My Experience

The DAS 28 mathematical model

My rheumatologist used the DAS28 mathematical model to assess the level of disease activity in my body. The data used for the model consisted of assessing the number of swollen joints, the number of tender joints, ESR and CRP levels, and feedback from me about where I would score on a level of well-being (pain, stiffness etc) between very good and very bad. A high score of 5.1 or greater will qualify you for treatment with an anti-tumour necrosis factor therapy in the UK. A score of less than 3.2 is considered to indicate low disease activity and a score of less than 2.6 indicates the disease is in remission. My score was 2.16, so well inside the remission range. You can read more about the DAS28 score here:
https://www.nras.org.uk/the-das28-score

5 years plant-based

Since adopting a plant-based diet 5 years ago my CRP levels have at times fallen into the completely normal range, which considering I never achieved a normal CRP reading while on 2 DMARDs and an anti-inflammatory over more than 2 decades, is incredible. During the time I was on 2 DMARDS and an anti-inflammatory my CRP was most often in the high teens or low 20s. The normal range is below 10.

Remission

I did get into remission once back in my early 30s, with the use of drugs. I was so well that I asked my rheumatologist to cut the dose of the DMARD I was on at the time, 3 grams of Sulfasalazine. The dose was cut back too much (to 1 gram) and I went into a massive flare. I had to return to the high dose of Sulfasalazine, plus start on Methotrexate as well before I got any real improvement. I never got back to how well I’d been before the cut in medication though and it took two years to get the flare under control, during which time I needed to wear splints on my wrists. At the end of the flare, I was left with fused and immobile wrist joints. To this day I have difficulty writing, playing musical instruments, racket sports and doing some other tasks because of the damage to my wrists from that flare. If I’d known then what I know now I could have got the flare under control in 7 days and not suffered long-term damage. Medically supervised fasting followed by a plant-based diet for those in extreme flares would be a more effective, faster, less damaging and cost-efficient way for the NHS to treat RA patients. This could be managed at the patients own GP surgery if they have phlebotomy services there. I hope I will see that become a reality.

Backed by science

Fasting followed by a plant-based diet for RA patients is backed by a scientific study published in the Lancet, demonstrating a reduction in CRP and ESR levels, and improvement in pain scores and numbers of sore joints after a 7 to 10 day fast, the benefits of which were still present a year later. You can read the abstract here: https://doi.org/10.1016/0140-6736(91)91770-U In my opinion, hanging onto the remission after fasting depends on finding the right diet and maintaining a daily time-restricted eating and intermittent fasting regimen. My experience of drinking milk and eating a slice of dry toast after obtaining remission with a fast was that extreme pain and disability set in within 30 minutes of breaking the fast. Nowadays I like to break my long fasts with steamed broccoli, which tastes out of this world when you’ve not eaten for 7 days and does not cause me any pain. Fasting and a plant-based diet work for me, you can try this yourself and see if it helps you. Freedom from pain might just be a week away. I have seen another study that claims to contradict the study in the Lancet, but they only fasted patients for 3 to 5 days on 3 separate occasions. That will not work, you need at least 5 consecutive days before the results start to appear, and if you’re in a severe flare it could well take longer than that. With my last severe flare, I did a 7-day water fast, after which time the pain had subsided. but I was still feeling unwell, so after a 2-day break, I followed that with a 5 day fast, after which time I felt completely fantastic. If you try it, then exercise caution in reintroducing foods, as the wrong foods (in my case animal products) will take you straight back into extreme pain and you will lose all the benefits you gained from the fast.

My next challenge

I am not as well as I was in that first remission back in my 30s, but that is due to other conditions I have developed as a result of stress, the effects of inflammation from the RA and diabetes I developed, partly from following the wrong diet guru. With more dietary changes I have also been able to reverse conditions related to diabetes and get my blood sugar under control. I plan to reverse diabetes completely and I’ll cover that in the next post.

I’ve been planning to write a blog documenting my journey to recover my health for quite a few years now. Every time I felt ready to launch, something would happen to knock my health for six and make me question everything I thought I’d discovered about nutrition, health and fasting. On top of those issues, there was a confusing array of information from those promoting a low-fat, plant-based lifestyle, and those promoting a high-fat, high-animal-protein-based lifestyle.

Much of this on each side outright contradicts the other side and both sides are subject to biases and agendas other than wanting the best for people. To add to the confusion, many of those who have benefited from a particular diet have become filled with zeal, claiming science to back up their every argument, while rarely actually reading or understanding the research for themselves. They have based their opinions almost entirely on what they’ve been told by people in authority and they attack anyone who disagrees with them with a disturbing degree of fervour that smacks more of religion than science. Science is evidence-based and does not need irrational, frenzied fanatics to defend it, the facts speak for themselves. Some of the authority figures in the respective nutritional movements are guilty of this behaviour themselves and incite hatred against and personal attacks upon the ‘opposition’, dragging what should be reasoned scientific debate into the playground. I’d like to put them all in detention and make them sit and think about what they’ve done because while this is going on and they are feeling smug about themselves and jostling for the upper-hand in the debate, people are dying for want of correct nutritional information. One of those who died was a friend of mine. Dead, in my opinion, because he followed the incorrect advice of one of these authority figures.

Science is not just another opinion

I’ll discuss why science matters and what constitutes valid science in other posts, along with why you should look at the research for yourself and not just take anyone’s word for it just because they sound confident or come with medical credentials. Don’t take my word for any of this either, just look at the research. Sure, listen to people’s experiences. I love listening to how others have recovered their health, or learning from their mistakes so I can avoid them myself, but it is dangerous to make life-changing decisions that will impact your health without fully understanding potential complications. I’ve made this mistake twice, both times with serious consequences.
The diet I have found to transform my health might not be the best diet for you and I’m merely documenting what I’ve done, the good and the bad, along with my reasons for doing so. What you take away from this is your responsibility. Look at the research, decide for yourself. What I will commit to, is that the message I’ve heard from doctors, that ‘diet makes no difference‘, in terms of controlling autoimmune disease, is flat out wrong.
I recently received a letter from my rheumatologist at hospital confirming that my rheumatoid arthritis is now in remission and being controlled with a plant-based diet and fasting, along with a small weekly dose of Methotrexate. It’s no fluke that I have been able to come off anti-inflammatories and another DMARD (disease modifying anti-rheumatic drug), while substantially lowering my CRP level (C-reactive protein – an indication of how much inflammation there is in the body). I have been systematically working my way towards this goal for about 10 years. Maybe others will be able to use what I’ve discovered to get themselves into remission within weeks or a few months. My current diet and fasting work faster than the drugs that I’ve been on, in terms of controlling flares (now occasionally triggered by eating tiny amounts of animal products inadvertently), and the only side-effects have been good ones. Obviously discuss any experimentation you plan to do with your doctor before-hand, as some of what I do in terms of fasting and eating large quantities of vegetables could be life-threatening in patients with certain conditions. My long-term hope is that the NHS in the UK will put nutrition and fasting on the front-line of medicine, that both subjects will be taught in medical school, and that the nutrition advice given to doctors will be correct. 
Having the correct diet and lifestyle for you, including regular fasting can have a massive impact on the likelihood of you developing one of the UK’s 5 biggest killers: coronary heart disease, respiratory disease, stroke, liver disease and cancer, as well as autoimmune diseases and type 2 diabetes. Once you’ve got one of these diseases getting the diet and fasting right might just save your life.