Dear Pharmacist,
Your post on rheumatoid arthritis and autoimmune disease intrigued me. I didn't realize eating beans, peanuts, peas, lentils, soy or tofu was an issue. I eat these foods frequently, and I still hurt. Can you tell me more?
--D.B., Houston, Texas
Answer:We have many medications for autoimmune diseases, but what you eat could negate the effects of your drug. I feel the avoidance of lectin-containing foods is wise for people who have a pain syndrome like lupus, MS, rheumatoid or Lou Gehrig's. I'm not saying these food groups are bad, they have fiber and some nutrients, it's just that some people experience flares from the consumption.
Research shows that these foods may harm the delicate intestinal lining. If they 'poked' microscopic holes in there, then lectins and partially undigested food globules would leak into your bloodstream. It's called "leaky gut" but medically-speak refers to this process as "increased intestinal permeability" or "intestinal malabsorption." Once the door opens in your small intestine, and your intestinal villi are compromised, all kinds of symptoms occur.
It happens like this: Lectins and undigested globules of food proteins are spotted in your bloodstream because they leaked out of your gut. They are also spotted in an organ (because they will park themselves eventually). Then your immune system gets fired up.
Your immune cells crank out pro-inflammatory cytokines which cause pain and swelling and attack the organ where they see the foreign protein 'parked.' For example, if they park themselves in your thyroid, you might have Hashimoto's or Graves, parked in your myelin, it spells more neuropathy for multiple sclerosis. Your joints, and it flares rheumatoid arthritis. Think of pro-inflammatory cytokines as pain-causing chemicals that you don't want hanging around in excess.
In case you share my column with clinicians, it goes like this: There are many food antigens, among them lectin and gluten (gliadin) which increase intestinal permeability, leading to intestinal malabsorption. You see an up-regulation of the NF-Kappa B pathway which launches production of pro-inflammatory cytokines; food antigens can counter the positive effects of medication because they cause production of inflammatory cytokines, histamine or interferon gamma.
The theory suggests that foods (like wheat, cereal, beans, tofu and lentils) could spell trouble for autoimmune sufferers. This is why the paleo diet, and the work by Dr. Loren Cordain and Dr. David Wolfe is gaining so much traction, it is grain and lectin free and I think it could resolve many pain syndromes. I also recommend Doug Kauffman's Phase One diet.
Foods with the highest lectin activity include grains (especially wheat, legumes (especially soy), nuts, dairy and nightshades like eggplant, peppers, potatoes, tomatoes and others. I'd give this diet 4 months at least, forever if you feel better. Many ask if soaking beans removes the lectins, I think it can help but I don't think it is 100 percent effective. Protect your gut lining with probiotics, digestive enzymes and avoidance of refined/processed foods.
