Gluten-Free Vegan Diet May Help Symptoms of Rheumatoid Arthritis

Quinoa salad with mango, carrots, fava beans, red bell pepper, red onion, corn, coconut and raisins

If you suffer from the often-devastating autoimmune joint disease rheumatoid arthritis, you may have a reason to try a change in diet: a gluten-free vegan diet may improve symptoms in some people who have been diagnosed with the condition, two separate medical studies show.

The diet might not slow the joint damage caused by rheumatoid arthritis — researchers in one of the studies, published in the journal Rheumatology, noted that damage continued to accumulate, but added that the study may not have been large enough to discern any protective effects resulting from the diet.

However, some patients in both research efforts reported that they felt better when eating gluten-free and vegan.

Celiac Disease, Rheumatoid Arthritis Share Links

The gluten-free diet isn't usually used to treat rheumatoid arthritis — instead, it's used instead to treat people with celiac disease and non-celiac gluten sensitivity. Anecdotally, however, some people with rheumatoid arthritis have reported great results from going gluten-free, and some physicians are recommending the diet for their rheumatoid arthritis patients.

There are links between celiac disease and rheumatoid arthritis — both are autoimmune conditions, which means they occur when your immune system mistakenly attacks your own tissues.

Celiac disease is caused by the gluten protein, found in the grains wheat, barley and rye. When you have celiac disease, gluten spurs your immune cells to attack your intestinal lining, causing it to erode.

Meanwhile, it's not clear what causes rheumatoid arthritis, although some researchers have speculated that the body's reaction to dietary proteins like gluten may play a role. When you have rheumatoid arthritis, the damage from the immune system attack occurs in your joints.

Researchers have shown that people with rheumatoid arthritis have a higher-than-normal chance of also being diagnosed with celiac disease.

In addition, there's some evidence that it's possible to be misdiagnosed with rheumatoid arthritis when you really have celiac disease — one common symptom of celiac is joint pain, which sometimes can be severe.

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Gluten-Free Vegan Diet Tested in RA Patients

The two studies that tested a gluten-free vegan diet in rheumatoid arthritis patients both included relatively small groups of people — a total of 27 people following the diet in one study and 22 in the other.

In the first study, conducted in Norway and published in the American Journal of Clinical Nutrition, the researchers first asked the 27 participants to fast for a week to 10 days. Next, they followed a gluten-free vegan diet for three-and-a-half months, and then followed an "individually adjusted lactovegetarian diet" for another nine months.

Over the course of the study, the patients in the treatment group saw their symptoms and most of their lab results improve as compared to a control group of patients following a typical omnivorous diet.

Meanwhile, the second study tested a gluten-free vegan diet on 22 patients, comparing them to 25 patients who followed a "well-balanced non-vegan diet." Both groups spent at least nine months on their diets.

The study reported that 40% of patients in the treatment group — nine people in total — found their symptoms improved significantly on their gluten-free vegan diets. One person in the control group following a non-vegan diet also reported significant improvement.

The researchers also tested participants for levels of AGA-IgG antibodies to gluten, along with anti-beta-lactoglobulin, an antibody to milk protein. They found significantly reduced levels of both antibodies in the people who responded to the gluten-free vegan diet (which of course would be free of milk as well as gluten), but no significant reductions in the levels of people who didn't respond to the diet, or who were following the non-vegan control diet.

So Is It The Animal Products? Or The Gluten? Or Both?

It's not possible to tell which part of the diet was the most effective, unfortunately — the researchers didn't test gluten-free diets and vegan diets separately.

In addition, the second study notes that the gluten-free vegan diet didn't work for everyone. The study results suggest that the positive effects in a subgroup of those who followed the gluten-free vegan diet likely was due to "a diminished immune response to exogenous [i.e., external] food antigens."

However, the authors said they couldn't rule out the possibility that the improvement resulted from just the decrease in the antibody levels — although it might seem likely that the decreased antibodies to gluten and milk were caused by excluding gluten and milk products, there's no proof of the mechanism involved.

Should RA Patients Consider A Gluten-Free Vegan Diet?

Well, maybe. The studies that looked at this question were small, but had promising results. However, more research will be needed to see what dietary factors might be in play, and to determine more specifically who might benefit from such an approach.

In the meantime, if you think you may want to try a gluten-free vegan diet to treat your rheumatoid arthritis, talk to your doctor first about being tested for celiac disease. The testing won't be accurate if you've already dropped gluten from your diet, since the celiac blood tests look for specific antibodies that will dissipate once you stop eating gluten.

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Castillo-Ortiz J.D. et al. [Anti-transglutaminase, antigladin and ultra purified anti-gladin antibodies in patients with a diagnosis of rheumatoid arthritis]. Reumatología Clinica. 2011 Jan-Feb;7(1):27-9. Epub 2010 Jun 23.

Hafström I. et al. A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Rheumatology (Oxford). 2001 Oct;40(10):1175-9.

Hafström I. et al. Gluten-free vegan diet induces decreased LDL and oxidized LDL levels and raised atheroprotective natural antibodies against phosphorylcholine in patients with rheumatoid arthritis: a randomized study. Rheumatology (Oxford). 2008;10(2):R34. doi: 10.1186/ar2388. Epub 2008 Mar 18.

Kjeldsen-Kragh J. Rheumatoid arthritis treated with vegetarian diets. American Journal of Clinical Nutrition. 1999 Sep;70(3 Suppl):594S-600S.

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