Doctor's Note

Please feel free to post any ask-the-doctor type questions here in the comments section and I’d be happy to try to answer them. For more information on the role that diet can play in arthritis, please see Dietary Osteoarthritis Treatment. Also, there are 1,686 other subjects covered in the rest of my videos--please feel free to explore them as well!

For more context, check out my associated blog posts: Preventing and Treating Kidney Failure With DietWatermelon for Erectile Dysfunction,How Does Meat Cause Inflammation?, Biblical Daniel Fast Tested, Biblical Daniel Fast TestedPlant-Based Diets for Rheumatoid ArthritisPlant-Based Diets for PsoriasisPlant-Based Diets for Fibromyalgia, and The Science of Acai Berries

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  • Michael Greger M.D.

    Please feel free to post any ask-the-doctor type questions here in the comments section and I’d be happy to try to answer them. For more information on the role that diet can play in arthritis, please see Dietary Osteoarthritis Treatment. Also, there are 1,449 other subjects covered in the rest of my videos–please feel free to explore them as well!

    • Lucyna Jacobs

      Hello Dr. Greger,
      It surpasses my belief that I am finally discovering this astounding portal. Thank you for your amazing work! I watch your videos on plenty of different topics yet my search began here at “Arthritis”.

      A year ago my 15 year old daughter fell victim to juvenile arthritis. In a blink of an eye of every doctor we visited methotrexate drug was prescribed. Any of my attempts to discuss the healthy diet were either dismissed, denied, or treated with anger, at one point even mocked :( Hence it has been a very scarry and lonely journey in search of sources articulating my own belief in natural healing processes.

      I have read China Study, and many more books about alternative treatment for arthritis, yet the professional research seems thrifty comparing to other medical studies.
      The staple argument of rheumatologists for using the toxic drugs is to stop inflamation to prevent deterioration of cartilage and deformity of joints.

      Why there is no research about drugs vs diet among the arthretic children. Is it because they are the best silent golden goose in the history of the disease? Methotrexate facilitators pronounce to us a life sentence of pain and deformation and say that diet has no meaning in curing this ailment. What segment of society is more vulnerable to such a threat if not that of little girls and their frightened mothers?

      Within our extremally small community of immigrant friends, I know 3 teenage girls who suffer from arthritis. Is being an immigrant even better an oportunity to the health care providers to say that we have no other choice but DNA altering drug?

      I was full of hope when I first brought my daughter to the world leading rheumatology unit in children’s central hospital in the nearby metropolitan city. “She will never get out of it” said the doctor to my teenage daughter – an acro- and hip-hop competitive dancer.

      The book “Blindness” by Jose Saramago, a Literary Nobel Price winner comes to my mind.

      I am willing to do anything to contribute to a survey/research/anything to help the arthretic youngsters.

      Thank you again Dr. Greger.

      • Michael Greger M.D.

        Thank you for sharing your story Lucyna. Methotrexate is indeed a pretty harsh drug, but as you know more than most, juvenile arthritis can be a pretty harsh disease. Though typically reserved as a second-line treatment reserved for those that don’t respond to less toxic drugs, methotrexate may be prescribed right up front if there is serious multiple joint involvement. In both these cases the benefits are expected to outweigh the risks. The nice thing about healthy dietary interventions is that there are no risks–just benefits–and perhaps particularly in juvenile rheumatoid arthritis patients who tend to suffer from inadequate nutrition. So it’s not either/or. Hopefully you can find a physician who respects your family enough to talk to about improving your daughter’s diet in addition to other medical interventions they have in mind. Two of the first things I would suggest is cutting out dairy (as there is a report in the medical literature of complete remission of the disease “after the elimination of all cow’s milk protein from her diet.”) and gluten-free trial, since (rarely) celiac disease can manifest with strictly joint symptoms.

        • Lucyna Jacobs

          Thank you for your reply Dr. Greger.

          One of my best friends, now 50, used to have arthritis as a child. Her father happened to be a farmacist and she remembers vividly his refusal to treat her with any toxic drugs. Her memory stops there and she does not know how her parents treated her, but she lived arthritis free up until now. When I mentioned my daughter’s condition to her she gave me a book by Patric Holford “Say no to Arthritis- the proven drug-free guide to preventing and relieving arthritis”. I am wondering if you know of this author and his book.

          I cook dairy and gluten free since January as a result of my own studies regarding arthritis, and my daughter is experiencing similar trial to the one experienced by a girl from medical report you had sent to me (“report”). She is fine and asymptomatic (while on methotrexate) until coming back from vacations with relatives who do not cook dairy free and eat with no reservations excluding junkfood.

          As to inadequate nutrition, I have three children. My first two are 6′ tall and exceptionally healthy at normal weight. My daughter with JRA is 4’11 and weighs 86 lbs. I am comming from heritage of pure, healthy european eating and lousy food was never in my kitchen. Yet we ate dairy, poultry and breads. (As a matter of fact, in the past, I could not imagine life without milk or rye bread). I seem to be healthy but with the dairy-, gluten- and meat-free diet since JRA entered our home, ironically I feel and look better than ever before even though it should be the other way around considering the tremendous stress I am going through with regards to my daughter’s health. Disease was an abstract term for me until now.
          If arthritis is a result of malnutrition, could it be because of internal malabsorbtion?

          Here is a picture of Methotrexate that I can not find peace with.
          http://www.youtube.com/watch?v=lkY7dWtPvus

          It alters our DNA. Without it my friend got healed from juvenile arthritis 40 years ago in Europe. With it my daughter seems worse just like most of other kids in North America.

          Your help means a lot to me Dr. Greger. If you know more as to methotrexate and alike vs. nutrition please let me know.
          Thank you again.

          • DrDons

            To add to Dr. Greger’s comments you may benefit from information on the John McDougall MD website. If you check on “Hot Topics read more” and then click on Arthritis you can view the 10 miinute video on Juliea Baker a patient with JRA or one of the three newsletter articles he has written about inflammatory arthritis. There are patients with arthritis who have triggers in plant foods. Hopefully the information on NutritionFacts.org and the McDougall website will help you and family members work with your physicians to remain healthy and on no medications.

  • http://www.facebook.com/profile.php?id=606393050 Linda Abbott

    Hi there. Do you have any information that can put to rest the theory that grain consumption causes inflammation which can sometimes lead to arthritis and joint pain. I’ve heard ideas like “cooked grains cause acid toxemia and contain opioids” to “grains and the synovial tissue in our bodies are similar chemically so our body attacks the grains, and they attack the joints”. Any aspect of this true to any degree?

  • msatomicpen

    at 35 and longstanding semi vegan, i had a ischaemic stroke of unknown etilogy. i´m now on crestor 5mg (for antiinflammatory purposes) and plavix 75mg. with history of lupus in my family. i want to get off of the pills.what foods do i eat tolower the inflammation.

  • Lucyna Jacobs

    Thank you Dr Dons,
    I have found the suggested links easily. I have come across Dr. McDoougall’s website during my research before, yet the arthritis section was quite hidden, so I missed it that time. I only knew he was teaching what I believed. Juliea’s story is very encouraging to both young girls suffering from JRA, and their mothers. Hope others will find it in this blog as well. Girls have been deeply affected by JRA symptoms, toxic treatment and prognosis coming from doctors belonging to “earth is flat” segment of people. Thank you for speaking up.

  • Michael Greger M.D.

    Please also check out my blog post, Watermelon for Erectile Dysfunction!

  • Scott

    I don’t see anything on this site about Fibromyalgia. My sister-in-law suffers from it and although I don’t hold out much hope that she will make a significant lifestyle change, I would like to be armed with some data when I suggest she incrementally move toward more of a plant-based diet.

  • Cypuppy46

    Dr. Greger, you are my new hero!  I have learned so much from your mini lectures- very well-researched and spin free!!!  Thank you so much- please keep it going!

  • Angela

    Thank you for such insightful information. I was diagnosed 3 years ago at 28yrs old. Started taking NSAID’s, steroids, methotrexate and now on Tocilizumab. but Since I quit dairy and gluten 2yrs ago my body feels better and I now only take Tocilizumab. I instany know if theres been dairy/whet in my food the night before because i’ll be to stiff to get dressed. i already eat very little meat, and I’m always aware of my food intake but I’m going vegan now after watching this video.
    I’m very thankful for this information.

  • Nancy H

    Linda, I have something that I think will help you. Message me back at nancyhelmold@gmail.com and we can talk.

  • bkp

    I have had RA since 1996 and am still taking methotrexate and placquinel. I have been following Dr. Esselstyn’s program (Whole Food Plant-Based, no oil, no dairy) for 3 1/2 months. I see no change in my RA symptoms. I tried to decrease my methotrexate from 10 2.5 mg per week to 8 2.5 mg per week (for 6 weeks) and my RA symptoms increased. Is there hope for me to get off of my medications?

  • veganwithlupus

    I have been vegan for 24 years, considering it the best thing I’ve done for my health and my conscience, but was diagnosed with rheumatoid arthritis 15 years ago after the birth of my son, later also being told I had lupus and Sjogren’s. I’m now 45, after living with relatively mild symptoms for years (taking naproxen and plaquenil most of that time) I now clearly have joint damage in my hands and difficulty walking with a swollen knee. I don’t know if there’s anything further I can do to help myself with diet or any supplements. I’ve tried such a lot of things already (perhaps mostly a waste of money) and I think I eat generally very well anyway, with a lot of very varied fresh (mainly raw) fruits and vegetables, lentils, beans, seeds etc, very little refined wheat flour or sugar. I used to be very active and walked a lot, but the recent increase in joint pain is now making it harder to exercise, though I’m still able to comfortably peddle a stationary exercise bike, though I hope that’s not going to do further damage to the inflamed knee? Unfortunately my rheumatologists don’t think there’s any connection between diet and RA, some other people have told me that I have caused or worsened my symptoms by being vegan. Any advice or suggestions would be very welcome. Thank you.

    • Rease

      Hi there — I, too, have lupus — 30 years! I began a vegan diet as well, but didn’t notice any significant change in my pain levels decreasing until I omitted all forms of oil and fat from my diet (with the exception of nuts, seeds and avocado.) As soon as I eat something with oil, I immediately feel it. Just wanted to pass that info on to you in case it’s of some help. I got used to sauteing foods in broth, wine, or just plain water, and I have a bunch of salad dressings without oil that are just delicious. So possibly try that…see if it makes a difference? Regards!

      • veganwithlupus

        Thanks for that, glad it’s working for you, I’ll give it a try.

        • Kate

          If u have a look at dr John mcdougalls diet it is not just being Vegan but whole foods and low fat, so no added oils or processed food. Follow his elimination diet if you have trouble still to work out the causes of inflammation as you will read in his success stories some havemto stop gluten, corn etc too.

  • Ande

    I have tried glucosamine and chondroitin for years for joint and knee pain and now my doctor say its Arthritis and prescript ‘Regenerix’ which is pretty expensive. I would want to try natural remedy, what would you recommend.

  • Anita Street Holton

    I had active RA from age 9 until age 20 that affected my ankles, wrists and elbows. I also had two joint reconstructions during that time because my elbows had almost seized up. Plus, I had very limited mobility and was confined to a wheel chair.

    At age 20 my RA went into remission but I continued to have pain and limited mobility although I was able to walk. If I walked for too long I would end up in severe pain and unable to walk at all until the pain subsided after a day or so.

    At age 43 (2 years ago) I changed to a plant based diet and not only lost 60 lbs (bringing my weight back down to a healthy weight) but I no longer had joint pain and was able to begin a much more active life style. I’m now able to hike for several hours a day without pain. I do believe that the change in my diet (no animal products at all, little or no oil, no processed foods, no sugar etc…) made the difference in my health.

  • Marsha

    Hello Dr. Greger,

    I have a problem that I was hoping you could help me with. I have been a vegetarian for a year and a vegan for 6 months. For the past 2 or 3 months I have been noticing increasingly sore joints. It started with sore knees and now it has moved to my hips. Having done some research I have come up with a few possible reasons, but I am not a doctor so I could be completely wrong. Is it possible it has to do with a vitamin D deficiency? I haven’t taken any supplements (wrong I know) and even before I was vegetarian did’t consume a lot of vitamin D rich foods. Another reason I have found is soy, but that could just be the soy scaremongering campaign… I would really appreciate any input, as the discomfort is increasing and I am at a loss.

    Thank you!

  • Jamie Ward

    I am a 28 year old female with RA. I have been a vegetarian throughout the course of my disease and definitely feel better eating a plant-intense vegan diet. I am a MPH student and I try to educate myself as much as possible, but I still feel overwhelmed with all the opposing views expressed by the medical community. Can you advise me on dietary lectins (http://www.ncbi.nlm.nih.gov/pubmed/10884708)? A close friend said I should stop eating legumes to improve my RA symptoms. The thought of not being able to eat hummus, lentils, and beans makes me want to cry. I would appreciate your insight on this subject.

    • Been There

      I am a 60 y/o female with a 15 year hx of RA. I have a brother two yrs senior with a 30 hx and an Aunt that had it for 60 years so clearly a genetic component. Each of us tried dietary approaches to the treatment of the disease without benefit. For me my condition significantly worsened. I should point out I followed a mostly vegetarian diet for 20 years before I was diagnosed. My brother is currently back on a vegan / microbiotic diet and his symptoms have significantly worsened. He is very twisted and crippled. While I am on methotrexate and rituxan infusions and doing better than I ever have. You make me feel terrible about my choice to take these “toxic” drugs but I am living a much more active life now. I would say to that concerned mother of the teen girl, be careful before dismissing all the Rheumy’s. You cannot feel your daughter’s pain or know the guilt you create in her for wanting other options to help end it. Keep an open mind.

  • Toby

    Hi Dr. Greger. Thanks so much for the work that you do. I popped over to pubmed to look at the abstract on the last journal article cited in this video. Can you clarify the conclusion? I realize that just reading the abstract doesn’t give the entire picture of the findings or the experiment. What I read and interpreted in the summary was that cumulatively strong (11%) and moderately strong (22%) = 33% of the patients had mucosal reactivity to cow’s milk protein, yet the very last statement made was that “mucosal reactivity to CM and gluten is seen in a minor fraction of RA patients and isn’t related to the frequently perceived intolerance to these proteins.” I may not be interpreting this correctly, but the fact that 33% had mucosal reactivity, followed by the statement that mucosal reactivity to CM is seen in a minor fraction of RA patients…, doesn’t seem to agree in terms of what they are saying as a conclusion. (I don’t know what the definition of mucosal reactivity is). But my main thought is, that I would doubt that many rheumatologists would even test for CM (cow’s milk protein sensitivity) for the authors to be able to make this blanket statement. Do they have data for that somehow regarding RA patients in general and their CM? From reading the abstract, that’s all that I can make of what they are saying, anyway. The gist of my question, is that I’m confused by their some of the conclusion in the abstract. Here’s the article: Scan J Rheumatol. 2010 aug;39(4):292-8 Self-reported food intolerance and mucosal reactivity after rectal food protein challenge in patients with rheumatoid arthritis.

  • Steven Crisp

    Dr. Greger,

    First let me say how thankful we are you provide these videos and this service to all of us. It’s like David against the Industrial Food Conglomerate Goliaths, and we are really happy to get these layman-understandable reviews of relevant scientific literature. THANK YOU!

    So here is my story/question: My wife (and I) went vegan after she was diagnosed with RA about 4 years ago. Her anti-CCP test was apparently “off the charts”. She was put on Methotrexate, which she decided to continue in parallel with the dietary change, since the goal was to minimize joint damage ASAP.

    We both loved the change to the vegan lifestyle. Upon moving back to the US from Europe a few months ago, and into a new health care system, my wife was tested again for RA … and the Rheumatologist found none, and her anti-CCP levels were normal. Great news of course.

    She’s now off all of her meds (more great news). But here is the lingering issue — while her lab tests (and X-rays) show no RA (or damage), her joints (fingers and ankles mostly) are still somewhat swollen and quite sore (more than they were when she was taking the Methotrexate). We’re wondering if we are missing something in the diet that may still be a source of the inflammation or auto-immune response.

    Do you have a suggestion of what to try? While we are 100% vegan when we eat at home, we will make exceptions when we eat out. We are always strict vegetarians, but sometimes the only options include eggs or dairy in the restaurant recipes. We don’t eat out that often, but is that the likely issue?

    Or might you suspect something else, like wheat or gluten sensitivities? Or maybe elimination of oil? Just looking for rational theories that fit her situation, so we know if we should be trying elimination diets, and if so, how long must they be adhered to before we should expect to see symptom relief.

    Thanks in advance for any suggestions or insights. Your work has already made such a difference, but we’d like to get her totally symptom free if at all possible.

    Steven

    p.s., we are loving your Hibiscus tea (started about 2 weeks ago)

    • Veganrunner

      Hi Steven,
      I also have an autoimmune disease. (Couple actually) but I no longer have symptoms. I would recommend that your wife give up the gluten-at least for 4-6 weeks and see if she notices a difference. Also when I first went vegan I ate a lot of tofu and tempeh. I woke up every morning with every joint in my feet hurting. It took me awhile to figure it out but once I decreased the tofu/tempeh the pain cleared up.

      So although it is difficult to say exactly what cured me I have a feeling it was just eliminating all the inflammatory foods. (Soy and gluten and animal) at this point I am not willing to add them back.

      Good luck! And good news about the RA resolving.

    • http://www.DonForresterMD.com/ Don Forrester MD

      I would definitely stay away from dairy as I have come across patients with RA who have noticed flares with minimal intake of dairy. As a clinician who has had the good fortune of working with Dr. McDougall I have encountered patients who still have some problems after going to a whole food plant based diets due to certain plant foods. The difficulty is finding the culprits as skin testing and blood testing for allergies often confuse the issue. I favor a more practical approach that you and your physicians can consider. I would read Dr. McDougall’s article, Diet for the Desperate in his December 2002 newsletter. He discusses the plant foods that are often the culprit and an approach for helping ferret out the offending agents. Bon chance!

  • E

    My mother in law has progressing scleroderma with raynolds disease. I am trying to find a nutrition regime for her that will alleviate symptoms. Could a vegitarian diet help? What about gluten and dairy?

  • Donna

    I was recently diagnosed with Rheumatoid Arthritis even though I’m pretty certain I’ve had the onset for over a year. Even though I have the prescription, I haven’t started any medication such as methotrexate (spelling?) due to the possible side effects. Instead, I’m 5 weeks into a plant based diet, but have yet to see any noticeable change in swelling and pain in my hands and feet. Regardless, I will continue eating this way to reduce factors of illness, but how long should I wait before taking (if at all) the medication? How long should it take for my NEW way of eating to help? I’m in a quandary!