Living with Rheumatoid Arthritis? A Gluten-Free Diet May Be the Way to Go

Living with Rheumatoid Arthritis? A Gluten-Free Diet May Be the Way to Go

We’re hearing a lot about gluten — or more specifically, the need to avoid gluten — these days. It seems that almost everyone is either on a gluten-free diet, or knows someone on a gluten-free diet. The grocery store is suddenly stocked with items claiming to be gluten-free, and even restaurants are getting in on the act, adding special items to their menus and adjusting recipes to meet the needs of those who cannot or don’t want to eat gluten.

With all of the attention that gluten is getting, you may be wondering if gluten really is harmful, or whether it’s just a craze that will soon go the way of other food fads. While undoubtedly there are some who have adopted a gluten-free lifestyle unnecessarily — by some estimates, that’s almost 90 percent of the people who have cut out gluten — there are some people who really do need to avoid gluten. The first group is those with celiac disease, a legitimate gluten intolerance. The other group that should avoid gluten? Those with rheumatoid arthritis.

The Celiac-RA Connection

The Celiac-RA Connection

Celiac disease and rheumatoid arthritis are often challenging to diagnose are often challenging to diagnose, as they share many of the same symptoms. Both are autoimmune diseases in which the immune system attacks healthy cells in the body as if it were diseased, causing similar symptoms that include joint pain, stiffness and swelling. Celiac often includes other gastrointestinal symptoms that aren’t present in RA, including cramping, bloating, diarrhea, nausea, vomiting and constipation, but many people who complain of joint pain are often diagnosed with RA, despite those other symptoms.

In addition, one condition can often lead to the other. Celiac often leads to arthritis, but more often, patients with RA develop celiac disease. This is in large part because even though RA can be managed with biologic drugs (check out for some of the latest RA treatment options) many patients do not follow a gluten-free diet as well. As a result, while their joint pain may be under control, their immune system still attacks the gluten inside the intestines, causing serious discomfort and, eventually, malnutrition.

What Is Gluten?

Before getting into the importance of going gluten-free if you have RA, it’s important to explain exactly what gluten is. Gluten is an amino acid, or protein, found in many grains, including wheat, barley and rye. It’s what gives bread it’s chewy texture, by adding elasticity to the dough. In addition to being found in breads and other baked goods, gluten is added to many packaged and processed foods, and can also be found in unexpected places, like salad dressing.

When one has a sensitivity to gluten, it causes the immune system to attack the lining of the intestine; more specifically, the antibodies attack the villi, which are microscopic protrusions on the lining of the small intestine that absorb nutrients from food. If the villi are destroyed, then the body cannot absorb nutrients, causing both tummy trouble and malnutrition, including anemia.

However, going gluten-free isn’t always great for your health either, as many gluten-free foods are low in fiber and other nutrients, and tend to be higher in fat and calories thanks to the ingredient substitutions. As a result, it’s important to only cut out the gluten if you really need to.

How a Gluten-free Diet Helps RA

You might be wondering what celiac disease and a gluten-free diet have to do with rheumatoid arthritis. After all, when you have RA, you tend to only have the joint pain without the problems with your digestive system.

Doctors note, though, that when you have one autoimmune disease, like RA, your chances of developing another disease increase considerably. Not to mention, several studies have indicated that RA patients that have drastically reduced or eliminated gluten from their diets have shown improvement in their symptoms.

When you are diagnosed with RA, talk with your doctor about your diet to determine whether going gluten-free can help. You may need additional testing to identify a gluten sensitivity or intolerance and if that could be causing your pain. If you do opt to go gluten-free, keep a few important points in mind:

  • Do not stop taking your medication without your doctor’s guidance. Even if you feel better, stopping or changing your medication on your own can cause you to get sicker or lead to side effects.
  • Research gluten-free eating, and try to eat as many naturally gluten-free foods as possible. Most fresh foods, including fruits and vegetables, do not contain gluten.
  • Learn to read labels. Manufacturers are not required to list gluten, and while it might be obvious that some ingredients contain gluten (anything containing wheat, rye, barley or flour, for example) other common ingredients, like malt, may not be as immediately apparent as gluten.
  • Understand that some packaged foods and restaurant items labeled as gluten-free may have been prepared in the same area as foods containing gluten, and therefore may contain trace amounts.

Paying attention to your diet can make a significant difference in how you manage a chronic condition. If you have RA, cutting out gluten could make the difference between constant discomfort and a relatively normal life, so be sure to talk with your doctor about your options.