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I was diagnosed with arthritis at a very young age. This was likely due to (at least related to) snowboard straps being too tight around my left ankle. I hobbled every morning for an hour, then a couple hours, then half the day.

One day I learned about modifying my diet to avoid inflammation. I greatly limited, but did not entirely eliminate, tomatoes and potatoes in my diet.

The effects were literally life changing. I no longer hobble each morning. If someone you know is suffering from arthritis I can highly recommend conducting this experiment for a few months.

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It's worth drawing a thick distinction between rheumatoid (autoimmune) and osteoarthritis (worn out).

Thank you. My wife suffers from this and its night and day different from osteoarthritis and my wife who has has been offered plenty of ridiculous "cures" that people somehow believe highly paid specialists just haven't though of.

Sorry your wife suffers from this. I just wouldn't be so confident that highly paid specialists have time to keep up on the latest research in their field. In my experience most do not. They're highly paid because they see a lot of patients, not because they read a lot of research.

They're highly paid because they see a lot of patients, not because they read a lot of research

This just isn't true. A GP (General Practitioner) sees a lot of patients. The only realistic reason you can get seen by a GP in good time is because they tend to leave some slots open for more urgent things: The reason you can't get in to see a specialist on the same day (usually) is because they don't.

Specialists get paid more because they specialize: They won't know as much about curing everyday ills and they gave up on that when they specialized. Medicine is complex, and it only makes sense to have folks specialize in some things (like bones and neurology and whatnot).

We see the same thing with other professions, though not all pay more for different things. Knowing how to run an industrial kitchen (factory, large cafeterias, etc) is different from fast food, for example. Folks with knowledge of specialized systems get paid more, in general: This is your medical specialist.

At least in France a GP (médecin généraliste) sees people for everyday things. The "truly urgent" things are rare, this is what emergency services are for.

Yes they see "urgent" patients that happen to be painfully sick (otitis for instance) and they need to give them well know and predictable medicine (and other such "urgencies" - which I put in quotes not because they are not urgent, but because they are expected and everyday business. If you had an otitis you will know that the pain is unbearable and that you either have to see the MD quick, lose your mind of have your eardrum break).

These GPs will push you towards a specialist in case they detect something abnormal because they do not have the current knowledge to treat you correctly.

For the record - one of my best friends is a GP and their work is terrific. They are a mixture of science, magic voodoo and psychologists to actually manage the everyday health of the whole society. I truly regard them highly.

Also, the amount of hours they do is insane - way too much in my opinion and yet it is so difficult to get an appointment. They are on a strike today, the first as long as I can remember to get their regulated fee to be raised.

A lot of medicine isn't latest research as standard of care isn't a fast moving target its just attention to detail.

I'm not sure what you mean, but both a co-worker and a co-workers wife found that eliminating nightshades like the GP did, eliminated their need for medication as well. My wife has a different autoimmune disorder, and had good luck eliminating a different food. The autoimmune protocol is the name for the elimination regimen. There is actually a great deal of literature to back this up. But I believe diet doesn't enter standard of care quickly because of low compliance, among more cynical reasons. This is just anecdotal, but it isn't just subjective symptom descriptions either. These people quit meds while under a doctor's care because their antibody tests reduced dramatically on the diet.

Ruling out peppers, eggplants and tomatoes isn't fun, but it isn't even close to impossible. Imagine having immune responses to corn! Maybe it won't work, but it only takes about a month to evaluate.

You are unintentionally illustrating my point. We are aware of the perception that non-medical people believe there is a miracle cure to be found in everything from eliminating tomatoes to according to one enterprising individual drinking your own pee.

My wife naturally rarely eats nightshades and consumption has zero correlation with inflammation or RA. If it were as simple as not eating tomatoes everyone would be cured. Instead every person that deals with that who goes to specialists regularly, who deals with the negative side effects of the drugs that actually reduce inflammation and keep your insides and joints from being destroyed has heard countless fake cures.

In my experience you are completely wrong about specialists.

It's a legal requirement for doctors to practice continuing education to keep their medical license. It is literally part of their job to "keep up on the latest research."

… but many satisfy this requirement by going to a pharma sponsored convention, which only has a small number of talks (all vetted by the sponsor to be favorable, if not actively marketing for sponsor), and just happens to be in a great resort of some sort.

Those who care, do real continuing education - often on their own time and without asking for official credit.

In reality it's just aspirational.

Rheumatology is one of the most exciting fields of medicine at the moment, it therefore attracts some of the brightest. I can assure you that they are up with the latest research, but it’s nice of you to so casually dismiss the work of their careers

Even osteoarthritis is now understood to be mostly caused by inflammation rather than wear and tear.

- https://www.youtube.com/watch?v=sUOlmI-naFs

- https://pubmed.ncbi.nlm.nih.gov/?term=osteoarthritis+inflamm...

Indeed. And with rheumatoid it can come a lot younger than your snowboarding years.

Can confirm that this also helps for eczema, allergies, asthma, and many other issues associated with inflammation - even weight gain, energy, and digestive issues. Cutting out potatoes, tomatoes, and some of the other nightshade family friends (still love those habaneros, though!) has made a world of difference.

Another one, although it is a bit harder to source at the right price, is water. Once you recognize the signs of sudden-onset inflammation, however subtle, when you remove and then try the above foods, it is worth seeing if you are having the same reaction to your water -- in my case, it changed me from a chronically dehydrated person who had to prep his day's water next to him to force himself to drink to someone who will literally get up and go across town to fetch more if there isn't enough in the house without it even feeling like it's taking effort or motivation.

It makes a huge difference to your mental clarity, as well.

Just what sort of water are you drinking?

I feel like the water thing needs explanation

Why tomatoes and potatoes?

Well, it could be placebo effect, but the thinking is/was that:

> Nightshade Vegetables

> Eggplants, peppers, tomatoes and potatoes are all members of the nightshade family. These vegetables contain the chemical solanine, which some people claim aggravates arthritis pain and inflammation. However, most reports are anecdotal, and while it certainly might be true for some people, there are no scientific studies done to prove that they actually cause inflammation or make symptoms worse, says Kim Larson, a Seattle-based dietitian and Academy of Nutrition and Dietetics Spokesperson.

https://www.arthritis.org/health-wellness/healthy-living/nut...

Inflammation is a tricky one isn’t it? Its level is an emergent property of a lot of factors. You can see how one tissue behaves with the addition of one reagent, but it’s difficult if not impossible to establish cause in a living system. People often talk about the “bathtub” - stressors, allergens, toxins, low sleep, add water to the bathtub, and it drains at the rate it’s able. When there are too many things filling the bathtub at once it overflows, and that is where you start to experience the devastation of inflammation. For me it feels like sinus allergies and extreme fatigue. The only thing that is productive is making space for recovery. If you aren’t able to recuperate, then the inflammation will take over and do it for you. That ends up leading internal scars it’s so intense.

Christmas is one of those times where the bathtub is likely flooded. Peak commerce. Rushing to hit year end deadlines. Squeezing in medical appointments before deductibles reset. Dangerous winter conditions, but also everyone is traveling at the same time. Rampant spread of diseases. Massive amounts of food, especially sugars. Low sunlight. Family drama. Irregular schedule. Financial stress. I could go on.

If one doesn’t take care to do that things that make the bathtub drain faster (nutrition, activity, rest, water…) you risk big inflammation and internal scarring.

This year I asked my family: does anyone actually like surprises? There was unanimous agreement that we all hate it. This allowed some novel flexibility. I started giving gifts in early December, and only had a few on the official day. All of the sizes were figured out, returns processed, and cardboard broken down over 2 weeks. We ended up having 3 quiet Christmas parties with small family groups over 4 days. It was more manageable than the usual tornado. I’ve maintained my standard sleep schedule. It was still all a bit overwhelming, especially for my neurodivergent ass having to socialize 500% more than usual. My bathtub is getting pretty full. So I’m going to go take a bath :)

> there are no scientific studies

If this treatment could be turned into a drug that had billions of dollars in revenue, as some arthritis drugs have, then there would be endless studies.

Sadly, that's not the world we live in.

"Lack of studies" in many cases is code for "there's no money to be made here."

This is too bad, because many extremely effective and effectively free treatments are ignored by scientists because they can't fund the research.

> If this treatment could be turned into a drug that had billions of dollars in revenue, as some arthritis drugs have, then there would be endless studies.

This is a thought-terminating cliche. It's entirely possible nobody has studied it yet.

It's also worth pointing out that drug companies have no incentive to research subtractive diets. They want to find additive treatments that keep symptoms at bay.

> It's also worth pointing out that drug companies have no incentive to research subtractive diets.

maybe i'm a bad reader but i believe that's what the person you're replying to is saying

Wow, I wonder if I completely misread the parent. A few sibling comments seem to have made the same misinterpretation. Maybe it was edited after I responded?

It's also possible that it has been studied, but it only works for a few people so the positive signal is swamped out by all the nonresponders.

This oft-repeated view is frustrating, because a huge number of studies on exactly this kind of thing are done.

Should there be more? Of course! But the money has to come from somewhere. For a study on potatoes and inflammation it has to come from the taxpayer or a non-profit institute. For a study on a new drug that has a potential to make a huge profit, of course it's much easier to find someone besides those to fund it. There are many problems with the modern medical system but I don't think this aspect is totally broken, definitely not to the degree that nay sayers would have you believe.

I believe there has been decades of study around diabetes (limit sugar), cardiovascular disease, (limit sat fat), skin cancer (limit sun) and so on. Why is it hard to believe the incentives for simple subtractive prevention isn't there (e.g. limit tomatoes)? More likely the ailment isn't one of the top X deadly things yet.

Lazy thinking. Governments that provide and purchase healthcare services are also in the business of funding research.

In what world do we not see an alignment of interests for studies from nutritionists and dieticians on this topic?

We have a LOT of studies on low fodmap diets and their health effects.

Unfortunately, this thinking came about through my direct experience as someone seeking treatment for a chronic disease. For the specific disease I have, there are endless studies about various drugs, and very, very few studies about non-drug treatments, many of which are known to be effective in the patient community, but lack enough "studies" to be part of the standard treatments recommended by doctors. Instead, we're offered drugs that cost $10,000+ per month. (Drugs which are backed by many, many studies, and yet are only around 25% effective after 2 years.)

Drugs which are backed by many, many studies, and yet are only around 25% effective after 2 years

First things first: Don't you think that if we had better drugs for whatever you have, that we wouldn't go with that in general? (I know there are exceptions that say that we wouldn't, but these are exceptions).

Second: 25% effective is better than nothing. I have MS. The first real drugs - all injections with plenty of side effects - were around 33% effective or something like that and might have reduced severity of the stuff it didn't stop. This wasn't after 2 years, this was the out-of-the-box effectiveness.

And it was still worth it. This is because an imperfect solution is better than no solution whatsoever. Know what happens in MS when you have fewer flares? You have less risk of permanent damage. It meant your risk of bad events is less. You have less chance of not being able to walk or not controlling your bowels or having full vision.

The drugs were imperfect because our knowledge was (and is) imperfect. That was the best we had at the time. But then again, it was the foundation for modern drugs which are more effective (and easier to take than an at-home injection). Cost is still an issue, but single-payer systems still pay for them because the overall cost is less than the cost of unchecked disease.

Most, if not all of the diets advertised for MS have not proven themselves, despite the claims of the folks writing the books (most of which have had other interventions and might have just been lucky with their disease progression, like I have been so far).

TLDR: An imperfect drug that helps a little is better than no help at all.

Your tldr pretty well sums up that you are responding about your feelings and not the comment.

In his case there is an alternative. It will never be promoted.

You can limit stress and find many practices and supplements which reduce anxiety and cortisol.

>Lazy thinking.

I'll pretend this insult wasn't here.

>Governments that provide and purchase healthcare services are also in the business of funding research.

Well, some research, but the $100M+ cost of studies to get anything approved as a medication is exclusive done by companies hoping to profit from selling it, AFAIK.

One effect of this system is that no one funds such studies for non patentable substances.

Here's a clustered search on nightshade and arthritis of pubmed

https://search.carrot2.org/#/search/pubmed/Nightshade%20and%...

Interestingly, many of those studies are about the beneficial anti-arthritic impact of consuming Solanum nigrum. That kind of contradicts the “avoid nightshade” advice.

Both are in the Nightshades family which contains a lot of alkaloids that are believed to be a cause of inflammation in some people. I've not seen any real studies about this though.

Also let's also keep in mind not all inflammation is bad.

As an anecdote, I know someone who had rosacea breakout and ended up eliminating tomatoes in particular from her diet and it seemed to do the trick so there should be something in tomatoes that causes inflammation...

What is an example of good inflammation?

Inflammation is a crucial part of the body's response to tissue damage, infection, foreign matter, and more. In response, the capillaries become more permeable. This allows white blood cells to leave the blood stream and enter the tissues to combat infection and destroy damaged tissue. The inflammatory response is part of a complex set of self-defense and repair mechanisms. Sometimes these go wrong, but without them you'd most certainly be dead.

Tissue damage, infection, foreign matter, etc are all bad. Inflation might help, but I think you’d need to show it’d be helpful without the presence of some worse thing to truly call it beneficial.

Inflammation is part of the immune response. It is beneficial when wounded and that's when the local body should become inflamed.

Chronic inflammation is not beneficial.

You are conflating the two

I’m not conflating anything. You’re saying the inflammation is beneficial, but what you’re describing is really a “lesser of two evils” situation, e.g. it’s better to have inflammation than it is to bleed out from a wound. But the best thing would be not to get a wound in the first place.

Sure boss, you're right. I'm guessing you're right a lot

Inflammation helps fight infection of any kind. You know fever? That's your body heating up to wean off infection.

When you tear a muscle or a tendon, inflammation helps blood to flow into the affected areas, speeding up the healing process.

Inflammation is one of the tools your immune system has to keep you in good health. Too much of it can have bad side-effects though, which is why we need to keep it under control.

Ok, I was imagining some food-induced inflammation since that was the context. Is there some healthy inflammation that comes from food vs the body’s natural immune response?

i believe there's some inflamation and immune system response anytime you introduce foreign bodies, including when you eat.

Inflammation is your body increasing blood flow, heat and nutrient supplies somewhere. The usual function is to heal something in a specific place (good inflammation), diet, lack of exercise, environment, and other factors can cause inflammation in many places in the body where it isn't needed. This often leads to issues.

Inflammation which is completely normal after a hard gym session

IIRC inflammation is linked to endotoxins produced by bacteria in the gut. Apparently curcumin has a good reputation for helping people with inflammatory conditions like that. And it's been proposed that it yields positive benefits by modulating the gut rather than being bioactive (curcumin is famously not bioactive).

You’re being downvoted because it sounds like woo but the people downvoting aren’t up to speed on the latest science.

Nightshades are tolerated by people with healthy guts and there is a smaller set of people with a gut dysfunction that means the solanine (alkaloids) in nightshades causes leaky gut syndrome leading to the inflammation you are talking about.

Curcumin (turmeric) does alleviate this inflammation pretty powerfully, at least on a temporary basis

Note that "leaky gut syndrome" is pseudoscience; there's no such thing recognized by the medical community. What is real is leaky gut, or intestinal permeability.

We absolutely know for a fact that some people can have dysfunction of the tight junctions which make up the lining of the intestines. We don't know too much about it, but the idea that bacteria and endotoxins can pass through the gut wall and into the bloodstream is established fact at this point. "Endotoxin" has the sound of a pseudoscientific word, but it simply refers to the lipopolysaccharides that bacteria use to build their outer membranes.

People with some autoimmune diseases have been found to have circulating endotoxins and other bacterial byproducts in their peripheral blood, though the process (bacterial translocation) and the mechanism by which these affect the body are both poorly understood. There's been very little research into what processes can cause intestinal permeability and gut dysbiosis in autoimmune patients. For example, it's unclear if it's the cause of the autoimmunity (permeability leading to SIBO-like bacterial overload leading to an aberrant immune response), or if the autoimmune disease causes it (systemic inflammation leading to permeability).

I've not seen any peer reviewed evidence about nightshades or glycoalkaloids. There's some research on curcumin and quercetin that's interesting.

> Note that "leaky gut syndrome" is pseudoscience; there's no such thing recognized by the medical community. What is real is leaky gut, or intestinal permeability.

This seems like oversubtle reasoning that cruelly dismisses legitimate suffering from an actual disease process.

You seem to admit there's a convincing scientific basis.

Leaky gut syndrome is pseudoscience but intestinal permeability is real? Ok. It seems like medical science isn't advanced enough to sort out most gut disease, it manifests in somewhat strange and seemingly mysterious ways, and people suffering are left to discuss amongst themselves online in order to find some relief after being shrugged away by doctors (or worse hurt by inappropriate medical procedures/medicines like antibiotics, etc.).

So instead of just condescendingly labelling them anti-science whackos ("pseudoscience"), perhaps we should be compassionate and recognize the condition?

There's a clear distinction. While leaky gut is a real medical term, it has been misused by people who believe it to be the cause of a multitude of ailments (for which the same community of course offers "detox" advice), with no scientific evidence. You can read more here: https://badgut.org/information-centre/a-z-digestive-topics/l....

Well I've got confirmed dysbiosis (GBT) from overprescribed antibiotics and from my experience, and reading up in those communities you're so contemptuous about, I get the sense that gut dysfunction manifests in seemingly random ways, a whole constellation of weird symptoms. You just feel horrible, sometimes there's no clear cause and effect, it seems random.

I agree there is a lot of just blatant nonsense and maybe they do misuse leaky gut but I think the medical community has a habit of vilifying people who are suffering real problems. I can't tell you how many times I've had a real medical issue (be it a bacterial infection, virus, or most recently, gut dysbiosis) and my doctor blames it on anxiety and offers me lexapro.

He's being downvoted because "inflammation" is caused by an enormous amount of things. It's not "linked to endotoxins". I tore my MCL and I had inflammation quite shortly afterwards, which likely protected my knee from further injury. Endotoxins had nothing to do with the inflammation I experienced.

I mean it in the context of people who have joint pain that’s not from injury. And yes endotoxins are linked to joint pain:

https://pubmed.ncbi.nlm.nih.gov/31653850/

Can you share any of the science you’ve come across that you find compelling based on sample size, effect side, etc? I’d love to know dosages.

It’s more of a meta analysis in my mind of all the different studies and anecdotes I’ve osmoted over the years. As someone else said earlier, there aren’t great and clear individual studies because there isn’t any money in it.

For dosing curcumin, you can try juicing a quarter inch of turmeric root a day and starting there, I have seen that knock out a lot of things within a short number of days

That isn't what a meta analysis is. I'm not trying to be cruel but people know all sorts of things that aren't true based on insufficient evidence and weak correlation. I did this thing and got that result is extremely powerful for an individual but without controlling for other factors its hard to know if they are assigning credit to an irrelevant factor or one that was more specific to their situation and not generalizable.

> That isn't what a meta analysis is. I'm not trying to be cruel[...]

That's why he didn't call it a meta-analysis but instead said "It’s more of a meta analysis in my mind of all the different studies and anecdotes I’ve osmoted over the years"

It'd be one thing if he said all those things as some sort of scientific fact, but he very clearly qualified his statements as hypothetical conclusions informed by surveying literature, reading developments and other things.

By saying "I'm not trying to be cruel" you seem to be at least aware that you're being pretty censorious. It seems misplaced to me.

You want me to call a spade a spade. Meta analysis is an actual term of art in the sciences. People sharing folk wisdom about diet is mostly malarkey of between zero and dubious value spoken in a confident tone it doesn't deserve.

Best to use ground black pepper when you use turmeric: that increases the bioavailability of the curcumin

I read (I think in a hn comment a while back, that the reason black pepper increases the bio availability of Turmeric is that it broadly increases the bioavailability of everything in your gut at the time. Which is probably not what you want.

(Will now go and look for the comment and edit here if I find it)

Can confirm for tomatoes. Definitely worth a try if you suffer from arthritis.

Rheumatoid or osteoarthritis?

Rheumatoid. For osteoartritis as far as I know there is not much you can do because the damage is already done.

Did you eliminate or make any effort to cut out vegetable oils? These are completely awful for health and should not be consumed.

Sorry, but WHAT? Any citation to backup your claim? Please and thank you.

Omega-6 vegetable oils as a driver of coronary heart disease: the oxidized linoleic acid hypothesis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196963/

I like that one and it has good references. I could find more (Crisco and trans fats... duh) but I mean come on...

Seed oils like canola oil are manufactured and did not exist before 1900. They're totally unnatural and heavily manufactured with solvents, preservatives, high heats, deadorizers, coloring. Seed oils go rancid so fast without chemical processing and preservatives before they're bottled.

Do you want to cook with stable saturated fats in ghee that has been used for generations after generations - Or manufactured seed oil, first sold to the public as Crisco by P&G? Seed oils do not occur in nature, they are manufactured. Do you want to shove it down your gut until good enough studies prove it's safe or unsafe? Not me!

Vegetable oils. Good history here: https://www.youtube.com/watch?v=4Uqj35nHB0g&t=749s This doctor looks into numerous studies in this lecture, but fats and seed oils are covered from 749s as linked and the next ~25 minutes. Its part 1 of 3 lectures. Highly recommend

This is interesting but a huge problem with dietary guidance is that the body and its processes are hugely complex and understanding evolves over time. A year after that was published the American Heart Association gives contradictory evidence. One could trivially spend one's entire life chasing emerging science and receive for your efforts zero benefit while people trivially ignore obvious and clear guidance on basic matters like diet, sleep, and exercise that is unambiguous.

https://www.health.harvard.edu/newsletter_article/no-need-to...

It's a fairly new hypothesis, coming out of recognition that plant oils with exception of olive oil, maybe some others, are fairly new thing in human diet and their usage (as replacement for animal fats) kind of correlates with raise of modern diseases and obesity.

There are also some molecular pathways that might be triggered by substances in plant oils but there's not much systemic research into this yet.

But I think it's all plausible. There's really no harm in restricting yourself to just olive oil out of all extracted plant oils. And since it cuts out most processed foods available on the market it might help you in other ways.

You can still eat plant oils with the whole plants they come from becuse you won't be able to eat even remotely close quantities of them this way.

Plant oils are not inherently safe. Canola oil for example is just rapeseed oil extracted out of plant variety that contain as little as possible of the poison that makes rapeseed oil not safe for human consumption.

The fact that we were able to breed the plant that doesn't immediatelly kill us doesn't mean it's fully safe to eat.

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