The Correlation Between Food and Joint Pain.

Michael Jurgelewicz, DC, DACBN, DCBCN at Designs for Health

Patients with autoimmune diseases such as, rheumatoid arthritis, systemic lupus erythematosus, or Sjogren's disease are typically given protocol-driven treatments with limited success because an acute care model is given to a chronic problem while the underlying causes are never investigated.

The problem with this is everyone has their own unique biochemical individuality. This is a common problem with almost all autoimmune diseases. There is endless research on intestinal permeability, aka leaky gut. The gastrointestinal tract is 80% of our immune system. When inflammation is present, the tight junctions and intestinal mucosa can become damaged, causing gaps or "pores" in the lining of intestinal mucosa. Toxic byproducts in the digestive tract are then absorbed into the bloodstream and transported on to the liver. The molecules of food and toxins are "leaked" through the GI lining and then eventually affect systems throughout the body, causing inflammation in our joints and expressing toxins in autoimmune conditions and food sensitivities.

Patients with rheumatoid arthritis (RA) often have an association between food intake and rheumatoid disease severity. In 2008, in looking at this immunological link between gut immunity and RA, food IgG, IgA and IgM antibodies were measured. In the intestinal fluid of many RA patients, all three immunoglobulin classes showed increased food specific activities, including gliadin antibodies.

There are some tests to consider for those with an autoimmune disease, as great strides have been made in regards to what labs can test for today. 

There are labs that assess food sensitivities, which is different than the IgE RAST test performed by traditional allergists. There is also a lab that can test for intestinal permeability. Through the serum they are able to detect antibodies to LPS, occludin/zonulin and the actomyosin network to identify the breakdown of a healthy intestinal barrier. In addition, a comprehensive digestive stool analysis is essential for healing the gut.

It is also very important to check vitamin D levels and to test for gluten-associated antibodies and cross-reactive foods since they play a large role in inflammatory and autoimmune processes.

Andrographis paniculata

Once these underlying areas of the patient's heath are explored, nutritional and lifestyle support would be used to address any dysfunctions, deficiencies, toxicities, etc. For symptomatic relief, Andrographis paniculata may be considered. This plant has been widely used in Ayurvedic medicine for centuries and in studies has been shown to support a healthy immune response in patients with autoimmune conditions. In a randomized, double blind, and placebo-controlled study published in Clinical Rheumatology (2009), 60 patients with rheumatoid arthritis were given 100mg of Andrographis paniculata or placebo three times a day for 14 weeks. It was found to be effective in reducing the number of swollen joints, total grade of swollen joint and tender joints. Andrographis paniculata helped normalize rheumatoid factor, creatine kinase, hemoglobin, immunoglobin IgA and IgM. The reduction in IgA and IgM is beneficial as there is positive correlation between the grade of cartilage damage.

In another clinical published in 2013, 8 patients with various rheumatoid conditions were given 300mg of Andrographis paniculata daily for 3 ½ years. Treatment showed significant improvement in number of swollen joints, total grade of swollen joint, total grade of tender joints, and improvement in quality of life. In addition, significant reductions in rheumatoid factor, erythrocytes sedimentation rate, pain, and C-reactive protein are being seen with Andrographis.