Most people remain ignorant of the profound effect that wheat (and related grains) has on human health including joint health. Most discussions about the relationship of wheat and arthritis that you find online are incomplete, confused, or just plain ignorant, including many coming from doctors, dietitians, even rheumatologists. So let me try to clear up these issues.
Wheat contributes or accelerates arthritis in everyone, although susceptibility varies and the mechanisms by which wheat damages joints also varies. We know that primitive humans who first consumed einkorn wheat, i.e., the original wild ancestral, 14-chromosome form of wheat, experienced a doubling in incidence of knee-arthritis, clearly evidenced in the fossil record. In addition to this telling observation, we know that:
- The gliadin protein of wheat is the initiating factor in rheumatoid arthritis due, in part, to the increase in intestinal permeability provoked by this protein.
- The amylopectin A carbohydrate unique to wheat raises blood sugar and thereby insulin to an extravagant degree. Repeated consumption of wheat products therefore leads to development of insulin resistance and expansion of intra-abdominal visceral fat. This creates body-wide inflammation, including in joints.
- The repeated rises in blood glucose causes glycation of joint cartilage, i.e., irreversible reaction of glucose with joint proteins. Joint cartilage is largely made of collagen that is glycation-prone, causing it to become brittle and subject to deterioration over time that leads to erosion of cartilage and, eventually, bone-on-bone arthritis.
- The herbicide, glyphosate, sprayed to kill weeds in wheat fields, as well as a desiccant at time of harvest, introduces undesirable shifts in gastrointestinal (GI) microbiome composition, favoring the proliferation of fecal microbes while killing off beneficial species such as Lactobacilli species. This leads to small intestinal bacterial overgrowth, SIBO, in which fecal microbes ascend into the 24-feet of small intestine. The small intestine is, by design, permeable, as this is where we absorb nutrients. But when trillions of fecal microbes colonize the small intestine, they shed their toxic components such as endotoxin that penetrates the small intestinal wall and enters the bloodstream, “endotoxemia.” Endotoxemia then “exports” inflammation to other parts of the body and amplifies joint inflammation. Couple this with the increased intestinal permeability triggered by the gliadin protein of wheat and you have a lethal combination. Effects include amplified pain and inflammation in joints.
- Anti-gliadin antibodies appear to trigger a variety of different forms of arthritis such as ankylosing spondylitis, psoriatic arthritis, and others (in people without celiac disease).
- People with so-called “non-celiac gluten sensitivity,” i.e., health phenomena associated with consuming wheat and related grains but distinct from celiac disease, commonly experience relief from joint pain with grain elimination. (Although called “gluten sensitivity,” it is not clear that gluten is the culprit. It could be gliadin, glutenin, amylase or trypsin inhibitors, wheat germ agglutinin or some other component of wheat/grains.) The mediator of joint pain in this situation has not yet been identified. In my experience, this often involves fingers and wrists, as well as knees and hips.
Wheat and grain elimination is therefore a powerful strategy to preserve joint health. Beyond this, in my programs we take it further to protect joint health and even rebuild joint cartilage and maintain or increase joint synovial fluid, i.e., the viscous lubricating fluid of joints. So we also:
- Address vitamin D—a major player in bone and joint health.
- Restore L. reuteri—We restore this microbe that has been lost by nearly all modern people, despite its ubiquity in mammals and hunter-gatherer human populations unexposed to antibiotics. The super-duper high bacterial accounts we achieve with L. reuteri yogurt provokes oxytocin release from the hypothalamus that, in turn, stimulates cartilage cells (chondrocytes) to produce the elements of joint cartilage. Also, L. reuteri has the unique ability to colonize the small intestine where it takes up residence and produces bacteriocins, natural antibiotics effective against the species of SIBO, thereby reducing endotoxemia and its effects on joints.
- Restore collagen peptides—Largely lacking from the modern diet due to silly low-fat dietary advice and thereby aversion to consuming organ meats. Obtaining dietary collagen rebuilds joint cartilage. Dosing for most forms of collagen is 10-20 grams per day, supplemented by intake from diet in slow-cooking tough cuts of meat and carcass broth.
- Restore hyaluronic acid—As with collagen, the abandonment of organ meat consumption like brain, tongue, and skin means that we ingest very little hyaluronic acid. A 4-ounce serving of lamb or sheep’s brain provides around 7 mg of hyaluronic acid. A dose of 100 mg of hyaluronic acid per day is therefore a confident dose.
- Address magnesium—Magnesium plays a role in bone and joint health. Like the other factors in this list, magnesium intake in modern people is much lower than ideal.
Conventional “solutions” to arthritis are, of course, not solutions. Non-steroidal anti-inflammatory drugs, the most common first-line treatment, disrupts the GI microbiome, causes stomach, duodenal, and small intestinal ulceration and bleeding, and over time leads to kidney disease and kidney failure. Prednisone is no solution—it does reduce inflammation, but also causes extravagant weight gain, type 2 diabetes, and stomach ulcers. Joint injections of hydrocortisone or hyaluronic acid relieve pain, but are temporary. Platelet-rich plasma and stem cells implantation remain uncertain in efficacy (but provide practitioners a way to monetize the condition.) And, of course, joint replacement is regarded as a success but is really an outright failure to prevent the disease.
The approach I articulate above may sound complicated at first, but it really isn’t. It begins with diet, then add each of the additional strategies one-by-one. Each component not only helps rebuild joint cartilage and synovial fluid, but also benefits overall health and body composition.