Increasingly, clinical ecologists (those doctors who believe that your health has to do with what you eat and how you live, not just what germs you contract) have concluded that arthritis is caused by an allergy to certain foods. Medicine is giving this theory a grudging nod after a Norwegian study published in the Lancet last year (12 October 1991) found that patients with rheumatoid arthritis improved after fasting, then following a gluten free vegan diet for three and a half months, after which they were put on a lactovegetarian diet. The study group showed significant improvements in all areas measured, including number of tender and swollen joints, pain, stiffness, grip strength and even white blood cell count. These benefits were still present a year after the study ended.

The Lancet concluded that "a substantial reduction in disease activity can be obtained by fasting followed by an individually adjusted vegetarian diet."It is already clear, however," the editorial noted, "that every rheumatology department needs a dietitian, if not a health farm."

Clinical ecologists believe that rheumatoid arthritis is primarily an allergy, either to food or to certain environmental chemicals such as tobacco smoke, pesticides, perfume or even hair spray.

Dr John Mansfield, author of Arthritis: The Allergy Connection (Thorsons), who has treated several thousand arthritis patients in the UK, believes that "most forms of arthritis are environmentally induced" and that some 90 per cent of patients can be successfully treated. Besides foods, some of the most common offenders are house dust, mites and moulds, smoking and intestinal candidiasis.

Doctors like Mansfield find the source of the problem through skin prick provocative skin testing (more useful for inhaled allergies than food, he says), elimination diets, among other methods. The treatment is either to eliminate the offender from the diet, or to use the provocative intradermal neutralization treatment or enzyme potentiated desensitization (developed by Dr Len McEwen, formerly of the department of Allergy at St Mary's Hospital. With neutralization techniques (favoured by Mansfield and subject to many more safety tests), a patient is given (either by injection or drops under the tongue) the dosage that "turns off" symptoms. The great advantage of this system is that your diet or treatment is completely individualized. The disadvantage, particularly of EPD, is that we don't know the long term effect.

The Dong Diet

In What Your Doctor Won't Tell You, Heimlich describes the work of San Francisco based Dr Collin H Dong, a victim of arthritis, who developed a "caveman type" diet to deal with his own crippling arthritis. Within a few months he was free of his symptoms and returned to playing golf, which at age 85, he still enjoys.

The Dong diet avoids meat, fruits (including tomatoes), dairy products, vinegar and other acids, all varieties of pepper, hot spices, chocolate, dry roasted nuts, alcohol, particularly wine, soft drinks, and all additives, preservatives and chemicals, particularly monosodium glutamate. The Dong diet has been fashioned to avoid many common allergens, including artificial ones. Because it avoids meat, it is naturally high in fish, and fish oils have been recommended in some quarters as being particularly good for arthritis victims (see below).

Avoiding Nightshades

Heimlich also claims that 70 per cent of arthritics who avoid nightshades report relief. This category of food includes white potatoes, eggplant, all peppers (except white and black, the kind sprinkled on food), tobacco and tomatoes.

Fish Oils

The Lancet (January 26, 1985) reported a double blind study of 20 arthritis patients, who experienced relief taking 15 capsules a day of MaxEPA (the equivalent of a single portion of a fatty fish like salmon), which contains omega-3 fatty acids. However, please be warned that high doses of fish oil supplements can lead to changes in white blood cell counts and excess bleeding in the brain. Best to consult a practitioner skilled in the use of fish oil supplements.

Good Old Aspirin

If none of the above works, consider taking enteric coated aspirin, which does not dissolve in the stomach. America's Health Research Group notes that this kind of aspirin causes fewer problems than the ordinary variety or than NSAIDs.