Rheumatoid arthritis (RA) is an inflammatory condition. Some people with a gluten intolerance may feel that eating gluten causes their symptoms to flare up.

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Some people find that removing certain foods, such as those that cause inflammation, from their diet can help them manage their RA symptoms. The foods that cause RA flares can differ from person to person.

Celiac disease is an autoimmune response to gluten that causes inflammation. A person can be gluten intolerant because they have celiac disease or for other, unknown reasons.

In some cases, gluten might make RA inflammation worse, too. Therefore, avoiding gluten could help people with a gluten intolerance improve their RA symptoms.

This article looks at the link between gluten and RA. It also discusses whether gluten can make the symptoms worse, as well as which foods to eat and avoid.

Gluten describes several types of protein found in grains such as rye, barley, and wheat. Gluten is present in the majority of bread, pasta, and other baked goods unless they are labeled gluten-free.

The reason it is called “gluten” is that it creates a kind of sticky, glue-like texture when grain flour mixes with water. This makes the dough more elastic and gives baked goods their familiar texture.

Can gluten affect the joints?

People who have celiac disease, which affects up to 1 in 100 people, cannot tolerate gluten.

In people with celiac disease, eating foods that contain gluten can cause sluggishness, bloating, and digestive problems. It can also cause pain, swelling, and inflammation in many areas of the body, including the joints.

Increasing research in recent years has also shown that gluten is associated with a variety of inflammatory illnesses, and this is not limited to celiac disease, wheat allergy, or gluten intolerance.

Like celiac disease, RA is an autoimmune disorder. In the case of RA, the immune system wrongly attacks tissues that produce synovial fluid in the joints. This causes joint pain and inflammation, which can lead to damage and deformity over time without treatment.

The same gluten-related inflammatory process may be a contributing factor in this disorder.

Some people may find that eating gluten makes their RA symptoms flare up and that eliminating gluten from the diet helps relieve their symptoms.

The link between diet and RA is not completely clear. However, there is research suggesting that certain components of gluten may trigger leaky gut syndrome (LGS) in some people.

While not all physicians yet recognize LGS as a formal diagnosis, research indicates that LGS may create openings in the intestinal walls for bacteria and toxins to come out into a person’s blood. This leads to a microbial imbalance and inflammation in the body.

While researchers have not determined a single cause of RA, they do speculate that LGS-related inflammation may be a factor.

In addition, according to research, people who have RA have more antigluten antibodies than people who do not, which suggests an inflammatory immune response related to gluten.

It is also possible for people to have both RA and celiac disease.

One 2019 study explains that there seems to be an overlap between the two conditions. The researchers revealed that people with celiac disease frequently have markers for RA (rheumatoid factors) and that people with RA frequently have signs of celiac disease.

People with RA may benefit from removing or lowering foods that contain gluten from their diets. This may seem difficult at first, but it should become easier over time. Gluten-free alternatives to common foods are becoming much more widely available.

Most major food groups contain no gluten, including:

  • vegetables
  • fruits
  • seafood
  • red meat
  • dairy
  • poultry
  • beans and legumes
  • nuts

Grains are the only source of gluten, yet not all grains contain gluten. Naturally gluten-free grains include:

  • rice
  • corn
  • sorghum
  • quinoa
  • millet
  • amaranth
  • gluten-free oats
  • buckwheat groats

There are also a number of naturally gluten-free flours to choose from. Manufacturers can make flour substitutes from the above grains in addition to foods such as:

  • potato
  • cassava
  • yucca
  • tapioca
  • beans, such as garbanzo, lentil, or urid
  • arrowroot
  • coconut
  • teff
  • chia
  • flax
  • nut flours, such as almond, hazelnut, or acorn

However, many manufacturers package these grains and flours using the same equipment as they do to package grains containing gluten, which may lead to contamination.

Therefore, a person should always read the label, which may state that the product came into contact with gluten or may contain gluten.

Those who are especially worried about gluten may want to only choose certified gluten-free products.

Packaged foods and products that normally contain gluten often have gluten-free alternatives. This includes everything from cookies and baked goods to pasta and bread.

Eating an overall healthy diet is also important for RA.

Though more research on this topic is still needed, existing research does indicate that adopting an anti-inflammatory diet that contains a wide variety of fruits and vegetables, spices, and probiotic foods may help promote an overall healthy body and reduce the levels of inflammation in the body.

Adopting a gluten-free diet is now easier than ever before, as many gluten-free products are becoming available. However, there are still a number of foods that people may wish to avoid.

Gluten comes from several different grains. Anyone looking to eat a gluten-free diet should avoid grains containing gluten, including:

  • wheat
  • spelt
  • kamut
  • farro
  • farina
  • durum
  • emmer
  • einkorn
  • bulgur
  • semolina
  • triticale
  • barley
  • rye

Although avoiding these grains will go a long way toward eliminating gluten, there are other foods to avoid. Some unexpected sources of gluten include:

  • brewer’s yeast
  • malt, such as malt vinegar, malt syrup, or malted milkshakes
  • wheat starch
  • oats that are not certified as gluten-free
  • gravy
  • salad dressing
  • dips
  • soups
  • beer
  • some wines

It is also still helpful to follow other guidelines about diet and RA. One study recommends that people with RA avoid eating foods that may cause inflammation, such as:

  • salty foods
  • processed foods
  • vegetable oils
  • butter
  • sugar
  • animal products

Any person with RA who suspects gluten may be contributing to their symptoms may want to consult with a doctor, who can make a recommendation on whether a person should avoid gluten.

If possible, a person should bring a food diary to the medical appointment or keep a food diary with the help of a healthcare professional.

A food diary contains a list of the foods a person has eaten, along with the symptoms they triggered. Having access to this could help the doctor or nutritionist identify any trends.

For some people, eliminating certain foods from their diet can help improve RA symptoms. Increasing research indicates that gluten can disrupt the gut microbiome, which can lead to a variety of inflammatory symptoms.

Some research suggests that people with RA are more likely to also have celiac disease. For this reason, eliminating gluten from the diet may be able to reduce inflammation and improve symptoms.

However, the effect of a gluten-free diet may be different from person to person. A person should speak with a doctor before deciding to avoid gluten.

In general, diet tips for people with RA include eating a wide variety of healthy, whole foods and cutting out processed and sugary foods.

How can a person know if gluten is making their RA symptoms worse?

If a person notices that their symptoms get worse after eating foods containing gluten, then gluten may be a factor in their symptoms.

A person can try to avoid gluten to see if their symptoms improve. A doctor can also order a blood test to check if a person has celiac disease or nonceliac gluten sensitivity.

Generally, having higher levels of certain antibodies or inflammation markers in the blood can indicate that a person may have one of these conditions in addition to RA. In some cases, the doctor may need to take a biopsy of tissue in the small bowel to confirm the diagnosis.

Should a person avoid gluten if they have RA?

If a person knows they also have celiac disease or gluten sensitivity in addition to RA, they should avoid gluten. If not, gluten may still play a role in the degree of a person’s RA symptoms.

A person can choose to try a gluten-free diet to see if their symptoms improve.

What other foods aggravate RA?

In addition to foods that contain gluten, other foods and drinks that may cause RA flares include alcohol, sugary foods, processed foods that contain trans fats, and foods with artificial additives.