What is rheumatoid arthritis?

Rheumatoid arthritis is a chronic medical condition that results in painful swelling in the joints. The disease usually starts in the hands and feet and works its way toward fundamental joints over time. Without effective therapy, rheumatoid arthritis can result in severe deformity and disability. Currently, the best remedies for rheumatoid arthritis are medications that suppress the immune system.

 

The cause of rheumatoid arthritis has eluded researchers for decades. The immune system is involved, obviously, but what causes the immune system in the first place? Researchers have started to find answers in an unlikely place: the human gut.  Is it possible that gut bacteria can hold a cure? Increasing evidence suggests the bacteria which reside in the human gut may be the cause of rheumatoid arthritis. 

What causes & triggers RA?

Nobody knows for certain what causes rheumatoid arthritis. Rheumatoid arthritis starts in people with the right (or wrong) combination of genetic factors and environmental exposures.  Quite simply, individuals that are genetically predisposed to developing the illness will develop rheumatoid arthritis. When the disease begins, however, it's self-perpetuating, so it is going to keep getting worse by itself.

 

Since people can't alter their genes, researchers have focused mostly on identifying the environmental insults. To put it differently, what causes rheumatoid arthritis? Things like cigarette smoke, silica debris and dust particles may be triggers in certain.  Yet tens of thousands of people who never smoke or possess these exposures nevertheless develop rheumatoid arthritis.

Bacterial and viral infections have long been suspected causes for rheumatoid arthritis. The immune system attacks the invader, but the immune system then becomes confused between what is and isn't foreign. From this moment on, the immune system attacks the joints. Despite years of searching, however, we haven't identified a particular viral or bacterial infection which causes rheumatoid arthritis.

 

An exciting new possibility has sparked intense scientific curiosity: the gut microbiome. 

Gut Bacteria and the Immune System

The walls of the gut create the home to a huge number of immune system cells. These gut immune cells are important gatekeepers. They have to detect and destroy foreign invaders that ride on the food that we eat. However, the intestine's immune system must achieve a delicate balance between fighting invaders and allowing nutrients to enter the body.  If the immune system is too lax, we get infected. When it's too aggressive, we get allergic reactions and potentially autoimmune diseases.

 

We now know that the microorganisms living in the gut have a profound effect on immune system functioning. The immune system in the gut is based heavily on the bacteria present to help do its job. There's a continuous exchange of information between gut bacteria and the immune system. Microorganisms from the intestine digest and detoxify substances and stimulate the immune system.

Is Gut Bacteria responsible for Rheumatoid Arthritis?

Not all gut bacteria are healthful. Actually, researchers may have identified the gut bacteria that cause rheumatoid arthritis.

Dr. Dan Littman of New York University School of Medicine And his co-investigators discovered that a specific bacterium, Prevotella copri, was present in the gastrointestinal tracts of individuals when they first developed rheumatoid arthritis. Prevotella copri was found in 75 percent of people with fresh, untreated rheumatoid arthritis, but only 21 percent of those with no disease.


If harmful germs and antigens enter your body, they attack other parts of your body, such as your joints. One method to fight bad bacteria is to increase the concentration of healthy bacteria, or probiotics, in your gut. This makes probiotics a exceptional alternative treatment for rheumatoid arthritis.

How can probiotics help in managing rheumatoid arthritis?

According to a recent research study,  a daily dose of probiotics led to less action and less inflammation of rheumatoid arthritis. Evidence suggests that the impact of probiotics could be observed even at places far away from where they're administered. Listed below are some advantages of probiotics:

- Reduce chronic low levels of inflammation in the absence of a significant threat

- Strengthen junctions with cells located in organs which contain and transport water and solutes

- Strengthen the lining of the intestine making it more resistant to toxins, allergens and pathogens

- Modulate resistance by training the immune system to differentiate the good guys from the bad guys


Can Probiotics help RA?

People who develop rheumatoid arthritis have a substantially lower amount of beneficial bacteria in their gastrointestinal systems. People with rheumatoid arthritis have significantly less Bifidobacteria, Bacteroides-Porphyromonas-Prevotella species, Bacteroides fragilis species and the Eubacterium rectale-Clostridium coccoides species.

 

It is too early to say whether gut bacteria causes rheumatoid Arthritis, just as it is too early to say whether gut bacteria prevents rheumatoid arthritis. Nevertheless, these scientific study results are hard to ignore. We know that getting healthy bacteria in the gut is essential for overall health. It appears reasonable, then, to take action to foster the growth and development of healthy bacteria.

 

It's reasonable to promote healthy gut bacteria by taking probiotics. In the end, probiotics are just capsules which contain healthy bacteria. But, probiotics are living bacteria. As such, the majority of the probiotics which are consumed die in the acidity of the stomach. The amount of germs which do survive is just a tiny fraction of the trillions of bacteria that line our intestines.

 

Unfortunately, taking one type of probiotic isn't likely to be adequate in preventing or treating rheumatoid arthritis. Consider that individuals with early rheumatoid arthritis are rather deficient in a whole slew of bacterial species. Some of these microorganisms aren't even commercially available as probiotics. Thus, it may make more sense to rely on prebiotics as opposed to probiotics. You should consult with a functional medicine doctor to evaluate what is right for you.

Probiotics or Prebiotics

Prebiotics like oligofructose and inulin are food for healthy gut bacteria. When you consume prebiotics, they travel throughout the gastrointestinal tract and make their way into the large intestine. The body doesn't digest these compounds, but wholesome bacteria do. Prebiotics encourage the growth and expansion of healthy gut bacteria. These healthful microorganisms also tend to push unhealthy germs such as Prevotella copri and stop them from taking root in the gut.


If you need probiotics, some natural sources of probiotics include yogurt, dark chocolate and kefir (a fermented dairy product). Furthermore, you can also consume probiotics in the shape of dietary supplements after checking with your functional medicine expert.

Summary

Despite intense research, scientists still do not know exactly what causes rheumatoid arthritis. However, evidence now strongly suggests that the number and kinds of bacteria within the gastrointestinal tract affects the development of rheumatoid arthritis. Prevotella copri might be a bacterial cause of rheumatoid arthritis.  Probiotics from food may be beneficial in balancing the gut microbiome. However, it's hard to know what sort of probiotic supplements to use. Another option is to be supplement your diet with prebiotics. Prebiotics encourage the growth and development of several species of helpful gut bacteria.

References

1. Liao KP, Alfredsson L, Karlson EW. Environmental influences on risk for rheumatoid arthritis. Curr Opin Rheumatol. May 2009;21(3):279-283. doi:10.1097/BOR.0b013e32832a2e16

2. Hotamisligil GS, Erbay E. Nutrient sensing and inflammation in metabolic diseases. Nat Rev Immunol. Dec 2008;8(12):923-934. doi:10.1038/nri2449

3. Scher JU, Sczesnak A, Longman RS, et al. Expansion of intestinal Prevotella copri correlates with enhanced susceptibility to arthritis. Elife. 2013;2:e01202. doi:10.7554/eLife.01202

4. Vaahtovuo J, Munukka E, Korkeamaki M, Luukkainen R, Toivanen P. Fecal microbiota in early rheumatoid arthritis. J Rheumatol. Aug 2008;35(8):1500-1505.

5. McInnes IB, Schett  G. The Pathogenesis of Rheumatoid Arthritis. New England Journal of Medicine. 2011;365(23):2205-2219. doi:doi:10.1056/NEJMra1004965

6. Cooper GS. Occupational exposures and risk of rheumatoid arthritis: continued advances and opportunities for research. J Rheumatol. Jun 2008;35(6):950-952.

Get a Consultation
(650) 539-4545
Get more information via email