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.

I do wonder if they’ll try another DMARD before a biologic. I really want something faster acting than another three month trial! (Not that I made it to three months with the other two.)

One I had an allergic reaction to, the other made me incredibly, out of character low! So the nurse told me to stop immediately. I tried them out at different times.

They don't necessarily take a full three months.
I had a massive improvement within two weeks of starting mtx. Hcq and sulphasalazine were a little slower but still less than three months. The benefits often continue to improve after three months.
Usually you have to "fail" three DMARDS before you can get biologics. So they might offer leflunomide or sulphasalazine next.

Good luck! I think as a pp mentioned, different things work for different people. Although I took a lot of painkillers daily and a flare up stopped me doing things I do think it was mild compared to some people's experiences.

I remember telling the Dr that improving my diet had helped loads and he dismissed it saying that was nonsense, but it has worked for me for 2 years now.

@Paddyhhhj Before my diagnosis, I ate yoghurt and cheese everyday. It has been hard to give up but so worth it. I have found Alrpo yoghurt to be a suitable alternative. I eat it with berries, nuts, seeds, cocoa nibs and cinnamon (to balance blood sugar levels).
I swapped out sweet things for dark chocolate. Anything above 70% is good.
I love the comment from a pp about the Zoe tool. I'd really like to try that myself one day.
If you look into functional medicine, which gets to the root of the problem, there is a wealth of information. It takes time to do your research but it's so worth it!!
The NHS is great, but they do just react to symptoms with medicine rather than getting to the root to make you well again. By the way, I absolutely believe people should take their medication and I will go back to it if I ever need to! But, it's so important for people to know there are other ways to help you improve too! Different things work for different people. Keep trying and remember that it's not just food alone that will improve your health. Sleep, stress and movement are also essential factors too.

My husband had awful side effects to methotrexate - permanent sore throat, upset tummy etc. Plus we didn't like the way it can affect the liver and cause complications.

So he came off it, and whilst waiting to see his consultant for an appointment he started taking Vitabiotics jointace max. The pack contains 3 different tablets (chondroitin, glucosamine, omega 3, collagen, turmeric etc)

After just 2 weeks he noticed a noticeable improvement in his hands and joints, the pain was greatly reduced.

He had the consultant appointment and it was agreed for the foreseeable future he would take these supplements and no other medication has been prescribed for now.

I got them from Holland & Barrett but you can get them from other stores.

Might be worth a try?

As someone with RA who is on biologics I would just be mindful of your particular circumstances when adopting different diets. I think we all realise now that UPF's are probably good to limit and a mediterranean style diet will help with high cholesterol etc. However, remember that RA is most often diagnosed in women and a significant proportion of those are around the menopause window. This is really not a good time to be limiting intake of any food that helps to maintain healthy bones. If you have RA you are much more likely to develop early osteoporosis anyway, so whatever else your diet does it really should maximise foods that help you maintain your bone health.

That’s a good shout - I’ll try them!

So good that your husband is in remission without having to take lots of meds, too.

Yes I hadn’t thought of that. I’m 45 and take HRT as it is, so definitely perimenopausal!

Poor OP. Quite a confusing thread, as everyone is saying to avoid or try different foods.

The AI diet actually is a bit like FODMAP
You exclude dairy,meat, carbs, nightshades, sugar and then gradually introduce one thing back at a time .
Different people will get different results

@CandidOP
One of the factors affecting womens diagnosis is medical gaslighting and the gender pain gap
It takes years longer for women to be diagnosed
2-10 years in fact
Which is an utter disgrace

Lots of conflicting advice.
But to answer the question- the drugs mentioned above made me feel sick and I lost my appetite.
I avoid - cheese, anything with tomatoes (acids) and …..potatoes.
Potatoes made a huge difference (nightshade).

It’s funny you talk of doctors gaslighting. At least their advice is evidence based, and not a load of individual based waffle based on social media.

It's a fluctuating condition so it's easy to make connections with diet and lifestyle changes that aren't real. Get the medication right, there's no magic diet, disease trends over time and across countries would show it.

Keep healthy so there's not more for your body to deal with, but otherwise don't try to feel it's your fault/under your control.

I asked my consultant many years ago when I was first diagnosed. The only advice he gave me was not to put any weight on. I have tried anti inflammatory diets but didn't notice any change. The only thing I avoid is banana - I don't know why but they make my joints worse.
I was also advised to take a Vitamin D supplement every day.
I've been on biologics for a while now and they have worked well for me - you do get used to injecting and I haven't had any side effects apart from a mild headache - I hope you can get your medication sorted soon

My dear dad had RA for years. He was diagnosed around the age of 41. When I was a teenager he had two horrendous flare ups after eating cheese (I think hard cheese). He was in absolute agony. He was very careful about avoiding cheese after those experiences.

Chocolate can never be UPF free because it’s by its very nature ultra processed.

Not sure why you are aiming this at me???

It was the reference to “medical gaslighting”, which I don’t accept. If anything confuses people, it’s the endless difference of opinion on social media, and attempts to undermine evidence based professional practice. I think you know that.

Do you actually understand what it means in this context?
Women are fobbed off , their pain is minimised or attributed to " your age"
This is what happened to me
Complete refusal to refer me for any investigations
8 years later I was finally diagnosed, the damage is already done.

Its a well evidenced and documented phenomenon .

The alternative to medical gaslighting is womens health being taken seriously not Instagram/ SM nonsense which I did not even reference at all

I dont think that’s as common as you think. RA is diagnosed with a simple blood test and most doctors would test for it, given symptoms. It’s wrong to tar a whole profession with the “gaslighting “ brush. And, anyway, making a mistake isn’t the same as gaslighting. Some people do accuse of gaslighting and similar these days because they want to undermine the profession, for political reasons. Perhaps you did not know that?

I’m sorry that you weren’t diagnosed, though. That must have been a very long and difficult experience.

Not sure there is a specific diet that is good for RA, but of course if your knee joints ache and your are fatigued, being generally lighter overall means there is less pressure on the joints and less weight to move from place to place. It can be depressing so the chocolate sounds important to keep on that basis though. :-)

You can get vegetarian omega-3 capsules made from algae (fish don't make omega-3 themselves, they get it from their diet, so you can cut out the middle-fish).

Its incredibly common
All the research has shown that womens diagnosis is often delayed by 2-10years
Im not tarring a whole profession, Im a HCP myself but please do some research and you will be surprised, it makes very uncomfortable reading and has thankfully made me question my own practice and that of others.
Im fully aware of the politics surrounding healthcare but this has zero to do with undermining them
It affects all areas of womens health
Womens symptoms and pain are minimised, its clearly documented that many health conditions in women are attributed to anxiety
My Gp refused to consider that my symptoms were any thing other than my age and I had to just" take paracetamol and get on with it "
I could barely get out of bed
RA is not diagnosed by a blood test alone btw
I had bloods,more bloods, ultrasounds xrays, dexa and mri ONCE I had finally been referred to a Rheumatologist .
The issue isnt my Rheum, shes great , its getting a referral in the first place

Well, we’ve had very different experience, and I’ve seen no evidence of this myself.

Thats the whole poiint
Its not about personal experience, although I experienced it myself, its about the wider issues affecting womens health, it made me investigate further and I was shocked at what I found regarding sex and also race based inequality in healthcare.

" It didnt happen to me" is hardly a thoroughly researched and evidenced argument , is it?

I will leave it there !