Rheumatoid arthritis (RA) is a crippling autoimmune disease, typically affecting close to 1.5 million people in the United States alone. This inflammatory illness causes joint pain, loss of mobility, and swelling within the body. This occurs because the body’s immune system accidentally ends up attacking itself, and this happens first at the tissues and membranes that surround and protect joints. (1)

How this disease actually begins and progresses is still being studied, but chances are that part of the problems that start with the immune system can be cause by genetics or environmental factors. The immune system is a complex machine, and is easily affected by the microbes that live in (and on) the body. There are trillions of these kinds of microbes within our digestive system, and the health of these microorganisms has been correlated with the effects of RA. (1)

With that being said, cleaning up the gut and corresponding bacteria within the digestive system can be one way to help cope with rheumatoid arthritis. Research has shown that a microbe called Prevotella (which can be grown in excessive amounts in people with RA) might actually be more of a trigger for this autoimmune disease, causing inflammation in the joints. For those with SIBO, or small intestinal bacterial overgrowth, the thought process is the same – with more overgrowth of microbe than normal, inflammatory processes are in high drive. (2) Cleaning up the gut through foods like fish, vegetables, and high-quality olive oils have been shown to positively affect the gut and tame the microbes causing overgrowth – and subsequently the inflammation in the joints. (3)

In regards to food intake, healing the gut through nutrient-dense foods is imperative for RA management. Consuming adequate amounts of macronutrients (protein, carbohydrates, and fat) within a well-rounded diet is key. “Eating the rainbow” is a statement often made in the health and wellness realm, and for good reason – multiple benefits reside from eating whole foods that contain a plethora of vitamins and minerals. Think of it this way – if it’s packaged or has a huge list of ingredients, it’s probably not doing RA any favors, and isn’t contributing anything positive to the health of gut microbes. (6)

Another environmental factor that can exacerbate symptoms of RA is cigarette smoking. Again – the exact cause of this illness is not clear yet, but it’s been researched multiple times that smoking has a high correlation with RA. One study done displayed an almost 50% chance of having RA when smoking for more than 20 years and more than 25 cigarettes a day! (4) Reducing or even eliminating cigarette smoking can be a big positive to combating the effects of RA.

Stress is yet another possible component of rheumatoid arthritis that causes an inflammatory response. Cortisol is a hormone within the body that typically functions as an anti-inflammatory; however, with prolonged and high-level stress situations, the body doesn’t “use cortisol appropriately, and therefore causes dysfunction. This can then lead to inflammation, which goes right to the joints with RA. Finding ways to work through stressful situations and coping appropriately to everyday stressors can be helpful in managing RA successfully. (5) One are that is getting more attention for stress management is biofeedback (using your own body to reward specific behaviors) – we currently use Neurofeedback as a way to train stress responses and its as easy as watching a movie or playing a video game!  This is just another example of how custom solutions can engage the natural healing process and lift the body up, rather than suppress the immune system.

Lastly, healing damaged tissue is imperative for conquering this autoimmune disease. Studies have shown that using stem cell therapy as a natural treatment for RA by essentially controlling the immune system are very promising! These stem cells are helping to balance out the differences between the inflammatory and anti-inflammatory properties of the T-cells that are present with RA, and getting them to regulate themselves to possibly delay progression of this chronic condition is key. (7)

With all of the natural remedies for taking control of rheumatoid arthritis (and many more that aren’t listed here), hopefully there will be something that can start to balance out the inflammation and promote a healthier and pain-free lifestyle for those affected with RA. Improving the health of the immune system is a life long process, but beginning to heal and implementing the above factors can certainly help point in the right direction. Speak with your functional medicine doctors in Boulder, Colorado if you need more guidance, or have questions about any of the natural treatments for RA!
Ian Hollaman, DC, MSc, IFMCP

(1) Torgan, C. (2013). Gut Microbes Linked to Rheumatoid Arthritis. National Institutes of Health, Department of Health and Human Services.
(2) Henriksson, A. E., Blomquist, L., Nord, C. E., Midtvedt, T., & Uribe, A. (1993). Small intestinal bacterial overgrowth in patients with rheumatoid arthritis. Annals of the rheumatic diseases, 52(7), 503–510. doi:10.1136/ard.52.7.503
(3) Rath, L. (2016). Gut Bacteria: A Potential Game Changer for Rheumatoid Arthritis. Arthritis Foundation, Rheumatoid Arthritis Blog.
(4) Hutchinson, D., Shepstone, L., Moots, R., Lear, J., and Lynch, M. (2001).  Heavy cigarette smoking is strongly associated with rheumatoid arthritis (RA), particularly in patients without a family history of RA. Annals of the Rheumatic Diseases, 60, pp. 223-227.
(5) Hannibal, K., and Bishop, M. (2014). Chronic Stress, Cortisol Dysfunction, and Pain: A Psychoneuroendocrine Rationale for Stress Management in Pain Rehabilitation. Physical Therapy: Journal of the American Physical Therapy Association, 94(12), pp. 1816-1825.
(6) Conlon, M., and Bird, A. (2015). The Impact of Diet and Lifestyle on Gut Microbiota and Human Health. Nutrients, 7(1), pp. 17-44.
(7) Luque-Campos, N., Contreras-López, R. A., Jose Paredes-Martínez, M., Torres, M. J., Bahraoui, S., Wei, M., … Luz-Crawford, P. (2019). Mesenchymal Stem Cells Improve Rheumatoid Arthritis Progression by Controlling Memory T Cell Response. Frontiers in immunology, 10, 798. doi:10.3389/fimmu.2019.00798