“Inulin appears to benefit inflammatory status, disease activity and clinical outcomes in patients with rheumatoid arthritis,” wrote a team of Iranian researchers from Isfahan University of Medical Sciences in Scientific Reports. “Incorporating it into their treatment protocol could be valuable for managing their condition.”
The study suggested that inulin works as a prebiotic that can alter microbiota, promote intestinal barrier integrity and confer anti-inflammatory benefits.
RA and the microbiota
Rheumatoid arthritis is prevalent in less than 1% of the population and can lead to fatigue, cardiovascular disease and pulmonary and joint issues. It can also cause pain and sleep disturbances, limiting an individual’s physical activity and quality of life.
Several studies have shown that increased inflammatory biomarkers are associated with RA. There is no cure for RA, and long-term prescription drugs to address symptoms have been linked to side effects like gastric ulcer, liver damage, kidney damage, headache and dizziness for non-steroidal drugs. Individuals with RA taking medications can also experience weight gain, decreased bone density and increased risk of infection for steroid drugs.
“Recent studies propose that patients with RA have considerable changes in intestinal microbiota compared with healthy individuals,” the researchers wrote. “The characteristics and understanding of gut microbiota have recently increased, indicating a broad field of research, especially in autoimmune diseases. The gut microbiota is the main source of microbes that may have beneficial and disease-causing effects on human health.”
People with rheumatoid arthritis also have lower quantities of Bifidobacterium species, and lactic acid bacteria is significantly reduced in RA subjects. Studies suggest that consuming probiotics, prebiotics and synbiotic products can reduce symptoms like inflammation, improve gut microbiota and reduce disease severity and symptoms.
“Inulin-type fructans (ITFs), including oligofructose, inulin and fructooligosaccharides, are indigestible, soluble and fermentable food components that have been identified as prebiotic properties and are recognized as functional foods,” the researchers explained. “Beneficial effects of ITF intake on improving metabolic parameters, maintaining the integrity and function of the intestinal mucosal barrier, and modulating immune system responses have been reported.”
Found in celery, chicory, garlic, onions, wheat, bananas, soybeans, artichokes and asparagus, inulin fructans can increase the level of bifidobacteria and lactobacilli.
There is a lack of clinical evidence about inulin supplementation’s effect on improving rheumatoid arthritis symptoms. The scarcity of information encouraged scientists to investigate inulin supplementation on RA and quality of life.
Study details
The randomized clinical study recruited 60 adults and assigned them to either consume either 10 g of inulin daily or a placebo for eight weeks. The researchers assessed 28 joints in the body, hand grip strength to determine muscle strength in a fixed position and pain intensity.
Findings suggested that inulin supplementation significantly improved areas like morning stiffness and acute phase protein (CRP) levels compared to placebo.
Researchers also used a questionnaire to evaluate disability status in study participants, examining participant ability to dress, stand up, eat, walk, complete hygiene, hand stretch, grip and perform general activity.
“Hand grip strength and quality of life in our study improved significantly,” they explained. “Despite these positive results, we observed no significant changes in pain intensity or ESR levels [a non-specific marker of inflammation].”
Source: Scientific Reports. doi: 10.1038/s41598-025-16611-3. “Inulin supplementation improves some inflammatory indices, clinical outcomes, and quality of life in rheumatoid arthritis patients”. Authors: Ali Tabatabaeyan et al.
