How many of my neighbours are suffering from this condition?
While the numbers for general joint pain are difficult to find, rest assured that you are far from alone in this as over four and a half million Canadians suffer from pain such as that of arthritis, including one in every 1,000 children.
What is rheumatoid arthritis?
Rheumatoid arthritis (RA) is a systemic, inflammatory, autoimmune disease that causes destruction of joints over time, making this a chronic condition. It often occurs within families with some studies suggesting a 60-70% genetic risk. The common signs and symptoms are pain and stiffness in the joints on both sides of the body, a loss of function, and potentially joint deformity. The pattern waxes and wanes with those afflicted moving through remission and flare-ups with triggers difficult to pin down.
Any systemic inflammation throughout the body can lead to a litany of conditions with major impacts, but arthritis seems to show changes in the body years before the patient might notice symptoms and seek out treatment.
I'm still not quite sure I understand the gut microbiota, care to explain a bit more?
Absolutely! Imagine a single individual decides to set up camp in the woods, this doesn't have much of an impact on the surrounding environment, but if that small camp swells to a metropolis of a million people, suddenly the environment is heavily impacted. This is similar to what's happening in the gut! Estimates place the number of microbes in the gut at approximately 38 trillion, a number that enables them to significantly impact the body considering they outnumber our own 30 trillion human cells.
These microbes help to synthesize vitamins, modify bile for fat breakdown, play a role in metabolism, and protect the body from the overgrowth of pathogenic microbes. So, any issues or imbalances with this community could spell disaster for the healthy human.
That makes sense, but how would the two connect?
Researchers have looked into how the microbiome, unique to individuals, could provide an additional diagnostic tool for certain conditions. Looking into certain patterns of microbes could point to the existence of conditions. When the healthy gut community is altered or becomes imbalanced, medicine refers to this as dysbiosis. In those with RA, there appears to be a low diversity of microbes and higher rates of dysbiosis.
In animal studies, researchers induced rheumatoid arthritis by disrupting the gut of the test animals. This led to an increase in the levels of pro-inflammatory agents known as cytokines which travel to lymphoid tissues around the body. This can induce the production of antibodies that target the individual's own body, eventually leading to autoimmune disease. The research also shows that patients with dysbiosis produce a decreased amount of Treg cells, cells that help maintain the immune system and prevent autoimmune conditions.
Are there certain species of bacteria that are different in those with RA?
The healthy human gut contains many species with the most abundant being Bifidobacteria, Lactobacilli, and others. Those with untreated RA have shown heightened levels of a species known as Prevotella copri and lower levels of Haemophilus than those treated.
What about using probiotics to battle the symptoms?
The literature here is still quite young as scientists work to determine which strains best benefit which conditions. Gut-targeted medicine is on the horizon, but much work needs to be done. The species Prevotella histicola has shown some protective benefits against arthritis in mice with little to no side effects. An option is to discuss microbiome testing with your primary care provider where you provide a stool sample to labs that have the technology to determine the species living in your gut. This could help them determine a more appropriate care plan that's specifically targeted at your own unique community.
Are there any other solutions for helping alleviate my pain?
By encouraging the growth of healthy bacteria, you could influence the pro-inflammatory agents circulating through your joints. These bacteria find it difficult to function and grow in a highly inflamed environment, and as they become more damaged, a vicious cycle occurs. Healthy bacteria are lost allowing pathogenic bacteria to grow, causing further inflammation, allowing these pro-inflammatory agents to circulate through the body and possibly to your joints.
Adding turmeric (Curcuma longa) to your diet can help control inflammation as the spice has been shown to be one of the most potent dietary sources for anti-inflammation. It has also been shown to mildly dilate the blood vessels which could help bring more nutrients into the joints and flush away waste. Reducing the inflammation in the gut also allows for the appropriate uptake of nutrients which could nourish the joints and prevent a worsening of symptoms.
Furthermore, for those seeking symptomatic relief, adding a daily dose of an herb known as Harpagophytum procumbens, or Devil's Claw, can bring the relief you need. The harpagosides, the active constituent of the plant act as an anti-inflammatory. Products such as Joint Pain Relief tablets can provide this benefit, but the European Medicines Agency notes that it could take upwards of 3 months to notice significant benefits as the harpagosides accumulate in the tissues of the body with patients noticing decreased pain and increased joint mobility with consistent use.
References:
https://www.ema.europa.eu/documents/herbal-report/final-assessment-report-harpagophytum-procumbens-dc/harpagophytum-zeyheri-decne-radix_en.pdf
https://www.nature.com/articles/nm.3914
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602494/
https://www.ncbi.nlm.nih.gov/pubmed/25319745
https://www.ncbi.nlm.nih.gov/pubmed/27160622/
https://www.ncbi.nlm.nih.gov/pubmed/27337150
https://www.ncbi.nlm.nih.gov/pubmed/28275210
https://www.ncbi.nlm.nih.gov/pubmed/28914373
https://www.ncbi.nlm.nih.gov/pubmed/29302905
https://www.rheumatologyadvisor.com/rheumatoid-arthritis-advisor/gut-microbiome-ra-connection/article/740897/
https://www.sciencedirect.com/science/article/pii/S2095809917301479