A Functional Medicine Approach to Rheumatoid Arthritis
- Muriel Wallace-Scott
- Nov 27
- 5 min read
Understanding Root Causes and Supporting Long-Term Immune Balance
Rheumatoid arthritis is described as a disease of the joint, yet many sufferers soon realise that the condition affects their entire body. Fatigue, brain fog, digestive symptoms, hormonal changes, anxiety, problems with sleep can all be commonly symptoms. From a functional medicine perspective, this broader symptom picture is expected.
Autoimmune disease rarely remains confined to one tissue. Autoimmunity develops when the immune system becomes chronically dysregulated, and we know that the immune system is in every part of the body.
Conventional treatments can be life changing. DMARDs, biologics, steroids, and NSAIDs help reduce inflammation and protect long-term joint health in those with fast progressive autoimmune attack. However, these treatments do not explore why the immune system shifted out of balance or what is driving chronic inflammation.
In functional medicine, we look at the whole body, and how every symptom is connected. We explore the connections between gut health, nutrient status, environmental exposures, infections, stress, sleep, metabolic function, and immune regulation. This is the essence of a functional medicine approach to support those with rheumatoid arthritis.
How Functional Medicine differs from conventional care
Conventional medicine focuses on managing rheumatoid arthritis
It is never one or the other. Rheumatologists play an essential role. They diagnose rheumatoid arthritis, monitor disease progression, and prescribe medication to reduce inflammation and prevent joint damage when necessary.
However, conventional care often treats symptoms in isolation. Digestive issues, fatigue, hormonal imbalance and headaches for example are usually viewed as separate problems rather than pieces of the same puzzle.
Functional medicine focuses on the root causes
A functional medicine assessment to rheumatoid arthritis asks the following:
Why did the immune system become dysregulated?
What is feeding into this chronic inflammatory state now?
What triggers flares?
What makes flares better?
Which systems are stressed, depleted, or overwhelmed?
What would help the immune system return to balance?
This lens considers gut integrity, the microbiome, nutrition, detoxification, hormone balance, environmental exposures, infections, nervous system regulation, circadian rhythm, and stress.
Why a Functional Medicine (Whole-Body) Approach Matters in Rheumatoid Arthritis
Autoimmune diseases rarely develop from one cause. RA develops through the interaction of genetics, environment, lifestyle, and immune triggers. A functional medicine assessment to rheumatoid arthritis approach looks at these upstream drivers carefully.
Gut Health and Intestinal Permeability
Research links gut permeability with autoimmune activation. Dysbiosis, SIBO, chronic infections, and food sensitivities all contribute to immune dysfunction. Improving gut health can reduce systemic inflammation and help stabilise flares.
Nutrition and Food Proteins
Certain food proteins, especially gluten and dairy, can fuel inflammation in susceptible individuals. Nightshades or processed foods may also worsen symptoms. Personalised nutrition is central to functional medicine care for rheumatoid arthritis.
Stress and Nervous System Regulation
Chronic stress alters cortisol signalling, heightens inflammatory cytokines, disrupts sleep, and weakens immune resilience. Many people correlate RA flares with periods of psychological or physiological stress.
Environmental Triggers, Including Mould
Mould and environmental toxins can keep the immune system in a state of chronic activation. Identifying and reducing exposure often leads to meaningful symptom improvement.
Infections Across the Lifespan
Past viral and bacterial infections shape immune behaviour. Understanding infection history supports a more complete picture of RA drivers.
What should a comprehensive functional medicine assessment include:
When someone with RA joins our clinic, we explore:
Gut health and microbiome balance
Nutrient status (including vitamin D, omega 3s, B vitamins, iron, zinc, magnesium)
Inflammatory markers
Blood sugar regulation and metabolic health
Hormonal balance
Detoxification capacity
Sleep patterns and circadian rhythm
Stress load and nervous system regulation
Past infections and environmental exposures
This comprehensive assessment helps identify the unique root causes driving each person’s disease activity. No two individuals with rheumatoid arthritis present with the same triggers, so they require different interventions.
Key foundations for healthy immune function
Although each plan is personalised, there are several key areas that are essential for immune regulation.
Optimising vitamin D: Vitamin D plays a key role in immune tolerance, inflammatory signalling, and joint health as well as gut health. Many individuals with autoimmune conditions have suboptimal levels, so assessing and correcting this is often one of the first steps in restoring balance. Remember as well that your vitamin D levels may be within the normal "lab range" but not within what we consider to be the "optimal" range.
Increasing omega 3 intake: Omega 3 fatty acids support the resolution of inflammation and have been shown to reduce joint tenderness and morning stiffness in people with rheumatoid arthritis. The aim is not simply to add a supplement but to ensure that intake is sufficient, well absorbed, and right for the individual.
Enhancing fibre diversity to support the microbiome: A diverse and resilient microbiome supports immune regulation, gut integrity, and metabolic health. Increasing fibre from a variety of plant foods can help nurture beneficial bacterial species that calm immune activation and reduce systemic inflammation.
Reducing exposure to inflammatory triggers: Ultra-processed foods, toxins, mould exposure, and certain food proteins can provoke immune reactivity. Identifying and reducing these triggers helps reduce the overall inflammatory load placed on the body.
Improving sleep quality: Sleep is one of the most powerful modulators of the immune system. Poor or fragmented sleep increases inflammatory cytokines and reduces the body’s capacity to repair tissues and regulate immune responses. Addressing sleep is therefore a crucial part of long-term RA management.
Supporting stress resilience and nervous system balance:Chronic stress amplifies inflammation, alters cortisol signalling, disrupts digestion, and increases the likelihood of autoimmune flares. Functional medicine places great emphasis on supporting the parasympathetic nervous system and improving stress tolerance through personalised strategies.
Correcting nutrient deficiencies: Micronutrient depletion is common in rheumatoid arthritis, particularly in nutrients involved in immune regulation, energy production, and tissue repair. Assessing and replenishing nutrients such as magnesium, zinc, B vitamins, iron, and antioxidants is essential for improving resilience.
Identifying personalised food triggers: Not everyone reacts to the same foods. Gluten and dairy are common culprits, but others may struggle with nightshades, processed foods, or certain additives. A personalised, evidence-informed approach helps identify which foods calm the immune system and which worsen symptoms.
Even simple interventions require nuance. For instance, some individuals cannot tolerate fish oil due to impaired fat digestion or gallbladder insufficiency. Others may struggle with vitamin D absorption or require different forms of magnesium. A functional medicine approach to rheumatoid arthritis ensures that these individual variations are recognised and addressed, so each intervention supports the body rather than overwhelming it.
Functional Medicine and Conventional Treatment Options: Both can work well together
Many clients ask whether they can combine biologics with functional medicine. Others wonder whether a root-cause approach may reduce the need for medication.
The answer is that the two approaches work well together.
Biologics and DMARDs can be really helpful tools for controlling RA inflammation for those with severe disease activity. Being on medications does not mean one does not need a holistic supportive aproach.
Some individuals find that optimising their overall health reduces the need for escalating medication. Others maintain stable doses with fewer symptoms. The goal is always improved wellbeing, preserving joint health and function, and using all tools available to ensure clients we support achieve the best possible outcome.
When the whole body is supported, clients will report benefits that extend far beyond joint pain, such as
More stable energy
Clearer thinking
Improved mood and lower anxiety
Calmer digestion
More balanced hormones
Fewer flares
A deeper understanding of triggers
A functional medicine approach shifts care from simply coping with symptoms to building long-term resilience and creating health habits.
We take time to understand each person’s unique story, history, physiology, environment, and lifestyle. With this information, we design a personalised plan that supports immune balance, reduces flare frequency, and improves overall health and wellbeing.
Rheumatoid arthritis is not only a joint condition. It is a whole-body condition that requires a whole-body approach.
If you would like personalised support with rheumatoid arthritis or another autoimmune condition, you are welcome to book ain with us or book a discovery call with one of our practitioners.
