Ankylosing Spondylitis

Answered on August 19, 2014
Created June 04, 2012 at 6:14 PM

I have been on paleo binges (90% of the time i suppose) For about a year now. I suffer from Ankylosing Spondylitis as well. I have found my ability to deal with gluten and sugar to be worse than ever. Is this a normal progression of this disease? If so, is staying 100% on the paleo diet the only means for me to avoid awful flare ups. As currently I am bouting with some synovitis that I just want to fuck off in the worse way. Any personal experiences or help is greatly appreciated.

Thank you



on June 05, 2012
at 12:09 PM

thakn-you for the insight. it is greatly appreciated

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5 Answers



on June 04, 2012
at 08:01 PM

I have Ankylosing Spondylitis and after being super strict for 6 months, I am finding that I am more tolerant to certain foods than I was before. I think this is because my gut is mostly healed.

When I first started paleo, I went completely starch free, as starch feeds the bacteria that is thought to cause AS. I don't know if your version of paleo includes starch or not, but that is something to consider with AS. The KICKAS website has a lot of good info specific to AS and diet.

Basically, the Klebsiella pneumoniae bacteria feeds on starch. Large amounts of this bacteria have been found in the guts and feces of people with AS. When this bacteria gets out of the gut (due most likely to leaky gut syndrome) the body creates IgA antibodies to fight the bacteria. This is problematic for people with AS because most of them are HLA-B27 positive. This genotype can cause the IgA antibodies to mistake certain connective tissues for the K. pneumoniae bacteria because their surface structures look the same (molecular mimicry). So, instead of just attacking the bad invaders, your body attacks itself as well. If you starve the bacteria - they cannot multiply causing the antibodies to wreak havoc all over your body. Some people do okay just removing starch, but sugar and dairy (because of the lactose) can be secondary food sources for the bacteria.

When I started paleo I avoided starch and sugar almost completely. I have eaten dairy the whole time, but pretty much just cream, butter and cheese with low lactose anyways. I focused on healing my gut by avoiding all grains, legumes and things with high anti-nutrient content. I ditched the NSAIDs as they have also been shown to increase gut permeability.

Over the past few months I have been able to add back in sugar (mostly in the form of fruit and chocolate) and occasional small amounts of safe starches (pretty much just tubers) without problems. I think staying away from the grains and legumes keep my gut in tact enough that the bacteria is staying where it is supposed to and not messing up my body. The few times I have tried to cheat with gluten, I have had immediate flare-ups and lower starch tolerance for the next few weeks. I Think the gluten must mess my gut up and make me more sensitive to everything. If I go crazy and eat potatoes everyday, I start to flare as well. Maybe overloading the gut with the starch fed bacteria is enough to start the leaky gut all on it's own.

So, that is my N=1 with AS and Paleo. Some people might have additional issues and have to do a full on auto-immune protocol, but for me at least, a low starch paleo diet has been enough for me to ditch all of my meds for the first time in 10 years.



on June 05, 2012
at 12:09 PM

thakn-you for the insight. it is greatly appreciated



on June 04, 2012
at 06:38 PM

I don't have exactly what you have in regards to pain/issues, but I know eating gluten + sugar = inflamation in my body (n=1).

To be pain free and not have any inflammation issues, I have to eat gluten free. I can get away with the occasional bit of sugar, but that's get away with, not "be healthy with". To really stay pain and inflammation free, I always have to ditch the sugar. (I have some nerve inflammation and lower back issues when I eat gluten / sugar).

Roll through a Whole 30 and see how you do. Sometimes it's best to go back to the basics and see if that helps.

I think that the 80/20 (or 90/10) rule can be useful for some people, but generally, you should still avoid gluten. There's also a subset of people who just have to live 100% of the time paleo (and judging from the way you're talking, you might be one of them). It's okay. It's just food. But to give some clarity to it, it took me a year and half to move from the thought of "it's just food" and "I can actually eat paleo and gluten free" to actually implementing the lifestyle.



on June 04, 2012
at 09:27 PM

I had a client who was able to ditch her medication on a starch free auto-immune paleo diet. She was super sensitive to gluten - reacted to some in her multi-vitamin. Here is a link to her story: http://paleozonenutrition.com/2011/02/12/auto-immune-disease-hla-b27-pain-free-on-no-starch-paleo-diet/

Besides KICKAS which has great info, take a look at SCD lifestyle (Specific carbohydrate diet) IT has a ton of useful info for gut healing. http://scdlifestyle.com



on June 04, 2012
at 08:08 PM

I come from a family line of AS sufferers. I have not been diagnosed with AS though Drs have run tests on me every few years because of hand, feet, back, and joint aches. I have been dx'd with celiac disease and breast cancer. Have you tried the KickAS diet? It works really well for me and a sibling who are prone to the pain. I have a friend with AS who finds sticking to it helps. It has a lot of overlap with Paleo plus some added restrictions of starches. I am not be surprised that your tolerance of gluten is worse I'd say stay off of it 100%. Usually people don't notice how badly gluten affects them until after they give it up for some time. http://www.kickas.org/asfood.shtml


on June 07, 2012
at 10:20 AM

I've been doing the paleo diet for one year and a half now and gluten free for that period of time. At first, I felt amazingly better but three months ago I got a big flare up and was finally (at least) diagnosed with AS which came back as a shock.

I know that the paleo diet gave me rest... I had just moved away from it, eating sweets (I be damned), making a single mistake with gluten provoked huge pain... ending up in staying at the hospital for a whole month away from my 7 year-old boy...

Eating paleo is just the easiest way to go gluten free (and no 80/20 for AS sufferers, it is 0 gluten or no interest in doing it). It works amazingly.

I made one move away and now have to take heavy doses of NSAIDs which hurts my bowels a lot. Well, thanks to that mistake, I was at least diagnosed and will be able to fend off attacks of laziness from my work place.

PALEO WORKS, it does, worth a try anyway and Mark's Daily Apple is the best place to start. I owe that guy a lot. A lot of people do as testimonies show. Of course complete remission in 3 days is not to be expected since a lot of damage has been done but a lot of comfort can be gained.

People with AS need tremendous changes in their lifestyles and eating habits, it is tremendous effort but it is worth every part of it and most importantly: it teaches your whole family and friends what eating well means. I'm happy to raise a kid this way and he gets sick once a year at most, my husband has been sick twice in 15 years.

Last thing to know: go gluten free, go starch free, go sugar free, go dairy free... still enjoy your meals (there is a lot left to enjoy) and be extremely strict with it.

My rhumatologist said "what you do... I don't know about it ... but keep doing it"... ;)

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