Something To Ponder

[tex]

Hi All,

For at least several years, I've been trying to resolve a question that keeps going through my mind. The answer to this question cannot be found in the literature, of course, because these are uncharted waters. Consequently, I don't expect anyone to be able to verify their answer with scientific research - I'm just looking for good, educated opinions. And who would have a better qualified, more knowledgeable opinion, about food-sensitivity issues, than the members of this discussion board?

Here's the question:

Disregarding osteoarthritis, (worn out joints), gout, and trauma, (physical joint injury), is it possible to develop arthritis symptoms from any cause other than food-sensitivities?

I believe that the answer is no. IOW, I believe that food-sensitivities are the cause of all arthritis symptoms, (allowing for the exclusions mentioned above). I have a personal interest in this, because I had major arthritis problems before I adopted the GF diet. Several of my joints were not only stiff, and swollen, but they were also red and obviously inflamed. They hurt all the time, and they were extremely painful to touch. If I accidentally bumped one of them, it could literally bring me to my knees. And I'm not talking about bumping a knee - I'm talking about bumping an inflamed elbow, or finger joint. Anyway, you get the picture - I had arthritis, and it was bad.

It took a while, but the diet resolved all that, and my arthritis disappeared. I still have proof that I once had arthritis, in the form of a couple of crooked, twisted fingers, that were permanently deformed, but once the diet took effect, they stopped changing.

Most of you know that after I had been in remission for a couple of years, I determined that casein, (and various other foods), no longer caused me to have D, bloating, or any other apparent MC symptoms. So, like most undisciplined mortals, , from time time, I would indulge in a bit of cheese, or an occasional candy bar, (with milk chocolate), or even a bowl of ice cream - the real stuff. They never seemed to cause any digestive system symptoms, but now and then I would notice that a little arthritis seemed to be creeping back in. I would cut all that stuff out for a few months, but the symptoms never totally resolved, and whenever I tried a challenge, I couldn't see any reaction.

So, I would shrug it off, and gradually fall back into my slovenly habits. I still avoid casein most of the time, but for the better part of a year, now, I usually eat a bowl of ice cream once a week, and some days, I'll eat a candy bar, (usually a Snicker). (I know - absolutely disgusting behavior, but I thought I was getting away with it).

I notice that I occasionally wake up during the night, or in the morning, stiff and sore - sometimes with a backache. It's not osteoarthritis, because the stiffness and pain goes away with exercise, or even just a little flexing. The problem was much worse, when I was taking a statin. Before I quit taking the statin, my fingers would sometimes lockup, and it was impossible to flex them, until I forced them down, with the other hand. Sometimes this would happen with one hand, and a couple of times it happened with both hands, at the same time. After I stopped taking the statin, it took about 6 to 8 weeks for that problem to slowly go away, and it hasn't happened a single time, since then, (I've been off the statin for 7 months, now). Of course, maybe I have some sort of permanent damage from the station, but while statins are known to cause stiffness and muscle damage, I'm not aware that they're associated with arthritis, but apparently this has never been studied.

Maybe it's just my imagination, but one finger joint, (the distal interphalangeal joint of my index finger, on my right hand), seems to be slowly conforming to the distorted shape of the finger beside it, (which was damaged before I adopted the diet). Not only does that joint appear to be growing crooked, but it is also twisting, (like the other finger). It doesn't seem to be inflamed, (no pain), but the joint is somewhat swollen.

All this makes me wonder if casein, (or possibly something else), is causing a low-level redevelopment of my arthritis symptoms. I've already cut out all sources of casein, but the thought just occurred to me that maybe I would be better off if I kept eating it, and ordered an Enterolab test, instead. In fact, maybe I should up the dosage, to make sure that I get a good, decisive, test result.

I never was tested for casein, (nor gluten), because back when I was reacting, I found that I reacted to lactose-free products that contained casein, so I just assumed that I was casein-sensitive, and I cut it out of my diet. I did order a test for soy, eggs, and yeast, and all three of those results were negative.

OK, so after all that long-winded prologue, now you see why I'm curious about the origin of rheumatoid arthritis. Do you have any thoughts on this issue?

Thanks for your time and your insight.

Tex

[Sheila]

I don't know how Hebenden's nodes are classified except as a form of arthritis. They are located on the last joint of my fingers, very painful when growing. Once the joint is fully distorted and stops "growing" the pain goes away. My mother had Hebenden's nodes and I've inherited them. When I started taking Celebrex I noticed the nodes stopped growing and the pain also stopped. When I stopped the Celebrex, the nodes started growing again. I'm still taking Celebrex, although I know I should stop as it doesn't help my intestinal problems. It does help the pain in my (osteo)arthritic joints. I wonder if I stop the Celebrex now, being GF for at least 3 months, how those joints will react. Interesting question, Tex. I'll stop the Celebrex as of today and watch to see what happens with my fingers and other painful joints. Let you know what happens.
Sheila

[dgshelton]

Tex - That's a very interesting question. My husband gets red swollen joints from time to time. He believes it is rheumatoid arthritis, but it has never been formally diagnosed as such. I have wondered if it is psoriatic arthritis because he also has bouts with patches of really dry itchy skin. It is usually in his feet or knees, not in his fingers. I definitely believe psoriasis is food sensitivity related.

Hugs,

[MBombardier]

Tex, since my enterolab tests (including for casein) showed no intolerances at all I have had to do my own challenges from time to time. I am a cheese addict, but I went dairy-free a few weeks ago as I really got into the paleo/primal way of eating.

I noticed I was feeling much better generally, so this weekend I indulged in some cheese to see if I could eat cheese, or if it did a number on my gut. It didn't bother my gut, but my right wrist, which has some cartilage damage, and my right thumb, which hurts significantly for no apparent reason, and my knees are all reacting like I had gotten into some nightshades.

So I suspect that dairy causes some inflammation in my system, which may bear up your hypothesis in some manner. My mother had arthritis, and Heberden's nodes, and my brother has arthritis, but so far, I don't. I do seem to be developing a node on my right middle finger, but it's been there without much change for a long time. Perhaps with my new way of eating, I won't have to deal with that.

[Gloria]

I have noticed that now that I'm back on Entocort, the pain in my finger joints has gone away again.

Gloria

[Zizzle]

Tex,
You may be familiar with the Dr. Brown protocol for treating RA, which involves pulsing of antibiotics, usually Minocin. Many people with crippling RA report marked improvement or remission, despite the discomfort of Herxeimer reactions. The thoery is that RA is caused by mycobacteria that make their way into the synovial fluid throughout the body - hence the bilateral nature of RA. Is your joint pain bilateral? I thought that was needed to prove RA status? Anyway, you know I'm a believer in bacterial or viral origins of autoimmune diseases. We all agree they can be triggers of disease, but I believe many continue to live inside us, out of the reach of antibiotics and modern screening methods. I do believe that food sensitivities can cause joint inflammation (or at least perceived pain) too, as evidenced by my lower back and hip pains that only return with diet slip-ups. My question is, is there permanent damage in those joints, or is it only transient inflammation caused by the food sensitivity? Your permenently crooked joints point to damage, but was that food-related or something else that is simply aggravated by the sensitivities?

[sarkin]

I'd like to throw gout into the food-sensitivity pile, too.

I went with "almost always" - not just because I like to hedge my bets

Tex,

That's really interesting... and something for me to keep in mind when I do my egg experiment. We of course are aware of the many non-GI ramifications of gluten sensitivity. Seems like we need to pay particular attention, in the case of dairy, to joint symptoms.

I'm leaving dairy on the "never" list, for now. (And will reconsider whether I want to take a chance on eggs, down the road.)

I'll be interested to hear whether your finger symptoms settle down... hope so!

Love,
Sara

[patc73]

Sara,
Remember we said we'd try an omelette someday? I've been feeling much better lately, taking Culturelle and avoiding all gluten and dairy. (Norman has visited several times!) So I tried a tablespoonful of scrambled eggs, and I was fine! When I'm "normal", my joints don't hurt, but when I'm flaring, EVERYTHING hurts: joints and muscles, with fatigue and even fever. So I'll try to be good and stay off the dairy and gluten. I've been diagnosed with osteoarthritic thumb joints, and I have symptoms sometimes of rheumatoid arthritis, especially in my hands and shoulders. My sister has rheumatoid arthritis also. (She can't have dairy, and is tentatively trying going gluten-free.) With me having two gluten-sensitivity genes, she does too, so she's paying attention to what's happening to me (I'm the oldest!)

[sarkin]

Pat,

How great that your sister is receptive! (My little brother... not so much - fortunately he's in pretty good health at the moment.)

I never had *horrible* symptoms from eating eggs, as I do from dairy and gluten. And yes, I do remember our dream of adding them back! I am going to wait longer, because I think the stronger and more healed I am, the better the chances that I'll tolerate them. And I think I will start with the yoke only, since I know for sure that I have had antibodies to egg whites.

I hope I have your luck, when I give it a try,

Sara

[tex]

Zizzle,

No, I'm not familiar with Dr. Brown's protocol for treating RA. IMO, though, the fact that an antibiotic stops RA symptoms does not constitute proof that RA is caused by bacteria. Minocycline has the most significant effects on the brain, of any of the tetracyclines. Also, anyone taking any of the tetracyclines is warned to avoid prolonged or excessive exposure to direct sunlight, so obviously Minocin significantly enhances photosensitivity. All that suggests that the antibiotic might be capable of affecting a wide range of chemical reactions in the body, (other than simply suppressing bacteria populations). Photosensitivity can affect, for example, vision, vitamin D synthesis, cholesterol sulfate synthesis, cancer risk, for lupus patients it can cause major skin problems, and who knows what else?

That's the one fly in the ointment about my arthritis symptoms - they fit every every criteria, except bilateral presentation. Both knees were affected, (though unequally), but only one elbow, (left side), and only fingers on one hand, (right side). It can't be osteoporosis, because hard work does not make it worse - the pain subsides with hard work. Of course, it's probably a unique form associated with food-sensitivities, as we've always understood, but medical science has no category for it - there's only osteoarthritis and rheumatoid arthritis. So what are we going to call it - it most closely resembles RA. As I said, if fulfills every criteria except a bilateral pattern.

My question is, is there permanent damage in those joints, or is it only transient inflammation caused by the food sensitivity? Your permenently crooked joints point to damage, but was that food-related or something else that is simply aggravated by the sensitivities?

I see what you're saying, but I'm not sure I can answer that question. I've always adhered to the "if it quacks like a duck" philosophy. The damage began before I changed my diet, and it seemed to continue for approximately 4 and a half years after I eliminated gluten, which would be about 3 years after I cut out the other food-sensitivities. As my gut healed, it slowly faded away. That implies that it could be associated with a malabsorption issue. However, it could also simply be associated with antibodies to food-sensitivities, still circulating in my blood, (remember, I may be a celiac), because my Enterolab test showed that I still had significant small intestinal damage, over 3 years after starting the GF diet, (presumably because the damage was massive to begin with, and it takes a long time for that level of damage to heal. That level of damage would also be associated with a high starting level of antibody production, which would virtually guarantee a very long interval of time before antibody production would decay to the point where anti-gliadin antibody production approached a more "normal" level.

FWIW, my RF test, (rheumatoid factor), was negative when it was checked in August of 2009, but, of course, only about 80% of adults with RA show a positive RF result, anyway, and I wasn't symptomatic, at the time of the test.

Tex

[Zizzle]

My RF test results have been in the high 20's and haven't budged in 6 years, even after a year on the GF diet (when the ANA levels finally went down from 4-alarm status). I don't know what to make of that, but every joint pain makes me worry about what comes next!! The low back pain should be the result on sitting at a desk all day and having weak abs. But I fear something like ankylosing spondylitis when it really acts up. Maybe my joint laxity plays a role too. My rheumy said people with loose joints are more prone to RA, not sure why.

Here's a list of possible types of arthritis that will make your head spin!! It sure doesn't have to be RA. Probably some rare form, fitting of our "rare" MC!!

http://www.arthritis.org/types-arthritis.php

[Zizzle]

A smoking gun?

Gut-mediated Autoimmune Arthritis Treated with Antibiotics

http://www.medscape.com/viewarticle/734789

At the Symposium on Autoantibodies held in Dresden, Germany, in September 2009, Professor Yehuda Shoenfeld from Tel Aviv University proposed that "all auto immune diseases are caused by external agents (drugs, viruses, bacteria, parasites)." This conjecture implies that sensu stricto there are no 'autoimmune' diseases; rather, these conditions are caused by molecular mimicry or crossreactivity between external agents and self molecules which may even involve a single 'self ' amino acid such as tyrosine.

Hmmm, some may have little gut involvement?

The findings of Wu et al. [2] lead to the question of which human autoimmune arthritic disorders these results could apply to. Tetracycline is useful in the treatment of some patients with RA;[10] however, this condition is not associated with the elevated levels of serum IgA antibodies that are characteristic of a disease caused by an agent acting across a gut mucosal surface. this caveat suggests that RA is not a gut-mediated autoimmune disorder but that it is more likely to be associated with an upper urinary tract infection in which the microbe is acting across a ureteric surface.[9] in addition, since urinary tract infections are common in women (particularly elderly women), this etiology might account for the greater prevalence of RA in women than in men.

So are food sensitivities only symptoms of a larger immune response against pathogens, or should they be considered pathogens in and of themselves, since they have the ability to launch an immune response?

[tex]

Here's a list of possible types of arthritis that will make your head spin!! It sure doesn't have to be RA. Probably some rare form, fitting of our "rare" MC!!

I stand corrected. They've got a type of arthritis to suit everyone, no matter how finicky. Strangely, they left off the arthritis associated with the IBDs. Whoever compiled that list is probably in cahoots with the crew that's proposing all those zillions of code changes. But are they all actually unique forms of arthritis, or simply the same syndrome, expressed in a different location, or by a different mechanism? Most likely, the treatment is the same for most of them - if it walks like a duck, etc.

Concerning your other post:

The observation that, "all auto immune diseases are caused by external agents (drugs, viruses, bacteria, parasites).", is not exactly news. That's been known for a long time, (but like a lot of facts in medicine, it has apparently never been accepted). He left out the most important agent, however - food sensitivities.

Regarding this claim:

This conjecture implies that sensu stricto there are no 'autoimmune' diseases; rather, these conditions are caused by molecular mimicry or crossreactivity between external agents and self molecules which may even involve a single 'self ' amino acid such as tyrosine.

Well sure, obviously, in the strictest sense, there is no such thing as an autoimmune disease, if you're going to ignore the fact that molecular mimicry and cross-reactivity between external agents and self molecules are autoimmune reactions. That's simply altering the definition of an autoimmune disease, by redefining an autoimmune reaction. An example of the cross-reactivity between external agents and self molecules would be a lectin, (such as an alpha gliadin peptide), attaching to an epithelial cell in the gut. If the immune system catches that lectin, it's going to flag it with a antibody, (an anti-gliadin antibody, in this example). This will provide a marker for T-cells to destroy that combination. If the lectin successfully attaches to an epithelial cell, then any T-cell that happens by is going to perceive the combination as a target, and try to destroy the lectin, (the gliadin peptide), and the epithelial cell to which it is attached, as a single unit. If that doesn't qualify as an autoimmune reaction, (by definition), I'm a monkey's uncle. If we change the definition of an autoimmune reaction, then that changes the whole ball game, obviously.

That article appears to contain a lot of research data, but if the data are the result of starting with mostly assumptions, and guesses, how valid are the data? The author appears to be sort of floundering around at random, trying things, and guessing at what's happening, without even bothering to define what he's trying to treat. To make matters worse, the sources that he sites, are based on speculation, as well. IOW, it amounts to guesswork based on prior guesswork.

The mechanism by which the arthritic disorder was produced was not investigated, although Wu et al. suggest it to be a nonspecific activity of antigen–antibody complexes.[2] the contribution of molecular mimicry between joint collagens and GPI to the development of arthritis in these mice remains unclear.

"Nonspecific activity of antigen-antibody complexes"? "The contribution of molecular mimicry between joint collagens and GPI to the development of arthritis in these mice remains unclear"? That simply says that they don't have the foggiest idea what they're looking at. How can anyone expect to develop a useful treatment, when they don't even know, (haven't defined), what they're trying to treat?

A food-sensitivity cannot be a pathogen, because, by definition, a pathogen is a bacterium, virus, or other microorganism that can cause disease. Lectins, for example, are simply inflammatory agents, they're not pathogens, (they can't reproduce, for one thing).

It's good that someone is working on these issues, but geez, they really need to buckle down and get serious about what they're doing, before they start publishing half-baked data.

I realize that this should, in a sense, support the opinion that Polly and I have regarding the origins of MC, but remember - it's possible to treat just about anything with an antibiotic, but that doesn't mean that an antibiotic is the proper treatment. The author's claim that arthritis is caused by a bacterium, (while that claim may be true, for all I know), is not validated by the fact that an antibiotic relieves the symptoms. (That's evidence, but not proof).

Tex

[Zizzle]

Tex,
Here's a recent review on Medscape about joint pain in IBD.

http://www.medscape.com/viewarticle/750 ... mp&spon=20

Arthropathies, an umbrella term for inflammatory joint manifestations and non-inflammatory peripheral joint pain, are the most common extra-intestinal manifestation in patients with inflammatory bowel disease (IBD) and these arthropathies are a major problem causing significant morbidity and disability. Articular manifestations affect approximately 30% of patients with Crohn's disease and those with ulcerative colitis.[1–4] Since 1930, IBD-associated arthritis has been investigated and it was commonly accepted that peripheral arthritis associated with IBD was similar to rheumatoid arthritis (RA). However, studies on arthritis in IBD demonstrated arthritis to be a distinct clinical entity.[5 6] Over the last few decades, IBD-associated arthritis is considered to be part of the group of spondyloarthritis (SpA),[7] together with ankylosing spondylitis (AS), undifferentiated SpA, psoriatic arthritis, reactive arthritis, arthritis associated with acute anterior uveitis and idiopathic arthritis. Sixty per cent to 70% of SpA patients have gut inflammation, mainly chronic inflammation discovered by ileocolonoscopy,[8–12] and 7% will develop IBD.[9 11] Thus, several studies confirmed the close relationship between gut and joint inflammation suggesting a common aetiology, but the precise origin is still unknown.

HLA-B27 seems to be a major susceptibility gene, and one I suspect many here have.

Approximately 8% of Caucasian Europeans are HLA-B27 positive

[tex]

Thanks, I hadn't seen that one, yet.

Spondyloarthritis pretty well fits my pattern of symptoms, especially:

1. Oligoarthritis, generally with asymmetrical presentation

2. Seronegative, (negative for rheumatoid factor)

But the part about it primarily affecting young men in their teens and 20s is not even close. I was in my late 50s when it showed up.

Tex