Rheumatoid Arthritis Linked to Gut Germs

Cynthia Bailey, MD|November 19, 2013

arthritis and probiotics

Can 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:

Photo: Thanks and Gratitide to HandArmDoc

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