Fatigue and rheumatoid arthritis (RA) go together like peas and carrots.
Fatigue can be defined as a severe weariness that doesn’t get better with sleep. This type of exhaustion is reported by upwards of 98% of people with RA, according to the Arthritis Foundation. That means that you aren’t alone – and waking up worn out or truly needing the afternoon nap may be signs that it’s time for some self-care.
Establishing a firm bedtime and wake-up time are one strategy to improve sleep and fight back against fatigue. Also, using a cane or other joint support device may alleviate some of the physical stress on your body.
Diet and RA fatigue
Many sources have lists of foods to eat to help battle RA fatigue. It is good advice to eat breakfast and consider adding protein-rich foods, like eggs, to your diet. Eating healthy whole grains, fruits, and veggies are excellent ideas as well. But, sometimes it can be more important what you EXCLUDE from your diet than what you eat.
In 1981, Dr. A.L. Parke and G. R. V. Hughes performed food challenges on a single patient with rheumatoid arthritis. The participant was experiencing a large number of RA symptoms at the time of the case study. Researchers selected this individual because the RA symptoms appeared to be exacerbated by dairy, and the participant consistently ate both cheese and milk.
The researchers found that when the participant ate dairy, there was a signifiant increase in disease activity. In particular, they noted that there was a significant increase in both:
- synovitis
- IgE antibodies
Synovitis and RA
Synovitis is swelling of the synovial membrane which is the protective boundary in your joints. Swelling of membrane causes great pain when the joints are moved and, if the swelling is untreated, can lead to degradation of the joint. This is a common symptom of people with RA.
Some synovial joints are:
- elbow
- wrist
- shoulder
- knee
- thumb
- fingers
- toes
IgE Antibodies and RA
Immunoglobin E (IgE) are proteins produced by the immune system. These are the cause of allergic reactions – when the body produces more IgE than are necessary given food intake. In this way, overproduction of IgE in RA may resemble an allergic reaction to foods.
Increased IgE production may result in symptoms in the nose, lungs, throat, or skin.
Additional study
While the above case study provides some promise for the impact of dairy-free diets on RA, it is important to remember that the trial only looked at one person. Single-person trials (also called “N of 1” or “n = 1” trials) are useful for forming hypotheses but not for drawing conclusions.
A 1983 study by Panush, et. al, was a 10-week, controlled, double-blind, randomized trial of 26 participants with RA. Two diets were compared over that time frame. With regard to dairy, the experimental group avoided all dairy while the control group did not eat cheddar cheese, ice cream, or sour cream. (Interestingly, the case study above used cheddar cheese as a trigger to measure disease activity).
This study did NOT find significant effects for the experimental diet group, and some members of each diet improved objectively over the course of the study.
However, two participants improved dramatically on the experimental diet and continued limiting intake of dairy beyond the trial. While this is not sufficient evidence that a non-dairy diet is a universally effective strategy to fight RA, the researchers noted that individualized diets may be valuable. Because of this, the researchers concluded that some patients with RA may benefit from changes in diet.
