Jeremiah Farias (00:00.078)
Did you know that rheumatoid arthritis and type 2 diabetes could be more connected than you think? In today’s video, we’re diving deep into the surprising link between these two chronic conditions and what it means for your health. And stay tuned to learn how managing one can impact the other in ways you’ve never imagined.

Hi, my name is Jeremiah Farias. I’m a functional resident dietician and I help adults suffering from blood sugar dysregulation issues. Conditions like type 2 diabetes and pre -diabetes using a bio -energetic approach to optimize cellular energy production. I hope you enjoy today’s content. Let’s start by understanding what is rheumatoid arthritis. Rheumatoid arthritis, RA for short, is characterized as an autoimmune condition that affects one’s connective tissue and leads to the destruction of one’s connective tissue. RA mainly affects synovial joints. Synovial joints are the most common type of joint throughout the body. They

include joints like the wrist, hands and fingers, elbow, shoulder, and even certain parts of the vertebrae. Autoimmunity is believed to be a state where one’s own immune system is attacking itself. And in the case of RA, this is a condition where the immune system or this immune dysregulation is causing damage and destruction to various joints throughout the body. Now, what are the symptoms of RA and how is it diagnosed? So because of the damage that’s being caused to the joints, you’re going to see swelling, pain, and even stiffness.

in those joints that are affected. An RA is diagnosed based on a variety of criteria and these criteria include the number of joints involved, the presence of rheumatoid factor and other antibodies in the blood, the duration of symptoms, and abnormal acute phase reactant markers like elevations in CRP and erythrocyte sedimentation rate. As you can imagine, RA can really affect someone’s day -to -day living because the pain can be so severe it limits what one is able to do on a regular basis.

basis. They may not be able to move. They may not be able to, of course, do activities that they used to enjoy, household chores because of impaired mobility, pain and stiffness in their joints. Some that I work with even need to use a cane or a walker to get around because their pain and their lack of stability is so severe. And unfortunately, RA is believed to be a progressive disease that can only be managed through medications to prevent further damage to the joint tissues. However, later in this video, I’ll share my experience

Jeremiah Farias (02:15.792)
working with those with RA and discuss the progress that they have been able to make through a variety of dietary and lifestyle interventions. So now that you have a better idea of what RA is, let’s briefly discuss type 2 diabetes. So type 2 diabetes can be characterized as a state where the body can no longer use or oxidize glucose within the cell. And in type 2 diabetes, there are various cells of the body that become insulin resistant. As a reminder, insulin is a hormone that’s released from the beta cells of the pancreas. Insulin does a number of things in the

body, but as it relates to blood sugar regulation, it first allows glucose into the cell and increases glucose oxidation within the cell. And second, it will tell the liver to stop producing or releasing glucose. However, in the state of insulin resistance, the cell’s ability to oxidize glucose is impaired and the liver continues to release more and more glucose via two processes, one called glycogenolysis and the other gluconeogenesis. Glycogenolysis is where the liver is

liberating stored glycogen or stored carbohydrate and gluconeogenesis is where the body is converting or the liver is converting fatty acids and proteins or amino acids into glucose. So what are symptoms of diabetes and how is it diagnosed? Symptoms of diabetes can vary, but they include cravings for sweets or other foods, especially after meals, having anxiety, poor sleep quality, brain fog, headaches, or even shakiness in between meals. And in extreme cases, you’ll

actually see numbness in hands and feet and even some blurred vision. And when it comes to diagnosing diabetes, it’s based on fasting glucose levels. So if someone has a fasting blood sugar of greater than 126 milligrams per deciliter, that is going to indicate diabetes or an A1C greater than 6 .5%. And the symptoms that come along with diabetes are often inconvenient. It hinders individuals from functioning at their optimal capacity.

and can make simple tasks very laborious or more laborious. And in extreme cases when diabetes or blood sugars are not well managed for an extended period of time, it can result in people ending up on dialysis due to kidney failure. It can result in blindness and even amputations. All right, now that we’ve discussed what RA is and what type 2 diabetes is, let’s review how the two are connected. We’ll start by looking at if there is an association between rheumatoid arthritis and type 2 diabetes. So one

Jeremiah Farias (04:45.392)
systematic review and meta -analysis from 2021 concluded that, So this means that inflammation is involved in the development of type 2 diabetes. And this is not controversial. Clinical studies even cooperate these findings. For example, in those with both type 2 diabetes and rheumatoid arthritis, when researchers

inhibit interleukin -1 or IL -1, you see a reduction in fasting hemoglobin A1c. This points to the fact that the inflammatory state of rheumatoid arthritis leads to increased inflammatory mediators, increasing glucose levels, but this increase in glucose levels is also likely related to elevations in serum cortisol that are also observed in rheumatoid arthritis. And to clarify, I’m not saying that if you have rheumatoid arthritis, you are going to develop type 2 diabetes or vice versa.

Instead, I want to highlight that the two are connected and what could be driving one can also be driving the other. Specifically, I believe that impaired energy metabolism is at the root of RA and type 2 diabetes. And to make this point, we’re going to look at the presence of mitochondrial dysfunction in both of these conditions. We’ll start by talking about RA.

One paper stated that in RA, the most severely damaged cells are chondrocytes and synovial cells. If the mitochondrial function in these two types of cells is disrupted, it will lead to the dysfunction of cell physiology and then trigger RA. This same paper highlighted the three ways that mitochondrial dysfunction can result in RA. They include first, impairing energy metabolism, two, excessive reactive oxygen species production, and third, activation of innate

immunity due to mitochondrial damage. The authors had this to say about the first point on impaired energy metabolism. They mentioned that mitochondria are indispensable for the energy supply of chondrocytes due to their essential physiological function of producing ATP from glucose. So if you cannot turn glucose from the carbohydrates that you consume into ATP or cellular energy, you’re not going to be able to nourish the cells called the chondrocytes which make up cartilage in our joint tissue. Without

Jeremiah Farias (07:07.28)
proper nourishment, you’re going to have degradation of these joint tissues. The next point is excessive reactive oxygen species and the authors had this to say, the reactive oxygen species synthesized in mitochondria also known as mitochondrial reactive oxygen species is mainly generated due to proton leakage in the electron transport chain. So reactive oxygen species are molecules that can cause damage in excess and the production of mitochondrial reactive oxygen

species are mainly generated when there is proton leakage in the electron transport chain. What I want you to know about this is first, proton leakage results in greater amounts of mitochondrial reactive oxygen species. And in previous videos, I’ve covered that when the membranes of our cells and our mitochondria are composed of lots of polyunsaturated fats, PUFAs for short, you’re going to have higher rates of this proton leakage occurring and more on that later. Lastly,

The authors mentioned this about the third point. Therefore, factors leading to mitochondrial DNA damage leakage may cause mitochondrial disorder and eventually lead to the occurrence of inflammatory reactions which may ultimately lead to RA. What this means is if you damage the mitochondria, let’s say that’s through consuming too many polyunsaturated fats in your diet or through other environmental exposures, you can cause the release of mitochondrial DNA and this release of mitochondrial DNA can

then lead to an inflammatory reaction eventually driving rheumatoid arthritis. So clearly, mitochondrial dysfunction is involved in rheumatoid arthritis and it should come as no surprise that mitochondrial dysfunction is also involved in type 2 diabetes as I’ve covered this in some previous videos. For example, one paper highlighted that an inhibition of mitochondrial function and an increase in lipid peroxidation have been described in skeletal muscle of insulin resistant patients. So in

insulin resistant patients are those with type 2 diabetes. And also notice how the authors point out the increase in lipid peroxidation. You remember from previous videos, lipid peroxidation is more likely to occur to polyunsaturated fats. Now for those of you with RA, type 2 diabetes, or both, have you ever heard this connection or this information before? If you have, let me know down in the comments. Now as you can imagine, I’m not the only one who has made the connection between impaired energy metabolism,

Jeremiah Farias (09:36.88)
conditions like type 2 diabetes and RA. For example, Dr. Ray Peet famously said, if we learn to see problems in terms of a general disorder of energy metabolism, we can begin to solve them. And another doctor, Dr. Chris Masterjohn says, energy metabolism governs everything. And in Dr. Chris Masterjohn’s article titled, Energy Metabolism Governs Everything, he makes the argument that disordered metabolism drives diabetes and this impaired energy production is also

going to lead to autoimmune conditions like rheumatoid arthritis. This is because in a low energy high entropy which means greater disordered state, there’s a mixing of things together and one is going to get sick often, have allergies and autoimmune disease, and we even fail to clear cancerous tissue. So how do we support energy metabolism and start to improve our rheumatoid arthritis and our type 2 diabetes? We need to be doing three things. First, we need to provide

ourselves with what they need. Two, protect them from things that cause damage. And three, create an environment which promotes their function. Let’s discuss each of these three points in a bit more detail. So first, what does it mean to provide ourselves with what they need? Our cells require energy from glucose and fats, and it also requires enough overall calories coming from protein, carbohydrates, and fats. And on top of that, we also need enough vitamins and minerals, micronutrients, to convert glucose and

fat into cellular energy ATP in the mitochondria. I’ve created previous videos where I go more in depth in how to ensure you’re getting enough overall calories and the importance of each of the macronutrients. So I’ll link to those videos in the description below so you can check those out. Next, what does it mean to protect the cells from things that can cause damage? There are a variety of molecules or compounds that can cause damage to our cells. For example, too many reactive oxygen species can impair the function of the mitochondria, therefore leading to

cellular dysfunction. I previously mentioned in this video that too many polyunsaturated fats, because they can increase proton leakage in the electron transport chain, are going to drive greater levels of reactive oxygen species. I’ll link to a previous video where I discuss PUFAs or polyunsaturated fats in more detail. The link again will be in the description. Lastly, certain toxins like BPA, air pollution, car exhaust, flame retardants, parabens, phthalates, pesticides, and more impair cellular energy production. The goal in

Jeremiah Farias (12:06.48)
in this case would be just limiting your exposure as much as possible while also optimizing detoxification in the body. And some of the steps that you can take to limit your exposure includes using a high quality HEPA air filter, having indoor plants that can purify the air, not eating or drinking out of plastic, but instead using glass or stainless steel, not using nonstick pans for cooking, having a high quality water filter for drinking and maybe even a shower filter, checking the quality of cleaning and personal care

products as these are major sources of endocrine disrupting chemicals. And then for optimizing detoxification, we want to get plenty of calories. You need enough energy to support detoxification. So plenty of calories from high quality protein, carbohydrates, fats, and ensuring plenty of polyphenol and fiber rich fruits and vegetables as these are going to allow for binding to excessive toxins. And we want to make sure we’re having regular bowel movements at least one a day, potentially even

more and finally doing some activities that encourages sweating whether it’s exercise or sauna use to get toxins out via the sweat. So lastly, how do we create an environment that supports optimal cellular function? We’ll look at five things. The first is proper hydration. We need to be properly hydrated for ourselves to work the way that they’re supposed to. And this means, you know, maybe carrying around a stainless steel or a glass water bottle and adding some mineral

to the water can enhance the hydration potential. I don’t recommend specific ounces per day because when they look at studies assessing the amount of ounces and fluid required to hydrate someone, they included the water that was coming from food and other beverages, not just purely water. And the body does a pretty good job of telling you when you’re thirsty. I think it’s important just to have some water available so that one can satisfy that thirst when it comes up. Over hydrating is also a stressor.

So I don’t recommend just simply cutting your body weight in half and then drinking that many ounces because that may lead to over hydration. The second concept is having an optimal pH. Sales require an optimal pH to properly function as well. And in a previous video where I reviewed the connection between diabetes and hypertension, I discussed a concept known as PRAL which stands for potential renal acid load and something called low -grade metabolic acidosis. So I’ll link to that.

Jeremiah Farias (14:36.08)
video in the description below so you can learn more about that because there is something to having a net acid load on the body that over time acutely but especially over time can cause a lot of issues. The third concept is our cells require enough stimulation through movement and exercise. This can mean reaching a certain amount of steps so low impact movement throughout the day anywhere from 8 ,000 to 8 ,500 steps per day is likely a great place and a great amount. On top of some more specific exercise like resistance training.

biking, etc. And another important concept is getting enough rest because our cells require enough rest. It can easily be overstressed. So there is a sweet spot when it comes to exercise and activity. But being sedentary is not supportive of cellular communications. We want to make sure we’re accomplishing that. The fourth concept has to do with sufficient amounts of hormones and even neurotransmitters. Hormones like insulin and thyroid hormone T3. And these neurotransmitters and hormones allow for

proper cell function and communication. The fifth and last concept is something that I’m grateful to Dr. Brian Walsh bringing to my attention because it wasn’t something that I would think of before. And this is the concept of having a sense of purpose. A lack of purpose can negatively impact how the body works. So for some, exploring and finding one’s purpose may be the first step before they can begin healing and making progress with their health. So by doing these three things, providing the cells with what they need to function, protecting them from things that can negatively impact how they work,

and overall creating an optimal environment for the cells to properly and efficiently communicate with one another, we’re going to have the healthiest cells possible. When it comes to RA, this means that we have healthy chondrocytes, we have healthy synovial cells, they’re getting what they need, the nourishment, and when they’re sufficiently nourished, they’re able to produce healthy tissue, which is key if we’re trying to heal and reverse the issues that are caused by RA. And when it comes to diabetes,

we’re trying to systemically improve how all the cells work in our body so that they can uptake glucose and oxidize it in the cell. Now I understand that this is a lot of information and if you need guidance on where to start, this is where you can apply to work with me. I have helped many with type 2 diabetes, rheumatoid arthritis, and some individuals even had both conditions at the same time. One of my clients with rheumatoid arthritis came to me and she was in immense pain and required a cane to actually get around. But after making a variety of diets,

Jeremiah Farias (17:05.68)
and lifestyle changes over a six month period, she was able to get off of her pain medication and dramatically improve her mobility and functionality to the point where she can resume activities that she enjoyed, which for her was doing hula dancing and she was in her mid 70s at the time. If this is something you’re interested in, you can find the link to learn more about working with me in the description below. Another connection you may not be aware of is how hypothyroidism is connected with both diabetes and rheumatoid arthritis. Dr. Brota Barnes documented this very well in his book,

book and this is why I created a video connecting both hypothyroidism and diabetes and how they can actually feed into each other. You can check out that video next. I’ll link to it right here. If you enjoyed today’s video, please be sure to hit that like button, share it with someone that you believe would benefit from this information. Also subscribe and turn on notifications so you don’t miss any future videos. Take care and I’ll see you next week.