Less than 3 months before my rheumatoid arthritis symptoms began, I had gone through a course of antibiotics. At the time, I was in school for my Master's and planning a wedding. My body was exhausted and I caught a cold a couple days before walking down the aisle. Regrettably, I did not take a complete course of probiotics after.
A year into my RA, I took a probiotic for 3 weeks and saw overall lower inflammation and pain in my joints. The gold standard probiotic is VSL 3. It has done wonders to rebalance my gut bacteria.
Since I had such a positive response to probiotics, my naturopath decided to test my gut microbiota. Collecting a stool sample is not the most pleasant experience, but beyond worth it. We used Genova Diagnostics, which looked for infection, inflammation, insufficiencies, and imbalances within my gut. The test came back pretty positive for me. I had an overgrowth of microorganisms as well as two predominating bacteria and fungus.
Genova also does susceptibility testing, meaning it tests the microorganisms vitality against natural and prescribed antimicrobials. From this, I did a 6 week treatment with 3 different antimicrobials. I'm on my last week, and I cannot believe the difference in pain and inflammation.
In many ways, this may seem counterintuitive. Does GI balance really affect RA? Our gut is a powerful part of our bodies that we are just discovering and studying. And, new research indicates that our GI health greatly impacts the structure and regulation of our immune systems1.
Antibiotics and RA Statistics
- Odds of developing RA are 60% higher for people who have taken antibiotics
- Those who have taken antibiotics in the past 1-2 years have 80% higher odds of developing RA, and those who have taken antibiotics in the past 5-10 years have 48% higher odds of developing RA
- Interestingly, antibiotics for upper respiratory tract infections have a strong association with cases of RA1
Antibiotics Affect RA
We all have a unique balance of bacteria, virus, and fungus throughout our gut, mouths and respiratory tract, which makes up our microbiota. This balance plays a crucial role in many of our daily functions, like metabolism. People with RA have reduced microbial diversity in their gut and lungs, and an altered oral microbiota. This may be due to microbiota disturbances from external factors, such as antibiotic usage.
Antibiotics alter, kill, and/or prevent multiplication of microorganisms. How they do this is complicated and varies among different types of antibiotics. Most importantly they don't discriminate. Some target specific pathways or features of specific viruses or bacteria, but they affect both microorganisms we want and don't want in our bodies. This includes microorganisms in our gut.
After antibiotic treatment, the composition, diversity, and colonization of microorganisms in our gut is altered. Since these microorganisms play a crucial role in our digestion, our metabolism and nutrient absorption is disrupted. This can play into irritable bowl syndrome and many other GI issues.
Our gut is so powerful and greatly impacts our immune system. If our gut is out of balance from antibiotics or other factors, then we may see disturbances in our immune system, like RA. This is such a new field that's being studied, which is exciting. The beginning research is unlocking a door of answers, especially for the autoimmune community.
RA Considerations Before Taking an Antibiotic
While antibiotics have saved and continue to save many lives, they should be used with careful consideration. People with familial history of RA or any autoimmune disorder should consider exhausting all other options before using antibiotics. In addition, a probiotic should be taken after antibiotic use with a recommendation for strong, good probiotic, like VSL 3.
References:
- Sultan, A. A., et al. (2019). Antibiotic use and the risk of rheumatoid arthritis: a population-based case-control study. BMC Medicine.
