Your rheumatologist diagnoses rheumatoid arthritis, looks after its medical care and monitors it, and nothing here changes that. Our naturopaths and nutritionists in Geelong and Drysdale work alongside them on the part that is yours to influence: what you eat, your gut health, your weight, smoking, sleep and the everyday load on your joints.
Some, and more than most people are told. A systematic review of prospective studies found that a Mediterranean-style diet was associated with lower disease activity and less pain in people with established RA [1]. Smoking is the strongest modifiable risk factor for developing RA and for it being harder to control [2]. And the gut and oral microbiome are altered in RA and partly normalise with treatment, which is why gut health sits in the picture rather than beside it [3].
Most people who come to us are already on treatment from a rheumatologist and want to do more than take it and wait. Some have flares they cannot explain. Some have been told food is irrelevant and do not believe it. Some are tired in a way the joints alone do not explain.
It is not “all in your head”, and it is not only about the medication. We will always listen.
We don’t diagnose or treat rheumatoid arthritis; that stays with your rheumatologist. Our part is the nutritional, herbal and lifestyle work that sits alongside their care.
RA is a systemic autoimmune condition, not just a joint problem, and the inputs the research keeps returning to are diet pattern, smoking, weight, gut and oral health, sleep and movement [1][2][3]. Those are the inputs we work on.
Diet pattern — a Mediterranean-style pattern built around vegetables, legumes, fish, olive oil, nuts and whole grains, with little processed food, is the diet with the most evidence in RA [1]. We start with what you actually eat and move towards it at a pace you can keep.
Food triggers — some people notice flares with particular foods. The evidence for any one food is thin, so we do not hand out a banned list. Where it is worth testing, a structured elimination and rechallenge, done with a practitioner and a diary, is the way to find out without narrowing your diet for nothing.
Gut and oral health — the gut and oral microbiome are altered in RA [3], and gum disease travels with it. Long-standing gut symptoms are worked on in their own right, and we will send you to a dentist if your gums need one. Our article on autoimmunity and the gut explains where the evidence sits.
Smoking — the single most important lifestyle change in RA, for onset, severity and how well treatment works [2]. We help with the practical side of stopping.
Weight and movement — excess weight loads the joints and is associated with higher disease activity; regular movement matched to your joints protects them. Both are worked on with food and a realistic plan, not a lecture.
Nutrient status — read from your GP’s and rheumatologist’s bloods, with anything missing arranged. Measured, not assumed, and any correction agreed with your prescriber.
Sleep, fatigue and stress — RA fatigue is real and multi-causal. Sleep, blood sugar, anaemia through your GP, deconditioning and mood all feed it, and several can be worked on.
What stays with your rheumatologist — diagnosis, disease-modifying medication and every decision about it, flare management, monitoring bloods, and anything to do with your eyes, lungs or heart.
Your rheumatologist diagnoses, prescribes and monitors. We work on diet, gut and oral health, weight, smoking, sleep and nutrient status, and we keep them informed. We never ask anyone to stop, change or delay disease-modifying medication, and we check anything we suggest for interactions with it before you take it.
Depending on what we find, a plan can include:
Setting up a Mediterranean-style diet pattern you can sustain, with the practical work of shopping and cooking done properly.
A structured elimination and rechallenge where food triggers are suspected, with a diary, so decisions rest on your own results.
Gut work, where symptoms or testing point there, and a dental referral where your gums need one.
Support to stop smoking.
Weight and movement work matched to your joints.
Reading your bloods with you, and a plan for anything that is low, agreed with your prescriber.
Herbal and nutritional support, chosen in consultation and checked against your medication. On immune-modulating therapy some things are off the table, and we say so.
Keeping your rheumatologist and GP in the loop.
We usually review at eight to twelve weeks, timed with your rheumatologist’s monitoring bloods where we can.
Download this list of Gluten Containing Foods
Always at diagnosis, always for treatment decisions, and always in a flare. A hot, swollen joint that is suddenly much worse, a fever on disease-modifying medication, chest pain or breathlessness, a red painful eye, or new numbness needs your rheumatologist, GP or an emergency department, not a diet change. Early, effective medical treatment is what prevents joint damage, and nothing we do replaces it.
We don’t diagnose or treat rheumatoid arthritis; medication and every decision about it sit with your rheumatologist. Seeing a naturopath is not a reason to stop medication or to start something you have picked up yourself, because both can do real harm. Arthritis Australia and healthdirect set out the medical side plainly.
Not with the RA itself; diagnosis and treatment stay with your rheumatologist. What a naturopath can do is work on the inputs the research links to disease activity: diet pattern, smoking, weight, gut and oral health, sleep and nutrient status, alongside your rheumatologist’s care and never instead of it.
A Mediterranean-style pattern has the most evidence: vegetables, legumes, fish, olive oil, nuts and whole grains, with little processed food. In prospective studies it is associated with lower disease activity and less pain. It is not a treatment for RA, and it works alongside your medication, not instead of it.
Not automatically. The evidence for any single food trigger in RA is thin, and cutting foods on a hunch narrows your diet for nothing. If you notice flares with particular foods, a structured elimination and rechallenge with a practitioner and a diary will tell you whether it is real for you.
Yes. We never ask anyone to stop or change it, and we check anything we suggest against it first. Some herbal and nutritional products are not appropriate on immune-modulating medication, and we say so rather than work around it.
In research, yes. The gut and oral microbiome are altered in people with RA and partly normalise with treatment. That does not mean the gut caused your RA or that a gut protocol treats it. It means gut and gum health are worth working on as part of the picture, alongside your rheumatologist’s care.
1. Forsyth C, Kouvari M, D’Cunha NM, et al. The effects of the Mediterranean diet on rheumatoid arthritis prevention and treatment: a systematic review of human prospective studies. Rheumatol Int. 2018;38(5):737-747. doi:10.1007/s00296-017-3912-1
2. Sugiyama D, Nishimura K, Tamaki K, et al. Impact of smoking as a risk factor for developing rheumatoid arthritis: a meta-analysis of observational studies. Ann Rheum Dis. 2010;69(1):70-81. doi:10.1136/ard.2008.096487
3. Zhang X, Zhang D, Jia H, et al. The oral and gut microbiomes are perturbed in rheumatoid arthritis and partly normalized after treatment. Nat Med. 2015;21(8):895-905. doi:10.1038/nm.3914
If you are on treatment and want to do more than take it and wait, it is worth seeing someone who works with your rheumatologist rather than around them. Our naturopaths and nutritionists consult from Geelong CBD and Drysdale, in person or by telehealth, six days a week. Bring your results and we will start by listening.
We are open 6 days per week, by appointment only. Book an appointment online via our online booking link.
