Research published in Annals of the Rheumatic Diseases by the University of Leeds in November 2024 suggests that there is a link between the gut microbiome and rheumatoid arthritis. More specifically, that there is a window of opportunity for a potential intervention point in those who are likely to develop rheumatoid arthritis (RA).
RA is an autoimmune disease affecting nearly half a million people in the UK, according to Versus Arthritis. It causes swelling, stiffness and pain in multiple joints, as the immune system mistakenly attacks healthy cells. While previous research has suggested a connection between the gut microbiome – the collection of microbes in the intestines – and RA, this study provides fresh insights into a possible point of intervention.
Dr Naveen Bhadauria, Consultant Rheumatologist at Pure Rheumatology London, explains, “These are early findings, but the research is very interesting and suggests a confirmation of what we already believe – that gut health plays a key role in autoimmune diseases, including rheumatoid arthritis. Currently, this lends more weight to lifestyle advice provided by rheumatologists – such as taking a probiotic, improving diet and sleep hygiene, and managing stress – to RA patients. In future, with more research and development, it could open doors to preventative treatments for RA.”
Gut Bacteria And Rheumatoid Arthritis: What Does The Research Say?
The study found that certain bacteria linked to inflammation appear in the gut roughly 10 months before patients develop clinical rheumatoid arthritis.
It followed 19 patients at risk of developing RA, taking stool samples over a 15-month period. Of these, five progressed to clinical arthritis, and their gut samples showed instability and an increase in inflammation-associated bacteria, such as Prevotella, around 10 months before their diagnosis. By contrast, the remaining 14 participants, who did not develop RA, had more stable gut microbiomes.
The findings suggest that monitoring gut bacteria could help identify individuals at high risk of developing the disease. Researchers are now considering potential interventions, such as dietary changes (including increased fibre intake), prebiotics, probiotics, and even improved dental hygiene, to reduce harmful bacteria linked to RA.
What Does This Research Mean For Rheumatoid Arthritis Treatment?
Despite the promising nature of this study, researchers acknowledge its limitations. The sample size was small – only 19 patients – meaning larger studies will be needed to confirm these findings. Additionally, while the study showed a link between gut bacteria and RA, the exact mechanism remains unclear.
As part of the ongoing research, the Leeds team will now analyse treatments that have already been trialled in order to determine how they might be used at this newly identified intervention point.
With further research, scientists hope to develop new strategies to help those at risk of RA, potentially changing the way the disease is managed in the future.
How To Look After Your Gut Microbiome
People with RA and those who are at risk – such as individuals with high levels of CCP+, an antibody that attacks healthy cells in the blood – are encouraged to take care of their gut microbiome as part of an overall approach to improve their health.
An imbalance in the gut microbiome is called gut dysbiosis. This is where harmful bacteria outnumber the beneficial ones. This imbalance can result in symptoms such as digestive issues, inflammation and a weakened immune system. In addition to RA, gut dysbiosis has been linked to other autoimmune diseases, irritable bowel syndrome (IBS), obesity and mental health disorders.
With so much research supporting the significance of the gut microbiome and its impact on both physical and mental health, we could consider treating this collection of bacteria as if it were its own system. This means taking steps to look after it – just like we consider our heart health by engaging in cardiovascular exercise and lowering consumption of saturated fats, or our brain health by maintaining good relationships and staying mentally active.
Some Ways To Support Gut Health Include:
Taking a daily probiotic
Probiotics contain beneficial bacteria that help balance the gut microbiome. These microbes add to the population already living in your gut. They support digestion, help prevent harmful bacteria from thriving, and may play a role in reducing inflammation. Probiotics can be found in oral supplements or fermented foods, such as yoghurt, kefir, sauerkraut and kimchi. If you are unsure about which probiotic supplements to take, your doctor may be able to recommend particular products that suit your needs.
Managing stress
Chronic stress can negatively impact gut bacteria and contribute to inflammation. Relaxation techniques such as meditation, yoga and deep breathing exercises may help reduce stress and support gut health. If your stress is related to a particular area of your life, such as your work or home life, try to focus on relieving stress in these areas by delegating your workload, or reaching out to others who may be able to help.
Eating a diverse, fibre-rich diet
A diet rich in fruits, vegetables, whole grains and legumes provides essential nutrients for beneficial gut bacteria. Fibre, in particular, acts as a prebiotic by feeding good bacteria and promoting a healthy gut environment.
Improving sleep hygiene
Poor sleep can disrupt gut bacteria and increase inflammation. Maintaining a consistent sleep schedule, limiting screen time before bed, and creating a relaxing bedtime routine can support better sleep and, in turn, gut health.
Factors such as antibiotic use can contribute to gut dysbiosis; however, it is not recommended to avoid taking prescribed medications in order to avoid microbiome imbalance. Instead, voice your concerns to your doctor, and continue with positive lifestyle habits to maintain your gut health despite antibiotic use.
What To Do If You Have Symptoms Of Rheumatoid Arthritis
If you are experiencing pain, stiffness or swelling in any joint in your body, it is recommended that you see a consultant rheumatologist as soon as possible to diagnose the condition and, if necessary, prescribe you a treatment plan for symptom relief and to prevent disease progression.
RA can affect individuals of any age, so it is important not to dismiss your joint pain, as prolonged diagnosis can result in disease progression and poorer treatment outcomes.
To book a consultation, call 020 7126 7264 or visit our contact page.
Article by Dr. Naveen Bhadauria
