Rheumatoid Arthritis Linked to Gut Germs

arthritis and probioticsCan rheumatoid arthritis be caused by not enough good probiotic bacteria in your gut?

It’s a seemingly wild leap, but a study just published in eLife suggests this is a plausible scenario. Researchers at the New York University School of Medicine found that patients with new-onset rheumatoid arthritis were more likely than other people to harbor the pro-inflammatory intestinal hooligan germ called Prevotella copri in their gut. They also had fewer good gut bacteria such as Bacteroides.

The full explanation is probably more complex than just the population of gut germs (also called the intestinal microbiome), but the connection is fascinating. Scientists agree that the full explanation for this debilitating condition probably involves a perfect storm of factors that includes a genetic predisposition, environmental and lifestyle factors (such as smoking), and the gut germ population. What I find intriguing is that it’s counterintuitive to connect your gut germs to your joints, but then, other conditions such as heart disease, obesity, asthma, and allergies have already been linked to your gut bacteria.  The bottom line for each of us is that maintaining a healthy probiotic population in the gut, which I call microbiome stewardship, is starting to look like an important part of health maintenance along with exercise, a healthy diet, and healthy lifestyle choices.

The connection between the human microbiome and disease is an exciting new frontier for medical research. It’s one that I expect will have far-reaching answers for more and more life-altering diseases that doctors and patients have been confounded by. It’s also a stark contrast to the “scorched earth” approach that doctors and patients have taken to the use of antibiotics in my medical career; we’ve looked at germs as scary and bad, and we’ve liberally used broad-spectrum antibiotics to kill them off. Now, we are learning that this alters the important balance of the beneficial human microbiome, perhaps to the detriment of good health. I find our new understanding refreshing and long overdue, and one that makes a lot of sense to me.

It’s why you should care about maintaining a healthy gut probiotic population (called a microbiome). When you put good germs into your gut through your diet then there is not as much room for health-destroying germs to thrive. I like to think of the gut like a crowded bus, if you have it filled with well-behaved germs that promote a healthy balance then the hooligan germs that wreak havoc with your health can’t fit in. You put the good germs in by eating probiotic-rich/fermented foods.

What are good sources of probiotic-rich foods?

Probiotic-rich foods include yogurt with live cultures, kefir, barrel-fermented sauerkraut or pickles with live cultures (you will find these in the refrigerator section of your natural foods store), kimchee, kombucha, etc. Remember, cooking and sterilization kills the good probiotic organisms so you need to read the product label to confirm that food was not processed in a way that kills the good probiotic cultures.

You can also take a high-quality probiotic supplement, but remember probiotic germs are alive and only work for you if you take a probiotic preparation that has kept the organisms alive. I have my doubts about probiotic capsules packaged and stored at room temperature on a store shelf and recommend that you ask an expert at your natural food store to recommend a high-quality supplement.

Probiotics are a subject I’ve been writing about for years. To see more of what’s caught my attention and what I personally have chosen to do for my own intestinal microbiome stewardship please read these posts:

Are Probiotics Good For Your Health?

Dermatologist’s Recommedation for Natural Skin Health; Kefir, the best probiotic for healthy skin

Dermatologist’s Recommendation for a Probiotic Powerhouse, Home Brewed Kefir

Photo: Thanks and Gratitide to HandArmDoc

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3 Responses to “Rheumatoid Arthritis Linked to Gut Germs”

  1. Kathy K November 19, 2013 at 8:03 am #

    Thank you so much for the refresher on this subject. I have tried so many things for my arthritis that I tend to forget what I really should be doing. Thanks for jogging my memory. I hope you are healing fast and well. I think of you and your office all the time and miss all of you.–Kathy

  2. Seppo December 3, 2013 at 10:07 pm #

    Dr. Bailey, I’m curious of the reasons you recommend kefir and fermented foods. I understand that they contain probiotics, but I’m not sure we really know what strains those foods contain. As I understand it, probiotics can be helpful in gut problems (and there’s some research suggesting fermented dairy products can have an effect on acne), but the benefits seem strain-specific. How do we know, or do we even know, that fermented foods contain helpful strains. It’s possible that they contain strains that compete with the native probiotics in the gut and possibly even make things worse.

    Curious of your take on this.

    Thanks for the informative posts! It’s nice to see dermatologists move beyond antibiotics :)

  3. Cynthia Bailey December 5, 2013 at 3:13 pm #

    We are just noticing the tip of the iceberg when it comes to probiotics, including the strain specific information in my opinion. I think the story is going to become much more complex as it evolves. That’s why I look at what humans have adapted to utilize over thousands of generations, and that’s the probiotic rich foods of various cultures around the world. Kefir is one of those foods.