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as if doctors needed more reasons to pump you up with antibiotics

This is more likely a candidate for a fecal transplant.

It might be the other way around. The use of antibiotics might contribute to the chances of allowing bacteria like this one raise in numbers and create issues.

Yes I agree. I’ve watched all seasons of House so I am qualified to make this medical determination.

Whoa! Happy to hear of any progress in this area. My Mom is practically crippled by arthriis, and I'm pretty sure it will also be coming to get me. Yay science! Go Go Go!

I hope this finally creates the incentive to conventional use of bacteriophages.

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my friend said she tried an IV antibiotic for her RA and it went away and never came back...

just keep in mind there's two main types of arthritis; osteoarthritis and rheumatoid arthitis. Osteo is basically just mechanical wear of the cartilage as where rheumatoid is an autoimmune disease that attacks the cartilage.

this article is specifically talking about rheumatoid arthritis

as if anti-science idiots needed any reason at all to gaslight people without even reading the article

It literally says in the article antibiotics aren’t recommended to treat this as it removes good & bad bacteria in the gut and won’t reverse the condition once it’s started.

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I wonder if the treatment they develop from this information will also benefit people with psoriatic arthritis. The conditions are very similar. My sister has been battling PsA since she was in her 20s, had to get a knee replaced in her 30s. I'd love to see an effective treatment come along.

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I thought I came up with this idea in high school in the 1980's. Apparently the Soviet Union did a fair amount of research at the time and the idea seems to be gaining traction again.

I still say we need to put research intro bio engineered gur bacteria to produce needed medicines like insulin with normal diet or "other" beneficial things.

So before anyone thinks that Rheumatoid Arthritis will be cured by antibiotics: they only found out that these bacteria may cause the formation of autoantibodies. Once you have those the removal of the bacteria won’t help with the disease.

Nope. Also psoriatic arthritis, reactive arthritis, gout, CPPD, etc. Lots of kinds of arthritis.

There’s also psoriatic arthritis, which is worth mentioning because it can seem like rheumatoid arthritis. In fact, testing negative for the rheumatoid factor is one of the ways to help diagnose psoriatic arthritis and distinguish it from RA.

Pretty sure it’s supposed to be injected and not go through the digestive system. Anyway effort should instead go into pushing companies to make insulin a couple dollars in America like everywhere else.

Also doesn’t seem easily regulated. Too much medicine, especially insulin, can kill you. Not a fun time.

We found that one previously unknown species of bacteria was present in the intestines of around 20% of people who were either diagnosed with rheumatoid arthritis or produce the antibodies that cause the disease. As a member of the Cherokee Nation of Oklahoma, I suggested we name this species Subdoligranulum didolesgii (“didolesgii” means arthritis or rheumatism in Cherokee) as a nod to the contributions that other Indigenous scholars have made to science as well as the fact that rheumatoid arthritis affects Indigenous people at a higher rate than other populations.

Subdoligranulum didolesgii has not been detected in the feces of healthy people before, and it is currently unknown how prevalent this bacteria is in the general population.

Psoriatic is often in conjunction with psoriasis. With RA they aren’t testing for a rheumatoid factor. They test for inflammatory markers. And it is possible to be diagnosed with RA without having any inflammatory markers. It is called seronegative RA.

Except where did I say there's only 2 types? I said the main types, which are the most common https://www.mayoclinic.org/diseases-conditions/arthritis/symptoms-causes/syc-20350772

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She could have had Septic Arthritis, from bacterial infection of the joints

It is possible to have psoriatic arthritis without any psoriasis rashes on your skin, which is the case for me. Nail psoriasis, such as pitting in your nails, is another sign and there are others.

They most certainly do perform rheumatoid factor tests. I had those tests done for it. I realize that’s not the only tests though. But my point anyway was about distinguishing PsA from RA, not how to diagnose RA.

And infectious too right? The one you can get after certain diseases no?

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Can we nuke it antibiotics? Or is it a type we actually need?

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I have PSA. Sucks. My skin is good except for 3 knuckles and my lower back. My joints are in hell.

I said often, I did not say exclusively in psoriasis patients. And there was never a rheumatoid factor test. Your doctor may call it that, but they are testing for the inflammatory markers. I have RA and have been on Humira for it for a couple years now. And I wasn’t talking about how to diagnose, I was adding to the point that you can show negative but still be diagnosed with something. And that it has an actual name, not just a misdiagnosis for another form of arthritis.

I was diagnosed with PsA after years of aero-negative RA. Achilles tendinitis changed everything

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Pitted nails for years now diagnosed with PsA

Sure, but I wanted to clarify for anyone reading the comments that you can have psoriatic arthritis without psoriasis. That is part of what makes PsA hard to diagnose and to distinguish from RA.

I believe you that there are tests for inflammatory markers, but there are also antibody tests, including RF. Here is a quote from rheumatoidarthritis.org:

> “In most cases of rheumatoid arthritis, the patient tests positive for rheumatoid factor (RF) and/or anti-citrullinated peptides (CPP) antibodies.”

They have a whole page about the RF blood test, so I don’t know what else to tell you. I’m not a physician.

My grandfather's arthritis was crippling for him. He had over 20 surgeries to remove excess bone so the majority of his joints (fingers, toes, knees, elbows, shoulders, hips) could function mildly. Was on a daily morphine prescription to dull the pain but it never really worked. Most task requiring finger dexterity were not done. Cracking open a can of beer was a task without him having his opener.

The amount of pain the individuals with rheumatoid arthritis go through is incredible and heart breaking to say the least.

I think some infectious diseases worsen psoriasis but aren’t the cause of it. It is believed to be genetic, and the cause is not well understood.

Yup same. Have no psoriasis on my skin, just nails. Was dxd in June with PsA after testing negative on RF, positive on inflammatory markers.

And yet that’s not tendonitis. It’s enthesitis, which is a PsA thing that feels and acts like tendonitis. Entheses are where the tendon attaches to the bone. Hurts like hell and responds poorly to tendonitis treatment. Mine is plantar.

Or lyme disease

Sorry to hear you’ve had so much trouble. That really sucks. I’ve had joint pain since I was a kid, and it got worse throughout adulthood. Finally in my thirties, I got diagnosed with PsA because my dermatologist noticed my nail pitting. Then I went to a rheumatologist. I had other symptoms as well.

I’m sorry to hear that. The joint pain really is hell indeed. Started when I was a kid.

This makes a lot of sense as my PsA emerged about a decade after I developed horrible IBS.

That’s what happened with me, too. My primary physicians never figured out my joint pain, and then the first time I went to a dermatologist, they noticed the pitted nails. Rheumatologist after that, and I had other signs of PsA.

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Interesting, particularly the test with mice resulting in a reaction so quickly.

Hi there, I'm going to my first rheumatologist appointment next week for some weird ongoing pain I've been having. I guess they'll do a bunch of test, but I have some significant dips that run horizontally across my finger nails. Is that similar to what you have? And what other symptoms alerted you to your diagnosis? Thank you!!

Unfortunately that’s very unlikely, as from the moment on there are auto-antibodies there is self-reinforcing mechanism that keeps on producing them (as you still have that auto-antigen in your joints there will be continuous inflammation).

Fecal transplants?

This is so important because it affects quality of life, which ultimately is more important than extending life. Autoimmune diseases make life a misery.

Sounds like my wife was right. She was severely arthritic, and also needed antibiotics from time to time. She was adamant that easing of her arthritis was a welcome side effect of the antibiotics.

This is more common than most people think, and providers often miss it on differential diagnosis.

I went through a similar process. Are you on any sort of immunosuppressant or just taking anti-inflammatories if you don’t mind me asking. Has your treatment helped at all with pain if you are on anything?

There are currently companies aiming to use engineered bacteria to treat inborn errors of metabolism. Think PKU. They are creating bacteria with the enzymes necessary and testing them to see if they will work.

Pretty sure Hitler did this to some degree can't remember what for though..

After 15 years of a nonspecific inflammatory arthritis, I developed scalp arthritis. Now I’m off my old meds and on a new one that’s working. Freedom!

Hello, the horizontal dips in your nails that you describe are different from the nail pitting I have. The nail pitting is like several tiny dot-shaped depressions in all fingernails.

I do not have all of the possible signs and symptoms of psoriatic arthritis, but the ones I do have are nail pitting, joint pain in fingers (they imaged my hands because of this to distinguish from osteoarthritis, and it is also not typical of RA), ankle pain, foot pain, plantar fasciitis, lower back pain, and a negative rheumatoid factor test.

Good luck with your appointment!

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I guess GP was meaning “rheumatic” arthritis not RA. That categorization subsumes PsA. I have enthesitis in my knees and ankles, as well as SI inflammation. Doctors keep shifting my diagnosis around from PsA to spondyloarthropathy etc since there’s no smoking gun. I generally just say I have a rheumatic disease as they treat it with the same biologics

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It can go into remission for periods of time depending on the success of the treatment.

Ya, that seems very definitive - assuming it is repeatable.

This could ultimately benefit people with all kinds of autoimmune disorders. They're all somewhat fundamentally related, after all. Very exciting. Autoimmune disorders, in general, is one of the few remaining big categories of disease we haven't made much headway in curing (much like cancer) and they are rapidly on the rise in the general population, too.

Maybe that is what it is- she said she had some kind of bacteria in her joints, yeah....it worked though and she has had like 5 more kids since she healed it and she now has 7 kids and is a vet and is rocking life and seems healthy

Thanks for responding.

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Have you tried working out? Mainly strength training, not running/traditional cardio. I have it too and when I started working out it was painful, but after awhile my joints felt better than ever! Probably due to the muscles doing more of the work and taking the strain off the joints and movement lubricates the joints as well. Start with really low weights and if an area is bugging you just do less reps or drop the weight even lower that day. Also with arthritis it’s important to not workout first thing in the morning when you’re stiff, your joints need time to warm up.

Do you know what type of doctor tried it?

Google fasting and psoriatic arthritis. Lots of positive results. Probably starves the bacteria. Known to work well with RA also. True North in California (largest supervised fasting clinic in the world) reports success especially with 3 main diseases: hypertension, type 2 diabetes and rheumatoid arthritis.

It seems to be much improved with prolonged fasting. https://clinicaltrials.gov/ct2/show/NCT03856190

It makes sense also in that prolonged fasting commonly improves autoimmune disorders. It has been theorized by many that autoimmune disorders arise from gut dysfunction. And fasting usually helps with gut dysfunction.

Thanks, I'll pass it along to her.

My 16 y/o was diagnosed with JRA at the age of 8. Their life has been severely impacted by RA. It would be nice to see some progress made.

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I have psoriatic arthritis. Not fun. It’s a weird disease; one day I have crippling pain in hands and feet, then another no pain at all. Weird too: getting up in the morning hurts like hell, but it can be gone in hours after using the joints. I just did some jogging, then had nearly a week with no pain. Such a strange thing.

What is your scalp arthritis like?

I have some kind of arthritis- fingers wrists have been itching like crazy. For some reason I wondered if weights would help.

it’s important not to eat animal products

Do you have a source on that?

It's a horrible disease. My wife developed it just short of her 29th birthday and has suffered from it and then the drugs for treatment.

Gouty Arthritis would like a word with you

Look up Onychorrhexis and see if that’s what you might have.

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And don’t forget ankylosing spondylitis, an auto-immune arthritis of the lower spine! It often co-occurs with both rheumatoid and psoriatic arthritis. I don’t recommend it.

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Just to offer a counterpoint as a person living with psoriatic arthritis… hunger exacerbates the pain. Badly. I have no appetite because of the medications I take and I always know it’s time for a meal or snack based on my pain level. There’s a direct correlation.

Fasting can be very stressful on the body and we already do it for 8ish hours a day naturally, which is plenty. Please don’t believe the pseudo-scientific hype.

Would Iike to read about the study and its implications/validity instead of people talking about their disease (that isn't RA even!)

I don’t have a statistic on misdiagnosis ready, I’m just a clinical lab scientist and have worked with several docs at two outpatient clinics in the last five years. Once at each clinic, I had docs misdiagnose gonococcal arthritis as rheumatic arthritis, and were surprised when the rheumatology specialists sent the patients back with antibiotics and orders for STI workups. They didn’t seem aware that N. gonorrhea could cause arthritis.

https://www.ncbi.nlm.nih.gov/books/NBK470439/#NBK470439_pubdet

Review paper says that in the 80s, data suggested that 14% of diagnosed arthritis cases were gonococcal in nature, but those statistics may not hold up in the context of today’s diagnostic rates. Regardless, arthritic symptoms in relatively young patients should definitely indicate for an STI workup in addition to normal RA testing and imaging.

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RA also attacked the synovial fluid in the tendons causing inflammation.

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Is this from the article? The site is down for me.

so can this info lead to a cure or something

This is interesting. RA is one of the 7 conditions also linked to people having Mononucleosis as a kid. The other CV conditions include Lupus, Celiacs, Irritable Bowel Syndrome, Multiple Sclerosis, and two I can't remember at the moment. All of these conditions feature inflammation as a marker. I wonder if the same bacteria or a similar bacteria may be found in those patients?

It started in July 2020 and felt like I had acne patches on my scalp that were so itchy it would disrupt my sleep. I couldn’t see it and it took a few televisits to realize I needed to be seen face to face. Phototherapy helped get rid of it and then I started Otezla. Joints feel much better but my scalp gets itchy from time to time but that’s about it.

Hence why Type 1 diabetes persists after the initial cause- often severe infection- is dealt with, in addition to the profound damage to the pancreas.

However, colonization or infection with such bacteria would likely exacerbate symptoms, since the autoantibodies were originally produced in response to the bacteria and expression would increase on any reinfection or colonial growth.

Autoimmune conditions are immensely tricky at baseline and our understanding of human microbiomes is still so limited that it's hard to say what might happen in either scenario.

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So will a broad spectrum antibiotic solve this issue?

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I have an idea that in the future we will realize that most of the diseases/cancers that plague us today, are caused by bacteria and viruses. We just don't have a full understanding of this relationship at the present time. I'm not a doctor and i hope I'm not totally wrong here or, worse yet if this is already a well known fact and I think I just came up with a novel idea because I'm special... Omg...

That’s wild, super observant to notice it.

You are describing my exact symptoms, but I haven’t gotten any diagnosis yet. One day I feel like I’ve lost like 50-60% of my grip strength, the next it seems fine (I have Psoriasis as well).

I used to weightlift pretty intensely for a while about 8-12 months ago and figured I just overdid it, but the pain never went away after I stopped because of it.

I have an appointment at a Rheumatologist soon in the hope that they can figure out what’s wrong.

Can I ask what they checked to diagnose it? What did they suggest for treatment? Have you noticed anything helping, or making it worse?

Sorry for the many questions, your description just hit the nail on the head for me, and I’m just hoping to be able to find some kind of treatment.

Thank you for sharing!

I have this bad boy with a nice side of Crohns collitus, hobbling to the bog in agony then not being able to sit due to agony in hips , breakfast of champions.

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Maybe if you know you have the genetics that would predispose you for RA that would be helpful to prevent it from manifesting? I don’t know. Haven’t heard about that yet.

Every physical long term condition has inflammation as a marker

Thank you. I am sure their sister DOES NOT want to hear some random person on the internet's opinion on how to "cure" her disease.

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PsA is a special hell. I watched my strong as hell father barely be able to get out of bed for months after he first started showing symptoms. From felling trees and loaded tons of timber solo into a huge trailer to unable to roll over without help in a matter of weeks.

Do you recall which antibiotic it was?

I’ve had autoimmune conditions all my life and they do just go away sometimes, then you get a different one. I even had some kind of arthritis for 15 years in my toes, ankles, knees and wrists from around age 10, but I don’t think that was autoimmune in my case. I took glucosamine and chondroitin 1500mg and 500mg for 3 weeks around age 25 and the arthritis just went away. It used to come back, but a couple of days of the supplements and it would go away again. It’s been almost 30 years now since it’s been back. This is also around the time I turned vegetarian. Pretty sure the supplements fixed the arthritis, but it is possible that meat eating exacerbated it.

It was arthritis so bad the doctor was talking about joint replacement and I sounded like someone playing the castanets when I walked.

I’ve never heard of anyone else having such a great response, and I was never tested for what kind of arthritis it was, but I presume osteoarthritis.

I also have a high genetic risk for osteoarthritis according to Impute Me.

Just throwing that out there in case it helps anyone.

Mine started as psoriasis back in 2011. I had patches on my legs and scalp. It was annoying, but manageable. I also had frequent pain and swelling in one pinky toe, with on/off hip and wrist pains. I was also a heavy drinker.

I started doing a lot international work with lots of travel and stress. I was in a hotel room hungover one morning in the fall of 2014. I woke in lots of pain. Both feet and ankles were swollen. Most toes were stiff and swollen. I started getting pains in various joints.

I got back home and saw a doctor. They diagnosed as psoriatic arthritis due to my psoriasis and the swelling of toes.

I went on methotrexate first. I also stopped drinking (8 years yesterday). The methotrexate knocked down all the swelling and eased some pain, but did nothing for the psoriasis. That was fall of 2014.

Sometime in 2015 I switched to Enbrel. At that point, I still had skin issues and lots of pain, but little swelling. The Enbrel seemed to help a little, but really not much, and also did nothing for my skin.

In 2016 I switched to Stelara. That helped the pain AND completely cleared up my skin. No more swelling, but still morning stiffness and occasional flareups of pain.

About 3 years in, the Stelara just stopped working. My skin was always great, but my pain and stiffness increased, especially in the morning.

I switch to Cosentyx in December 2019. That felt like when I started Stelara, but even that has stopped being as effective. I have some skin issues on my scalp now and the arthritis can be severe in the morning. I’m looking at options for what I can do next.

I find exercise helps a lot. Mornings are horrific, with intense pain in feet and hands. But it goes away as I move. But sometimes the pain lingers all day like a toothache.

My plan now is to exercise more and stretch. I’ve found stretching at night right before bed helps with the mornings.

It’s a scary disease in how variable it can be. It really makes me wonder how much time I have left.

Yes it is a quote from the article

That may be the case, but it doesn't follow that a course of antibiotics, implying reduction in certain species of gut bacteria, would immediately (if at all) reduce levels of the antibodies that cause rheumatoid or other autoimmune diseases.

Not that her symptoms didn't improve from the antibiotics, I'm just suggesting that this mechanism isn't plausibly why they improved

No, that's not how the immune system works

I would doubt it being osteoarthritis as that presents in older age only and is not really reversible.

Yeah there are some autoimmune conditions that remit completely (especially in youth) or come in attacks in random intervals. There is some evidence that meat can exacerbate inflammation, so maybe that helped in your case. I’m glad yours went away!

Guillian Barre

So does this make RA contagious? If someone doesn’t wash their hands properly after using the restroom…..?

>aero-negative

seronegative?

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Along with knee pain did anyone here experience eye pain? For me, knee pain is not that severe but the eye pain is unbearable and it happens 2-3 times a year. Only way I get relief is by closing the eyes and not let any light pass. My doc linked this to seronegative arthritis :(

How is it that it’s 2022 and we’re just fixing this bacteria?

Not with any reliability. A stroke and two heart attacks have left a few gaps. Sorry.

Is there any chance that you scientists stop using the words "may be" in these pronouncements?

It's as useful as saying a 26" Louisville Slugger may also be the culprit.

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Good. We need more funding.

I was diagnosed ~ 13 years ago. It’s been a theory for some time.

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Arthritis is strongly associated with inflammation. It seems quite possible that this bacterial infection somehow takes advantage of the inflammation. Especially in the presence of sustained high blood sugar, which is extremely common especially among people with persistent inflammation, the conditions for unusual bacterial flare ups could be generated. There is increased blood flow, warmth, and excess blood sugar all together. So it seems likely that we need to think about arthritis as a systemic condition with multiple related factors.

Presumably yes

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Dont forget plant based diets as well.

Any way you can reduce your intake of ultra processed foods, red meat and dairy will improve gut health.

So you're going to cancel out one random person's advice with another person's random anti-advice?

How about you take the advice and go and verify it yourself?

Inthink youre right -but kost relevant to us will be the association of bacteria in our gut to many of these diseases, and the health of our guts are often intrinsically tied to our diets

We are what we eat, after all.

Do you know this for certain with the RA and PsA antibodies, or are you saying in general that we never lose antibodies? Because the latter is not true.

Try hat is some really fascinating work. Understanding mechanisms is usually a very useful step in finding solutions. Love this type of science.

One person’s random, unsolicited advice versus the lived experience of a person with the disease in question. Not quite the same.

You have done prolonged fasts and your symptoms immediately came back when you broke the fast? That isn't what True North, the premier supervised fasting clinic reports, though they were just referring to rheumatoid.

My mom's arthritis was awful and she died from it last year.

That's a long way of saying "anecdote". I just encouraged someone to do their own research. Are you saying they should just trust you?

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That’s in autoimmune diseases in general. So in RA you’ve got auto-antibodies against antigens that can be found in your joints. So basically there is an inflammatory trigger in your own body that keeps on reinforcing the production of these antibodies. In PsA autoantibodies don’t play a a big role in the formation of arthritis.

I’m saying the lived experiences of marginalized, disabled, and chronically ill people should be given some weight, yes. Certainly more weight than some person clearly advertising a specific clinic that peddles unproven methods for a completely different diagnosis.

Also, some more free emotional labour for you: disabled and chronically ill people are constantly accosted with unsolicited medical advice. This is a common experience and one that is not at all helpful.

Scalp psoriasis I think…

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I don’t have PA or RA but I have had pretty intense joint pain from complications from multiple Lyme infections and I can say fasting has changed my life. You are conflating daily hunger triggering pain vs a systemic, long term change. There is a ton of evidence that exists and continues to be added to that the longer you put you body into autophogy the better results there are for things like inflammatory and immune diseases. Also the more your body produces glucagon vs insulin over the long term has been a significant factor in my reducing inflammation in my body. I have like 90% less joint pain now than I did 2 years ago. Again not a direct correlation but if you want the lived experience of someone who has done it long term and isn’t just baiting some hype article online then here it is. I’ve also had long conversations with my doctor about fasting and the biological mechanisms it triggers to reduce inflammation system wide and how he has seen significant results across the swath of patients that he’s recommended it to to help with certain conditions. I went in for blood work to make sure fasting wasn’t causing any problems and had a pleasant surprise that my doctor supported it, he never brought it up unprompted.

My mom collected them all

I wonder if this is why many improve their arthritis with meat only elimination diets? I imagine there is a major impact on gut microbiota.

You’re literally promoting disordered eating. I’m glad you’ve found some relief but the dangers far outweigh the potential benefits for most people.

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I don’t know that’s it’s pseudoscience. They’ve been using fasting as treatment for a long time in parts of western and Eastern Europe. Doctors prescribe it and the national insurances cover it. The reason it’s not caught steam here in the US is partially because of how our healthcare system works. There’s no incentive for anyone to produce work and trials showing that fasting works or helps multiple conditions, and therefore insurance won’t cover it.

I've had it my entire life, I'm 34 now and it's made its way into my spine, I take shots that without insurance would cost 3k a pop but still isnt stopping the damage. I hope they can find the cure so people do t have to deal with what I go through on a daily bases.

I have been having almost the same exact issues, I have days where I hobble around at work and then a few days later I'm fast walking everywhere without any pain. I described it to my doctor as being like waves, sometimes it recedes but it can come back hours or days later and this rash near my eyes isn't going away but at least it hasn't flared up as bad.

After getting minor improvements with the rash and no change to the pain when it shows up I'm finally convinced to tell my rheumatologist since he already treats my fibromyalgia.