Numerous environmental factors have been implicated in the development of autoimmune disease, including antibiotic use, birth by cesarean section, chemical exposure, poor diet, and sleep deprivation, among others (1, 2, 3, 4, 5). While it is widely believed that disease onset requires an environmental trigger, most autoimmune conditions have a genetic component as well (6).
Genetic information can be a powerful tool in aiding both diagnosis and treatment. One particular group of genes that has been strongly associated with various autoimmune diseases is HLA-B27. In this article, I’ll discuss HLA-B27, the role of a gut microbe called Klebsiella, and why a low-starch diet may be effective for those who have an HLA-B27-associated autoimmune disease.
What’s This about HLA?
“Antigen” in this case refers to cell-surface proteins. Putting it together, HLA is essentially a group of genes that determine which proteins are present on the surface of your immune cells.
Humans have a total of 23 pairs of chromosomes, with one of each pair coming from each parent. You therefore inherit one set of HLA genes from your mother and one from your father, on the maternal and paternal versions of chromosome 6. HLA is a highly polymorphic gene, meaning there are many different possible gene set variants, or “haplotypes,” that you can have.
The astounding number of haplotypes for HLA likely evolved to allow for the fine-tuning of the human adaptive immune system, but certain haplotypes can also predispose an individual to a particular disease of the immune system. You may have read my previous article in which I mentioned the role of HLA haplotypes in susceptibility to mold illness. HLA-DQ haplotypes have also been associated with celiac disease (7), while HLA-DRB1 has been associated with rheumatoid arthritis (8). For the remainder of this article, I’ll focus on HLA-B27 and its connection to autoimmune disease.
The genetic link between autoimmune disease and dietary starch.
HLA-B27 Is Associated with Various Autoimmune Diseases
The prevalence of HLA-B27 varies between ethnic groups and populations worldwide but is generally not a very common haplotype. Only 8 percent of Caucasians, 4 percent of North Africans, 2 to 9 percent of Chinese, and 0.1 to 0.5 percent of Japanese people possess HLA-B27 (9).
The most closely associated autoimmune disease with HLA-B27 is ankylosing spondylitis (AS), an inflammatory disease in which some of the vertebrae of the spine fuse together, inhibiting mobility. An estimated 88 percent of people with AS are HLA-B27 positive, yet only a fraction of HLA-B27-positive people will develop AS (10). Other autoimmune diseases that are associated with an HLA-B27 haplotype include Crohn’s disease, ulcerative colitis, psoriasis, reactive arthritis, and uveitis (11).
Making things a bit more complicated, HLA-B27 is itself polymorphic, with more than 100 different subtypes (12, 13). These are distinguished by a two-digit number added to the “parent” haplotype. Many of the most common subtypes of HLA-B27 (such as B2704 and B2705) are associated with increased risk of AS, while other subtypes (like HLA B2706 and B2709) actually appear to be protective against the disease (14, 15). This is likely due to the structure of the protein encoded by the HLA gene, as we’ll explore more in the next section.
The Klebsiella Connection
As early as 1980, AS patients were identified as having elevated levels of serum IgA, suggesting the abnormal movement of microbes from the gut into the bloodstream (16). More recently, microbiome analyses identified greater abundance of a gram-negative bacterium called Klebsiella in stool samples of patients with AS (17). Fitting with their hypothesis of bacterial influx into the bloodstream, researchers found that these patients also had elevated levels of anti-Klebsiella antibodies in the blood (18).
In other words, the immune system produces antibodies against Klebsiella in an effort to remove it from the bloodstream, but these antibodies can also “accidentally” bind to HLA-B27. This idea of antibodies binding to “self” is characteristic of autoimmunity.
Although Klebsiella is one of the most widely studied microorganisms in relation to HLA-B27 and autoimmune disease, the concept of cross-reactivity applies to a number of different microbial (and dietary) antigens. For example, Proteus bacteria have been suggested to be involved in the development of rheumatoid arthritis via the same molecular mimicry mechanism as Klebsiella (21). As we’ll see next, knowledge of these mechanisms and the bacteria involved can really help shape our approach to treatment.
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Why a Low-Starch Diet Might Help
The composition of the gut microbiota is constantly shaped by the influx of dietary substrates (22), including proteins, fats, and carbohydrates. Within carbohydrates, substrates can be further categorized as simple sugars and polysaccharides like starch or cellulose.
Biochemical studies of Klebsiella have shown that this bacterium does not grow on cellulose derived from plants but can grow readily on more simple sugars (23). Most simple sugars like glucose are absorbed in the proximal small intestine and therefore do not travel as far as the large intestine, where the majority of microbes are located. Simple sugars from the diet are therefore unavailable to Klebsiella.
Starch, however, is not as easily digested or absorbed, and some of it remains intact when foodstuffs finally reach the colon. Klebsiella have been shown to manufacture pullulanase, a starch-debranching enzyme, that enables them to break down starch into simple sugars for energy and growth (24).
Several studies have applied this information in humans. One randomized control trial split people into two groups: a high-carbohydrate, low-protein diet or a low-carbohydrate, high-protein diet. They then compared the abundance of Klebsiella in fecal samples. The average number of Klebsiella was 30,000/gram in the high-carb group compared to 700/gram in the low-carb group (25). Another study found that a low-starch diet reduced total serum IgA in AS patients (26). The majority of these patients also reported a decline in symptom severity and, in some cases, complete remission.
Take Steps toward Remission
Now that you better understand the science behind HLA-B27-associated autoimmune disease, here are three things you can do to take action.
Find Out Your Haplotype
Currently, there is no readily available, user-friendly means of determining HLA haplotype from full genomic sequencing data (from companies like 23andme). While there are a few HLA-related SNPs that can be identified in the raw genetic data, at best these are only correlated with HLA haplotype and do not provide information about subtype. The best and most accurate way to determine your haplotype is to request a blood test from your healthcare practitioner that uses a more targeted DNA sequencing approach to identify which alleles you carry (27).
Experiment with Your Starch/Carb Intake
Even if you don’t have access to genetic testing, or if you’re HLA-B27 negative, you can still do a self-experiment to see how you personally tolerate starch. I am a big proponent of n=1 experimentation and finding the diet that is right for you. Eileen Laird of Phoenix Helix has written an excellent post in which she shares the results of her own and several other Paleo autoimmune bloggers’ starch experiments. Many found that they can tolerate some forms of starch but not others. This is really valuable, since we know that a diet devoid of fermentable fiber like starch can be detrimental to the long-term health of the gut microbiota (28).
Heal Your Gut
At the risk of sounding like a broken record, healing the gut is absolutely critical to achieving and maintaining optimal health. A leaky gut allows bacteria and dietary proteins into the bloodstream, which provokes an immune response. Regardless of your HLA haplotype, strengthening the integrity of the intestinal barrier is an important step towards achieving remission. Supporting a diverse, healthy microbiota can also help to keep Klebsiella and other potentially problematic microbes at bay.
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For about two months, all food I have eaten apart from the odd occasion has been under 3g starch/100g with plenty of dark leafy greens. This is after noticing a connection between starch intake, my bloated tummy and temporal lobe seizures. I actually upped my sugar intake a little as I do not feel okay without carbs (missed opportunity in some peoples view). Despite of this, my weird blood sugars completely stabilised (normal fasting but extremely high postprandial), my tummy stopped looking seven months pregnant and my glands on my neck went down. I don’t know if I am this haplotype or not but I think who the low starch diet does work for, seems to be pretty obvious pretty quickly so worth a shot if any suspicion. It did not solve all my issues, but it is so worth it. I can even tolerate moderate amounts of inulin rich vegetables now – could not before – so I think it is klebsiella.
I totally agree with B1
I test positive for HLA B27 – and discovered this when I was suffering for years with pain/inflammation/depression – was diagnosed with AI – Seronegative Spondylitis that had AS symptoms – as well as Hashimotos. Cleaned up everything I could, went paleo and added in amazing supplements that finally kicked the symptoms. Fast forward, it’s been over 3 years and I have labs that show total remission, no sign of issues, no symptoms, and I went from taking 5-6 prescription Aleve to zero medications or OTCs. I spent so many years feeling hopeless, and wish more people could have the experience I have had in recovering my health.
what supplements do you take?
What supplements did you take???
You said it helped, so please share for others to explore!
could you please provide us with more details about you supplementary diet?
Which. Supplements
Hi just wondering what you took? I just got dianosed and i am wanting to know best things to try
Kate, do you mind sharing what supplements you used?
Can you share the supplements you took? Thank you!
I find the Klebsiella link interesting. When I tested for MARCoNS, staph was negative but there was an overgrowth of Klebsiella in the nares. I couldn’t find any literature linking overgrowth in the nares to overgrowth in the gut, so I didn’t treat it with the recommended antibiotics. This info makes me wonder if I should as I also have histamine intolerance and Klebsiella is a histamine producing bacteria. I do have AI dx but not the ones mentioned in this article. Does anyone know if overgrowth in the nares is linked to overgrowth in the gut?
Where do you mean by nares? Your nose?
Is starch necessary in the diet? And if you don’t get enough do you damage your mucosal layer? (In the same way as very low carb does by starving the bacteria and forcing them to eat the mucus – this causing long term problems)?
Why is some tips of starch OK… and not others? What’s the difference? Isn’t starch, starch?
And what does it say for those of us who’ve had DISASTEROUS results on a low starch diet?
I’m sorry to hear that it didn’t work for you. What happened when you tried it, what was the “disaster”?
This article does not recommend a low-starch diet for everyone. It suggests that it may be helpful in a small subset of people: those with HLA-B27, Klebsiella pneumoniae overgrowth in their gut, and certain autoimmune conditions.
cathy, i would really really like to hear what happened to you on the starch free diet. i personally had so much hope with all the success it has had for others, but something went wrong. I would really like to compare notes.
Terrific informative article! I may have AS. I say may, because I believe in the power of mind to heal and stay healthy and have personal experiences to validate.
Diagnosed initially in my lumbar area, in my late 20s and supposedly confirmed again in my early 60s, but interestingly, I sustained a severe blow to the same lumbar area in my 20s. I’m curious if the injury created an environment to encourage AS. And who knows what else, having had different locations of spinal injuries, exposure to bacteria/viruses/molds, the possibility of latent vaccine reactions, the list of possible aggravators could be long. In my 20s, I was told there was no reversal only that I have it and expect degeneration. Even with the “there is nothing that can be done” statement, I walked out of the chiropractor’s office not accepting that belief. In the last 10 years, I’ve noticed slight discomforts in my lumbar area, but only with a very few specific situations. Now with this new information regarding genetic predisposition, and perhaps possibly having a gene variant, I’m quite a bit more curious.
I feel fairly certain I have minimized or delayed the degeneration, if I actually have AS, with several decades of using supplements, herbs/botanicals and healthy food choices. I currently am on a Vit D3 protocol to elevate it even higher (much beyond the accepted US standard values), along with increasing glutathione production and of course and maximizing a healthy microbiome. I make limited and selective carbohydrate food choices and have for several years. I really appreciate Chris presenting this information, and everyone sharing the comments and experiences, Thank You!
Felt converted reading your story. I am 26 right now, was diagnosed with AS(multiple joint pain, hip, and Hla B27+) 10 year ago, totally ignored the docs and only with the power of mind got rid of multiple joint pain. Life well for about 7 years completely normal and healthy life. Now that I have developed lumber and cervical disc bulges and pain in lower back. I am a little paranoid after looking at the MRI and the pain in my lumbar spine( it probably was a sports injury). Now I don’t know how to go about it, to consider it as slip discs or AS. I would be glad to know how you manage to do well even with these hindrances. It has become difficult for me to imaging myself living for more than 40 years. Any suggestion or opinions are welcome.
I haven’t been diagnosed with anything because I haven’t been to see a doctor about my symptoms (pretty much all the symptoms of SIBO). I’ve done my own research instead and changed my diet completely taking out starch and grains, and my symptoms only return if I slip up in my diet. Since I’ve started this clean, “real food” diet, I’ve felt so much better, not just physically, but mentally as well.
Thanks for the shout-out, Chris. As a fan of your work and the N=1 experiment, I’m honored.
I am HLA-B27 positive with AS and colitis. I went starch free October 2015 & within 24 hours noticed a profound change with my colitis symptoms. The pain took a few more month to be impacted. I was already GF & following a very clean AIP diet, so giving up starch was not that difficult for me. I did notice a decrease in my energy after a month or so on the NSD, so it’s important to be conscious of nutrient density. My rheumatologist doesn’t support this diet however. I am currently med free except for the occasional NSAID.
Taking out starch… what is it that is considered starch?
I’ve asked numerous times to get info or referred to a dietician as I’m no where near diet educated. My body has always done good to crave what I need.
Nutrient density… please detail this more.
I have inflammation in my esophagus, so I am limited on my eating ability. So I need to intake what I need explicitly. My Dr’s don’t get it and I get the “eat green, good proteins, and some fruits” talk. I already know that, that’s basic knowledge. But they also tell me to drink lots of water. I told them I try to drink one bottle 20 oz of water, but they say I need to drink 4 times that. If I drank the amount of water they want daily, I would not be able to eat anything as I’d be full for the entire day. One bottle of water fills me up for half a day.
Hi Ann – the short answer to your question ‘What is starch?’ is to buy yourself a cheap bottle of iodine from the pharmacy and test foods. If the food turns black with the application of iodine, it contains starch (throw out the tested piece!). More information can be found on the Kickas website.
I have chronic demilating inflammatory polyneuropathy.
I am wondering if there any documentation of the diet and the disease.
I have had disease for 16 years ,. My treatment consists of 2 cyclosporine,100mg daily ,. Also 3 plasma phersis treatments weekly.
I look forward to any knowledge you can offer.
Thankyou. Richard Austin.
Hi Richard Austin
I viewed your post & I said, “WOW”! I have been diagnosed with that as well, 3 years ago. I’ve met one other person with this disorder. I have NOT gone the traditional route for it doesn’t heal the root cause. With diet changes & supplements + findings of methylation problems & high lead content blocking methylation & addressing those root issues I have been healing. I have hit a plato as my FM Dr. has been only able to take me this far. Looking forward to my first appointment with Dr. Nett. If you haven’t looked into getting an appointment with this group maybe that would help you. Best to you..
I am a female with Ankylosing Spondylitis diagnosed in 1990 when I was in my late teens. I am also HLA B27 positive. I have had only mild reduction in spinal flexibility, but I have had major joint inflammation in hip, knee, shoulder, chest and even jaw and heel (yes, you can get AS inflammation in these odd places). The inflammation of the iris, or Uveitis (iritis) is also part of the Ankylosing Spondylitis autoimmune arthritis syndrome. I have had that too, for many years about 3-4x per year, and the only thing that helps is steroid eye drops every hour, tapering frequency gradually over 6 weeks. AS runs in my family: my grandmother was never diagnosed but she had similar symptoms and also developed kyphosis (a hunchback).
I believe I’ll avoid my grandmother’s advanced AS condition because of 3 things that have step by step put my AS into remission. Yes, low-starch was part of what helped.
1. The first thing which greatly reduced the severity and frequency of joint inflammation, was taking high doses of Vitamin B5, of at least 500 mg a day. It is generally protective and took about 3 months to take effect. I only learned over many years of going on and off B5 that it made a significant difference. Megadoses of B5 do not help with my family members’ rheumatoid arthritis or bursitis or frozen shoulder, but it definitely works for my arthritis. An uveitis (eye inflammation) attack has generally come on a few weeks after I’ve been a bit lax with taking my daily B5, and the uveitis heals within 4 weeks (heals much faster than otherwise) when I double my daily Vit B5 dose along with taking the eye medicine.
2. My joint AS went even further into remission when around 2002 I started thyroid medication for severe hypothyroidism caused by autoimmune thyroiditis (Hashimoto’s), and I also stopped taking birth control pills. My husband realized the best thing he could do for my overall health was to have a vasectomy to get me off contraceptive drugs. The AS was improved to the degree that I only got joint inflammation when I exercised, and I could manage the pain with aspirin or naproxen sodium and reduced joint activity. (Sadly, even mild exercise always made my joint AS worse, not better.)
3. The final thing that put the AS in joints completely into remission AND put most the Uveitis into remission was in 2012, when I started a low-carb, high-fat, moderate protein diet (borderline keto), and also stopped most cow dairy (I still eat cow butter and goat/sheep dairy). I also went gluten free and mostly grain-free. I found out later that going gluten-free is highly recommended for people with AS as well as Autoimmune Thyroiditis, and can be beneficial for any kind of autoimmune issue really. This change in my daily diet resulted in losing a lot of excess body fat over 12 months, about 1/4 to 1/5 of my total body weight (I went from size 16 to size 4-6 clothes). It also improved my mental health, gave me an overall sense of calmness, and sharpened my cognitive ability. Because of improvements to AS, thyroid health, and weight loss, I can now handle moderate and occasional vigorous exercise without joint inflammation, and I’ve only had 2 episodes of uveitis since then.
I am interested in the #3 change you made. What do you and do not eat for the gluten free diet? I am not diet savvy, so I have no clue where to start.
This…
low-carb, high-fat, moderate protein diet (borderline keto).
What does that entail? Can and can’t eat foods?
Just some basic detail would help compared to no help from my numerous Dr’s that tell me I need to eat good proteins and green veggies and all will be fine.
They act as if this will go away on its own. They act like they have no clue how much pain I’m in. Even when I couldn’t stand up and walk right, my dr asked me in total surprised voice “are you having trouble walking?”. I was in excruciating pain, moaning, teary eyes cause it was so bad. And I have a high pain tolerance, and he knows that. Yet he just seemed oblivious to it all.
To reply to your post I am a 63yo male Dx w AS in 1986. No diet made much/any difference and I took Sulfasazine and Celecoxib to help with swollen joints and constant pain. Had joint replacement surgeries etc but not until I switched to the Paleo diet in April did I find some improvement in pain levels, mobility. Month ago got my results from 23andMe and discovered many SNP’s including MTHFR. Now take 8mg/daily of MethylFolate and B12 and swollen knees and hands are finally gone. Get your genetic testing, find out what you are dealing with and go from there. After 30yrs of suffering there is a beautiful bright light at the end of that tunnel! Best of luck and wishing you better health!
That’s awful. Check out a low lectin way of eating via The Plant Paradox AND/or the IBS Low Starch Diet. I love the first book and going to order the second one also. Hope it helps. Diet and what we put into our bodies is key for healing-maybe what we leave out is key 😉
Hellov there. I’ve had the same(except eyes) symptoms with AS. Diagnosed 10yrs ago, now developed slip discs in lower back. Can you please elaborate on low carb high fat and protein diet. Do you mean, mostly meat and basic veggies? Every information is useful.
Just the other day I found out (ultra sound) that my thyroid has almost been distroyed by autoimmunity and a lot of other hormones are out of whack as well.
I’m rather confused about the carb issue as well. High carb/low fat is no good for me. Low carb/ high fat makes me crash. When I eat something sweet, like (dried) fruit, I fall asleep. My staple in carbs are plantain and sweet potato. This worked, more or less, for about 10 months. Now, for no reason I can see, I crave sweet and cacao. This is completely new, as I never had a sweet tooth and I always have chocolat in the house without craving it.
Perhaps you should try going ZERO carbs for a month and see if that helps. My guess is it will since it most likely will eliminate any and all cravings for sweets/carbs.
I’m wondering if going zero carbs for a month would then instruct your T4 to convert to too much RT3 making you short of T3.
Perhaps you just need to give the diet more time to feel better. If you’ve been eating carbs it will take your body some time to switch over to the natural state of burning fat for energy, including your brain. This is a good article that describes the process. https://fitness.mercola.com/sites/fitness/archive/2012/08/17/human-body-favors-fat-adaptation.aspx
When I stopped carbs I felt awful. I had a fever that came and went, horrible cravings, headaches, my trips to the bathroom were urgent…for over a month I was passing blobs of mucous (yes, I said it). My sister-in-law had a similar experience but different. She got a body rash, extreme fatigue, debilitating aches (even worse than before). She even passed out cold a few times.
I think Chris Kresser has written about fat adaption in the past. So has Mark Sisson and Joseph Mercola.
What I took from it is that we are all different and what is going on inside our bodies is different so we are not going to react the same. What was miraculous to me was that after months of what seemed like an adjustment period, on a very strict diet, I felt 10 years younger and looked it too. When we switch our diets there’s a lot going on. My doctor described it as the good-guys crowding the bad-guys out and they weren’t leaving without a struggle.
Give it time. Know that there will be discomfort. It’s a sign you are healing. When I read the comments section here I see so much hope, positive experiences and mentorship. It’s really uplifting and I wish everyone success and health.
Hi
I have HLA-B27 gene and AS. I am pain-free following a starch-free diet. I recommend reading up on Professor Alan Ebringer’s work. There is also a Facebook group called “The Low/No Starch Diet for Ankylosing Spondylitis” which I suggest anyone to join.
Good luck…
You want PROOF ????????????????? Then do a no starch diet for a set period of time & see first hand what happens to your body, since for unknown reasons it doesn’t seem to work for everyone, yet does work for many. 2.5 yrs ago I did it, after being convinced of the probable validity, from reading the AS/no starch research, and on the 4th day my Ankylosing Spondy (hla-b27 neg) was already 85% better, and remained better most of the time When I went no dairy as well, it remained about 85% better, but ALL the time ! No more antiinflams, steroids, Tramadol, Tylenol, etc. and the joy of walking again & being able to sit for longer than 3 minutes at a time without sacral pain. Over the course of the past 2.5yrs, did lots of “gut healing” efforts, but I always felt that those darn Klebsiellas were barely “controlled” & at bay only via the diet, but that I just couldn’t fully conquer them. Almost three months ago, I began a dis-parasite protocol, and by the end of the 1st month, I noticed that I felt even way more than 85% better & could FINALLY eat some significant amounts of starch & dairy again, without the usual repercussions. Time will tell how it goes, once I finish off the few remaining capsules of dis-parasite formula. Will have to go back and check my genetic testing for which HLA halotypes I tested as. Don’t wait for your conventional MD to recommend a no starch diet, as it will NEVER happen, and is certainly not necessary. You can control what goes into your mouth and do a trial just by yourself. I would never say it was easy, BUT neither was all that pain and immobility easy. Wishing you all the same degree of empowering success that I have experienced !
Lynn, what dis-parasite protocol are you using?
Emily & Heather,
I first used the Pharmaceutical product “REPINOX”=Nitrazoxanida/Nitrazoxanide 500mg, twice a day for 5 days.
On day 6, I immediately followed with the “Freedom, Cleanse, Restore” (FCR) botanicals from Parasitology Center Inc. for 3 full months.
https://www.parasitetesting.com/fcr_promotion.cfm
Hi Lynn, would you mind sharing the dos-parasite protocol you did? I need to do the same. Thanks.
Emily & Heather,
I first used the Pharmaceutical product “REPINOX”=Nitrazoxanida/Nitrazoxanide 500mg, twice a day for 5 days.
On day 6, I immediately followed with the “Freedom, Cleanse, Restore” (FCR) botanicals from Parasitology Center Inc. for 3 full months.
https://www.parasitetesting.com/fcr_promotion.cfm
I have a starch intolerance and have delayed reactions to grains and potatoes, and other things like tapioca. So I’m following these diet guidelines. My big question though is: How do we fed or gut bacteria while avoiding starch?
Fruit, including tomatoes, cucumbers, olives, etc. Animal fiber = connective tissue (collagen), cartilage, whole small fish, etc.
Keep in mind, tomatoes are a nightshade and can be troublesome for those with gut issues.
I’m 70 y.o. and was diagnosed with HLA B27 some 19 years ago after my first bout of uveitis. I spent the previous 27 years on a farm, and had no problems.
After moving to the coast, and in an urban environment, I developed severe uveitis and was sent straight to the eye doctor. This move, and the associated stress, bought on the condition..
I had another bout 3 years later. After reading up on the condition, I started taking probiotics, and cut out eating bread.
Have had no further problems since then, but have severely restricted my starch intake, but still eat potatoes now and again, and my besan pancakes which are made out of fermented chick pea flour.
I find that bread is the main culprit which brings on an arthritic twinge.
Thanks for the article.
Dave
I have been on a low-starch diet since 2006, after reading Carol Sinclair’s book ‘The IBS Low – Starch Diet’ and realizing that what she was describing was me in a nutshell. I thoroughly recommend this book if you have tried gluten-free & still experience pain of any sort- A.S., gut, (crohns etc included), joints, back, knee, arthritis of any kind, etc.
Carol explains how to test foods for starch and how to go about finding which foods affect you.
This book has a forward by Alan Ebringer former professor of immunology at Kings College, London, who discovered that the Klebsiella bacteria in the gut mimic the B27 gene, and that they feed on starch. If starch is reduced klebsiella numbers are kept in check.
I have not had blood tests done – it was enough for me to be free of pain. I have enlarged joints on my fingers but they are not painful unless I eat starchy foods, fructose or nightshades.
I have had AS for 11 years. Undiagnosed until 2015. It’s been so enlightening to finally figure out the intense pain all of these years. So many doctors have no clue about how diet can effect health. I would never have guessed that changing my diet could help with my pain. But I switched to the AIP diet in December and my pain left for 5 straight months. I also incorporated doterra’s oils and vitamins. I then quit the diet, got lax, and had pain again. Not as severe but now I’m going back on the diet. I gotta learn to stick to it 🙂 it helps a ton.