Amazingly, the cause of this disease is unknown. However, it is generally accepted that certain microbial infections in people who are genetically susceptible to RA can trigger this autoimmune disorder. One of these is a bacterium called Proteus mirabilis, which, if it infects the GI tract or the urinary tract, is believed to trigger RA. Researchers at Griffith University in Queensland, Australia, concluded that the best way to prevent and treat RA would be to limit the levels of this type of bacteria in the gastrointestinal tract and to treat urinary tract infections. When P. mirabilis that make their home in the gut interact with the immune system and trigger the production of antibodies, it can begin a cascade of autoimmune events associated with RA. I think of antibodies as guided missiles that your immune cells release to attack a foe that triggers an alarm response in your body.

Research has found that using herbs as plant-based medicine to destroy these bacteria in the gut greatly reduced the production of anti-Proteus antibodies. These same patients also had an improvement in their arthritis symptoms. This study showed clearly that treating the gut bacteria is a valid strategy for treating inflammatory arthritis, and helps lay the scientific foundation for my gut-repair approach in the Arthritis Protocol. Bacteria, fungi, and viruses have also been studied as potential causes of RA. In addition to Proteus, bacterial pathogens such as Coxiella burnetii, oral anaerobic bacteria, and the species Staphylococcus, Streptococcus, Neisseria, Haemophilus, and Mycoplasma have all been reported as causes of RA, although there has not been enough strong evidence to prove this.

Researchers at Baqiyatallah University of Medical Sciences in Tehran, Iran, studied the fluid inside the joints of people with RA, looking for different species of Mycoplasma. Twenty-three percent had one species, 17.5 percent had another species, and 10 percent had yet another, showing that it isn’t the cause of RA in everyone but it could be in some people. This also supports the idea that infections could be one of RA’s triggers and that treating the infections or helping your immune system fight the infections better by repairing and strengthening the gut bacteria is a strategy worth incorporating in a comprehensive and effective approach to preventing and treating this condition. For each person, genetics explains only about 20 percent of why he or she developed rheumatoid arthritis. External triggers are responsible for the other 80 percent. Other than infections, these include smoking tobacco; a diet high in foods that induce inflammation, such as sugar, fried food, red meat, dairy, and alcohol; severe, ongoing chronic stress; a sudden traumatic event (a huge stressor that happens all at once and overwhelms the body); a physical injury; and exposure to environmental toxins like mercury in fish, and other toxins like pesticides and plastics. Like most chronic inflammatory conditions, it is believed to be caused by an interaction of these potential triggers in people who are genetically susceptible.

Researchers at the University of Rome in Italy are working to identify a specific genetic pattern that is associated with RA, because this would help us identify people who are more likely to develop this disease. As research continues to unfold, identifying more genes has the potential to help create specific treatments targeted to these genes. Until then, we have to target the external triggers. Keep in mind that even though we might not know all the specific genes at play, they are still influencing your arthritis. You may experience the stress of a divorce and never develop Rheumatoid knee arthritis, while this same traumatic event will trigger the disease in your best friend because she is genetically sensitive to developing it. Or a divorce could bring on a mild case of arthritis for you and a more severe one for your friend. This is why we need to pinpoint your potential triggers. Once we do that, we can fix the underlying problem and live symptom free. In Healing Arthritis, we will work on fixing these triggers together.