Some people find that removing certain foods, such as those that cause inflammation, from their diet can help people control their rheumatoid arthritis (RA) symptoms. The foods that cause RA flares can differ from person to person.
In people with celiac disease, which is a severe form of gluten intolerance, eating gluten can lead to inflammation in the body. Therefore, avoiding gluten could help people with a gluten intolerance improve their RA symptoms.
In this article, we look at the link between gluten and RA. We also discuss whether gluten can make the symptoms worse, as well as which foods to eat and avoid.
Can gluten make RA symptoms worse?
There may be a link between diet and RA, but it is not entirely clear.
RA is a chronic condition in which the immune system wrongly attacks tissues and synovial fluid in the joints. This causes pain and inflammation in the joints, which can lead to damage and deformity over time.
The link between diet and RA is not completely clear. Removing certain foods from the diet can help some people manage their RA symptoms.
However, scientists need to conduct more formal, high-quality research before healthcare professionals can definitively link any specific foods with RA symptoms. Also, different foods affect people in different ways.
Some people find that eating gluten makes their RA symptoms flare up, and that eliminating gluten from the diet helps relieve their symptoms. These people may have an intolerance to gluten.
Celiac disease refers to a severe intolerance to gluten. It is an autoimmune condition that affects around 1 in 100 people around the world, according to the Celiac Disease Foundation.
Celiac disease and RA are both autoimmune conditions that can cause inflammation in the body.
In people with celiac disease, eating foods that contain gluten can cause sluggishness, bloating, and digestive problems. It can also cause pain, swelling, and inflammation in many areas of the body, including the joints.
This occurs because the immune system treats gluten as a foreign invader, so it mistakenly attacks the tissue in the intestine. Some of the inflammatory proteins related to this process can enter the bloodstream and cause joint changes that may feel similar to the symptoms of arthritis.
In general, diet tips for people with RA include eating a wide variety of healthful whole foods and cutting out those that could cause inflammation, such as processed and sugary foods.
How common is celiac disease in RA?
People with RA may be more likely to have celiac disease or gluten sensitivity than people without the condition.
One study notes that antibodies associated with celiac disease and gluten intolerance appear more frequently in people with RA and Sjogren’s syndrome than people without these conditions.
Another study explains that there seems to be overlap between RA and celiac disease. The researchers revealed that people with celiac disease frequently have markers for RA (rheumatoid factors), and that people with RA frequently have signs of celiac disease.
This does not, however, mean that everyone who has RA will have a gluten sensitivity.
Seeking testing for both RA and celiac disease as soon as the symptoms appear can help doctors correctly identify the underlying issue and work toward finding the best treatment.
Testing for gluten sensitivity
Doctors can test for celiac disease or a gluten sensitivity using a blood test. Generally, having higher levels of certain antibodies indicates that a person has celiac disease or is sensitive to gluten.
If the blood test comes back positive, the person may find that cutting out gluten from their diet makes them feel better overall.
In some cases, the doctor may need to take a biopsy of tissue in the small bowel to confirm the diagnosis. It is necessary to consume gluten before the biopsy to avoid getting a false negative test result.
Foods to eat
People with a gluten sensitivity will benefit from removing foods that contain gluten from their diets. This may seem difficult at first, but it should become easier over time; gluten-free alternatives to common foods are becoming much more widely available.
Most major food groups contain no gluten, including:
- red meat
- beans and legumes
Grains are the only source of gluten, yet not all grains contain gluten. Naturally gluten-free grains include:
- gluten-free oats
- buckwheat groats
There are also a number of naturally gluten-free flours to choose from. Manufacturers can make flour substitutes from the above grains, in addition to foods such as:
- beans such as garbanzo, lentil, or urid
- nut flours such as almond, hazelnut, or acorn
However, many manufacturers package these grains and flours using the same equipment as they do to package grains containing gluten, which may lead to contamination.
People who are severely allergic to gluten should always read the label. The label may say that the product comes into contact with gluten or may contain gluten.
Those who are especially worried about gluten may want to only choose certified gluten-free products.
Packaged foods and products that normally contain gluten often have gluten-free alternatives. This includes everything from cookies and baked goods to pasta and bread. Again, be sure to read the ingredients label and check that the product is certified as gluten-free if necessary.
Eating an overall healthful diet is also important for RA. Adopting a diet that contains a wide variety of fruits and vegetables, spices, and probiotic foods may help promote an overall healthy body and reduce the levels of inflammation in the body.
Foods to avoid
Adopting a gluten-free diet is now easier than ever before, as many gluten-free products are becoming available. However, there are still a number of foods that people may wish to avoid.
Gluten comes from several different grains. Anyone looking to eat a gluten-free diet should avoid grains containing gluten, including:
Although avoiding these grains will go a long way toward eliminating gluten, there are other foods to avoid. Some unexpected sources of gluten include:
- brewer’s yeast
- malt, such as malt vinegar, malt syrup, or malted milkshakes
- wheat starch
- oats that are not certified as gluten-free
- salad dressing
- some wines
It is also still helpful to follow other guidelines about diet and RA. One study recommends that people with RA avoid eating foods that may cause inflammation, such as:
- salty foods
- processed foods
- animal products
What to ask a doctor
Anyone who suspects that they have a gluten allergy or sensitivity should see their doctor. An early diagnosis is key to preventing complications in the future and may help reduce symptoms and condition progression.
If possible, try to bring a food diary to each medical appointment, or keep a food diary with the help of a healthcare provider.
A food diary contains a list of the foods a person has eaten, along with the symptoms they triggered. Having access to this could help the doctor identify any trends and may even highlight another potential allergen they can test for.
For some people, eliminating certain foods from their diet can help improve RA symptoms. People with celiac disease will benefit from removing gluten from their diet. More research is needed before scientists can say for definite how different foods affect RA symptoms, and different foods affect different people in different ways.
Some research suggests that people with RA are more likely to have celiac disease. In people with celiac disease, eating gluten can cause inflammation and arthritis-like symptoms. For these people, eliminating gluten from the diet can reduce overall inflammation and improve their symptoms.
Anyone who suspects that they have an allergy or sensitivity to gluten should talk to their doctor to receive a full diagnosis.