I have heard a lot about many patients of Rheumatoid Arthritis condemning the use of dietary changes in management of their RA conditions. Some of them have never in the first place believed that diet and food allergies play a part in their autoimmune disease, while there is another group of them who tried dietary modifications but did not witness any improvements to their conditions hence they begin to be skeptical and lose confidence with this approach of RA self-help.
So, what could have been the reasons why restrictive diet is working for some people but not so well or not at all for others?
1) You blindly follow certain non-customized/uniform diet plan that has proven to work well for others
I had once made the same mistake of blindly following whatever diets that have been said to work very well for many others with RA. These include but not limited to McDougall’s diet, Specific Carbohydrate Diet (SCD), the Gut and Psychology Syndrome (GAPS) diet and Paleo. These diets have many things in common. They all advocate the use of fresh, real foods such as starch, fruits, vegetables and meats, while all processed foods and grains are not allowed. They are all ‘hunter/gatherer’ diets to a large degree. Others follow another versions of lactose-free, dairy-free, grain-free, gluten-free or even nightshade-free diets. I’d also followed these diets before but none of them, in their own rules, work for me. (*Ps. I do not mean to trivialize the efficacy of these diets. I acknowledge that they do in fact work for many people out there for their purposes and importantly, they promote healthy eating away from inflammatory diets. Just that, for diets specific to RA, I’ve formed my own opinion on whether these diets may or may not work). It took me months after months of switching from one diet to another, following specific meal plans from time to time, to test out what worked and what did not.
Gradually, it had only become the more clearer to me why most of these diets did not work for me at all. The reason is simple, because the diet is not customized and individualized enough. There is no ‘one size fits all’ diet for everyone because we are all different in terms of chemical, biological and psychological make-ups and for the very reasons that we are allergic and intolerant to different foods and environmental factors. What are okay for another person may be a toxin or poison to you. For instance, brown rice has been purported to be fairly ‘safe’ for most people with allergies but this is exactly one of the very food I’m highly allergic or intolerant to. Yet, without knowledge of this fact, I’m consuming brown rice as if it is one of the safest food for me in the world. Apart from these, you may tolerate a cooked food while same food eaten raw can produce symptoms.
Remember, not all foods that are working fine for other people with RA are good for you. Perhaps like myself, you may have food allergies to even the healthiest of foods, such as vegetables and fruits.
2) They overlook hidden allergenic ingredients in certain foods and supplements
While blood tests such as RAST, ELISA or ALCAT can easily help us to pinpoint and identify specific allergens that aggravate our RA condition, they are not all the answers we are seeking for. At best, they cover only as many as 200 foods and additives items; but what about the rest of the foods that are not covered in these blood tests? The only test that we can conduct and answer all our questions is therefore very obvious, the Elimination Diet.
Performing an elimination diet to detect the problem foods takes dedication, time and discipline; and the whole daunting process can be most frustrating. Therefore, this can be the very reason why diet has been working for some but not the others – the real relentless efforts in trying vs a lack of trying. For someone who has performed a proper elimination diet, as correctly and comprehensive as it can be, the person will know that this isn’t easy but the effort really pays off. The results differentiate who get well and who do not; because a well planned and conducted elimination diet gets to allow you to avoid hidden allergies in ingredients of certain foods and even supplements that you are taking day in day out. You may think that you are allergic to the noodles but in fact, you are actually allergenic to the MSG that is found in the gravy. Therefore, hidden additives can be as much of a problem as the foods themselves are for you.
The following foods account for some 70%-80% of food-allergic reactions in people with common food allergy problems. They are milk, eggs, peanuts, soy and wheat (gluten).
(a) Milk Allergy – Occurs when our bodies react to proteins in cow’s milk, casein and whey. Milk protein may be a hidden ingredient in a variety of foods including:
- milk and its derivatives
- kosher dairy
- powdered milk
- evaporated milk
- condensed milk
- malted milk
- whole milk, low-fat milk, non-fat milk, skimmed milk
- goat’s milk (some people may be tolerant to goat milk even though they cannot tolerate cow’s milk)
- butter, butter fat and butter oil
- cream, whipping cream
- curds, custards
- half and half
- all cheeses
- many margarines
- ice cream, sorbets, sherbet
- non-dairy creamers,
- many desserts, puddings, chocolates, nougat, etc
- many frostings, creamed foods, buttered foods
- breads, pancakes, waffles, mashed potatoes
- many baking mixes
- packaged cereals
- breading on fried foods
- artificial butter flavoring
- and foods that contain the word ‘casein’ such as casein, caseinate, ammonium caseinate, calcium caseinate, hydrolyzed casein, iron caseinate, magnesium caseinate, potassium caseinate, rennet casein, sodium caseinate, sodium caseinate solids, zinc caseinate
(b) Eggs Allergy – Important to recognise that components of egg may be individually used for specific actions in food preparations. For example, in Japan, hen’s egg lysozyme is used in medications.
The following labels may indicate the presence of egg protein:
- Egg white
- Egg yolk or yellow
- Whole egg
- Powered egg
Other foods that may contain egg proteins are:
- Baked goods eg bread
- Baking mixes, batters
- Bearnaise sauce
- Breakfast cereals, French toast, muffins
- Cake flours, cookies, custards, creamy fillings
- Candy, ice cream, marshmallows, pudding, sherbets, souffles, sweets
- Egg noodles, macaroni, spaghetti
- Hollandaise sauce, mayonnaise, tartar sauce
- Malted cocoa drinks
- Pancakes, waffles, quiche
- Meringues, marzipan,
- Processed meat products eg sausages, meat loaf, bolognaise, etc
Some vaccinations contain egg proteins and pose a risk of triggering an allergic reaction:
- Measles-mumps-rubella (MMR) vaccines may be safe for children with egg allergy though eggs are used to produce them.
- Flu (Influenza) vaccines may sometimes also contain small amounts of proteins.
- Yellow fever vaccine
- Rabies vaccines
(c) Peanut Allergy – Peanuts and tree nuts are responsible for the greatest number of severe or anaphylactic allergic reactions. Individuals who are allergic to peanuts are said to not be allergic to nuts such as almonds, pecans, or walnuts; and these nuts can be substituted for peanuts.This is contradicted by a recent study, which showed that 50% of individuals allergic to peanuts reported allergic reactions to other nuts as well. These findings were not validated by further clinical investigation.
Foods that may contain peanut or peanut oil are:
- Peanut butter
- Peanut oil
- Satay sauce
- Thai and Malaysian foods
- Baked goods, baking mixes, battered foods
- Biscuits, breakfast cereals, egg rolls, cookies
- Margarine, marzipan, pastry
- Vegetable fat and oil
- Worcestershire sauce
Items occasionally made from peanuts:
- Hydrolyzed plant protein
- Hydrolyzed protein
- Hydrolyzed vegetable protein
Different names for peanuts:
- Monkey nuts
- Beer nuts
- Mandelona nuts
- Earth nuts
- Goober nuts
- Ground nuts
(d) Soy Allergy – Due to almost unlimited uses of soy, it is a particularly insidious hidden allergen. As with many other allergens, reaction may also occur to very small quantity of soy protein. Soybean lectin is often an important allergen. Soy products are often purchased as alternative to cow’s milk, often with assumption that a soy-based product is free of cow’s milk protein. This is not always true, hence caution is required when reading labels.
Labels that may indicate presence of soy protein:
- Gum arabic, guar gum
- Bulking agent
- MSG (Monosodium Glutamate)
- Protein extender
- Soy flour, soy nuts, soy panthenol
- Soy protein
- Soy sauce
- Soy bean and soy bean oil
- Vegetable broth
- Vegetable gum
- Vegetable starch
Foods that may contain soy protein:
- Baby foods
- Bakery goods
- Bread, breakfast cereals, muesli
- Burger patties, hamburger patties, hotdogs, pies
- Butter substitutes
- Candy, cakes, chocolates, cookies, desserts, crackers, ice cream
- Canned meat, packaged soups, tuna
- Cheese made from soybeans
- Chinese foods
- Gravy powders
- Infant formula
- Liquid meal replacers
- Meat products such as sausages
- Salad dressings
- Seasoned salt. stock cubes
- Soups, stews
- Soy sprouts
Other sources of contact with soy:
- Body lotions and creams
- Enamel paints
- Printing inks
(d) Wheat Allergy / Gluten Intolerance – Wheat is most rich in gluten, with the other grains containing a lesser mixture of gluten and gliadin. In addition to being present in all wheat-based food products, wheat gluten is frequently added to baked products made from other grains, including those made from soy flour. Coss-reactions, although unusual, may occur between wheat, barley, rye, maize, and rice as well as between the pollens of cereals and cereal flours.
Labels that may indicate the presence of wheat:
- All purpose flour, bleached flour, enriched flour, graham flour, high gluten flour, high protein flour, unbleached flour, wheat flour, white flour, whole wheat flour
- Durum wheat
- Gelatinized starch, modified food starch, starch, vegetable starch, wheat starch
- Gluten, vital gluten, wheat gluten
- Hydrolyzed vegetable protein
- Miller’s bran
- MSG (monosodium glutamate)
- Whole wheat, wheat bran, wheat germ, etc
Foods that may contain wheat:
- Alcohol that is made from grain alcohol – beer, wine, bourbon, whiskey
- Baked goods, biscuits, cakes, cookies, crackers, baking mixes, cream of wheat
- Barley bread, battered foods, gravy
- Breaded meats, breaded vegetables, canned or processed meat, luncheon meats, sausages
- Breakfast cereals, cereal grains
- Candy, chocolate, ice cream, licorice, milk shakes
- Macaroni, noodles, pasta, muffins, tortillas, pita bread, pizza, pies, pastries, vermicelli, waffles
- Malt, barley malt, Ovaltine
- Pies, doughnuts, dumplings, farina
- Soup & soup mixes
- Soy sauce, mayonnaise
- Some baby foods
Similarly, there may be lots of hidden allergen with the supplements that we are taking for treatment of our RA. ‘Hidden’ not for the fact that it is not listed on the label, but that they are often listed right at the very bottom of the bottle, under ‘other ingredients’ in kinda smaller writing. Therefore, take precaution and pay attention to the labels before making your purchase decisions.
3) You may be suffering from combination or synergistic or concomitants food allergies
Say you have ordered your ALCAT blood test which returns your result that identifies your allergies on the severity scales of low, moderate to high. The lab test does a great job in providing a useful rotation diet with your result, which also let you consume some of the less severe food allergens occasionally, on a rotational basis. According to this lab result, you are only mildly allergic to corn, but you can rotate corns by eating them once every 3 to 4 days. So, you enjoy the corns with your favourite banana; and alas, you are starting to feel the flare-ups a few hours later. Obviously your ALCAT is showing that you are only mildly allergic to corns and nil allergy to banana, but why is there such a reaction?
This is what people called a combination or synergistic or concomitants allergies. Do not blame it on the ALCAT test, which is correct to pinpoint that you are actually not allergic to banana by itself. However, what ALCAT cannot tell you and what you do not know is that when you consume corns and banana together, you will suffer a severe allergic reaction.
According to Allan D. Lieberman, M.D.,
“A concomitant food is one which provokes a reaction in a susceptible individual when another allergen – such as a pollen – is present. This means that you can be more reactive or more symptomatic following the ingestion of specific foods during certain pollinating seasons … Synergistic foods are those which, when combined and eaten together in the same meal, can cause an allergic reaction – even though when eaten separately they might cause only a mild reaction or none at all.”
Dr. Jaqueline Krohn (1996) gives us a “heads-up” about foods that are proven to cause synergistic (combination) allergic reactions:
(a) Proven Synergistic Foods
- Corn and banana
- Beef and yeast (baker, brewer, malt)
- Cane sugar and orange
- Milk and mint
- Egg and apple
- Pork and black pepper
(b) Possible Synergistic Foods (identified but not verified)
- Wheat and tea
- Pork and chicken
- Milk and chocolate
- Cola and chocolate
- Cola and coffee
- Coffee and chocolate
Concomitant foods are foods when consumed while someone is exposed to pollen, the lethal combination have been known to trigger an allergic reaction in any forms.
(a) Proven Concomitant Foods
- (Pollen) ragweed & (Foods) milk, melons, bananas and lettuce
- (Pollen) Iva ciliate & (Foods) wheat
- (Pollen) pigweed & (Foods) pork
- (Pollen) grass & (Foods) beans, peas, soybeans, grains, apples, carrots and celery
- (Pollen) cedar & (Foods) beef and yeast
- (Pollen) oak & (Foods) eggs and chestnut
- (Pollen) pecan & (Foods) corn and bananas
(b) Possible Concomitant Foods (identified but not verified)
- (Pollen) dust & (Foods) nuts
- (Pollen) influenza vaccine & (Foods) onion
- (Pollen) Iva ciliate & (Foods) tea
- (Pollen) pigweed & (Foods) lettuce
- (Pollen) oak & (Foods) apples
4) You are severely allergic to anything possible – not just foods or additives or environmental allergens
If you have done them all – ie been really careful in planning and correctly executing an elimination and rotation diets, and you read labels and identify hidden allergens in all foods and supplements that you are taking in and avoid all possible synergistic foods consumption – and still have not shown slightest improvements in your RA condition; then the likelihood is that you can be severely allergic to anything possible.
What I mean by anything possible is referring to the possibility that with RA and Leaky Gut, you are becoming allergic to important nutrients within the foods that you eat, the supplements that you take, the medications you consume to relieve your pain and even your own organs. The extent of your allergies may have expanded to include the following though not limited to:
- Amino acids (eg arginine, glutamine, glutathione, histidine, lysine, tryptophan, tyrosine and valine, etc)
- Vital minerals and vitamins (eg Vitamin A, B, C, D, E, K and magnesium, calcium, sodium, zinc, etc)
- Organs, glands and body systems (eg brain and nervous system, endocrine system, muscles and connective tissues, lymph, blood, etc)
- Body biochemicals (eg neurotransmitters, enzymes, body proteins, peptides, histamine, etc)
Many seriously-ill RA patients may have allergy problems that seemingly take on overwhelming barrage of new unknown sensitivities. While these information may sound absurd to many people and is something that mainstream medicine does not acknowledge, this is however an accepted phenomenon with many NDs well-versed with allergies around the world. Believe it or not, I’m someone with the first hand experience with these.
These are also the reasons why many people take high potency vitamins but do not feel any differences when the same vitamins are working so well for many others. The absorption problem makes this call between individuals. For some of them who have screened their supplements or vitamins with bioresonance machines such as Vega machine, they would probably have been told that certain supplements and vitamins are not doing any goods for their bodies, and advised for these to be taken off from the regimen. The most bizarre of all is the allergies to our own organs or other body chemistry of biological makeups. In my opinion, these kinds of allergies also account for our autoimmune condition, where our body is attacking our own body tissues internally. We often focus on external allergies, when for most part, we overlook or do not know that we should also put our attention to internal allergies.
So, is this the dead end? Are you going to say that, what are the points of telling you all these when there are absolutely nothing you can do about these? Being allergic to foods are bad enough, now that I’m saying that you may be allergic to a whole lot more things you cannot previously imagine possible. Is this going to mean that you are never going to get better? If you want to find out, watch this blog. I’ll get there.
JulieFebruary 2, 2013 at 10:31 pm (10 years ago)
Thank You for posting this information. I was just diagnosed with RA and I am 33 and have always lived a healthy, active life and have eaten clean for the last 3 years. My doctor has me on a GF, DF and staying away from all processed food and refined sugar. When did you start experimenting with your diet? I am on predisone and that helps a bit with the pain, but I just started on medicine that will take up to 3 months to see if they help at all. How did you know when things were getting better from your diet or from your meds? I am keeping a food journal daily also stating how I feel energy and pain level daily. This blog is just what I was looking for! I am REALLY trying to stay off high dose of meds and stronger meds if I can, so thank you!!!
dianaFebruary 4, 2013 at 10:52 am (10 years ago)
Hi Julie, I’m sorry that you have to join our family of RA. Since you have been living healthily, do you actually ponder why you have RA in the first place? If you have not thought about it, I think you should spend some time noting down circumstances or event surrounding the onset of your RA. For me, I’ve been experimenting with diet a few months after my diagnosis. To be honest, I am not into anything holistic or alternative until my RA diagnosis; but as I started to spend more time with reading up and researching, it becomes apparent that alternative approaches can teach me the methods and the ways of true healing from RA. My experiments with diet was very varied; I switched from one diet to another, according to recommendations by people with RA and so-called health practitioners. When these do not help at all, I began to doubt diet and went on many other endeavors; but eventually, I came to the realization that diet does matter; just that my approaches are wrong. After making sense out of what I’d done wrong in the past, I got it right eventually, after one-and-half years later.
Technically, with prednisone, you will see immediate effects. With others like MTX, it takes months to kick in. For me, prednisone worked like wonder; as long as I took it, my pain was reduced tremendously. But I never get on MTX, had been resisting it from the very start.
The best way to know if a diet plays a role in your RA inflammation is always to perform a juice fast or pure water fast. Usually by Day4 or Day5, any food effects would have passed out from your body system. If you are feeling very well, no or significantly reduced pain, high energy level during the 4th or 5th day, then you will be assured that you need to alter your diet accordingly with foods that do not aggravate your RA. With inflammation down, your body can start to heal. Address your causes (leaky gut, food allergies, heavy metal, emotional trauma, etc) with the necessary nutrition, support and supplementation, preservere and you can stay off those high doses of meds in no time.
JulieFebruary 6, 2013 at 3:35 am (10 years ago)
Thanks You!! Yes — I have quetioned why I have gotten it, and unfortunately it does run in my family, however I realize that does not mean I HAVE to be diagnosed with it. If I had to put a trigger to it — I would say the genetics probably gave me a stronger chance of getting it, then stress and being run down with work and life. I often wonder if I had symptoms a few years back that I just ignored? I have not done enough research to see if that happens?
The predisone has helped tremendously with the pain, I agree with you on that!!! I have been on the for the last month and it has helped with my pain, but it has not completely taken it away (although I am trying to only take 1 pill a day vs the 2 I was prescribed) I only take 2 if its unbearlable, but it has not helped with my fatique — and that is just awful most days!!! I started on plaquenil last week — this is the one the doctor said can take up to 3 months to kick in. I was put on this versus some of the other stronger meds b/c my husband and I wanted to have a baby this year — so they said this was the safest option to help slow down or stop the progression of the diease along with allowing me to hopefully live “normal” again.
I am going to take your advice with trying the “diet tests” for lack of a better word 🙂
I am so grateful to have stumbled across your blog! You have such great resources on here!!
dianaFebruary 6, 2013 at 12:34 pm (10 years ago)
Yes, since you and your husband are planning to have a baby, the doctor will not put you on the more popular MTX which most rheumys usually recommend. I radically changed my diet before attempting conceiving – dairyfree, glutenfree, no meats and mainly vegans & fruits-based meals, little seasonings. Basically, I just ate for filling my tummy. And 3 months along, I really got pregnant and it was a healthy pregnancy. My RF factor was down by half by the time I was conceived, so the doctor only prescribed Prednisone since she claims that is the safest during pregnancy. Good news was that I was in remission so I was off pill say 90% throughout my pregnancy. I hope you can successfully conceive and carry as soon as possible. Try changing your diet. What’s the harm of eating healthier anyway? Go alkaline, take more greens, drink more pure alkaline water and let me know how you go down the road. As for the reasons of getting RA, I believe your body has an innate ability to tell you these and it is about finding the ways to tap or access this information. I’ll be away for two weeks and when I return, I will post information about muscle testing. Advanced muscle testing should be able to help you uncover these. Take care now!