Nutrition, Autoimmune And Arthritic Conditions: A Case Study

Ankylosing Spondylitis  (AS): 

A young woman I knew was diagnosed with AS after graduating from college. Looking back on her life, she had terrible pain in her legs in high school, 1996-9, which went undiagnosed. In college, she had a severe inflammatory reaction in her eyes, which caused blindness for about 4 days. She was told to stay in bed. She thought it was from not taking care of her contacts, but later found that AS is an inflammatory process that may show up in other places, including organs. Once diagnosed, Mobic was prescribed to manage pain. 

In 2008, she consulted a Naturopath when the symptoms worsened.  Joint swelling and pain, inflammation flared up in numerous locations.  The naturopath's nutritional approach sounded good on the one hand, but there was so much pain, she consulted with traditional MD's, received the AS diagnosis, and started on Enbrel, an auto immune suppressor, with quick relief. The nutritional piece was set aside at the moment.  She stayed on this medication until pregnant with her first child, gradually stopping the medication and changed her lifestyle. She did use the Enbrel for flareups up until 2018.  

This is a fact: you can heal your body. With determination and support, chronic illness can be reversed. There is always a genetic component, but this is only about 20% of the influence. Lifestyle is key to changing the hormonal and cellular composition in our bodies, and this demands managing both stress and diet, adding a balance of pleasurable movement and exercise. Food is like pharmaceuticals, it will either help or you or hurt you. Choose foods that support rather than hinder health. Certain foods trigger her swelling and pain to this day, but it is rare. The foods that aggravated her the most were, processed foods, sugar, gluten, dairy, meat and beer (wheat beer is a gluten source).

If individual case studies show that AS and other autoimmune conditions ARE helped by diet, I thought I would see if the literature concurred.  McFarlane et al, did a systematic review of whether diet plays a role in the onset of ankylosing spondylitis (AS), or can diet affect the course of the disease? This is an important question for many patients and healthcare providers.  Because lifestyle and diet are WITHIN OUR CONTROL.  Sixteen studies (nine observational and seven interventions) were included in the review.  “Evidence of a possible relationship between AS and diet is extremely limited and inconclusive due to the majority of included studies being small, single studies with moderate-to-high risk of bias, and insufficient reporting of results."  Macfarlane, T. V., Abbood, H. M., Pathan, E., Gordon, K., Hinz, J., & Macfarlane, G. J. (2018). Relationship between diet and ankylosing spondylitis: A systematic review. European journal of rheumatology, 5(1), 45–52. https://doi.org/10.5152/eurjrheum.2017.16103)

I thought this was a grand study, and was looking forward to the conclusion, but was disappointed.  With the history of the young woman’s case, nutrition did and does still play a very big part in this disease process.  What she learned in the process of treatment, was that certain foods were triggering the inflammation. She was determined not to have to take a medication long term, with so many side effects which motivated her lifestyle changes. Research points to a high correlation to gut dysbiosis and AS as well as other arthritic conditions. As is a common result of AS, none of her joints fused, as she continued to exercise and change her nutritional behaviors.  Others are not so lucky.  Even without the support of research, this story needs to be told.  Case studies do provide a pathway to change for others. Read on.

In this second study, it appears there is support for the nutritional approach with AS and other arthritic conditions.  Haugen et al reported with dietary interventions, "Less pain and stiffness were reported by 46% of the 342 patients and 36% reported reduced joint swelling”. Similar beneficial effects of diet were also reported in other rheumatic disease groups. Fifteen percent of the patients with rheumatoid arthritis and ankylosing spondylitis (AS) had been through a fasting period. Less pain and stiffness were reported by 2/3 of the patients in both groups and half of the patients in both groups reported a reduced number of swollen joints. I thought it interesting that "a fasting period" brought results of less pain and swelling as well. Fasting puts the body into a ketonic state, which stimulate healing responses throughout the body.

 Haugen M, Kjeldsen-Kragh J, Nordvåg BY, Førre O. Diet and disease symptoms in rheumatic diseases--results of a questionnaire based survey. Clin Rheumatol. 1991 Dec;10(4):401-7. doi: 10.1007/BF02206660. PMID: 1802495 https://pubmed.ncbi.nlm.nih.gov/1802495

In addition to the lifestyle changes above, The Trager Approach, meditation and yoga all helped this young woman manage the stressful impact of her life and living with a disease process. Stress relief lowers cortisol, and allows a balance of hormonal responses throughout the body. Find a way to reduce your stress and you will reduce inflammation. I am an educator, and offer this information for you to do your own research! Let me know what you find!