Elimination Diet: Less Is More

Vegetables
Vegetables
http://www.flickr.com/photos/10216416@N00/ / CC BY-NC 2.0

Rheumatoid Arthritis Guy was surprised at the number of private replies that he received yesterday, in response the Sunday Break post which mentioned that he was on an elimination diet. As I complete my first month with these dietary restrictions, I realize that I have never written much about this issue, other than an occasion reference here and there. So I thought it might use today’s post to go into a little more detail.

Plus, I think it would be nice if we could have one public conversation that we could all benefit from, instead of a collection of separate private conversations. (Although, if someone still feels shy, please feel to still private message me.)

I started this elimination diet a month ago for two reasons.

The first was that I had just gone into another major flare. On top of months of physical therapy and acupuncture, I was also nearing close to three months of Arava – and had already been on Prednisone for a few days. To be honest, I was getting impatient. Even though I had experienced a slight uphill improvement over the past couple of months, here I was – once again – dealing with intense pain and inflammation.

I felt a little exasperated.  In addition to the above treatment items, I was doing my yoga routine as frequently as possible. I was writing on my blog every day about my experiences. I was visiting my psychologist once a week. “What more could I possibly do?” I thought to myself, “I’m already doing everything that I possibly can.”
I then told myself that there was always something else that I could try, even though I might feel like I had already run out of options.

“Diet!” entered my head.

A few years ago, when I stopped taking my methotrexate, I immediately started a gluten-free diet. I improved almost overnight. I’m not saying it was all due to the diet, as I think that finally stopping a medicine that clearly was not cooperating with my body helped as well. But I started to learn the ins and outs of gluten-free eating, and I loved it. This change seemed to be working in my favor.

I once even spent a month in Paris while on this diet. Luckily I found some small organic grocery stores that had a wonderful selection of gluten-free products…far above and beyond anything that I have encountered in the United States to this day. I walked home a happy camper, with my personal basket cart on wheels full of gluten-free croissants, baguettes, pastas, pizza crusts, and cookies. (I must admit though, that walking by the windows of the pastry shops on every other street corner was pure torture!)

So the thought of once again going on an elimination diet was not completely foreign to me, although this time I told myself that I was going to expand it to include other food items.

The second reason for starting this latest elimination diet: one of the things that I had noticed during the past few months was that my RA always seemed to have some of its strongest peaks on Sunday evenings. It became so obvious that I could no longer ignore a possible connection between my diet and my rheumatoid arthritis.

You see, if there was ever a day of the week when my meals are almost exactly the same, it is on Sunday. We always have a late brunch that includes waffles or pancakes, a large fruit shake of papaya, banana, and milk, and a huge bowl-sized mug of coffee with milk.

First on my elimination list: gluten, dairy, and caffeine.

And if I’m going to do this I might as well do this right, no? So I added beef and chicken. I added the nightshades (tomato, potato, bell pepper…I don’t include eggplant because I never ate this anyways.) And lastly, in order to reduce my consumption of soda (which is not too high, but it still usually beyond where I would like it to be) I added corn syrup.

At first I thought it was going to be difficult to maintain this diet, but a month in I don’t even have any desire to start reintroducing any items to see if they act as inflammatory food triggers for me.

One of the first triggers that I seem to have identified, somewhat accidentally, was dairy. A couple of weeks ago I was offered some homemade chocolate mousse that I could not pass up…what harm could it possibly do? Well, a few hours later I realized the “harm” it could do. This morning I drank a cup of (caffeine-free) coffee with lactose-free milk. Still no go – a few hours later I had once of my worst peaks in weeks. So for the moment, dairy will stay on my list.

(I have had coca cola on a few occasions – I do have to mix my rum with something during Friday’s happy hour! But my corn syrup restriction has prevented me from buying a lot of knock-off salad dressings and condiments in the grocery store, which is a good thing.)

Other than that, I’ve stuck to my diet. I continue to be fascinated with the wide range of other food items that are out there, that I never previously enjoyed. In general, I feel like my overall energy level has risen. And as people who have been following my blog already know, a little less than two weeks ago I have a major overall improvement unlike anything that I experienced during the past half year.

Did my diet play a role in the drastic reduction of my rheumatoid arthritis symptoms? I have no doubt it did. Was my diet the sole cause of my improvement? It’s hard to say, especially since I continue to simultaneously implement a handful of other treatment options. Am I going to make any changes? Certainly not anytime in the near future!

So this is where I stand. And my meals haven’t suffered in the least! For example, last night’s dinner was pan-fried trout (fish on the weekends is still something that I allow myself to eat) served with pesto fusilli (made with rice and quinoa flour) tossed with cooked portobello mushrooms, sliced olives, and fresh chopped basil – all topped with a few drops of garlic-infused olive oil. To put it bluntly, the quality of my meals has actually increased since I started this diet!

If you are thinking of starting an elimination diet or already currently on an elimination diet, please do share your experiences with the rest of us. While each one of our bodies is different, I have no doubt that there is quite a bit of good information that we can learn from one another.

*****

Here are a few other recent posts that also discuss RA and diet:
The Life and Adventures of Cateepoo
Living with Rheumatoid Arthritis
The Truth About JRA

*****

Stay tuned…for the next adventure of Rheumatoid Arthritis Guy!

*****

Update: Angie from RA and Me also runs a blog on dairy-free diet – you can find it at The Non-Dairy Queen.

19 Comments
19 comments
  1. Seeking Solace says:

    I became a pescatarian (a vegetarian that eats seafood) to help with the inflammation. So many processed foods cause inflammation and we surely don’t need any more than that.

    Becoming a pescatarian was not hard for me. I have never been a huge meat eater and I was a vegetarian in my early 20′s. Giving up caffeine; however, is not something I can do without serious consequences! Since I can’t drink alcohol becuase of the methotrexate, I have to have some sort of vice, right? LOL!

  2. Lana says:

    Thanks RA Guy for your insight on this. I was a diagnosed a year ago and my condition is just getting worse despite all the meds I am on. I have been thinking that a gluten-free diet and thought it would be complicated considering how busy my life is – school, work, 2 kids. But this helps. You have laid it out perfectly. Thanks again!

  3. Lisa says:

    Thanks for posting this! I wonder, too often, why is it that we so often forget to focus on one of the things most controllable – our diets? I’m guilty like everyone else. You might have just inspired me to reevaluate things.

  4. Alisa says:

    I cut out beef & oranges from my diet about 7 years ago. Other foods that have reacted to me if eaten on regular basis have been mushrooms, tomatoes, broccoli. Everyone has different reactions which is why I kept a food diary in helping me eliminate certain foods. I personally think that this is worth trying so I agree with you RA Guy. I hope it goes well!!

  5. Michelle says:

    Two tablespoons a day of Tart Cherry Juice Concentrate works wonders! Helps with inflammation and a GREAT antioxidant!

  6. Stephanie says:

    Thanks for the post!

    This is exactly what me and my mom are going to start working on when me and my family get moved back to Colorado this week.

    The only time I really eat “bread” products is in the morning to take my drugs and even that can be changed. Shoot! I don’t even eat past actively. When I have spaghetti, I usually fix a spaghetti squash and I am quite happy with the results.

    I do not drink but I do have a new soda addiction- Pepsi Throwback…made with sugar but even that is going by the wayside.

    We have to get into the mindset that foods are chemical reactions for the body and they can be natural but cause bad reactions, just like the manufactured stuff.

    I will start to document what is working for me and what isn’t on my blog!

  7. RA Guy says:

    Seeking Solace – “Pescatarian”, I love it! I’m going to start using this word to describe myself. For some reason when I tell people that I have been eating vegetarian, they immediately ask me if I continue to eat fish and seafood.

    Lana – if you do start a gluten-free diet, I’d love to hear from you how it goes!

    Lisa – glad my post could inspire…it’s obvious that you already have the motivation inside you though. If you do move forward I’d love to hear…I’ll be checking out your blog (as usual).

    Alisa, Millicent, Michele – Thanks for the additional information!

    Stephanie – good luck with the move, I’ll also be reading your blog to hear how any dietary changes work for you. It’s amazing how much of our immune system is associated with the digestive tracks…once we stop and look at it this way, testing diet makes more sense, no?

  8. Deborah says:

    What I struggle with is how to eat when I am hiking and travelling. My stomach is wrecked from years of MTX and Relafin. So I no longer do so well on my old standby of nuts and apples. Plus I have a very high metabolism, I need a lot of calories and fat or I become weak and suffer from low blood sugar.

    So any suggestions on non milk based, non gluten foods that
    1)will keep on a long hike or car trip.
    2) and are nourishing and filling
    3) and are not too hard on sensitive stomachs

    Would be much appreciated. I’ve been stumped by this for awhile now! Very frustrating that bread and cheese are about the best answers, except of course for those of us on elimination diets!!!

  9. Liz says:

    Thank you so much for your posts, they are always insightful and make me reflect on my own situations.
    Recently, I have become a vegan. I see a chiropractor who also does holistic therapies, and he saw that my RA was not being treated by my celebrex/plaquenil/humira. So, for the last 2 months I have tried to be vegan and have as little processed food in my diet as possible. I still get flares, and I say to myself ‘it’s not improving my RA’, but then I look back to how I was in March or April and there is no denying now that I am in a much better place now. I’d recommend it to anyone.

  10. Angie says:

    WOOOOOHOOOOO!!!!!!!!!!!!! I’m so glad you came to the other side!!! I have the hugest prema-grin right now!!! In the past 2 months since I’ve eliminated dairy and gluten I feel great! I know that it has made a difference along with the medication. I have another blog beside raandme and it’s called thenon-dairyqueen@blogspot.com but make sure you put the hyphen in! It follows with my fb page. In the blog I have a list of yummy non-dairy alternatives that you can try. I’ll also be attaching all of your posts on my Non-Dairy Queen FB page! If you have a bread machine, Bob’s Red Mill and Namaste both have yummy bread mixes. I think you can bake them in the oven too. I’m just lazy. I make a loaf, slice it, then freeze it. OK, up on my hemp soapbox: i HIGHLY HIGHLY reccommend hemp milk to anyone who wants to go dairy-free and is looking for a milk alternative. Hemp has omega 3 & 6 in it which is really important for us RAers. Living Harvest brand in the tastiest I’ve found. And if you can’t find it locally, they have a website. Alright. Climbing back down again. RA Guy, I wish you luck! I’m so excited for you! And kudos for giving up nightshades. I can’t seem to give up tomatoes. But, I did eliminate for a while and there was no difference when I reintroduced them.

    LANA-If you really want to try the eleimination diet, you really should try to omit dairy too. Our bones can’t afford to lose any calcium and that’s what happens when you consume dairy. Your body needs to use calcium to help it break down animal protiens. If there isn’t enough in your blood, your body will leach it from your bones.

    LISA-I’m glad you’re re-evaluating!

    DEBORAH-You can get single serve soy and rice milk off the shelf at stores. Be careful with soy. Doctors usually reccommend no more than 2 servings a day. If you get a stainless steel thermos, you can keep “milk” cold for hours and hours.

  11. Lola says:

    All the Doctors I’ve ever seen have said diet has nothing to do with RA. That statement has always just seemed so ridiculous to me. Anything that goes into your body has the potential to cause some sort or reaction. I wouldn’t be surprised if most people were allergic to something. I decided to get tested and found out much to my surprise that I really was allergic to about a dozen different foods. Eggs and dairy being the most severe of myy allergies and the most consistently consumed. I have been egg and dairy free for almost 4 years now. I also went gluten free for six months. While my RA is severe and I do not belive that changing my diet is some magic cure. I definitely felt a change in my body the times I’ve cheated. It may not be a cure but it can’t hurt to find out what our individual bodies react to and make the necessary changes based on what you find out.

  12. Robin says:

    Hey HEY RA Guy!! I am catching up on your posts for the first time since I’ve been back from my trip and we’re both doing elimination diets! Everyone is doing elimination diets! I’m so so so happy for all of us because we’re going to show those ridiculous doctors out there that diet does affect our RA. I started 2 weeks ago for real so I’m hoping for a breakthrough this week. I’m glad yours is working, it gives me strength.
    take care! -robin

  13. Cathy says:

    I can’t say enough good things about elimination diets. I started my first elimination diet (gluten, dairy, tomatoes, sugar, caffeine, chocolate, citrus, and peanuts) almost four and half years ago when the medications I was on were not working. In fact, I was going downhill. Within two months of starting the elimination diet, my inflammation rates were back within normal and I started feeling better. Eventually I was able to start reducing/eliminating the medications. As of last year, I am med free! I know this isn’t the choice for everyone, but it is the right path for me. I believe that our bodies really do want to heal but we have to learn how to help them through the process after years of dumping on them. Not all foods are intended for each body. I have found that what bothers our bodies also changes and we have to occassionally eliminate foods again so our body can feel what it is like without them and then let us know when we reintroduce them that they aren’t wanted (nausea, dizziness, headached, rash, etc.)

    My sister has been fighting the beginning stages of RA but through diet changes has been able to stay off meds. Like me, she can tell through stiff fingers if she ate too much sugar (too much for us can mean a gluten free muffin) or consumed gluten. It seems difficult at first, but as RA Guy mentioned, there are so many wonderful food choices available that it can and does work.

  14. stationaryfaery says:

    Hey RA guy,
    First I want to say THANK YOU for this blog. Your insight and wit has helped me through a pretty lonely flare, and reading through your old posts made me a little less down about things ^_^

    That being said, I’ve been thinking about trying an elimination diet, but I don’t know where to start. I can’t figure out what foods I CAN eat, and the more I research the longer the “can’t” list gets! Do you know of any useful sources for summing up this type of diet? It’s easy to get lost in the sea of information on the internet.

    I’m glad this diet is working for you and hope it continues to do so!

    -stationaryfaery

  15. Jaci says:

    Wow! I am so thankful to have found this post! I am 25 and found out I have RA in January. Very discouraging to feel like I am in the best shape of my life in summer of 2009 and then feel crippled just months later. I have no clue how the pain of RA came on so rapidly and strong.
    I have been in terrible pain and I’m desperate to get feeling better before it gets worse. I have so much to learn, but I’m so ready for change! I sit here with swollen feet, and both my hands and feet feel like they are turning into cement. Does it always feel like this?
    Thanks for creating this support group! I will be following for sure! It’s nice to talk to real people with RA and not just my doctor.

    Jaci

  16. Melissa says:

    I just started an elimination diet which consists of only Vegetables, fruit and brown rice. Oh my goodness does it suck lol. I am 23 I have a fast metabolism and usually LIVE off of everything bad like fast food and sugary snacks. This has been pure torture for me and I’ve been doing it for 5 days. I am supposed to do it for a month! ugh. No signs of improvement yet and I am actually getting worse so I don’t know if maybe I am allergic to some kind of veg or fruit I am eating now. This is the hardest thing for me right now. I’m also reading a book called Sick and Tired and that restricts you from even more food! including fruit! I have been very hungry and angry these past few days and my friends aren’t helping talking about ordering pizzas and drinking milkshakes. =( any advice?

  17. janet says:

    Well, Melissa, I wish I changed my diet at 23 rather than 39! Embrace and feel better about a healthy lifestyle and all it will bring you. What would you rather have a pizza or excellent health. Not even good health but something above and beyond that. The first week is the worst (as is anytime you have to get back on track when you fall off) then it all falls naturally into place – no cravings, no panic, your body works how it is supposed to work. I have been at it for a year and the worst times are when I fall off the diet for too long – I feel horrible, am in pain and have a hard time refocusing but when I’m doing well, it can’t be beat! Think of the positives. Remember, it’s only a burger, donut, pizza, etc (now doesn’t it seem gross to put those in your body anyways?)

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