Pre and probiotics for joint health

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We previously discussed all things pre and probiotics and looked at why they may be a useful addition in your inflammation-reducing routine - if you missed it, you can link back to it here. Today, I’m going to be diving deeper and taking a look at the latest research into the use of pre and probiotics in the management of joint issues, specifically rheumatoid arthritis. We know that the health of the gut is implicated in several health conditions, and this one is no exception, so it’s no surprise that there’s now interest in the role that gut-supporting pre and probiotics may have on the health of our joints. Let’s get started...


To recap, what are pre and probiotics?

Prebiotics are specific types of fibres that provide substrate for the gut microbes. They essentially function as ‘food’, promoting the growth of gut-friendly microbes. Meanwhile, probiotics are the live microbes themselves (1). As they both work together, it is important to have a good supply of both.


How is the health of our gut linked to rheumatoid arthritis?

The cells of the gut lining are joined by tight junctions which create a barrier between the outside world and our inside world, helping to filter out pathogens to prevent them from entering the bloodstream. When this system functions normally, foreign pathogens are presented to immune cells in the gut lining. If they are harmful, a normal immune response is activated, where antibodies are produced to destroy the pathogen so that it cannot pass into the bloodstream (2). However, if this barrier is compromised, harmful pathogens are able to effectively bypass the immune cells and pass straight through, which activates a systemic inflammatory response. This increased gut permeability is well documented in research and has been shown to play a role in conditions such as ulcerative colitis and rheumatoid arthritis (3).


We know that pre and probiotics can improve gut health by encouraging a healthy microbiome, which has led researchers to suggest pre and probiotics may be a useful strategy for managing rheumatoid arthritis, an inflammatory condition of the joints. Two recent study reviews reported a reduction in pro-inflammatory cytokines (chemical biomarkers which indicate inflammation) in participants with rheumatoid arthritis taking probiotics, which is promising. However, it is still unclear if this has any measurable effect on the severity of symptoms (4,5). 


It is also worth noting that many of these studies are only conducted on small numbers of participants and for a short amount of time (up to 3 months), so it is difficult to draw conclusions on whether they might be beneficial in the long term. As for prebiotics, research on effectiveness is still in its infancy in this area.


Is it worth adding probiotics into my routine for joint pain?

We definitely need more research in this area, but current results certainly give hope for the future of joint care. For now, as we know probiotic foods are useful for overall health which in turn can influence inflammation, if you enjoy them it may be worth including them in your diet regardless. Dosage of probiotic supplements in studies vary and we are still unclear on the best strains to go for, so the food-first route may be the best option until we know more, as you’ll also be getting a range of essential nutrients too. Fermented foods such as yoghurt, sourdough, kimchi, sauerkraut and kombucha, and traditionally fermented cheeses are all great sources of probiotics - now all there’s left to do is to find your favourite!


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