Rheumatoid arthritis - the “perfect” diet?

[Paddyhhhj]

Hello, i was diagnosed with RA about three months ago. I have “failed” methotrexate and hydroxychloroquine and am due to see my rheumatologist again to be put on something else. I am hoping to perhaps try a biologic? But I find medication tricky always.

Anyway, in the meantime, I’m trying all I can do to help myself with lifestyle.

What is the so-called “perfect” diet to help control RA symptoms? Did anyone find a diet that helps?

I don’t eat gluten because I’m coeliac anyway. And I eat 95% UPF-free. But I do eat a lot of dairy (vegetarian) and I do eat a lot of chocolate (fairly healthy, UPF-free).

Anyway, please do give me some tips!

What about exercise? I find strength training utterly exhausting right now. Like, bone tiring.

Anti inflammatory diet really which it sounds like you're doing, low sugar, lots of good fats. Would you be able to take fish oils as supplements being veggie?

I perhaps eat too much chocolate? Probably a bar a day! But very high quality, non-UPF (not a giant bar, but like the size of a Mars, I suppose?)

I also eat a lot of full fat yoghurt and cheddar cheese. Like, every day.

A fish oil supplement is a good shout. Omega 3,6,9? Are they the ones?

I listened to this podcast today & the woman said intermittent fasting has really helped her RA symptoms - might be worth a listen? https://podcasts.apple.com/gb/podcast/intermittent-fasting-stories/id1440334876?i=1000751697326

I have never found diet to have any impact on my PsA (which I appreciate is not RA). I might feel better in myself when my lifestyle is a bit healthier but it’s never made a difference to pain/stiffness/fatigue levels although different things work for different people: Biologics have been life-changing though.

Hi.

I did Zoe and found out that sugar didn’t really affect me but fats (even good ones) did. My body just didn’t metabolise it well. It took about 12 hours to digest and if I had another fatty meal within that period it caused inflammation. Since being aware of it, I never take any Naproxen and only occasionally ibuprofen if I’ve relaxed it a bit or been on holiday.

I lost a stone really quickly too.

I was always convinced it was sugar and I was so surprised.

Zoe was expensive but life changing for me.

I’m hoping that they’ll give me biologics next. Nervous about side effects and self-injecting though!

Oh that’s super interesting. The thingy that goes in your arm? How long did you leave it in there for and do it for?

Friend of mine actually reversed her vegan diet for oily fish when she had an RA diagnosis. Said she felt so much better. She ate oily fish couple of times a week.

I managed to get my RA into remission with low carb and dairy free.

Came back with a covid infection so just started the same diet on the 1st of march.

It’s so hard though as I love dairy.

DH's RA is under control with biologics and methotrexate, but he is still in pain most of the time. But he does a manual job and also has osteoarthritis.

I’m a lifelong vegetarian and wouldn’t like to eat fish. I wonder if the supplements work just as well?

Or in fact whether the omegas (which ever is the oily fish one) can be found in a vegan supplement? One of the omgegas we all get too much of and one ofthem we dont have enough of

This is the answer OP - Algea omega 3 is what you want

Most people do not consume enough Omega-3 fatty acids, particularly EPA and DHA, which are crucial for heart and brain health. While Omega-6 is abundant in modern diets, an estimated 76% of the global population falls short of daily recommended Omega-3 levels, primarily due to low consumption of oily fish.

Key Details on Omega-3 Deficiency:

• The Problem: Modern diets are typically high in Omega-6 (found in vegetable oils/processed foods) and low in Omega-3 (found in oily fish, walnuts, flaxseed).
• Essential Types: The body cannot produce Omega-3s, making dietary intake of EPA, DHA (marine sources), and ALA (plant sources) essential.
• Low Consumption Consequences: Insufficient intake may lead to dry skin/hair, joint pain, increased inflammation, and higher blood pressure.
• Improvement: Increasing intake of fatty fish (salmon, mackerel) is recommended, or using algae-based supplements for vegetarians

It was a couple of years ago but I think it was a couple of weeks for arm thing & I followed their food suggestions for a few months quite strictly. Now I’m just mindful of too much fat and it works.

you log your food & get a score. It’s more about what you add than avoid. So crisps were a low score but add hummus and it improved 😁

@Paddyhhhj
Can I ask how you knew that you had failed Hydroxy and methotrexate after 3 months?
Ive started and am not expected to see any effects for 3 months with first review at 6 months .

Have also been considering AI diet including cutting out red meat/ nightshades etc

I have RA and PSA for over 40 years now and run classes in conjunction with our local arthritis charity to help people live well.

I promise tou that there is no food or ideal diet for arthritis. You will generally feel better when you eat better, lose weight, move more but that is true for everything.

Everyone who has turned their arthritis around has not done so through food you do this with drugs, particularly biologics which are life changing and are necessary.

Please do eat better of course but nothing in your food source will help reverse this. Please go to a rheumatologist and get the drugs.

Please also dont listen to snake oil salesman and entertain:
Copper bracelets
Turmeric
Aloe Vera
Glucosamine
Joint active vitamins

The Zoe project is expensive, but their food science podcasts are free. https://zoe.com/learn/category/podcasts/zoe-podcast-long-episodes If you prefer to read the transcripts are also on their website somewhere.

I listened to one when I'd been more or less bed bound for 10 months with a terrible RA flare up. The scientist being interviewed talked about her latest trial, where test subjects were given 6 small portions of fermented food daily for a couple of months, blood tests taken before and after the trial showed their inflammation markers had dropped by 20%.

I was in so much pain that I was more than willing to eat 2 tablespoons of fermented vegetables and kefir 6 times a day on the off chance that it might reduce the pain by 20%.

I still listen to their podcasts, and have radically overhauled what, and when, I eat. All in an attempt to boost my gut microbiome and have the best possible chance of keeping my autoimmune ailments in check.

I was diagnosed with RA in 2023. I tried methotrexate and sulphasalazine. Neither worked for me. I had 2 steroid injections which helped massively in bringing down my inflammation though.

I am now in remission and have been for over a year. The main cause of my illness was stress so I work very hard on this and it has made a massive difference.
I also improved my lifestyle. It wasn't bad previously, but the changes I made had a significant impact.

I cut out gluten and dairy, which made an unimaginable improvement for me. I avoid processed sugar. I try to eat berries and fruit and veg every day. Personally, I found that I feel less fatigued when I eat meat so I have increased that. I really notice the days when I don't eat chia seeds, flaxseeds and pumpkin seeds! I also haven't drank alcohol since being diagnosed. I don't miss it at all. Green tea is very good for reducing inflammation and you can get different varieties of it. I take vitamin d and b12, which are very helpful for autoimmune diseases. I also take magnesium, folic acid and NMN. I have considered taking LDN from a private chemist to help with fatigue (I have Fybromyalgia too). I use British Supplements as they are 'clean' vitamins. I take a liquid form of omega 3 fish oil too.
A mixture of manuka honey, tumeric and black pepper works miracles for me. I take half a tea spoon 3 times a day and I rarely get infections/viruses.

Consistent sleep helps me lots also.

This is what has worked for me. However, I believe that every individual is different. Some improve with anti-inflammatory diet, some with keto, vegan or carnivore. Unfortunately, it's a case of trying different options until you find the right one for you. I whole heartedly believe you can improve your symptoms.

Look into functional medicine too!! This may help you identify the root cause rather than simply treating the
symptoms (as the NHS focus on).

Wishing you the best of luck in improving your RA.

They might try you on sulfasalazine which is what my sister now takes, took a while but it now controls her symptoms fairly well with little side effects. I think they usually will try you an a few DMARDs or combinations before switching to biologics but it probably depends on your consultant. I think for diet being vegetarian is the best one especially if you lean to the Mediterranean style one. I think many meats and other flesh have been proinflammatory excepting oily fish.

All this.
D
I've had RA for 12 years and am hugely sceptical about miracle cures and diets.
If there was one that worked my rheumatologist would have mentioned it.
Nevertheless in desperation I tried all sorts in the early years. Nothing made any difference.

Did you not inject the methotrexate? Why did you fail hcq and mtx? Did they not work?
I take hcq, mtx and sulphasalazine. Together they work but the mtx gives me terrible headaches. My joints are brilliant though.

Haha salty crisps and hummus are a dream pair 😁

Methotrexate - it gave me incredibly low mood and the RA nurse told me to stop immediately before saying “any suicidal ideation yet?” (Yikes).

And I developed a hefty rash and swollen ears after a month of hydroxychloroquine and the nurse, again, told me to stop immediately.

I haven’t had my appointment yet to see what else I’ll be given.

I’m disappointed about the hydroxychloroquine as - before the rash really kicked off - I thought I was having no side effects!

I’ll definitely get the medication - there’s just a gap between stopping the one that I had a reaction to, and getting an appointment to try the next one. In the meantime, I want to try and help myself a bit if I can.

Arg RA is no fun!

Oh fermented is a good shout. I keep meaning to eat more fermented food. I think kefir would be an easy one daily, I do like kimchi also!

Did it help you?

Thank you! Your diet sounds great. I do really like healthy things like nuts and chia and berries. I wonder if my heavy consumption of dairy is my downfall! I eat cheddar every day, and have a bowl of Greek yoghurt. Perhaps I’ll try and knock that on the head for a couple of weeks and replace with something else that’s v healthy and see!