I have found one of the biggest frustrations with RA patients is that traditional treatment approaches seem palliative at best. Many seek answers beyond medication regimens on what they can do to treat the disease. In this blog I will explain how functional medicine offers new insight into this disease and will shed some light on the (hidden) causes of RA and what you can do about it.
In recent years, the Paleo Diet has received considerable attention as a means for improving overall health. The anecdotal evidence for patient improvement on a Paleo, or the more restrictive Autoimmune Paleo (AIP) diet, is abundant. What you hear less frequently is that some people experience negative effects, or a worsening of symptoms with a Paleo or AIP diet. It seems counterintuitive that eating a healthy diet high in cruciferous greens such as kale, cabbage, and broccoli, in combination with high quality proteins and fats, can make you feel worse. Why is that the case?
In today’s functional medicine practice, practitioners like myself are confronted with a myriad of chronic inflammatory conditions and autoimmune diseases. Functional medicine is often referred to as "systems medicine" as it understands the importance of assessing and treating all systems individually, while also keeping the interconnectedness of these systems in mind. When dealing with autoimmunity however, one system in particular, the gastrointestinal system, appears to have more and more clinical relevance with autoimmunity, especially with a condition called leaky gut.
In my practice, I take a close look at my patients dietary habits and get to see first hand the ill effects that certain foods and substances can have on the body. One of the primary “offenders” to the health of many people are grains, particularly those containing a protein called gluten. Grains that include this protein are wheat (all forms such as semolina, durum, etc.), rye, spelt, kamut, barley, and most types of oats.
As of 2012, the US Department of Agriculture has yet to release guidelines for certified grass-fed labels on meat products and poultry. Navigating this world is complex and labels can be misleading. Understanding the label nuances allows you to make better decisions that are more in line with your ethical or nutritional values and save money on high priced items that are not what they claim to be.
The longer sensitive individuals eat gluten, the more likely they are to develop other autoimmune diseases
A landmark 1999 study published in Gastroenterology found that the duration of exposure to gluten in celiac disease patients affects the risk of developing other autoimmune diseases. The finding made age at diagnosis an important factor in the overall health of patients with celiac disease.
Italian researchers screened 909 patients with celiac disease for other autoimmune diseases, including IDDM (Insulin-Dependent Diabetes Mellitus), DH (Dermatitis herpetiformis), Hashimoto’s thyroiditis or Graves’ disease, autoimmune hepatitis, alopecia, atrophic autoimmune gastritis, connective tissue disease (rheumatoid arthritis, systemic lupus erythematosus, dermatomyositis, scleroderma, or Sjogren’s disease), psoriasis, Addison’s disease, unexplained cerebellar ataxia, epilepsy with cerebral calcification, or immune anemia, neutropenia, or thrombocytopenia.
They then compared the prevalence of these conditions in three subgroups, separated based upon when the patient was diagnosed with celiac disease (before age 2, between ages 2 and 10, and after age 10).
The team found the prevalence of the other conditions was highest in the subgroup of patients diagnosed after age 10. Similarly, patients diagnosed between ages 2 and 10 had a higher rate of other conditions than those diagnosed before age 2. This suggests that the prevalence of autoimmune conditions increases with increasing age at diagnosis of celiac disease (ie, increasing duration of exposure to gluten).
The researchers’ chart below demonstrates the frequency of developing other autoimmune diseases.
The authors concluded: “Indeed, the age at diagnosis of celiac disease is the single best predictor of the prevalence of autoimmune disease.”
Source: Ventura A, Magazzú G, Greco L; SIGEP Study Group for Autoimmune Disorders in Celiac Disease. Duration of exposure to gluten and risk for autoimmune disorders in patients with celiac disease. Gastroenterology. 1999;117:297–303.