HomeHealth ConditionsArthritisCan Synbiotics Reduce Rheumatoid Arthritis Symptoms?

Can Synbiotics Reduce Rheumatoid Arthritis Symptoms?


The findings of a new study suggest that this is indeed the case. The study reports that synbiotics reduce rheumatoid arthritis symptoms as measured by joint pain and disease severity scores and lower C-reactive protein (CRP) and insulin levels in patients with the disease.


Synbiotics are food supplements that combine probiotics and prebiotics. Probiotics are the good bacteria typically found in fermented foods, such as yogurt, kefir, cheese, kimchi, sauerkraut, and fermented soy products. Prebiotics include certain plant-based fiber-rich foods that are fermented in the intestine by good bacteria and help promote their growth. Rheumatoid arthritis is a chronic autoimmune disease that manifests itself in the form of tender, swollen joints and is caused by the immune system attacking the lining of the joints. Some studies have found that microbial populations in the intestines of rheumatoid arthritis patients are different from those of healthy individuals with the former showing a significant reduction in the levels of good bacteria—Bifidobacterium species and lactic acid bacteria.1, 2

A new study published in the British Journal of Nutrition attempted to examine the effects of the combined use of probiotics and prebiotics (synbiotics) on the clinical symptoms of rheumatoid arthritis and on parameters that measure inflammation, oxidative stress, and insulin resistance.3 The study was conducted at a hospital in Kashan, Iran and enrolled 54 rheumatoid arthritis patients between 25–70 years of age. The patients were randomly divided into two groups of 27 patients each. One group was administered a synbiotic supplement containing Lactobacillus acidophilus, Lactobacillus casei and Bifidobacterium bifidum and the prebiotic inulin for 8 weeks. The other group (control) was given a placebo containing starch.

The patients’ weights, heights, BMIs, and severity of rheumatoid arthritis (disease activity score or DAS-28) and pain (visual analog scale) were measured before and after the 8-week treatment. Tests for CRP, nitric oxide, fasting blood glucose, triacylglycerol, very low-density lipoprotein (VLDL), low-density and high-density lipoprotein cholesterol (LDL- and HDL-cholesterol), insulin, insulin resistance, beta-cell (insulin producing cell) function, insulin sensitivity, total antioxidant activity, GSH (an antioxidant), and malondialdehyde (an indicator of oxidative stress) were also conducted before and after the 8-week treatment.

The results showed that CRP levels were significantly lower in the synbiotic treated group. Moreover, DAS-28 was significantly improved and pain reduced with synbiotic supplementation. In addition, levels of nitric acid and GSH were increased, insulin reduced, and insulin resistance and beta cell function improved with synbiotic treatment. The levels of VLDL-, LDL- and HDL- cholesterol as well as glucose, insulin resistance, and parameters related to oxidative stress (total antioxidant activity and malondialdehyde) were not altered by treatment.

A limitation of the study was that patient compliance was not verified through analysis of stool samples or by measuring levels of short chain fatty acids, which are produced by the bacteria upon fermentation of the prebiotic compounds.

In summary, the study demonstrates that synbiotics reduce rheumatoid arthritis symptoms, as gauged from pain and overall disease severity, and improve the biochemical profiles of some metabolites, such as CRP, insulin, nitric oxide, and GSH. However, the exact mechanisms by which synbiotics confer health benefits in patients with rheumatoid arthritis is not properly understood and will have to await further studies.



Written By: Usha B. Nair, Ph.D.

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