Can Probiotics Help RA?

There is a lot of discussion among a wide range of individuals about the roles that your diet and your digestive system play in the inflammatory response in general and RA specifically. The people having the discussion range from highly respected doctors to patient advocates to the modern version of snake-oil salesmen. The reported experiences range from “curing” RA through a modified (often very restrictive) diet, to patients that can identify specific food triggers that bring on flares, to people like me who can’t even draw a dotted line between what I put in my mouth and how my joints feel. (The connection between wine and headaches, yes. The connection between food and flares, no.)

In short, the discussion is very lively with proponents and opponents on every conceivable side of the argument.

I put much of this down to the fact that RA affects people individually and therefore different people will have different reactions to the same treatment options – be it medical, homeopathic, or dietetic. As a result, what may work wonders for one person may have little or no effect on another.

I also have a high interest in the science behind all of this and a quick internet search will bring up a mountain of evidence that ties our gut bacteria to our immune systems. This is also why I’m so intrigued by studies that report taking certain probiotics can positively impact key RA clinical scores. These include improved Disease Activity Score of 28 joints (DAS-28) and serum high-sensitivity C-reactive protein (hs-CRP) concentrations. (As an aside, the latest study also showed improved cholesterol and glucose levels.)

There are a number of theories of why this might be. One that seems to make sense to me is that people with inflammatory diseases (like RA) have inflammation in their digestive tracts. This makes it easier for bacteria and other elements to enter the bloodstream and trigger an inflammatory response in areas such as joints. 1 If this is true, maintaining a healthy balance of gut bacteria should help minimize the overall inflammatory response and thereby reduce RA symptoms.

The latest study I’ve seen2 showed clinically relevant improvement in a study group who took probiotics for eight weeks versus the control group that took a placebo. That is, the people who took the probiotics had less inflammation than those that didn’t. For those of you who know your probiotics, there were three involved in the study: Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium bifidum.

I’m not suggesting that the scientific community abandon all research for an RA cure except for gut bacteria. Nor am I suggesting that everyone rush out and buy bottles of probiotics and add to their collection of daily pills. What I am suggesting is that this is interesting and you might want to do some reading on your own. And as always, if you decide this is something that you want to add to your RA treatment plan, you should with your rheumatologist about it first.

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