An Osteoarthritis Recovery Story

Jacqueline wrote us in late March asking for tips for osteoarthritis.

She had experienced continuous pain and stiffness in her thumbs for the last year, and occasional pain when gardening for more than 10 years. Her younger sister also has joint pain and can’t turn her neck. Her father, now 73, has had pain in his thumbs for decades which eventually spread to his fingers, and a shoulder spur which had required surgery. Jacqueline’s dad says that osteoarthritis “runs in the family.”

Of course, even if there is some sort of genetic basis for osteoarthritis, it will be modifiable through diet and nutrition.

Jacqueline had been eating low-carb since 2003: meat and vegetables for dinner, fruit and yogurt or eggs, bacon, and sausage for breakfast, but an occasional sandwich for lunch. Around 2007, Fitday gave her macronutrient ratios as near 65% fat, 17% carb, 17% protein. In 2009 she gave up wheat entirely. At that point she developed dry eyes.

Upon reading our “low-carb dangers” series which discussed dry eyes (see Dangers of Zero-Carb Diets, II: Mucus Deficiency and Gastrointestinal Cancers, Nov 15, 2010), she decided to add some carbs back to her diet. Potatoes and bananas cured her dry eyes.

But the joint pain remained, and she asked for any further suggestions. My reply was:

Shou-Ching had a condition like that and it got better with regular vitamin K2 supplementation. Presumably it was caused by improper calcification. Magnesium, vitamin D, and vitamin C are the next most likely to be important.

I think malnutrition is probably the major cause of osteoarthritis. (We know it can cause it in moose!)

For rheumatoid arthritis the cause is usually infectious. Low-dose antibiotics, as suggested by the Road Back Foundation, often work.

The dry eye indicates a glucose and/or vitamin C deficiency. Either will contribute to joint problems too, since the joint lubricants are all made from essentially the same materials as tear lubricants / mucus. So it’s good you’ve re-introduced starch, but I would add more than just some potatoes and tubers. After you’ve gotten used to very low-carb it can be hard to re-orient yourself to the quantities you may need. If glucosamine helps, that suggests you don’t have enough glucose to make your own glucosamine. I would eat more starches and take more C also.

I think you’re probably close and a little more diet experimentation should be able to fix the problem. Rice and vitamin K2 are probably your best friends.

Jacqueline implemented that advice. She wrote back in early May:

What I did:

I kept on taking the 1.5g glucosamine daily and tried, really tried to up my carbs (as starch) intake – you’re right, once you get used to not eating them, it can be quite hard to do. I seem to have succeeded somewhat as I have gone back to using Fitday a bit and have managed (on the days I was checking) about 100g carbs a day. If I didn’t manage with the carbs, I consciously tried to eat a bit more protein on the day instead.

I have increased the frequency with which I take magnesium and vitamin K2 … and started taking a vitamin C (1g) every day. I’m easing off on vitamin D though as summer and some sunshine is finally here. I’ve also pretty much stopped the fish oil – this is of course related to your recent posts – because I do eat oily fish weekly and other fish and seafood regularly….

I have also cut out my addiction to cashew nuts since I was in Paris for a few days before Easter….


The aching and stiffness has been receding steadily. The right thumb was already improving with my trying to increase carbs (because of the dry eyes) and taking the glucosamine. The right thumb now feels pretty much back to normal. The left thumb has also stopped aching especially over the last 2-3 weeks although it is still a bit prone to ‘catching’ with sudden pain – and a sort of pulling in the ligaments  – as if it can’t react quickly enough to a sudden move e.g. when driving. I am now – over the last few days – playing the piano a lot more (got a bit out of practice with the Paris trip etc.)  – and my thumbs are recovering well – not sore the next day like they were before.


There are basically three kinds of arthritis:

  • osteoarthritis, which I associate with nutrient deficiencies, is a loss of cartilage and lubricating fluid in the joints, or an improper calcification or ossification of the soft tissue;
  • reactive arthritis, which is due to infections; and
  • rheumatoid arthritis, which is an autoimmune disorder but the autoimmunity is usually caused by an infection and clearing the infection will usually clear the autoimmunity.

Food toxins can also collect in the joints and cause immune reactions that produce arthritis-like joint symptoms. Foods that frequently cause allergies, such as tree nuts, may be worth eliminating as a test, as Jacqueline eliminated cashew nuts.

Since diagnosing the cause of arthritis symptoms is an art more than a science, and nutrient deficiencies are easily remedied, they’re almost always a good place to start with any joint pain and stiffness.

I’m glad they’re working for Jacqueline! It’s nice when the easy fixes work.

Leave a comment ?


  1. Hi Perry,

    Yes, it is possible.

    Most of those brain diseases are associated with an interferon-gamma immune response, which is mainly produced by bacteria and viruses. But I don’t think we can rule out the possibility that eukaryotic pathogens can contribute or cause diagnostically similar illnesses.

  2. 2 Paul

    What do you mean when you say IF negatively impacts Candida and protozoa infection ? I searched a bit but I found only the opposite.

    2 Perry

    Search for
    Traversal of Candida albicans across human blood-brain barrier in vitro.

    2 Morris G
    I didn’t understand your IF notes? Could you clarify ?


  3. majkinetor,

    Have you tried an occlusive dressing for the psoriasis/ezcema ?

    You can use straight Vaseline, apply liberally to patches then wrap with saran wrap all the way around the leg.

    Of course, a steroidal ointment will work much better but if you wanted to for go the drug, the vasoline did help me tremendously. The wrap is key though. Wear it at night.

  4. Nope, not that way, the most similar thing was clay over the night wrapped in saran so it doesn’t dehydrate.

  5. @majkinetor
    What do you not understand, I can elaborate ? When I do IF the inventory of feces/bacteria in the gut decreases, other factors ie CHO and fibre also contribute but it seems to a lesser degree (I am still experimenting) . This observation is indirect but I think correct. The inventory reduction correlates fairly well with my joint health and very well with other markers such as nocturia. These effects are surprising to me, I have not seen this discussed elsewhere. I should mention that I am in good health and have not been overweight prior to PHD so my metabolism is probably worn but not damaged to the extent of presenting clinical symptoms. I have varied my energy intake from 2400-3300Kcal over many weeks without gaining/losing weight; BMI 23 and lean. My state of health does not seem to be typical of posters here and that may be a critical difference. I view studies only as being useful to design self-experiments so do not put much trust in them. My prejudice is that individual variation eg effects of disease is too large to enable anything beyond some organizing principle on a population basis.

  6. Hi majkinetor,

    IF is good but ketosis is bad. I have found that ketosis promotes fungal infections and I believe it is because they are eukaryotes and metabolize ketones directly. Ketones diffuse throughout the body and aren’t chaperoned by human transporters, so they are highly accessible to pathogens. Protozoa should also thrive on ketones.

    IF is healthy but you have to balance those benefits against the slight risks of a few hours of mild ketosis. I do IF but I would be cautious about any long fasts.

  7. Thanks 2 all for explanations.

  8. I’ve posted this info before, so sorry for the repetition.

    I was dx’d with Rheumatoid Arthritis in 2008. I had testing done through The Arthritis Research Center ( and tested positive for both mycoplasma and chlamydia.

    I approached my MD about using low dose pulsing antibiotics per Dr. Thomas McPherson Brown’s protocol.

    I started out low and slow, at 50 mg Doxycycline on MWF in 2008. About six months later, I raised it to 100 mg MWF. Then, 150 mg MWF in 2010. I’m currently on 200 mg Doxy MWF, which is the “standard dose”.

    About a year after starting treatment, I retested with TARCI, and the test results showed I had cleared the mycoplasma infection. I did not retest chlamydia due to finances.

    I’m doing well, knock on wood, and I consider my RA in remission. I still have joint achiness off and on, but it’s more background noise than anything that limits my activities.

    I take Natren probiotics on my days off antibiotics. I have not had any stool testing since 2007, again due to finances, but it would be good/ideal to check for bacterial counts—good and bad—plus fungus infections regularly with a stool test.

    I used to be anemic, but no longer. I think going gluten free, improving my diet, and checking this disease helped reverse that. CBC comes back normal now, on all counts.

    Brown felt that depression & fatigue were often the first signs of the disease. I most definitely had that before I had any joint pain.

    On a side note, I haven’t been healthy for a long time, although I certainly thought I was healthy! When I was 12, I had a ruptured appendix and spent 2 weeks in the hospital! For sure, that was a sign of trouble in the gut. My parents & doctors knew nothing of probiotics and of course, I returned to my SAD when I got out.

    A year later, when I was 13, I was traveling in China with my parents, and I was laid flat by some sort of terrible GI infection with loose stools, fever, and weakness. This was 1975 in mainland China where no one in my family spoke Chinese and no one in the hospital spoke English! I eventually recovered, but it gave everyone a scare.

    Then, when I was 14, I woke one morning with severe back pain, and a high fever. I couldn’t get out of bed and the paramedics were called. At the hospital it was determined that I had a raging Staph infection in my sacroiliac joint. The MDs weren’t sure if I was going to make it. IV antibiotics. I was in the hospital for 30 days! Then, on antibiotics for six months afterwards. Nary a probiotic or concern for gut health then.

    No one at the time thought any of these events were connected, but in hindsight, it seems clear to me they were, and that I had been living with infections and comprised gut health for a long time.

    It wasn’t until my 40s that I realized my health was unraveling. I discovered I was severely gluten intolerance, and a stool test revealed a severe fungal infection and bacterial overgrowths. Then, boom, arthritis.

    I think the stage was set long ago, when I was a bottle fed kid with a crappy diet who eventually had severe gut dysbiosis and migrating infections.

  9. Zachariah Salazar

    Movement can be the missing ingredient…

    Joint surfaces get their nutrition through imbibition which is basically pressure and motion. Movement is needed across as much of the joint surface as possible to take advantage of quality nutrition as well as pressure necessary to maintain joint health..

    Lets start with pain then look at how the body uses pain as a signal to protect VS a real sign of injury.

    Western medicine still promotes a view that pain equals injury. This is not true. Pain is an action signal; its is the nervous systems attempt to improve its representation of itself. There is no pain in the body all pain REPRESENTS in the brain…

    Insight to this has been promoted by the likes of Norman Doidge MD in his book The Brain That Changes Itself.

    This is an easy to read book that explains neuroplasticity: how the brain can change and how we can use this to overcome injury and pain and become better than we currently are. It explain how the brain like the body responds to stimulus (training) for better or worse. You get good at what you practice.

    The point to take home is that the brain cares more about survival than anything. The brain is also a predictive engine (look up Bayesian neuroscience). Prediction is a better strategy for survival than just reacting to what you are sure of. Emotion is part of our survival response system. Emotion comes before thinking and rationalizing. When i teach seminars on pain and precision movement I use the phrase “You React Before You Reflect.” The easy example would be going to a scary movie. Even though you know you are in a movie theater and you know that the filmmakers will attempt to scare you with a scene to make you startle, you still jump. It is in your nervous systems best interest to make you flinch just in case the danger is real. Then you get to chuckle as you rationalize what just happened. You React Before You Reflect.

    In the body the sequence goes like this: loss of speed, loss of range of motion, pain appears, structures begin to either adhere or break down. You can end up with degeneration or ossification depending on the part of the body and the loads causing the event. Hips often degenerate. Shoulders often freeze. As your brain loses information about an area of the body it begins a protective process that starts by limiting motion. If you give an area of the body more information or even force it into action for example by a reflex you can reset the system so to speak. Joints will move better (better speed better range of motion etc) which allows less used surfaces of the joint to be stimulated by imbibition. The joint can return to a healthy state. Since this becomes real tissue change over time to maintain this change requires movement. Like brushing your teeth. You have to move it or you will lose it.

    As a survival based system you brain pays attention to movement more than pain. You brain doesn’t need extra info about the pain you are experiencing when you step on a tack. It needs resources to move away from pain more than it needs detailed info about pain. Researchers Wall and Melzak put forth their Gate Control Theory of Pain in 1965. It has been updated most recently as the Neuromatrix Theory of Pain. The concept is that ALL sensory information coming into the body will have an effect if it reaches a threshold to cause a response from the nervous system. So your mood, environment, how rested you are and how deficient you are in nutrients all matter both as individual spikes and valleys and as a sum of stimulus coming into the body. If there is enough good stimulus then you feel better function better and feel less pain. If your system becomes overwhelmed then you feel worse.

    How does movement can play into this?
    Movement is the way we get to shelter, to food and to find mates. Movement information combines with visual and vestibular info to build a picture of the world around you. The nervous system makes predictions based upon need, want, avoidance of harm, novelty and familiarity etc based on the data it receives. The more you can hone the system the less threatening the world is the less distress and pain you feel.

    Your body has systems and tools to allow all of this movement for living to occur. For example the signal travels to slow from the foot to the brain when pain is felt. The body uses reflexes to allow you to retract or pull back from harm before the brain registers pain. This limits damage. The body uses smart sling systems ( Gracovetsy THE SPINAL ENGINE) to improve efficiency of motion to reduce energy spent while acquiring needs. These attributes can be harnessed as a self adjusting (self-healing) tool.

    Examples of this are used in my profession daily. I teach other practitioners how to use motion, reflex and sensation to stop pain and move better.

    I have used many simple techniques to alleviate pain and to allow the reversal of osteoarthritis through normal means once healthy motion has been established.

    This is why movement arts like Tai Chi and what I practice, Z Health Performance can reduce pain and improve health. The difference between Z and TC is through a huge amount of work martial arts practitioners collected motions that could improve well being. Z Health is based on neurophysiology and neuroplasticity. If you made a martial art that was designed around how YOU were made your individual anatomy the way your joints muscles and organs move and their potential for movement. Thats what we do. In my practice I have 22 years of experience with many different systems of health and motion. I use Z Health as the backbone. It allows input constantly from research and science to improve the system.

    My point for that self promoting aside? I have seen how movement takes care of osteoarthritis pain. I work with people in Phoenix and around the world through travel and over the internet. In Z Health we have always recommended Paleo variations for health pain relief and athletic performance. I stumbled across the PHD doing research for a client with Celiac and have adopted it into my practice and Z Health is recommending it as an ideal diet. Diet can easily be half of the equation. With sound nutrition and precision movement I have yet to find a person I cannot help with pain. I need people to hear this how important movement is for those who are not really into moving (exercise etc). I need the movers to understand that the diet can be the tipping point that allows all of their exercise to “work”.

    Seek out a Movement Specialist that deals with pain and athletic performance. Ideally ANYONE that specializes in movement will have the skills to test the visual system and vestibular/equilibrioception as it relates to joint position (proprioception).

    For those of you just starting the diet stick with it and figure out how to get ALL OF IT in your life. I have dealt with people for years on diet adherence. It is rarely the diet that is hard. It is a lack of preparation and healthy respect for their current habits and how it makes their bad eating patterns efficient and therefor easy. You just need to allow yourself the time it takes to make the new diet part of routine so it cost little in terms of time and stress…


  10. Hi Michelle,

    Thanks for sharing your story. You’ve had quite a few trials! Hopefully the worst is behind you, the best years ahead.

    Hi Zachariah,


    Those are great points. Diet is as much a matter of lifestyle as foods. Eating well in today’s world requires cooking for yourself, which is hard to fit into many people’s schedules. It’s very easy to eat what others eat, to eat processed and readily available foods. But these may be the very foods that prolong disease.

    I’m looking forward to learning more about movement and health. As I’ve mentioned to you, when I was sick I didn’t want to move or exercise. I think that’s a natural healing response of the body, to conserve energy for immune function, but when the disease is chronic it’s not necessarily beneficial.

    Now I’m looking forward to catching up on all the movement I missed in the previous 20 years!

    Best, Paul

  11. “Food toxins can also collect in the joints and cause immune reactions that produce arthritis-like joint symptoms.”

    Hi Paul, I wondered if you might be able to elaborate on this a little a bit more. I read a post on Archevore/PaNu a while back where a reader with arthritis commented that there is something in common with joint tissue and gluten so when the immune system mounts an attack on gluten it can mount the same attack on joint tissue. I hope I remember that correctly as I can’t find the original post on the site but I am wondering if this is the same kind of thing you are talking about.

    My mother has osteoarthritis which is progressively getting worse, I’ve tried to convince her that ditching the n6 oils and the gluten grains would go a long way to ease her problem (she is also overweight) but so far all efforts have been futile! I’ve got your book but I doubt I could get her to read it. Any help would be greatly appreciated.

  12. Hi Doug,

    Gluten and joint pain would be a good blog post topic. I’ll look up papers when I get time.

    I don’t know how to get people to give up grains and n6 oils. If we could do that we could fix a lot of disease. We can try to write a more accessible, popular version of our book but it might not persuade her and that would take at least a year.

    If she sees you becoming healthier that might be the most persuasive evidence!

    Best, Paul

  13. thanks Paul, will keep a look at for futher blog posts of yours relating to joint pain

  14. Rose-hip extract (with the Galactolipid GOPO) has been getting a bit of press locally of late (syd, australia) for helping with osteoarthritis and arthritis.

    supposedly there is evidence to back it up.
    here’s a link as a starting point for anyone interested in researching;

    note this is a product seller web site, so it will be biassed.

    “GOPO (glycoside of mono and diglycerol) is the active compound isolated from the rose-hip rosa canina that has been clinically proven to help reduce joint pain and stiffness, improving flexibility and mobility.”

  15. I am reading these arthritis related stories with lots of interest. Is it possible to heal / partially replace a completely missing growth plate through diet? I’m thinking of Blount’s disease for example. I had it fixed with surgeries as a kid and the doctors told me that I had to be very careful, no high impact activities for the knee so the bone would not move again. Besides maintaining a healthy weight and avoiding high impact jumping or running, can a healthy nutritious diet improve this condition?

  16. I have had RA for 3 1/2 years. January 2011 I took my last injection of Cimzia and started a Paleo diet. It has evolved. Starting in the fall I gave up dairy (use coconut milk now) use only olive oil for salads, coconut oil, palm oil and grass fed ghee to cook with.Recently have given up chocolate (dark) and coffee. Not sure I notice any difference. I take Kapparest, VD 2000, GI Retrieve, Natural Calm (just started), fish oil, krill oil(started 2 weeks ago) and V B6.The supplements were added in July. I make my own Coconut kefir and add 4 TB of coconut oil to it. I also use Opticleanse and a probiotic. I play golf, cycle and try to do strength training. I am not 100% and would like to know what I can do different to get to that point. Is it a process and can it take more time to heal? Would love to hear your take!

  17. Hi Marybeth,

    Antibiotics are likely to help. I favor doxycycline as it does the least to harm gut bacteria. We’ve discussed this, but the Road Back Foundation (in our blogroll) has more information.

    Intermittent fasting can help. So I would try that. Have a bit of coconut oil and spinach during the 16-hour daily fast if you get hungry, or a bit of protein.

    Then I would focus on micronutrition. Selenium, iodine, and our other “essential supplements” are highly desirable. Start low with iodine and increase very slowly, taking 6 months to reach 3 mg/day. Be sure to take a multi. Eat nourishing foods – 3 eggs a day, liver, seafood/shellfish, seaweed, green leafy vegetables, bone broth soups.

    I wouldn’t give up quite so many foods. Chocolate, coffee, and dairy may be beneficial. Giving up those would make sense in a case of food sensitivity/allergy, but you haven’t mentioned improvements from removing a food.

    If you’ve read our book, it’s a pretty good program for RA, just follow those steps and add in some doxycycline.

    Best, Paul

  18. Dry Eyes Vitamin Deficiency : Improve Eyesight Without Glasses - pingback on September 18, 2012 at 9:13 am
  19. Nirmala Bagri

    Dear sir
    What are causes of osteoarthritis. I am having severe problem especially during working in kitchn and performing house hold responsibilities

  20. Hi, I am a 51 yr old mom and I have been struggling with osteoarthritis for several years now, in my big toes especially but also increasing into both feet, my shoulders and lower back and neck ache all the time too. I am overweight and trying to lose those pounds at this moment. I have thought maybe gluten is the culprit (online reading) but see it is mostly for reumatoid arthritis. I currently take 500mg magnesium tablet, 4,000 vit d3 drops(in water) and a buffered vitamin c. i have been off of gluten for about a month and still not much relief, maybe a teeny bit but I dont know for sure. help! what ? else can I do to reverse this condition. diet.. supp. any help i would be ever so greatful! Thank you. KIm

    • Hi Kim,

      Have you read our book and followed our advice? There are many things you can do to help. Osteoarthritis usually has a major nutritional component.

      Best, Paul

  21. Osteoarthritis Paleo Diet | My Good Health lost - pingback on March 12, 2016 at 1:49 am
  22. I am so grateful to have literally stumbled upon this site
    I have OA and am hypoThyroid. Not sure if I have Hashimotos doctors are conflicted on the tests. What I do know is I lost all the cartilage in both hips and had 2 total hip replacements. I lost all cartilage in both thumbs so they are very painful. Now my knees are loosing cartilage
    I am studying autoimmunity and believe it plays a huge part in degenerative diseases and pain.
    I am reading books and experimenting with different diets. Thanks for all your writings

  23. Hi I have a knee pain for 10years,Im 33years old.I went many doctors but none of them give any help.All of them said that knee injury has no remedy.II have a damaged or poor cartiladge at my left knee.If I drink bonebroth it helps a lot .But I want to get back my health again totally.One day no pain following days too much pain.What should I do?Can you give any advice please?

    • Hi Nermin,

      Find out if you have one leg shorter than the other.
      This can cause problems for the knees (& other body parts) over time, even if the difference is only small eg. ~ 10mm (1cm).

      Usually it is the shorter leg that will get more wear than the longer long. And sometimes you can also see this as increased wear on the sole of the shoe on the shorter leg.

      …anyway, if you do have a shorter leg, alter your shoes to equal your leg lengths. Not only will this reduce the wear/weight on your shorter leg, it will slightly alter the position of the pressure points (~ wear points) on your knees.

      If the leg length discrepancy is not that great, you may be able to achieve by removing the insole from the long leg shoe, & adding multiple insoles to the short leg shoe.

      Good luck.

      • …even if you cannot fully equal the leg lengths with insoles alone, any change towards equalling will help your knees.

        And you can then look at shoe modification, when you have the time & money.

    • Hi Nermin,

      Bone broth is good — in general, extracellular matrix from shellfish and bones/joints/tendons cooked in soups and stews will help you. Vitamin A and D optimization and circadian rhythm entrainment are also important, also check your thyroid status. PHD diet and lifestyle advice should fix these joint issues. Also, wearing minimalist shoes which force you to meet the ground with the mid-foot instead of the heal will reduce shock on the knee and promote healing.

      Best, Paul

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