[HN Gopher] A bacterial culprit for rheumatoid arthritis?
___________________________________________________________________
A bacterial culprit for rheumatoid arthritis?
Author : pseudolus
Score : 285 points
Date : 2023-05-01 17:02 UTC (5 hours ago)
(HTM) web link (www.the-scientist.com)
(TXT) w3m dump (www.the-scientist.com)
| treeman79 wrote:
| Sounds like a resurgence of Marshal protocol.
|
| My autoimmune condition Sjogrens (similar to RA)was initially
| diagnosed (later confirmed) specifically because symptoms always
| improved on antibiotics. Was an old optha-neurologist doctor who
| had noticed this trend over his life time.
|
| I later found the marshal protocol. But modern doctors have no
| interest in bacteria as a cause of problems.
|
| https://mpkb.org/home/patients/protocol_overview
| lostlogin wrote:
| I'm not a warrior for animal rights and actively trap pests
| including mice. But the animal testing here gives an
| uncomfortable feeling.
|
| However it's hard to think of an alternative that doesn't end up
| with things like coerced adults or poorly consented paid
| volunteers.
| kytazo wrote:
| For me it was electricity, make sure you're not exposed to high
| currents and strong electrical fields. Especially things like a
| modern macbook charger plugged in is capable of producing fields
| up to 1000v according to the emf meter I got on hand.
|
| My own experience is very consistent confirms it as well.
|
| Check how can a two hour session where you get your body voltage
| close to 0 can reduce inflammation. Imagine the opposite effect,
| possibly multiples. https://yewtu.be/44ddtR0XDVU?t=1667
|
| You can also check this lecture by Dr Jerry Tennant which may
| give you a better understanding overall. Hope this helps someone.
| Firmwarrior wrote:
| you can "get exposed to a field up to 1000v" by rubbing a
| balloon against your hair
| zabzonk wrote:
| only if you don't have your tin hat on
| anonymouskimmer wrote:
| > Some people at risk for the disease have antibodies against
| this bacteria, and Subdoligranulum activation of T cells was more
| prevalent in people with RA than in healthy controls.
|
| Very important to qualify (through studies) whether this is the
| cause of rheumatoid arthritis, or just one of a number of
| precipitating things. The answer will tell us whether
| treating/preventing Subdoligranulum is a silver bullet, or
| whether, like cancer, we have a lot more work to do.
|
| > "It's hard to know how big of a player this specific isolate
| is," he said. "It could be the dominant player, and that's why
| they came across it first. But it could be that if they went back
| and did larger screens, that they would come up with more -- that
| [Subdoligranulum] would be just one of many."
|
| > In keeping with this, the researchers only found this
| Subdoligranulum strain in 16.7 percent of people at risk or with
| early-stage RA, indicating that this strain is likely not the
| sole driver of disease.
|
| Regardless, given the results mentioned here, I would bet that
| "infection" with this strain would exacerbate RA through
| increased production of antibodies. So it seems a good target to
| reduce severe RA.
| kstrauser wrote:
| And it's not unprecedented. It was in my lifetime that we found
| out that stomach ulcers could be caused by H. pylori
| infections. For many people, what'd previously been a chronic
| condition could be cured with a round of antibiotics.
| barbariangrunge wrote:
| I speculated last year that various known diseases could turn
| out to have some sort of microbe, or microbe-like cause that
| we're unaware of; things we haven't seen or noticed yet. And
| that we might occasionally find out, with new tools, that a
| difficult condition has an understandable, discrete, physical
| cause. Similar to how people discovered that the flu and
| strep-throat and meningitis etc were caused by the tiny
| living or life-like critters (are viruses alive?).
|
| I was insulted and mocked by everyone I said it to
|
| But if nobody looks, we'll never find out. It looks like
| somebody looked in the case of ulcers and arthritis
| f6v wrote:
| > I was insulted and mocked by everyone I said it to
|
| I mean, it's not a fringe theory. MS could be one example.
| graeme wrote:
| Germ theory is not widely believed. Not really. We wash
| our hands because we've been trained since a young age to
| do so, and generally accept that touching stuff is
| unsanitary.
|
| But that's about it. Witness the reaction to aerosol
| spread of disease despite literal videos that can capture
| and show aerosols being spread around a room. People
| simply don't believe it.
|
| They likewise don't believe in any kind of long run
| response to an infection. We associate the symptoms of
| acute immune response to be the virus itself, and the
| entirety of the virus.
| throwaway22032 wrote:
| You're conflating two issues here.
|
| I believe that car accidents cost lives, that power tools
| can take off my fingers, that illnesses like coronavirus
| can kill me or give me chronic lung conditions.
|
| I also believe that it's worth driving, woodworking, and
| interacting with people in public despite those risks.
|
| Most people, excluding the rare nutjobs, are like that.
| If you force them on an issue and don't accept variants
| of "I don't care" as an answer, they might come up with a
| bizarre explanation, sure.
|
| It's hard for a lot of people to simply be honest and say
| - yes, sure, but I think it's worth it, instead of trying
| to deflect.
| treeman79 wrote:
| Look up Marshal protocol. I was diagnosed from how my
| symptoms always had a positive response to antibiotics.
| darkerside wrote:
| Lyme disease also causes symptoms that overlap with RA, due
| to the Borrelia burgdorferi bacteria. It is latent in some
| people and causes serious symptoms in others.
|
| I truly wonder sometimes whether antibiotics are actually
| underused in medicine (while simultaneously being overused in
| the food supply chain).
| nradov wrote:
| Antibiotics are both overused and underused in medicine. We
| still see antibiotics being prescribed as a prophylactic
| measure even without a confirmed bacterial infection, or
| for minor bacterial infections that patients could probably
| clear on their own. People think of antibiotics as being
| benign but they come with significant risks and side
| effects, including disrupting the gut microbiome.
|
| At the same time we lack evidence-based medicine guidelines
| for treating most low-grade chronic bacterial infections.
| In many cases there aren't even reliable diagnostic tests
| for such conditions, so it's not clear what the root cause
| of a patient's symptoms are and physicians have to try
| treatments at random in an attempt to find something that
| works. More basic research is needed in this area.
| echelon wrote:
| > I truly wonder sometimes whether antibiotics are actually
| underused in medicine
|
| Killing gut microbiota is also being increasingly linked to
| diseases, so it's likely a very complicated balancing act
| where we need to maintain the correct bacterial flora.
| f6v wrote:
| > Lyme disease also causes symptoms that overlap with RA
|
| This could just mean that diseases trigger same pathways.
| Overlap doesn't mean a common etiology.
| darkerside wrote:
| Just about nothing means anything. But it's still worth
| investigating correlations.
| hospitalJail wrote:
| >I truly wonder sometimes whether antibiotics are actually
| underused in medicine (while simultaneously being overused
| in the food supply chain).
|
| In the US, this is basically a given. You don't have to
| look past the lobbying numbers to understand why.
|
| I'm curious outside the US, how often antibiotics are given
| out. From my buddies telling me stories about Mexico + the
| fear mongering with US Physicians, you'd expect a superbug
| to have broken out by now.
| ejb999 wrote:
| >>you'd expect a superbug to have broken out
|
| You'd expect it, and it has.
| zamnos wrote:
| > [MRSA] caused more than 100,000 deaths attributable to
| antimicrobial resistance in 2019.
|
| https://en.wikipedia.org/wiki/Methicillin-
| resistant_Staphylo...
| moneywoes wrote:
| What about the whole super bug antibiotic resistant thing
| dopkew wrote:
| There are some who propound a more nuanced approach:
|
| https://news.ycombinator.com/item?id=35704698
| nradov wrote:
| Multiple superbugs have broken out and are killing
| thousands every year. The irresponsible overuse of
| antibiotics in places like Mexico is certainly part of
| the problem.
|
| https://www.cdc.gov/drugresistance/about.html
| hospitalJail wrote:
| https://en.wikipedia.org/wiki/Clostridioides_difficile_in
| fec...
|
| There is no mention on your page, or the wiki, that
| antibiotics are the cause the resistant bacteria.
|
| I can logically see why we would believe this, but you'd
| expect given the use of antibiotics on the farm and in
| non US pharmacies; we'd have such a superbug
| scientifically proven by now.
| anonymouskimmer wrote:
| Scientifically it's nearly impossible to prove things.
| However, scientific evidence supporting the antibiotic-
| driven increase in antibiotic resistant "superbugs" has
| been found.
|
| https://www.theguardian.com/environment/2019/sep/19/super
| bug...
|
| Antibiotics, and antibiotic resistance genes, have
| existed for an uncountable number of megayears.
| Antibiotic use by humans is probably not creating many
| new antibiotic resistance genes, if any at all. But is is
| driving the increase in bacteria that contain these
| genes, as well as encouraging the horizontal transmission
| of antibiotic resistance genes and the accumulation of
| multiple such genes in so-called "superbugs".
|
| https://www.nature.com/articles/s41467-021-22757-1
|
| https://pubmed.ncbi.nlm.nih.gov/30248271/
|
| https://genomemedicine.biomedcentral.com/articles/10.1186
| /s1...
| yarg wrote:
| It's a fairly clear case of natural selection.
| yarg wrote:
| I think in general the answer is more likely to be
| probiotics than antibiotics.
|
| I think we underestimate the extent to which pathogens
| thrive in niches carved out by the absence of symbiotic
| bacteria required by our microbiomes.
|
| Fecal transplants have shown significant results in some
| diseases (such as Crohn's): https://academic.oup.com/ibdjou
| rnal/article/21/3/556/4602907
|
| > Based on [Pediatric Crohn's Disease Activity Index], 7 of
| 9 patients were in remission at 2 weeks and 5 of 9 patients
| who did not receive additional medical therapy were in
| remission at 6 and 12 weeks.
|
| > No or modest improvement was seen in patients who did not
| engraft or whose microbiome was most similar to their
| donor.
|
| So I think it's either a case of pathogens that fit in with
| the established microbiome or that the microbiome is
| missing vital components.
| darkerside wrote:
| Once your microbiome is disrupted, I believe studies
| indicate that it's unlikely that adding probiotics in
| will fix it. I could see antibiotics followed by
| probiotics being an effective treatment for a microbiome
| gone haywire.
| yarg wrote:
| You still should consider collateral damage - we've been
| throwing broad spectrum antibiotics at damned near
| everything for decades.
|
| We've started an arms race with a staggeringly dynamic
| enemy, and our solution thus far has been to attack them
| with static munitions, until those munitions stop
| working.
|
| You can mitigate the issue with combination antibiotic
| therapy (it's harder to evolve resistance on multiple
| fronts simultaneously), but in general (when we use them)
| we need to move towards targeted antibiotics.
|
| The difficulty being that you actually need to diagnose
| the specific problem before treatment, not just that it's
| bacterial in nature.
|
| This requires pathogen detection and recognition:
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4941824/
|
| This adds significant complexity (though I don't think
| that knowing what you're doing is a bad idea).
|
| We've been using nukes for a long time now, we need to
| move to scalpels.
| davidjones332 wrote:
| [dead]
| drewg123 wrote:
| I'm curious if there is a similar bacteria that triggers Crohn's
| disease and/or Ulcerative Colitis.
|
| I'm wondering this because there is a large crossover in the
| biologic "TNF Blocker" drugs that treat RA, Crohn's and UC
| (Humira, Remicade, etc).
| broguinn wrote:
| >Antibiotic exposure was associated with an increased risk of
| IBD as compared with no antibiotic exposure for all age groups,
| although was greatest among individuals aged 40-60 years and
| >=60 years (age 10-40 years, IRR 1.28, 95% CI 1.25 to 1.32; age
| 40-60 years, IRR 1.48, 95% CI 1.43 to 1.54; age >=60 years, IRR
| 1.47, 95% CI 1.42 to 1.53). For all age groups a positive dose-
| response was observed, with similar results seen for both
| ulcerative colitis and Crohn's disease. The highest risk of
| developing IBD was seen 1-2 years after antibiotic exposure,
| and after use of antibiotic classes often prescribed to treat
| gastrointestinal pathogens.
|
| https://gut.bmj.com/content/72/4/663
| darkerside wrote:
| So people who were more likely to use antibiotics because
| there was a suspected infection were more likely to have
| Crohn's disease, possibly underlying at the time
| velavar wrote:
| Similar sufferer of recurrent uveitis here (spent 10 years
| doing several tests none of which ever explained what I have,
| only excepting HLA-B27 which occurs with several of these auto-
| immune diseases). The only thing that helps me now is Humira. I
| wonder if gut bacteria has anything to do with my condition and
| how I can even go about digging into this :/
| drewg123 wrote:
| Interesting. I have Crohn's, and I've gotten uveitis during
| really, really, really bad flare ups. I've had Crohn's for 40
| years, and I wasn't even aware there was a link until my
| gastroenterologist told me about it.
| hkt wrote:
| I'd wager yes, for that very reason. Years ago I was in
| hospital and a registrar told me that guts are smelly but
| they're the next big frontier of medicine. I didn't immediately
| know what she meant, but having thought about it since, she was
| absolutely right. The biome has a lot to answer for.
| spondylosaurus wrote:
| Crohn's and several forms of arthritis are closely linked to
| the HLA-B27 gene. (And I should know, because I have the whole
| shebang :P)
|
| There have been some (tenuous) hypotheses suggesting that
| certain types of otherwise-benign gut infections in HLA-B27+
| people basically short-circuit your immune system and teach it
| to attack its own tissues. So if you're HLA-B27+ you're not
| guaranteed to have an autoimmune disease, but you're
| potentially one bad stomach bug away from developing one.
|
| Which, to be fair, all of this is still highly speculative, and
| it seems like even the hypotheses treat the resulting
| arthritis/IBD as an immune condition rather than a bacterial
| condition--Remicade et al are our best bet either way. But I'd
| love to one day unravel how a single gene can singlehandedly
| mess up your spine and your gut and your eyes and your skin!
| manmal wrote:
| Does HLA-B27 increase gut permeability? IIRC gut microbes
| should only be presented to the immune system if they migrate
| into the bloodstream?
| hanniabu wrote:
| As someone that's been dealing with SIBO (small intestinal
| bacterial overgrowth), I'm confident that most diseases are the
| result of your gut microbiome.
|
| Really looking forward to research in this field and I hope the
| US starts putting more focus on phage therapy.
| mjhay wrote:
| I agree. The frustrating thing with a lot of this is that
| microbiota seem to follow the Anna Karenina principle: every
| healthy microbiota is alike, but every dysfunctional one is
| dysfunctional in its own way. FWIW, I have a friend whose
| SIBO spontaneously went into remission almost immediately
| after travelling to a tropical country. Of course, that
| probably wouldn't work for you.
| colordrops wrote:
| Did you take rifaximin, and did it work? I'm currently on my
| fourth day, and am finding that all of my joint pain has
| disappeared. Could be coincidental, but now there's the
| coincidence of this story in Science.
| hanniabu wrote:
| Been dealing with it 3 years now, took the first 1.5 years
| to figure out what it was. So far took 2 rounds of
| rifaximin. The first round didn't do much, but the second
| round (with neomycin) got rid of my methane overgrowth. I
| still have a hydrogen overgrowth and waiting on insurance
| to improve another round of just rifaximin.
|
| Do you have a methane or hydrogen overgrowth?
| pazimzadeh wrote:
| You could try some over the counter herb-based
| supplements:
|
| Herbal Therapy Is Equivalent to Rifaximin for the
| Treatment of Small Intestinal Bacterial Overgrowth
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030608/
| Subjects with newly diagnosed SIBO by lactulose breath
| testing (LBT) were given two open-label treatment choices
| based upon individualized treatment preference; either
| two 200 mg rifaximin tablets three times daily (TID) or 2
| capsules twice daily of the following commercial herbal
| preparations; Dysbiocide and FC Cidal (Biotics Research
| Laboratories, Rosenberg, Texas) or Candibactin-AR and
| Candibactin-BR (Metagenics, Inc, Aliso Viejo, California)
| for 4 consecutive weeks immediately followed by a repeat
| LBT.
|
| I have been taking Candibactin-AR and Candibactin-BR with
| my meals and have seen an improvement in my stool
| consistency (I have recently diagnosed SIBO/Crohn's). I
| was given the metronidazole for one week and it helped as
| well, but symptoms came back.
| colordrops wrote:
| Only hydrogen.
| jmclnx wrote:
| Interesting, I new someone who had RA in her 20s, by the time she
| reached here mid 30s, it was gone. This was a long time ago but
| the doctors then were a bit surprised.
| 0x486566e7279 wrote:
| did she have children? pregnancy suppresses the immune system,
| many women find that auto-immune conditions go away
| (temporarily usually) when they are pregnant.
| oaththrowaway wrote:
| I know a lady who has 9 children. She loves being a mom, but
| she also loved being pregnant because it was the only thing
| that helped her RA
| jmclnx wrote:
| Not until after it went away.
| steve_adams_86 wrote:
| That really is interesting. I started developing it in my early
| 20s, and I still have it (mid 30s now), but in some ways it has
| improved quite a bit. I have no idea why or how. I'm grateful,
| though I assume it'll eventually get worse again rather than go
| away.
|
| It has been useful in motivating me to use my hands before I
| can't, which is bitter sweet I guess. Certainly sweet in that
| I've appreciated my hands in ways I likely wouldn't have known
| I should otherwise.
|
| Here's hoping that it continues to fade!
| eastof wrote:
| Same story here but with my feet instead, now I slackline to
| keep up my foot stregth. Do you use TNF inhibitors?
| steve_adams_86 wrote:
| No inhibitors or medications of any kind during the onset
| or most of the progression.
|
| I find exercise useful too. Not much can keep the cold and
| wet conditions from making my hands scream, but when I
| climb and deadlift it has the odd effect of reducing pain
| after a half hour or so, and keeping it at bay for hours.
|
| People have told me this means it can't be arthritis, but
| I've met others with a diagnosis who have the same
| experience. So long as the activity doesn't involve impact
| or to much opening and clenching of my hand while under
| stress, it's very relieving (though painful at first).
| bbojan wrote:
| I had psoriatic arthritis and it just went away after several
| years. The only thing that could keep it in check was comfrey
| ointment (I tried everything conventional medicine had to offer
| except biologics). But since about two years ago I am symptom
| free.
| virgulino wrote:
| Ankylosing Spondylitis is a closely related disease, treated with
| the same anti-TNF biological drugs.
|
| There is 30 years of contradictory research on the association of
| the disease with the bacteria Klebsiella pneumoniae. So far, it
| has come to nothing.
|
| https://pubmed.ncbi.nlm.nih.gov/1561397/
|
| https://pubmed.ncbi.nlm.nih.gov/29438717/
| atombender wrote:
| There's also psoriasis (and psoriatic arthritis), where it's
| been firmly established that one subtype -- guttate psoriasis
| -- is triggered by _Streptococcus pyogenes_, which also causes
| strep throat, which is very common.
|
| This is a strain of bacteria that can also cause rheumatic
| fever, which has an autoimmune component; it's capable of
| molecular mimicry, which causes the body to develop antibodies
| against itself. So the thinking goes that many strep bacteria
| can linger in the body and cause autoimmunity.
| chabes wrote:
| I have a sibling that has been diagnosed with AS, along with a
| handful of other related diseases, such as juvenile rheumatoid
| arthritis.
|
| The specialists can't concur with their own conclusions, let
| alone the conclusions of others. Diagnosis changes every few
| years. It's a confusing situation for the patient and their
| family.
|
| One treatment that is used for a specific condition might have
| harmful - even carcinogenic -side effects. It's difficult
| spondylosaurus wrote:
| I hesitate to give unprompted quasi-medical advice to a
| stranger online, but if the potentially harmful treatment
| you're referring to is biologic therapy, just know that
| millions of people have taken TNF inhibitors for decades to
| positive ends. There are risks, to be sure, but not
| necessarily greater than the risk of untreated autoimmune
| disease--runaway inflammation is linked to heart problems,
| for example, and untreated Crohn's/colitis massively
| increases your risk of colorectal cancer.
|
| I mainly mention this because I was terrified of starting
| Humira when I got diagnosed with AS years ago--those black
| box warnings are legit scary. But I had to weigh the risk of
| _maybe_ developing a rare side effect versus the guarantee of
| my spine permanently fusing and my immune system burning
| everything else to the ground out of spite, and ultimately
| went for the Humira. And I 'm glad I did, because my quality
| of life has improved massively.
|
| Which is all to say that I hope your sibling's doing okay and
| found a treatment that works for them. It's scary out here,
| but there's hope, I promise.
| spondylosaurus wrote:
| Came here to mention AS and the klebsiella hypothesis. Like you
| said, nothing conclusive has come out of it (and certainly no
| evidence of using antibacterial treatment successfully to treat
| AS), but I still find it super interesting considering the high
| comorbidity between AS and intestinal diseases like Crohn's and
| ulcerative colitis. IIRC some of the more recent "AS is a form
| of reactive arthritis" truthers have focused on gut infections
| specifically as the pathway.
|
| Big grain of salt, of course. Thankfully even if we can't
| pinpoint its exact etiology we still have a million proven
| drugs to throw at this thing.
| virgulino wrote:
| I started with a diagnosis of reactive arthritis (still
| called Reiter's Syndrome at the time), after an intestinal
| infection. After 10 years of feeling fine and unmedicated,
| but with occasional flare-ups, I suddenly went downhill and
| my diagnosis was changed to ankylosing spondylitis (modified
| New York criteria). To my knowledge, there is very little
| research on the separation or progression between reactive
| arthritis and ankylosing spondylitis.
| spondylosaurus wrote:
| That's brutal. I hope you're doing alright these days.
| virgulino wrote:
| I loved your username "spondylosaurus", it made me laugh,
| thank you. I wish you well too. Cheers!
| zeagle wrote:
| I'm surprised to see an article on rheumatoid arthritis (RA) at
| the top of HN.
|
| RA is a complicated disease. This is interesting but there is
| already data implicating infections like P. gingevalis, EBV,
| Parvovirus B19 with plausible mechanisms like citrullination of
| proteins, molecular mimicry contributing but there is no direct
| evidence and issues with these being prevalent in the general
| population.
|
| The question to ask when reading this are: Does this
| antibody/evidence of prior infection raise or decrease the
| probably of developing pre-RA? clinical-RA? Is it pathogenic or
| just an interesting finding? What's the prevalence of these
| antibodies in first degree relatives without disease or healthy
| controls in the general population e.g. can you reasonably use it
| for screening? I'd say the answer is no / we don't know to all of
| these and they it needs more research before this is clinically
| interesting.
|
| RA is a complicated disease but ultimately a clinical (/imaging)
| diagnosis based on synovitis and extraarticular features
| supported by investigations. There are mouse models of arthritis
| e.g. collagen induced but sometimes hard to translate to humans.
|
| If you are interested in the topic. Think of RA in terms of a
| susceptible host progressing to benign autoimmunity, subclinical
| disease, then clinical disease. Factors like HLA-
| DR4/DRB1*0401/0404 increases an individual's lifetime risk but
| are seen in 20-30% of population vs 0.5-2% of the population
| having disease so aren't helpful from a screening point of view.
| Environmental exposures like smoking (the data says in shared
| epitope + individuals) raise that risk significantly. Other
| exposures like microbiome are clearly important and they interact
| with the immune system (e.g. via TLRs) so they probably make a
| difference but aren't well studied (this work would fit in here
| trying to address it). There is good cohort data that many
| patients develop detectable autoantibodies years ('benign
| autoimmunity) before becoming patients with clinical disease. But
| even with everything Ive said this is still a two-way street:
| some of these individuals don't develop disease and can even lose
| their autoantibodies. In at least one real world cohort I'm aware
| it's been shown of you can be very high risk with ethnicity,
| CCP+, RF+, have a family member with RA (in some sense
| controlling for genetics, environmental exposures) and you still
| have even odds of progressing to disease vs. losing your double
| seropositive status and not developing disease. So what do you do
| with that? (It comes down a clinical diagnosis with prompt
| recognition, treatment to target of remission.) The (very
| important) trials so far for treating/preventing preclinical RA
| in ~similar high-risk individuals have been sadly negative or at
| best may delay onset slightly (abatacept, hydroxychloroquine).
| spondylosaurus wrote:
| Damn, do you work in rheumatology? I rarely see explanations
| this detailed (and well-communicated) about autoimmune
| conditions, even when I'm going out of my way to look for them.
| Color me impressed.
| Keyframe wrote:
| Hope there will be advancement for RA. It took my father away,
| doctor, at 71 years old. RA led to lung fibrosis which ultimately
| gave him a heart attack.
| deeel wrote:
| Had a major flare up of RA after a particularly stressful moment
| in life. Went to doctor who prescribed steroid lotion - a non
| starter.
|
| After research and some trial and error what solved it fairly
| quickly were high doses of extremely high quality fish oil (DHA &
| EPA) and an overall cleaner diet with less low quality gluten.
|
| As for the "spots" sunlight seemed to be the best disinfectant to
| the point where now if there is any flare up I just get a nice
| tan and they go away.
|
| I have no scientific basis for any of this so DYOR.
| fswd wrote:
| If I take antibiotics, my back pain 100% goes away.
| sec400 wrote:
| As a side note/additional area to explore, some antibiotics do
| also have anti-inflammatory effects
| kvgr wrote:
| I have same anecdotal evidence about my mood. I had some tooth
| infections and took some strong horse dose antibiotics couple
| times in my life and my mood and "adhd" symptoms got better.
| manmal wrote:
| Anecdotally, I've experienced these benefits after ca 9
| months of strictly no sugar (not even fruit). But just a
| couple weeks of eTRF (stopping to eat at 3PM) gave the same
| results (normal IF did nothing of the kind for me).
| 7speter wrote:
| A lot of people (me included) report this when they induce
| ketosis after eliminating carbs and sugar. It would seem
| reducing carbs and sugars would drastically change the biotic
| makeup of one's gut, so this is all seeming to be tied to
| ones gut... microbiota is very interesting.
| so-and-so wrote:
| I know someone who has it. How lond does it usually take to go
| from a research like this to a medicine available to patients (if
| the hipothesis turns true)?
| cornhole34 wrote:
| ~8 years at best if everything goes well (rarely ever does),
| there are outliers like Polio took ~4 years, and Covid took ~1
| year. But those are much different than RA.
| bastardoperator wrote:
| I was diagnosed with RA, I ignored it forever until I was having
| issues functioning normally. I was prescribed prednisone for a
| week and then methotrexate/folic acid. The methotrexate helped me
| feel fine despite decimating my hairline.
|
| After about a year into the pandemic I just stopped taking the
| methotrexate/folic acid after a couple of years of using it
| regularly, and I haven't had an RA issue since. I had tried this
| way in the past, but I would get flair ups, but this time around
| no symptoms.
| 300bps wrote:
| I've had mild psoriasis since I was a young teenager.
|
| One day it disappeared. Then about 15 years later it came back.
| In one particularly stressful time of my life it progressed to
| psoriatic arthritis. Then that went away when the stressful
| situation was resolved.
|
| I'm now trying to retrace my steps to try to make it go away
| again. Low inflammation diet, lots of sleep, low stress.
| Havoc wrote:
| TIL hairline. My doc never warned me about that
| codeaken wrote:
| I have been following RA for years now. There is a small public
| company (OMX:SYNACT) I found that are in its Phase 2b with a
| medication that looks very promising. They completed their Phase
| 2a with statistical significance in a couple of key indicators.
| It looks like to be on par with JAK inhibitors but with a cleaner
| safety profile and no need for injections.
|
| Unlike the JAK inhibitors that suppresses the immune system,
| their pill instead resolves the inflammation by activating
| receptor 1 and 3 in the melanocortin system. Phase 2b completes
| this summer and I am personally super excited to see the results.
| newprint wrote:
| Unfortunately, few months ago, my gf who is in her very early
| 30s, was diagnosed with RA. She was immediately placed on the
| very expensive medication - $5000/month (you read it right, a
| month). It helps a lot, but not 100% effective and we don't know
| how it will work long term. We are hoping, that some new
| treatment might be available in the future.
| shswkna wrote:
| My sister had RA in her early twenties. For years no treatment
| was able to restore a reasonable quality of life. There were
| many side effects which needed treatment as well. She went from
| doctor to doctor, while she lost the best parts of her life.
|
| An unexpected path led her to a tropical diseases doctor who
| had positive results with RA patients by using an
| unconventional treatment not supported by mainstream medicine
| at the time: He tested the patients blood for bacteria (by
| cultivation in a lab) and prescribed an antibiotic course that
| matched the detected bacteria. This treatment (testing +
| prescribing antibiotic)was repeated in regular intervals over
| the course of a whole year.
|
| Her RA flare-ups stopped and recurred only in ever longer
| intervals which were arrested by this treatment. After a year
| the progression of the RA had stopped.
|
| This treatment is controversial because it is considered bad
| practice to prescribe antibiotics liberally, for several good
| reasons. Mainstream medicine did not have a theoretical
| foundation to justify this treatment path.
|
| The tropical disease doctor founded his treatment on the
| empirical research by some research factions that the "auto-
| immune" theory of RA was not showing the full picture.
| GuardianCaveman wrote:
| Is there any more information you can provide so I can help
| my wife find a similar treatment?
| toast0 wrote:
| > This treatment is controversial because it is considered
| bad practice to prescribe antibiotics liberally, for several
| good reasons. Mainstream medicine did not have a theoretical
| foundation to justify this treatment path.
|
| This doesn't seem like prescribing antibiotics liberally to
| me? Having symptoms, test for bacterial infection, prescribe
| antibiotics seems reasonable to me with no medical training.
| I would consider liberal prescription to be something like
| prescribing antibiotics based on symptoms that align with
| viral infection, without doing any labs to determine the type
| of infection and hoping for the best.
| [deleted]
| newprint wrote:
| Would you be able to tell me more ? My email is in my About
| section. Thank you !
| hbarka wrote:
| > and prescribed an antibiotic course that matched the
| detected bacteria
|
| Interesting. Can antibiotics be matched to that level of
| specific targeting?
| monknomo wrote:
| There are different classes of antibiotics and the
| different classes work better or worse against different
| types of bacteria.
| Rimintil wrote:
| That's cheap. $12K/month for two self-administered biologic
| injections.
| newprint wrote:
| for RA ?
| cellularmitosis wrote:
| That's probably Humira, so RA, Crohn's or UC. Many of the
| immunomodulator drugs are in a similar price range.
| spondylosaurus wrote:
| Praying for generic adalimumab to finally hit the US
| market. People overseas have been getting this stuff for
| a hundred bucks a pop for years now, but AbbVie's done
| everything in their power to extend the US patent for as
| long as possible. They'd milk us forever if they could.
| paddim8 wrote:
| Mine cost about 350EUR or so for 6 pens. I only pay
| 240EUR a year though.
| alistairSH wrote:
| Yup.
|
| Family member is on Remicade. It's administered in two
| doses (IV infusions) every 4 months, so 6 treatments/year.
| And retails for something like $12k/treatment. And many
| insurance companies have removed it from their list of
| preferred drugs due to the cost, leaving patients to fight
| for medically necessary treatment.
|
| It's a fucking nightmare (as if RA on it's own isn't bad
| enough).
| sparkie wrote:
| My body created an antibody to infliximab after about 6
| months of treatment and I had a bad reaction to it. 6
| months of expensive treatment wasted.
|
| Doc replaced it with Azathioprine, a cheap generic, and
| I've had no major flare-ups of UC in 6 years.
|
| If I have minor symptoms (usually triggered by certain
| foods), I also take mesalazine, but once I am in
| remission I can do without the mesalazine. If I withdraw
| from AZA when I am in remission, minor symptoms typically
| return after around 3 months, but subside after I resume
| taking the AZA for a couple of months. I can retain
| remission doing 3 months on, 3 months off.
|
| Use of Azathioprine is still controversial for treatment
| of UC:
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034525/
|
| I have no noticeable side-effects from taking
| Azathioprine.
| bernardlunn wrote:
| Fasting is free
| skyyler wrote:
| Please hesitate before offering medical advice to strangers
| next time.
| lostlogin wrote:
| Was that advice even 'medical'?
| more_corn wrote:
| Yes
| softfalcon wrote:
| I feel for you. We're in the same boat. My wife is a similar
| age and also has to finaggle her way around these ludicrously
| expensive RA medications. I also really hope a new treatment
| will arrive before this one either stops working or we become
| incapable of affording it.
| eklavya wrote:
| My friend has RA, after being on medication for years where he
| would have nausea for at least a week every month. He stopped
| taking any medication altogether. He goes to Gym twice a day
| and keeps a strict diet (relaxed at times). He is way better
| since the last 4 years.
| eastof wrote:
| I also have RA and have the exact same experience. I really
| wish doctors would actually present lifestyle changes as an
| alternative treatment. Sure if flares every once in a while
| but my feet are super strong now with barefoot running &
| slacklining and I hardly even notice it anymore when I'm
| moving.
| ww520 wrote:
| There're generic versions of the drug coming to market.
| Amjevita from Amgen is bio-similar to Humira and just got FDA
| approved. It costs about half at retail. As more generic
| versions of the anti-TNF biological drugs coming online, the
| price should be driven down.
| MrFantastic wrote:
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682732/
|
| Both groups observed significant decrease in disease activity
| score (DAS) (p < 0.001). Significantly higher decrease in pain
| in fasting group on seventh day (p = 0.049). No significant
| difference was observed in total fatty acid profile, butyrate
| and propionate but acetate increased significantly (p = 0.044)
| in fasting group and decreased significantly in MD group.
| eastof wrote:
| I know I already posted in another comment but how active is
| she?
|
| I was diagnosed in my 20s and at first it was a real atruggle
| to get out of bed. After initial rounds of steroids/TNF
| blockers, I really started to focus on strengthening my
| affected joints and it has quite literally been a miracle cure
| for me.
|
| Nothing too crazy at first either, mine is in my feet so just
| lots of yoga and walking a couple miles or so a day did it for
| me.
| dukeofdoom wrote:
| Would this cause arthritis in hips too, or just hands?
| spondylosaurus wrote:
| Arthritis in the hips sounds more like a form of
| spondyloarthritis. (Ask me how I know, lol.)
| dukeofdoom wrote:
| How do you know? I know someone that had this, which led to
| difficulty walking and inactivity, which resulted in blood
| clots in legs.
| spondylosaurus wrote:
| Aw, I'm sorry to hear that. AS can absolutely wreck your
| mobility over time. (And the reason I know is because I
| also have AS--I should've been more clear and gestured
| towards my username :P)
| dukeofdoom wrote:
| Not sure if it was the same thing, or just worn out hips,
| Osteoarthritis? But in retrospect, I've been thinking
| about it. A timer and getting up from the computer every
| half hour or wearing compression socks and maybe a foot
| massager would have helped. But I'm not sure if it would
| have been enough to prevent DVT.
| dghughes wrote:
| This reminds me of my GERD when it was bad and if I had the flu
| (yes I was vaccinated) my GERD symptoms disappeared. It was flu
| not a cold and I didn't have a runny nose if anyone is assuming
| it was post nasal drip causing a antacid effect.
|
| I developed hypothyroidism a few years later too. I know people
| can develop type 1 diabetes from influenza I had a first aid
| instructor tell me of a local incidence of such a thing after a
| block party. The pancreas and thyroid both being part of the
| endocrine system it's tempting to guess of wild things going on
| inside me.
|
| So GERD and hypothyroidism and viruses who knows what is going
| on. It's hard to not sound like a nut telling stories that are
| just anecdotal!
| quantumwoke wrote:
| Although the title is definitive, it should really say
| "possible".
|
| > In keeping with this, the researchers only found this
| Subdoligranulum strain in 16.7 percent of people at risk or with
| early-stage RA, indicating that this strain is likely not the
| sole driver of disease.
|
| Still, exciting work. The gut-brain axis is so important.
| bighoki2885000 wrote:
| [dead]
| bgribble wrote:
| I know anecdotes aren't data, but I would not be surprised if
| this was hitting close to the truth.
|
| I had a friend who had RA starting in her teens and was on very
| heavy medication for it, with no real hope of improvement. In her
| mid-20s she changed her diet significantly -- I think she went
| gluten free, maybe it was some other restriction. I thought it
| was silly TBH, why would changing what you eat affect arthritis?
|
| After about 6 months her RA was entirely in remission and she was
| off all of her medication. As far as I know has not recurred. I
| can very easily imagine that dramatic diet changes affect the gut
| biome and could have tipped the scales to make her gut less
| hospitable for specific causes of RA. I hope so!
| zzedd wrote:
| very similar experience with me. after frustration with medical
| treatment over many years into my mid-60s, i went gluten-free
| and symptoms cleared within weeks.
| broguinn wrote:
| The gut-brain axis is so important. It's only natural that
| commenters here would want to know when a treatment for RA is
| available based on these findings. Nothing's for certain, but it
| wouldn't hurt to improve your gut biome.
|
| - Take a probiotic and prebiotic daily. Swanson sells a bunch of
| cheap and high-quality ones. - Some people have had luck
| improving their gut health with supplementing collagen peptides.
| YMMV.
|
| Obviously, the gold standard is a double-blind study that proves
| the effectiveness at eliminating rheumatoid arthritis through
| intervention. Both of the above suggestions are well-tolerated in
| the general populace.
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