Does Gluten Affect RA?

People who have a wheat allergy may be sensitive to foods containing gluten.  However, it is important to note that it is the wheat contained in foods which causes an allergic reaction, not specifically gluten.  Wheat allergies are acute--within minutes or hours of consumption--and can be very severe.  Symptoms can include swelling, itching, or irritation of the mouth or throat; hives, itchy rash or swelling of the skin; nasal congestion; headache; itchy, watery eyes; difficulty breathing; cramps, nausea or vomiting; diarrhea; or anaphylaxis.
Approximately 3 million people in the United States have celiac disease, an autoimmune disorder of the digestive tract by which eating foods containing gluten results in damage to the finger-like villi of the small intestine and interferes with absorption of nutrients from food.  Celiac disease is difficult to diagnose because the symptoms often mimic other diseases.  More than 300 symptoms may be associated with celiac disease, including bloating or gas, itchy skin rash, headaches, depression, mouth sores, fatigue and joint pain.

Is gluten connected to rheumatoid arthritis?

A dietary link to rheumatoid arthritis has been suspected for decades and the effects of different diets on arthritis symptoms have been reported.  A number of patients with RA may self-report adverse reactions to certain foods, such as cow’s milk or wheat, without showing objective reactivity to these foods upon testing, according to a 2008 study (Lidén, 2008).  Researchers found that perceived food intolerance is reported by RA patients in similar percentages to the general population.  According to a study conducted over half a century ago, researchers determined that rheumatoid arthritis is not related to a gluten-induced intestinal defect (Binder, 1966).

More recent research, however, shows that a gluten-free vegan diet can improve the signs and symptoms of RA compared to a well-balanced, non-vegan diet.  This benefit may be related to a reduction in the immunoreactivity to food antigens that were eliminated by the change to a gluten-free vegan diet (Hafström, 2001).  For RA patients who also experience non-celiac gluten sensitivity, avoiding gluten may improve some of the overlapping symptoms such as joint pain, brain fog, and fatigue.

In another study, a gluten-free vegan diet in patients with RA decreased total cholesterol levels, low-density lipoprotein (LDL), and LDL/HDL ratio.  It did not significantly change high-density lipoprotein (HDL) or triglyceride levels.  The gluten-free vegan diet also induced lower body mass index (BMI) and higher levels of atheroprotective antibodies against phosphorylcholine (anti-PCs) of the IgA and IgM subclasses.  Anti-PCs help to protect against heart disease with an inverse relationship between low levels of anti-PC IgM and increased development of atherosclerosis (Elkan, 2008).

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Gluten and Rheumatoid Arthritis