I get asked all the time about whether going gluten-free will help arthritis symptoms. Perhaps unhelpfully, I always say that it is a tricky topic. Why? Well, generally the evidence shows that for most people eating gluten doesn't have any effect on arthritis. Having said that, everyone is different and some people feel that avoiding gluten helps their arthritis symptoms or digestive problems.To help you decide what you think, here is a quick low-down on gluten and arthritis.
Why avoid gluten?
Gluten is found in wheat, rye and barley. People with the auto-immune condition, coeliac disease, have to cut out gluten to avoid damage to their gut. Some people can also have a wheat allergy, which means that they get swelling and hives almost immediately when they eat wheat.
A gluten sensitivity or intolerance is different from both of these conditions. It is a more delayed response by the body to eating gluten and may cause a wide-range of symptoms, including IBS.
What about arthritis?
Anecdotally, some people do find that cutting gluten out helps their arthritis. However, the evidence varies:
- Osteoarthritis - there is no reliable evidence for any kind of a link between primary osteoarthritis (as in not caused by another condition) and gluten.
- Inflammatory arthritis (rheumatoid, psoriatic, ankylosing spondylitis) - I couldn't find link between eating gluten and developing rheumatoid arthritis. But, coeliac disease is more common in people with auto-immune disorders, including arthritis, and some people with coeliac disease develop associated arthritis.
Gluten intolerance might affect arthritis: a group of Scandinavian researchers have repeatedly concluded that a vegan or vegetarian gluten-free diet improves inflammatory arthritis. However other research hasn't backed this up and it's not clear whether it's avoiding gluten that helps or the other diet changes, like cutting out meat. A review of the effect of diet on rheumatoid arthritis concluded that restricted diets didn't have any benefits and that cutting out so many foods meant some patients were at risk of nutritional deficiencies.
What should I do if I think I have a gluten intolerance?
If you think gluten might be aggravating your arthritis then a dietician or registered nutritionist can help you identify if you have an intolerance and trial cutting gluten out of your diet. If you find when you reintroduce it your symptoms get worse, then you might want to go gluten-free (it's really important that if you think you might have coeliac disease that you don't cut it out until you have been diagnosed as the tests only work if you are eating gluten).
Eating gluten-free can be a challenge; it's hidden in many processed foods so read packets carefully. Advice from a dietician or nutritionist can also make sure that you are still getting a enough fibre and not missing out on any nutrients whilst you adjust to a gluten-free diet.
There are lots of gluten-free recipes on this blog to help you eat healthily if you have an intolerance or coeliac disease. I'd also really recommend Coeliac UK and MedicineNet for further information.