If rheumatoid arthritis could be cured by diet, your doctor would prescribe that first — and your insurance company would likely refuse to cover a $10,000-a-month biologic until you proved that diet didn’t work for you. But they don’t, and it’s not because doctors are evil. It’s because rheumatoid arthritis is not a food problem.
Now before you get mad at me, I’m not saying diet doesn’t matter. Diet absolutely matters. But it’s important to understand what diet can do for rheumatoid arthritis… and what it cannot.
I understand why people want food to fix this. That was my entire story.
When I was diagnosed with rheumatoid arthritis, I spent the first seven or eight years trying to heal it holistically. When you’re diagnosed with an autoimmune disease, everything feels out of control. Your life flips upside down overnight.
Medications feel mysterious. You hear about scary side effects. You may already have some mistrust of Western medicine. And suddenly food feels empowering. It's the one thing that gives you a sense of control. I remember dropping money I didn’t have on a juicer. I bought cookbooks. Ordered supplements. Every new plan felt like the thing that would finally fix it.
And sometimes I’d feel better for a while.
But eventually the disease would come roaring back. And I was left wondering what I had done wrong.
It wasn’t because I didn’t try hard enough.
It was because I misunderstood how the disease works.
Let’s zoom out. Think about how often doctors tell patients to change their diet and exercise before prescribing medication.
If you have:
Your doctor will often say:
“Make lifestyle changes first. Come back in six months.”
Why?
Because those conditions are strongly influenced, and sometimes reversed, by diet and exercise.
When lifestyle works, it becomes first-line treatment.
So if rheumatoid arthritis were primarily caused by food, diet would absolutely be first-line treatment.
Let’s talk about insurance.
Insurance companies use something called step therapy, also known as “fail first.” If you need an expensive medication, they often require you to try cheaper options first and prove they don’t work before they approve coverage.
Biologics for rheumatoid arthritis can cost $10,000–$13,000 per month.
Insurance companies do not want to pay for that.
If diet alone could cure rheumatoid arthritis, you would be required to try that first before ever being approved for a biologic.
But you’re not.
And that’s because large-scale evidence does not show that diet alone can:
Rheumatoid arthritis is not a metabolic disease like type 2 diabetes. And it’s not just “painful joints.”
It is an autoimmune disease.
That means your immune system, which normally protects you, begins attacking your own joints, specifically the lining called the synovium.
The synovium helps nourish and protect your joints. In RA, immune cells flood that lining with inflammatory messengers like TNF-alpha and other cytokines.
This causes:
Over time, that inflammation can erode cartilage and bone.
Without treatment, repeated flares can gradually damage the joint itself.
This inflammatory process is systemic — it affects the whole body, not just one joint.
Here’s something interesting.
Your rheumatologist might not ask much about diet, but they will absolutely ask about exercise.
Exercise used to be a sore spot for me. When my rheumatologists would ask me about exercise I'd feel a lump rise in my throat. "Why are they asking me if I'm exercising?? I just finished telling them that I could hardly move this morning??" So eventually I asked why.
My rheumatologist explained that your immune system and your joints are deeply intertwined. Your immune system lives in the synovium. It’s constantly monitoring for micro-injuries, wear and tear, and helping repair small damage. I mean, think about how much your joints go through in a day! They need a lot of support from your immune system.
So basically, exercise creates a controlled inflammatory response.
In healthy people, inflammation isn’t bad — it’s part of repair. And even in people with RA, exercise-induced immune responses are generally beneficial.
Over time, consistent exercise can modestly reduce some inflammatory markers and improve immune regulation.
But it does not selectively block specific inflammatory signals like TNF-alpha.
That distinction matters.
To visualize this, imagine a chart:
DMARDS and biologic medications are designed to block and disrupt inflammatory messengers.
These drugs directly interrupt the autoimmune cycle. They reduce swelling, prevent joint damage, and are considered disease-modifying therapies.
They change how the disease behaves.
Their impact is significant and targeted.
Exercise temporarily activates the immune system in a controlled way. Muscles release signaling molecules, and over time this can lead to modest reductions in inflammatory markers.
Exercise is powerful.
But it does not directly block inflammatory messengers or halt joint erosion.
Its impact is supportive — not disease-modifying in the same way biologics are.
Foods that have been studied and proven to support RA patients like fish (omega-3 fatty acids), turmeric, etc. can reduce production of certain inflammatory cytokines.
They can:
But again — the effect is modest and supportive.
They cannot stop joint erosion or shut down the autoimmune cascade.
Rheumatoid arthritis has natural peaks and valleys.
When I would hit a breaking point, I’d try a new supplement or diet. And often, that timing overlapped with a natural dip in disease activity.
So it felt like the diet worked.
Until the next flare came.
And then I felt like I had failed.
Looking back, I don’t think I failed. I think I misunderstood disease patterns.
I’ve been in a near-remission state for about five years.
I still have flares, but overall my medication has worked well.
At the same time:
The American College of Rheumatology recommends this pattern to support RA management.
I absolutely believe diet and exercise help support lower disease activity.
But medication is what prevents joint damage.
One rheumatologist once told me:
“Think of your joint like a Tootsie Pop. How many licks does it take to get to the center?”
In RA, the question becomes:
“How many flares does it take for your joint to go away?”
You can’t predict that number.
But you can use therapies we know prevent damage.
Medication isn’t easy. Finding the right one can take time.
But it can give you your life back.
Buying a juicer and drinking celery juice every day is not going to protect your joints the way you deserve.
Diet and exercise matter.
They support your health.
They improve quality of life.
But rheumatoid arthritis is an autoimmune disease — not a food disease.
And right now, medication is the only tool we have that can reliably stop joint damage.
The field of rheumatology is massive. Scientists are working every day to develop better treatments — and hopefully one day, a cure.
Until then, you deserve to understand what works, what supports, and what protects.
Meet Ellen, a chronic illness advocate and the founder of Flare Family. Since developing Rheumatoid Arthritis in 2010, she's dedicated herself to empowering others navigating similar journeys through her TikTok account, @ellenwitharthritis. Led by compassion, she is working to build a community where everyone feels heard, understood, and uplifted.
Ellen is a graphic and web designer who enjoys spending time with her partner, Jarrod, and soul dog, Dolly. Her not so guilty pleasures are Bravo reality shows, donuts, and finding great hiking spots.
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