“There’s no clear scientific evidence that a gluten-free diet helps any form of arthritis,” says Stacy Ardoin, MD, a rheumatologist and professor in the division of rheumatology and immunology at Ohio State University Wexner Medical Center in Columbus. “It’s a maybe,” says Rochelle Rosian, MD, a rheumatologist at the Cleveland Clinic in Ohio. Some people with psoriatic arthritis say that a gluten-free diet does help them better manage their joint pain.
What Is Gluten, Anyway?
Gluten is a protein found primarily in wheat, barley, and rye, along with foods made with any of these grains, including most breads, cereals, pastas, baked goods, processed foods, and even beer. People with celiac disease typically can’t tolerate any gluten, even traces that might be lingering on a cutting board or knife, or the small amount found in soy sauce or some gravies, Dr. Rosian says. But true celiac disease affects only 1 in 100 people, according to the Celiac Disease Foundation. It is an autoimmune condition — in which your immune system mounts an attack on your own body, in this case your small intestine — that causes damage to the digestive system and symptoms such as diarrhea, bloating, and fatigue. Yet people who don’t have celiac disease can still have gluten sensitivity. An analysis of studies in the Journal of the American Academy of Dermatology suggested that people with psoriasis have over 2.2 times the risk of developing celiac disease compared with the general population and that a gluten-free diet may help some psoriasis patients. RELATED: The Pros and Cons of Probiotics for Rheumatoid and Psoriatic Arthritis And that inflammation can make you more sensitive to gluten, Rosian says. “Gluten-free diets have significant overlap with anti-inflammatory diets,” she notes. Researchers have already found connections among various autoimmune and digestive diseases such as Crohn’s. People with psoriasis and psoriatic arthritis are at increased risk of developing inflammatory bowel disease (IBD) and other gastrointestinal illnesses, according to a study published in June 2021 in Wiener Klinische Wochenschrift. Other researchers have found links between celiac disease and the likelihood of Crohn’s patients developing rheumatoid arthritis, according to a study published in April 2019 in the Journal of Community Hospital Internal Medicine Perspectives. The same connections may apply to psoriatic arthritis, Rosian posits. RELATED: Double Trouble: When Psoriatic Arthritis and Crohn’s Disease Strike
How to Tell if Gluten-Free Is Right for You
While there’s no science to prove that cutting out gluten helps psoriatic arthritis, it can’t hurt if you want to modify your diet, then gauge the effect on your symptoms, Rosian says. Julie Cerrone Croner, 35, a blogger and holistic health coach from Bethel Park, Pennsylvania, has been gluten- and dairy-free for about seven years, and has found that the combination works for her. If she accidentally eats gluten, she says, “I can tell. My gut will ache, my knees will ache and swell, my energy level drops, and I usually have a pounding headache. It can take a few days for my body to get back to normal.” Keep in mind that if the modifications have any effects, they won’t be instantaneous. “It can take two or three weeks for your gut to calm down, so be patient,” says Rosian. If you go gluten-free and still have gut issues, get checked by your doctor. Another point to remember: Going gluten-free is no substitute for your prescribed psoriatic arthritis treatment. “It’s meant to be complementary, not alternative,” Rosian emphasizes. And it’s not always an easy switch. “Some people aren’t huge fans of the texture of gluten-free pasta or bread,” says Julie Stefanski, RDN, a spokesperson for the Academy of Nutrition and Dietetics based in Morrisville, North Carolina. Brian LaFoy, 51, of Plano, Texas, didn’t see his psoriatic arthritis improve when he became what he calls “gluten conscious” about six years ago. But he shed 30 pounds as a side effect of the diet — he says he drastically cut his beer consumption — and has definitely benefited from the weight loss. Being lighter may also ease stress on joints. “They aren’t as sore,” he says. RELATED: 7 Reasons to Lose Weight for Psoriatic Arthritis
Challenges of a Gluten-Free Diet
If you’re still game to go gluten-free, know that some GF foods can also be more expensive or higher in fat, calories, and carbohydrates than their gluten-containing counterparts, Rosian says. And if you’re eating out, sticking to the plan can be a challenge. Still, gluten-free food has become so popular that even some grocery store chains have their own line of choices, and restaurants often offer gluten-free options. Frozen and canned vegetables, whole fruits, fish, beans, lean cuts of chicken and beef, and dairy products like milk and yogurt are naturally gluten-free and generally safe to eat, Stefanski says. With packaged foods it’s important to read every label to check for gluten-based ingredients. Also check out the allergen statement at the end of the list, especially if food has been processed in any way — for instance, some sausages and yogurts contain added gluten as a thickener. “It’s important to find all possible sources of gluten,” warns Stefanski. You also want to make sure that you’re not missing out on critical nutrients — another problem for some on a gluten-free diet. “The nutrients that are added back to processed wheat foods, such as iron and B vitamins, can also be found in naturally gluten-free options,” Stefanski says. Your best bet: Choose whole foods that are naturally gluten-free, such as rice, potatoes, and corn, rather than gluten-free versions of bread, crackers, or pasta. RELATED: Your Psoriatic Arthritis Diet Questions, Answered
