What to do about arthritis flares!

Joint Pain

“I have arthritis and am sometimes in constant pain. I thought maybe it was gluten related so I eat gluten free bread but that didn’t help. The doctor says I have irritable bowel syndrome (IBS) and none of the medicine is working. What do I do?”


This post appeared first in the Montgomery County News. However, since the editor (justifiably) believes there is a limit to the amount of space I can use, that column is shorter. There is more information here than was published in the paper.

I have often heard some version of this question. And I have also done significant research beyond that discussed in my book. As my readers know, food is very commonly the root cause of inflammation. And I am an advocate of trying an elimination diet which means you figure out some food that might be the problem, eliminate that food and see what happens. This reader tried to do just that by eliminating glutens in bread but that didn’t seem to help. I should point out that she undoubtedly missed a veritable mountain of gluten sources by just eating gluten free bread.

I am not a doctor and my book consistently encourages a sick person to consult with their doctor so I am pleased that the reader has done that. But the world is full of people who take lots of medicine but the problems don’t go away. So when what you are doing doesn’t work, do something else! But what else????

If gluten is not the problem, what is?

Offering the benefit of my research, I suggested that the problem could well be another protein (certain lectins) in all grains, legumes, and nightshade vegetables (and a few other things). Tomatoes, peppers, and potatoes are an incomplete list of nightshade vegetables; click here for more detail.   I have seen eliminating these foods to be amazingly successful for many people with autoimmune diseases. I cannot describe how nice it is to hear someone say, “I don’t remember when I have felt this good.”

Chapter 12 in my book, Enzyme Deficiencies, Autoimmune Diseases, and Allergies, lays out a pretty broad spectrum of possible factors that can mess with our digestion. And constant pain and bad digestion always means inflammation. Arthritis (and lots of other conditions) are autoimmune diseases that most often appear with chronic inflammation. All autoimmune disease come saddled with nasty flareups.

When medication doesn’t work

Doctor’s are usually good at diagnosing a condition but can’t find the cause, leaving the patient to cope when medication fails to resolve the symptoms and prevent recurrences. It may be difficult for a doctor to figure out the cause of an autoimmune condition (for which there may be an underlying genetic basis) but the ongoing existence of digestion problems suggests that diet needs to be considered. So far I haven’t found many cases when diet didn’t need to be considered.

What is autoimmune disease?

What we do know about autoimmune disease is that your immune system is attacking something in your body. In the case of arthritis this is usually joints but the spectrum of autoimmune condition possibilities is broad and complex, sometimes organ specific. This link shows how broad the spectrum and will, quite frankly, blow your mind.   But in every case, your immune system has gone rogue for some reason.

This frequently happens because some plant (and even sometimes non-plant) protein in your food is not digesting completely and is escaping your intestines in complicated ways. Dr. Amy Myers does a nice job of explaining that in this link. Thus we have inflammation.That improperly digested food is NOT supposed to be getting out of your intestines. Your immune system is on alert for inflammation and supposed to catch stuff that isn’t right and get rid of it. Or at least it tries. But sometimes those foreign proteins showing up in your blood stream look like other natural proteins in your body and your system gets confused.

Your immune system usually responds to the bad stuff and ignores everything else. However, when it can’t tell the difference, an immune response to something not bad (like your fingers or knees) can occur. This means that anytime that particular protein arrives in your intestines, your immune system goes on-ready, attacking not only what it considers a foreign protein with a history of being a troublemaker (the food) but also the natural body protein (in this case, joints) that unfortunately looks like it. This would be described as a “flare”.  Read here for a more technical description.

Phytic Acid and Lectins

The logical first step to relief is to figure out what that protein might be and stop eating it so your immune system will stand down. 

Both phytic acid, which is explained in my book, and the troublesome lectins described above are designed to protect a plant seed from early germination, provide nutrition for the seed’s growth, and keep animals and insects from eating the seeds. So it shouldn’t be much of a shock that foods containing these two don’t digest very well. The environment in your intestines doesn’t lend itself to growing plants.

My book’s chapter, What the Heck is Phytic Acid?, explains how to minimize the problems with phytic acid. Unfortunately, those tactics may have no effect on lectin. The only fix is to eliminate lectins from your diet.

Eliminate and reintroduce food.

Thus the goal is simple. Eliminate all grains, legumes, and nightshade vegetables and see if you get a miraculous recovery in a few weeks. (If you aren’t really sure what a grain or legume is, then you have a lot to learn and should read my book, It’s All About the Food). Take note that when these foods are eliminated in a diet, gluten goes out with the lectins as a natural course.

If eliminating those food does not accomplish significant improvement, neither lectins or gluten are the problem. But, of course, something is the problem.

On the other hand, if you are amazed by how good you feel after eliminating sources of lectins, then you can try to gently add the nightshade vegetables back in, one at a time, to see if your recovery holds. If you have a autoimmune response you may well be avoiding these foods for the rest of your life — or until you decide the misery and long term consequences are worth it.

If you have several autoimmune conditions (which isn’t at all uncommon) or you can’t even imagine how to go about this, then you might prefer to have direction on how to accomplish elimination and reintroduction of foods. I can highly recommend Dr. Myers’ book, The Autoimmune Solution, and Dr. Tom O’Bryan’s book, The Autoimmune Fix. Both books are easy to read and provide good direction.

Don’t continue suffering with an autoimmune condition. Do something about it.

Pat Smith is the author of “It’s All About the Food,” a book that guides nutritious food choices as the way to avoid illness and maintain a healthy weight. Pat is a resident of Montgomery County, president of Ouachita Village, Inc board of directors  (Montgomery County Food Pantry), chairman of the Tasty Acre project, and member of the Mount Ida Area Chamber of Commerce board of directors.