Can probiotics help with rheumatoid arthritis?

Rheumatoid Arthritis (RA) is a painful, degenerative condition affecting around 1% of the population where joints stop working and can end up destroyed. For many years research has suggested that it is linked to gut dysbiosis (an imbalance in the gut microbiome that is associated with disease). Comorbidities for RA include hypertension, ischaemic heart disease, osteoporosis and depression.

It’s usually managed with drugs including methotrexate, leflunomide or sulfasalazine or, for some people, hydroxychloroquine. It has been shown that taking some of these drugs modifies the gut flora.

Image courtesy of National Library Of Medicine US, Public domain, via Wikimedia Commons

While researchers have been looking at the potential usefulness of probiotics for at least 20 years and while the evidence base still needs to be strengthened, it is becoming clearer that probiotic supplementation, especially with L. Casei, offers promising benefits to people with RA, as too may eating fermented foods in general. You can find Lactobacillus Casei in raw milk, live yoghurts and some cheeses and it is also used to ferment green olives. Species related to L Casei can also be found in fermented sausages, vegetables, wine, and occasionally sourdough.

For a summary of the evidence, including exactly how probiotics can physically change the immune system, from open access journal Frontiers in Pharmacology, click here: 

Some studies have demonstrated benefits for eating fermented foods, including anti-oxidant, anti-microbial, anti-fungal, anti-inflammatory, anti-diabetic and anti-atherosclerotic activity, according to PubMed click here

Figures from NICE, 2020

  • About 1% of the UK population are confirmed as having rheumatoid arthritis (RA) is about 1% of the UK population — it is the most common inflammatory arthritis.
    • Around 1.5 men and 3.6 women per 10,000 people develop RA per year in the UK.
    • RA onset can occur at any age, but peaks between 30–50 years. 
    • The peak age of incidence in the UK for both men and women is the 70s.
  • RA is 2–4 times more common in women than in men.
  • Approximately one–third of people stop work because of RA within 2 years of its onset and this increases thereafter.

Reference click here