Foods May Contribute to Rheumatoid Arthritis Through a Leaky Gut - The Gut-Joint Axis
By Dr. Scot Lewey
Foods frequently blamed for food allergies and sensitivity reactions are also believed to cause or contribute to inflammatory and autoimmune conditions. These common foods are likely doing so through a process of gut inflammation resulting in leaky gut. This injury, especially occurring in genetically predisposed people, and in the setting of altered gut bacteria (dysbiosis), and immune stress likely predisposes to further inflammation and leaky gut. This vicious cycle is thought to allow toxic food protein-bacteria complexes to enter the body resulting in a variety of inflammatory and/or autoimmune conditions such as rheumatoid arthritis. A new study sheds some additional light on link of food intolerance to rheumatoid arthritis is reviewed in this context.
Researchers from Norway in 2006 published in the British journal Gut additional new evidence of the link between foods and rheumatoid arthritis. Professor Bradtzaeg and his colleagues at the Institute of Pathology in Oslo measured IgG, IgA, and IgM antibodies to foods. The measured these antibodies in blood and intestinal fluid in people with rheumatoid arthritis compared with healthy people.
The researchers performed blood and intestinal fluid antibody tests to the following food antigens: gliadin, oats, cow's milk proteins (casein, lactalbumin, lactoglobulin), soy, pork, cod fish, and egg (ovalbumin). These foods are in the top 10 of common food allergens as well as food protein intolerances.
What they found was a "particularly striking (incidence) of cross reactive food antibodies in proximal gut secretions" as well as increased IgM antibodies to some of these foods in the blood. The findings in the blood were less striking than in the intestinal secretions. This is consistent with difficulties finding elevated blood antibodies to foods in people with rheumatoid arthritis and other autoimmune/inflammatory conditions despite a lot of anecdotal and elimination diet experience supporting the role of foods in these conditions. Interestingly, Dr. Ken Fine's stool antibodies tests may be on to something.
The results, in their opinion, indicate that measuring blood antibodies to foods in rheumatoid arthritis provides little information about the role of foods in rheumatoid arthritis. However, intestinal antibodies not only show a "striking" pattern of elevation consistent with adverse food immune reactions but also that there appears to be a potential cumulative effect of multiple foods. That is, not only may some foods trigger an abnormal immune response resulting in joint inflammation but the combination of multiple problem foods may be a key component to this link. Their results support the connection of mucosal (gut) immune activation from cross reaction of foods to rheumatoid arthritis in at least some people.
What might this mean? This data supports the concept and the experience of many people that elimination of certain problem food combinations may be beneficial in preventing or reducing joint inflammation. This is both exciting and intriguing.
Multiple commonly eaten foods frequently linked to food allergies and sensitivities may be contributing to inflammatory and/or autoimmune conditions. These common problem foods or their lectins are likely contributing to the process of gut inflammation. This is likely causing gut injury resulting in leaky gut. This injury and leaky gut, especially in genetically predisposed people, may, in the setting of altered gut bacteria (dysbiosis), predispose to further injury. This then allows the entry of toxic food protein (lectin)-bacteria complexes into the body, especially the blood stream. The result is inflammatory and/or autoimmune conditions like rheumatoid arthritis.
This gut-joint axis is likely the same mechanism as the gut-brain axis and gut-skin axis that produce the myriad of symptoms and diseases we are now seeing. The associated food protein (lectin)-bacteria immune reactions in the gut are increasingly being blamed for the development of a myriad of diseases.
Much more needs to learned, but it is interesting that certain foods keep showing up as the usual suspects. These problem foods or lectins include the grains (especially wheat, barley, rye, oats, corn), dairy (casein), nightshades (potato, tomato, peppers) and peanuts, soy and other legumes. Diets eliminating or restricting these foods have been reported as being beneficial for many symptoms and diseases. However, definitive links are difficult to establish because of limitations of scientific research.
The foods implicated are usually limited in some manner in a variety of elimination diets such as the gluten-free/casein free diet, naked diet, paleolithic/hunter-gatherer or caveman diets, arthritis diet, low carbohydrate diet, anti-inflammatory diet, and six food elimination diet.
The Paleolithic or Hunter-Gatherer diet specifically recommends restricting grains, dairy and legumes. Various anti-inflammatory or arthritis diets usually recommend eliminating either wheat or gluten, dairy and the nightshades. The dietary approach to autism commonly advocated is a casein-free, gluten-free diet.
Despite lay public reports of great successes with such elimination diets, mainstream medicine continues to be slow to study the dietary treatment of disease. However, especially in the past two to three years more studies are appearing showing links supporting a significant role of food and bacteria in the gut and various autoimmune diseases.
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Reference: Hvatum M, Kanerud L, Hallgren, Brandtzaeg P. The gut-joint axis: cross reactive food antibodies in rheumatoid arthritis. Gut 2006; 55:1240-1247.
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Dr. Scot Lewey, a food allergy expert-the food doc, is a medical doctor specializing in diseases of the digestive tract (gastroenterologist). For over two decades he has been practicing medicine, writing articles, and participating in research. Read more articles here and visit thefooddoc.com
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