Remission of palindromic rheumatism through ketogenic and carnivore diets: A case report

The low-carbohydrate ketogenic diet (LCKD), developed a century ago to treat epilepsy, is now commonly used as a therapeutic intervention for obesity, type 2 diabetes and other conditions associated with insulin resistance. A growing body of literature supports the use of LCKDs for conditions associated with autoimmunity and inflammation. Here we present the case report of a 61-year-old man diagnosed with palindromic rheumatism (PR) – often a precursor to rheumatoid arthritis – whose condition was considered to be in remission after he adopted an LCKD and subsequently transitioned to an even lower-carbohydrate ‘carnivore’ diet. The patient was able to discontinue all arthritis-related medications, and currently, 7 years after initially starting the LCKD, he continues to follow a carnivore diet and reports no daily pain while remaining active in endeavours that require manual dexterity, such as woodworking and playing the guitar. Through anti-inflammatory effects and the removal of dietary irritants, dietary carbohydrate restriction may have potential therapeutic benefits for PR, a condition for which effective treatments and disease-modifying strategies remain elusive.