoring the fact.
Agreed, helixhelix The relative influence of diet may well vary from one person to the next (it's complex enough in people who are notionally disease-free).
I'm not in your position (no DMARDS or similar medication) but my WOE (way of eating and schedule of meals, I think) contributes to reliably very low CRP and ESR as well as triglycerides. (It might be a coincidence, this is only an anecdote of my experience such as this managing a couple of other issues.)
On the occasions that I pick up a bug or have inflammation from another cause, then the pain in my affected joints increases substantially until it subsides some time after the other inflammation/infection clears up.
So much of what Helix said rings true for me.
I also wish to add that until we reach a point where we have better labels for all the variations of diseases thrown under the umbrella of RA than we really can't be sure what type of disease diet, exercise and life style changes helps without added prescribed medication.
Andy, do you have bone erosions? Have you been diagnosed with an aggressive erosive form of RA? Were you anti CCP positive? I only ask in hopes of seeing if any connections can be drawn from anecdotal evidence.
Perhaps it's possible that people, like Clint, who have loads of data could help scientist find clues to whats going on instead of just saying it helps 19 out of 20 people improve. Maybe sharing more specific details would prove beneficial? Don't know it really may all be random. It's just a thought.
I have significant joint damage. Both knees were booked in for replacement when I was at my worst moments. But I candled that and given my significant improvement in my RA hopefully will be able to postpone those operations for many years. I am looking to my next visit to the Nuffield Orthopaedic and to get an MRI scan which I hope will show no further damage and possibly some improvement in my knee joints.
My right elbow will not straighten feeling more at a right angle and that is has some pain still. Not enough to cause me any concern, the pain only occurs when I push it, which I do at my yoga sessions.
My hips have been out of line and did cause me to walk with a limp, but again the yoga is doing wonders by them.
My right shoulder has been totally stiff so that when I started yoga I could not lift my right arm. I can now and get it over my head. As yet I cannot get my arms vertical and straight, but I will. This right shoulder will ease up. At least I keep telling myself that!
Might the increased pain levels be a result of stopping the sulpha rather than the diet? It can take a while for the effect of the drugs to wear off so if you stopped it any time in last 6 to 8 weeks it could be that?
Thank you helixhelix it could be. I was only on it for 5 weeks but it could have been beneficial in that short time. I had a reaction when I had to stop methotrexate so it could be.
Hopefully it will pass soon as don't really want to carry on as I am until July.
No special diet has ever been clinically proved to help,RA.
Most people find eating a Mediterranean type diet with fresh fuit & vegetables, avoiding processed foods & keeping well hydrated keeps them on an even keel.
Eating too much fruit can cause digestive upsets if you suddenly start eating more...... maybe you have overdone the fruit?
If the food you are eating now has caused your pain levels to increase, it seems something doesn’t suit you.......so why not go back to your previous eating habits & see if the pain improves?