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#520273 - 09/02/20 06:48 AM Kicking AS with my Microbiome and Anti-TNF
Spiderpidge Offline

Registered: 06/16/17
Posts: 6
Hi Guys,

I'm 38 yrs old and I've been managing AS for the last 20 years, yearly Iritis flares, swollen knees, pain pretty much everywhere and poor gut function. I've tried everything over the last 20 years, diet/exercise/meds, I even had discussions with Prof. Ebringer many years ago and he very kindly sent me some information on the link between bacteria and AS.

Over the last 5 years I've gradually got better and I wanted to know if any of you have tried this method and also found success?

The first major change was taking Anti-TNF, it was a complete game changer for me, I started on Humira in 2015 and it wore off after 12 months (maybe developed anti-bodies) so I was put on Simponi and still on it today. However, even when on Simponi Anti-TNF I still had flare ups and up until 2018 I was still unable to run, walking was even a struggle due to severe and constant inflammation in my left knee.

Today I am totally pain free and have not had a flare in 2 years, I can run, walk, cycle, play sport and It can't have been the Anti-TNF that produced this result because I was on it for 3 years with littell change to my flare ups or my swollen knee. So what changed in the last 2 years that stopped this illness in its tracks?

What I believe really made the difference was when I introduced lots and lots of fermented food and FIBRE into my daily diet 2 years ago. Sauerkraut, Gerkins, Kimchi, Kefir, Sourdough. All made by my hands at home using traditional methods and the raw bacteria and yeasts that live on us and around us.

When I first started eating fermented foods I wanted to really hit it hard, so I was consuming a pint of Kefir and about 100g of Saurkraut daily. I also gradually increased my intake of fibre because that's what good bacteria love to eat.

Here's what else I've been eating for the last two years to increase both fibre and good bacteria levels. I start the day with a fruit smoothie (drunk over 15-30mins period to avoid insulin spikes) of apple, pear, banana, 50g chia seeds, 100g frozen blueberries and 50g frozen raspberries and 500ml water. To be fair that is enough for both myself and my partner.

Other Items that I included in my diet daily and still do now 2 years on are 100% whole grain peanut butter, whole grain sourdough bread and as much veg and fruit that I can get in at other meals. I eat meat maybe once a day, but not usually too much of it. Some days I won't eat meat at all depending on what's in the fridge.

I know some of you will be like "OMG my gut would go crazy if I eat tons of fibre" but that's why I ate large amounts of the fermented foods first, then introduced the fibre gradually. The bacteria and yeasts contained in fermented foods are ultra important in replenishing the gut and healing it and they do this by consuming the fibre in fruit, vegetables and seeds. Bacteria and Yeasts have a symbiotic relationship with humans that has developed over 100's millions of years, if we feed them right they will make sure we are healthy and pain free.

I'm now thinking of stopping my Anti-TNF to see if any inflammation comes back, but this is something I'm trying to do very gradually and space out injections further and further apart until I no longer need it. I'll keep you updated on this part, fingers crossed it works but it might take me another 3 months to be off them totally.

Please let me know if any of you have tried Anti-TNF in conjunction with fermented foods/high fibre diet and if you've had any success or failures.

All the best

#520287 - 09/07/20 09:53 PM Re: Kicking AS with my Microbiome and Anti-TNF [Re: Spiderpidge]
alex266 Offline

Registered: 09/06/20
Posts: 1
Thank you for posting such a helpful insight into your progress against AS. I'm fascinated by the microbiome, and I think this is a valuable example of its importance.

I'm curious as to the timeframe of your dietary changes, in particular the bread. Did you spend a long time consuming the fermented vegetables before introducing any sourdough? And did you find eating too much sourdough caused inflammation?

Sourdough is interesting because it is high in resistant starch, so should theoretically be good food for Klebsiella. But maybe the enzymes in the dough change the starch somehow? My instinct is that it is far better for the gut than non-cultured bread, but I haven't seen any medical literature on this, at least in terms of starch content / digestion / microbiome.

Also, have you found that the improvement of your gut health has allowed you to eat a wider range of foods?

One thing that worries me about a no-starch diet for AS is that whilst it may successfully starve the troublesome Klebsiella bacteria, it also starves all the other microbes that feed on starch. I suspect this may lead to longer term narrowing of the foods able to be tolerated.

Using fermented foods to regularly introduce healthy microbes seems a much better approach to me!

#520291 - 09/10/20 06:57 AM Re: Kicking AS with my Microbiome and Anti-TNF [Re: alex266]
Spiderpidge Offline

Registered: 06/16/17
Posts: 6
Hi Alex,

Unfortunately for my body the NSD had limited success, it also made me very tired and I craved carbs like crazy, I tried it for years and even when combined with Anti-TNF it didn't give me the relief that this method has given me. The body needs carbs in the form of starches, resistant starch and fibre is highly important for a healthy gut. Another thing to consider is the fact that if you can re balance you microbiome and feed good bacteria what they need, they will in turn also kill any unwanted bacteria including Klebsiella. One thing I have learnt from fermenting is that good bacteria are far more powerful and abundant than bad bacteria.

And to answer your question about what foods I can eat, this method resolved my gut to a point where I can eat anything with zero flare. Spicy foods used to be a massive problem for me, now I can eat them everyday if I want to.

Firstly I must stress that the Anti TNF treatment is important, this will reduce inflammation to a point where making changes to diet is a lot easier. So for me this was my starting point and once signs of lowered inflammation were showing using Anti TNF I then started with the dietary changes.

Another thing I also think is important to the success of this method is fermenting your own foods in your own home, this is because you ferment with the natural bacteria in your home environment. The shop bought stuff is unreliable in terms of culture type and quantity and some of it is semi pasteurized before it is put on shelves. Plus it's far cheaper to buy cabbage, chop it up and stick it in a jar with salt water for 2 weeks than it is to spend £5 per 500ml of Kraut.

I started by drinking Goats milk kefir, Cows milk kefir also work but goats is apparently better for allergies etc.. This was drunk daily and starting out at 100ml per day for a week and increase by 100ml per week until up to about 500ml per day. This is where my whole fruit smoothie making started too, I started making a kefir smoothie on a morning. I then drank this amount for approximately 3 months until I got a bit fed up of making kefir. So I modified my method and started fermenting vegetables, making sourdough and eating whole fruit and smoothies daily.

I bought a 5 ltr fermenting pot from Germany and started fermenting vegetables (cabbage or gherkins) with just salt and tap water, forget about using distilled or filtered like some people say, tap water works exactly the same.

Around the same time I also bought some Organic stone ground wholemeal Rye flour and started a culture at home just by mixing flour and water. There are many guides online for this. I would highly recommend using only Organic Wholemeal Rye flour for your starter, the Rye has way more fibre than any other flour and is therefore the best for creating cultures. This can take up to a month to become fully stable and usable for making good bread. Again tap water is fine.

I don't think there are any hard and fast amounts of food eaten or time frames, I just started eating it gradually until I could eat every day. The gut re balances pretty fast, I'd say within a month I was eating it daily with no issues. To be honest right from the very first time I started eating fermented veg and wholegrain sourdough my body couldn't get enough of it. Maybe it was telling me that's what it needed all along?

I read a book a while back talking about how to keep your microbiome healthy and diverse. One by Michael Mosley " the clever guts diet". It recommended eating lots of plant based wholegrain foods every week, I aim for 30 different ones as a minimum.

Eating the whole food is the important part, and you'll understand why as soon as you start fermenting foods. The bacteria love fiber in whole foods. All this sterile and processed food that we eat, including white flour, is a perfect breeding ground for bad bacteria.

If you ever want any help fermenting your own foods or making sourdough just let me know.

#520293 - 09/10/20 09:53 AM Re: Kicking AS with my Microbiome and Anti-TNF [Re: Spiderpidge]
Spiderpidge Offline

Registered: 06/16/17
Posts: 6
I forgot to mention, Chicken bone broth has also been a fairly regular food that I have cooked and eaten over the last few years. I'm sure that has also contributed to the healing of my gut.

#520319 - 11/01/20 04:00 PM Re: Kicking AS with my Microbiome and Anti-TNF [Re: Spiderpidge]
Mark55 Offline

Registered: 05/20/09
Posts: 54
Hi Alex, thanks for sharing. I've tried fermented foods (made sauerkraut & kefir) before but not at the level you're describing.

I was able to get total remission of my AS with the carnivore diet (100% meat) last year, but it fell apart if I cheated even a tiny bit, and was too monotonous and antisocial to sustain. It remains an emergency option for me if my AS ever gets too bad / untreatable later in life. It took 3 months of being strict with it for it to really give me any relief though, and I definitely didn't cram fermented foods every day for 3 months when I dabbled with them.

I am not on Anti-TNF, however I might be able to get on them next year, and also the symptoms you describe in 2018 sound worse than mine - I still have periods with no pain / flare ups, however I can't exercise barely at all without triggering a flare up.

You've inspired me to start a load of krauts & veg, kefir and sourdough going, to give them a massive try in a month or two. Please let us know how it goes if you stop the anti-tnf smile


#520320 - 11/03/20 09:23 AM Re: Kicking AS with my Microbiome and Anti-TNF [Re: Spiderpidge]
DrNateD Offline

Registered: 10/14/20
Posts: 1
The SAA is sponsoring a study exploring the role of the microbiome and AS disease activity:

SAA Research


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