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Author Information

I am a New Zealand registered nurse and nutritionist (Grad Cert Sci: nutrition, Massey Univ). I am a Certified Zone Instructor, and have worked teaching Zone diet principles to hundreds of clients over the last 10 years. More recently after finding that eating Paleo food choices was the "icing on the cake" health wise, I have become a Paleo enthusiast and teacher. Follow me on twitter @juliannejtaylor

Auto-immune disease HLA-B27, client pain free on no starch, paleo diet

In August 2010 I met Tab, an energetic 28 year old, through CrossFit Auckland where I work as a nutrition coach. Tab had a goal to lose weight. As we went through her medical issues Tab told me she had an auto-immune disease, non specific, but linked with the HLA-B27 gene. As a result she suffered back pain which was at times debilitating, and she swallowed voltarin to keep it at bay. It was always present and she could no longer run without a lot of discomfort. Another symptom of this auto-immune disease for Tab was iritis which flared up every few months, also eczema. She also said that she had problems with some foods that caused IBS symptoms; sugar, corn, dairy and mushrooms had been identified as causing problems for her.

When anyway even breathes the word auto-immune disease, my first response is a strict  paleo diet, and possibly removing eggs and nightshades as well. Loren Cordain has written extensively about the connection of agricultural foods triggering auto-immune disease. I suggested Tab trial a strict Paleo diet.

But what about this specific gene HLA-B27? I’ve seen clients with this before. HLA-B27 is strongly associated with ankylosing spondylitis (AS). 95% of people with AS have this gene, although only a small percentage of people (10 – 20%) with HLA-B27 develop AS. It is also associated reactive arthritis (Reiter’s Syndrome), inflammatory eyes disorders, uveitis and iritis, psoriatic arthritis and ulcerative colitis and irritable bowel syndrome (IBS).

There are several theories as to why people with this gene develop auto-immune diseases. With respect to AS sufferers, they also have HLA-B27 gene plus IBS, suggesting a gut problem may contribute. (Although Tab has never had a positive diagnosis of AS, she had relatives with it, and her back pain suggested it). As only a small percent of people with the gene develop AS, this suggests an environmental trigger. (As Matt Ridley says in Nature via Nurture says “Nature loads the gun, environment pulls the trigger”) Dr Alan Ebringer, at Middlesex Hospital, London noticed this link and began researching a possible trigger, which he thought might be a microbe. The hypothesis was that a certain percentage of people were infected by a microbe that possessed molecules resembling the blood group HLA-B27, when a person becomes infected by this microbe, and develops anti-bodies against it, these same anti-bodies attacked their own similar tissue.

After testing different microbes in rabbits (injected with HLA-B27 lymphocytes) a bowel microbe called Klebsiella was identified. Klebsiella appeared to have molecules that resembled the HLA-B27 blood group and also the collagens found in the spine and large joints. Klebsiella microbes are a normal component of human bowel flora, but AS patients tested were found to have greater amounts in their stools. Elevated levels of antibodies to Klebsiella were found in AS patients, especially during the active phase of the disease, i.e during flare-ups. Further studies in other countries also found elevated anti-bodies to klebsiella in AS patients. The next problem was getting rid of the klebsiella. Antibiotics will kill it, however reinfection is likely. The answer came, like many discoveries, by accident. One of Ebringer’s patients wanted to lose weight, and asked for a diet plan that would work. He devised an unconventional plan. As much steak and tomatoes as you can eat, plus a bottle of red wine a day! When he next saw the doctor he remarked “Not only have I lost weight, but my joint and back pains have disappeared!” The penny dropped for Ebringer, the diet lacked starch, the klebsiella must be living in the gut feeding on undigested starch. Tests on patients confirmed this, and he found several nutrition studies that demonstrated bacterial growth in the colon is fed by dietary starch. Ebringer tested a no starch diet on hundreds of AS patients at the Middlesex Hospital in London. These patients continued their medication, however he found he could achieve therapeutic effects with much lower levels of drugs. The low starch diet was found to be particularly effective for those with early stages of the disease, before irreversible spine and joint damage. It is also pertinent to note that he found not all AS patients respond to a no starch diet, but it is worth trying as it usually makes a difference.

Carol Sinclair, who suffers IBS, back and other joint pain, wrote a very accessible book on her own search to find a cure for what seemed like multiple health problems. Subsequent tests showed she had the HLA-B27 gene which led her to the research by Dr Ebringer. She experimented with a starch free diet, and found her IBS resolved and her pain disappeared.

I’d read this book some years ago and when Tab told me of her medical problems, which mirrored Carol Sinclairs, it seemed to me that she might benefit from a starch free diet, in addition to an anti-autoimmune paleo diet, and I suggested she read Carol’s book. She immediately read both “The IBS Low Starch Diet” and “The Paleo Diet”, and altered her diet. The Paleo diet cuts out all gut irritating foods, that cause leaky gut. A leaky gut allows fragments of bacteria and other partially digested proteins to get through to the bloodstream, and if these are similar to our own tissues, like the klebsiella bacteria, an  auto-immune reaction is set up. So in theory, a dietary approach that allows the gut to heal, and also decreases the food source to the offending bacteria, should reduce the auto-immune reaction.

Here is Tab’s own story:
“My name it Tab and I started Paleo eating at the end of August when I meet Julianne through CrossFit, I was tired of being overweight and needed to get a handle on my fitness before returning to work. I am 5’10” weighed in at 98.8kgs on August 21st, I now weigh 88.3kgs, and I’m at least a dress size smaller. (15 December 2010)

I have an Auto-immune disease not specifically diagnosed, however I’m HLA-B27 positive and I get iritis in alternative eyes when I’m stressed, and my back constantly gave me pain causing me to chew through pain killers. I’ve always been told that there was no cure and that all we can do is manage the pain. Julianne put me onto the IBS diet book which had some interesting information about being HLA-B27 positive, I felt like the book was written about me. The book suggested that starch could cause these problems, through leaky gut and my body attacking itself. So I decided to remove all starch from my diet. And wow would you know it……… my pain reduced within 3 days.
At first it was difficult to remove bread and rice and pasta and other starches from my diet as I felt like I was missing out, but with advice and encouragement from my Husband and Julianne I have managed it. In November I was still getting some pain, and I discovered quite by accident that the Vitamins* I was taking were also adding to my pain, as once they ran out my pain completely disappeared, returning occasionally.

I still occasionally struggle to maintain Paleo eating and have occasional moments where I think I’ll be okay and eat some potato or something only to discover that my pain is back, however I’m still slowly losing weight, pain free and enjoying experimenting with natural foods. Another result was that my eczema cleared up.”

*The Vitamins were Usana Essential Multivitamin and Mineral tablets. Here is a list of the “Other Ingredients” contained in the supplement.

A quick search and on http://celiacdisease.about.com/od/medicalguidelines/a/medications.htm found this statement “…any starch ingredient (including “pregelatinized starch” and “sodium starch glycolate”) not labeled specifically as coming from a gluten-free source — for example, corn, potato, tapioca — should be a cause for alarm. In addition to starch, other inactive ingredients that might come from wheat or barley include — but are not limited to — dextrates, dextrins, dextri-maltose, and maltodextrin.”

Either the starch or gluten derived filler (Tab discovered she was also extremely sensitive to gluten) in the multivitamin was enough to cause an ongoing level of chronic pain. Without this multivitamin Tab experienced complete relief from back pain and was able once again to run without discomfort.

Further reading and resources:



The Bacterial Connection to other Chronic and auto-immune conditions.

There is growing interest in the theory that bacterial (or other biological agents), can trigger diseases in susceptible people. Ebringer’s research also found people with Rheumatoid arthritis, who have the HLA-DR4 gene, have anti-bodies to proteus bacteria. And that ‘molecular mimicry’ may contribute or cause this auto-immune disease also.

Rheumatoid arthritis is caused by Proteus: the molecular mimicry theory and Karl Popper.
Ebringer A, Rashid T.
Front Biosci (Elite Ed). 2009 Jun 1;1:577-86.

Another resource on the treatment of rheumatic diseases with antibiotic therapy here:


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74 Responses to “Auto-immune disease HLA-B27, client pain free on no starch, paleo diet”

  1. Wow, is this ever timely, Julianne—I’ve just taken a client on with a history of AK, and was looking to find anecdotes of how diet positively affected remission. Great stuff, thank you!

    February 13, 2011 at 6:40 pm Reply
  2. This is great, Julianne. I had exactly the same experience when I first started the no-starch diet about 5 years ago. The next phase of my dietary experience was more difficult and frustrating as I worked through random flares over the next 18 months or so even though I thought I was sticking to a strict no-starch diet. Many folks will stop trying the diet at this point and say “it didn’t work for me”, but I’d encourage them to soldier on and do the following:
    1. Keep a detailed food journal
    2. Test everything you eat with iodine

    The journal will allow you to look back and see what you ate that may have caused a flare. For me, the flares could come as soon as 4 hours post-meal, and so it was pretty easy to look over the last meal’s ingredients and identify the likely culprit. I’d then eliminate that ingredient from my diet and try again.

    The iodine will help when you’re eating foods that are processed (salad dressings, ice creams, coldcuts, vitamins, etc. All of which I eventually eliminated from my diet…for the most part) and will also help identify starch in normally non-starchy foods like apples. Apples can be picked green and shipped to you with high starch content.

    Yes, it sounds like a lot of work and it WAS at first. But like anything else it gets easier over time and the payoff is enormous: no pain, no flares, a normal life.


    April 5, 2011 at 12:33 pm Reply
    • Thanks, it is great to hear of your experience in dealing with this. I learn so much from real people’s real life diet trials and what works and what doesn’t.

      April 6, 2011 at 12:19 am Reply
  3. Katherine #

    Thankyou for posting this. I discovered that the joint pain and other symptoms I have are realted to starch through following a low carb paleo diet. I don’t have a diagnosis but am convinced it is a form of AS. It’s so affirming and encouraging to read of others having similar experiences and finding success with no starch paleo. Funnily enough I am flaring at the moment after starting some new multivits last week lol.

    September 21, 2011 at 3:01 pm Reply
  4. Alan Evans #

    Hi .My name is Alan ,and i live in North Wales.
    Iv’e been on the NSD for five weeks .After the first two weeks i thought I was quired,and i stoped taking my NSAID’s,but soon after came the flair ups.they hit me bad in the back of the neck and up to the top of my head, the discomfort makes me very aware of any cherk or jolt.If I could ridd this I would be more than happy with the diet.My overall spine is a lot less pain full.I do have some fusion but its been more than comfourtable the last month.
    My immediate broblem is weight loss,I’v been quite lean all my life ,but have lost a lot following the diet.Does anyone out there have a solution to this? I’ve been contiplating trying these body builder powders or energy drinks,I live in the sticks and the most ready body building produce is a bowl of porridge!!
    Ive been quite shocked by the ammount of starch in apples and pairs .Kiwi fruit,so my breakfast is back to a boiled egg and a pinch of salt.
    Buy my problem is sustaining or gaining weight and energy while continuing with a NSD.
    I’m trying ti gather currage to confront my GP on changing my NSAID to something less gut busting.
    It will be in the new year hopefully

    Thankyou or “diolch ” in Welsh


    December 12, 2011 at 3:08 pm Reply
    • Hi Alan,
      I’d suggest eating a lot more food – but just of the foods you can tolerate. Eat plenty of protein, and fats that are rich in monounsaturated fats and shorter chaing sat fats: macadamia oil, grass fed meat fat, coconut oil and cream (watch the additives in the cream though) Fruits that are starch free, and veges as tolerated.
      My client above ended up eating quite a few fruits. She couldn’t tolerate dairy so protein powders were out.

      Try taking a good dose of omega 3 fish oil, get a good quality one, as I find fish oil very anti-inflammatory. NSAIDS are not great for the gut, so can make things worse. It would be good to try alternatives if possible. See what your doctor says.

      January 9, 2012 at 1:51 am Reply
      • Alan Evans #

        Thank you for you’re advice.I think as I get more experienced with the diet it is getting less of a problem . For example.Iv’e been adding a lot of caned tomatoes to my diet,thinking they were OK,bur after an iodine test I was shocked to see it turn black.The same with fruit, I try to leave them to completely ripen before consuming.
        Generally I’m getting better.I don’t feel I’m walking through the resistance of four feet of water any more.And the pain and low tolerance to jerk in the back of my head is better.
        In a word I see enough positive change to continue .
        I’m down to half a pill of meloxicam 7.5mg twice a day.
        I will also approach my GP in the next week or so.

        I appreciate you’re help thank you.
        Alan Evans

        January 9, 2012 at 12:38 pm Reply
  5. James #

    I have HLA-B27, rheumatoid arthritis, iritis and am now on the following no starch meal plan after experiencing ankylosing spondylitis symptoms.

    Activated almonds
    Half avocado
    canned wild salmon

    Canned wild salmon
    Brazil nuts & olive oil

    Boiled egg, Spinach, oyster mushrooms, red capsicum, cucumber, pumpkin seeds, turmeric spice & olive oil.

    I do not try to run, and am also trying apple cider vinegar, honey and cinnamon drinks, glucosamine sulfate, chondroitin, MSM supplements as well as Thompsons Mens multivitamin.

    January 31, 2012 at 10:46 am Reply
    • How is it going so far?

      January 31, 2012 at 9:04 pm Reply
  6. carole #

    Thank you for information on this site. I think the hardest thing is getting started, knowing where to start. That is what I am looking for. any advice on just getting started?

    February 29, 2012 at 9:33 pm Reply
    • Check out the info in the paleo challenge tab

      February 29, 2012 at 9:44 pm Reply
  7. Hi, I am a Physiotherapist from India. In 2005 I came to know that I am HLAB-27 positive and started very active exercises, and thanks god I was out of it. So I thought the active stage is over now nothing to worry. I had regular backaches and did my best with exercises. last year I enrolled for Masters and just forgot the exercises. My pain kept increasing and I came up taking NSAIDS. Now when I went for XRay it shows both my SI joints are fused.I am having very severe pain around the SI jnt (both). I cant bend forward, both my hamstring have tightenning. Need help. Looking for your response. Thanks

    July 6, 2012 at 6:23 pm Reply
    • I’d suggest you try a paleo diet, but starch free.

      See paleo guidelines tab. Get a copy of Carol Sinclairs book mentioned in the article – it is very useful


      July 6, 2012 at 6:42 pm Reply
  8. Tracey Morgan #

    Hi i was diagnosed with HLA-B27 a few years ago,then started to notice a pattern after eating bread and pasta my eye(episcloritis) would flare up also bloating and pain all over my body. So i cut out gluten which reduced all of those symptoms automatically. I knew i was on the right track,but after reading about this article i will now reduce more starches. I am pretty sure i have Ankylosing Spondylitis as well even though it did not show up in my Xray which i was later told it doesn’t show up on Xrays anyway. I had told my Dr my symptoms before she gave me its name. So i am looking forward to reducing more inflamation, I am also trialling a Alkalising diet at the moment.
    Thanks for the great read,

    September 6, 2012 at 12:46 pm Reply
    • Thanks for sharing your experience. Keep me posted on how you feel with less starches.

      September 6, 2012 at 1:09 pm Reply
  9. darshan #

    Hi i was diagnosed with HLA-B27 few months.Even though it did not show up in my Xray which i was later told it doesn’t show up on Xrays anyway. I had told my Dr my symptoms before she gave me its name.i’m having pain in my all over body.how to remove this disease.


    September 17, 2012 at 5:16 pm Reply
    • Get a copy of the book mentioned – Carol Sinclairs starch free diet and use paleo food choices also. It should help

      October 5, 2012 at 8:35 pm Reply
  10. Vicky #

    I am 150 pounds or so overweight. I know I cannot eat starches at all. I need a 7 day menu plan in order to stay on board. Can someone help me. I am in continuos constant pain. I can barely breathe anymore. I can’t hardly move without being out of breath. Help.

    November 1, 2012 at 2:37 am Reply
  11. kcambell #

    I am so glad to have found this site. My children and I have fought a “mystery” problem for years. Our health is usually manageable as long as we stay on a very simple diet. When ever we leave our diet we experience everything from angry outbursts, depression, hives, difficulty focusing and passing blood. Our diet is high in protein and very low in carbs. If we become ill it can always be traced to food. We had a dinner party that we were not able to avoid eating. This time I am afraid I will have to go to a doctor for assistance in managing our challenges. Thank you so much for your Paleo Physicians Network link.

    November 5, 2012 at 2:34 am Reply
  12. joe fanelli #

    I am 53 and on samponi with pain. I am very active and like playing golf ,I also have HLA b 27 + I tryed to get you book for diets but was not sucess. I do not no what to eat and have nobody to cook for me. I would like to no what to eat or is there some company that i could call for meals to pay need help THANKS

    January 9, 2013 at 1:44 pm Reply
    • Get a copy of Carl Sinclairs book as mentioned. She has recipes in her book. http://www.amazon.com/IBS-Low-Starch-Diet-Carol-Sinclair/dp/0091912865/ref=sr_1_1?s=books&ie=UTF8&qid=1357696965&sr=1-1

      January 9, 2013 at 3:03 pm Reply
    • joe fanelli #

      I have read carl Sinclairs book and have a question, Is starch free and gulten free the same I thought it was but not sure I tested gulten food with iodine and it came up dark like bread

      February 7, 2013 at 2:17 pm Reply
      • No they are not the same. Gluten is a protein found in grains, barley, rye and oats, it is very difficult to digest and promotes inflammation in the gut, it is also linked with auto immune disease.
        Starch is a carbohydrate that is found in many vegetables as well as all grains. Grains contain both starch and gluten.

        February 7, 2013 at 2:25 pm Reply
  13. Ann #

    I am encouraged by your article and by your readers comments. Two of our 3 sons have been diagnosed with AS and our daughter has both IBS and Hashimotos thyroid disease. I am going to have both my husband and myself tested for the HLA-B27 gene as I suspect we each carry the gene. He suffered for years from severe back pain. I have gone through IBS, back pain and many other medical problems over the years but never did I think they could be originating from the same thing. I have Carol Sinclairs book (excellent) and Rob Wolf’s book on the paleo diet. I have started the eating plan Rob suggests and feel better already (even if it may only be a psychological boost so far). Thank you.

    January 15, 2013 at 4:56 pm Reply
    • Hi Ann,
      Good to hear you are feeling better on the plan.
      With both HLA B27 and hashimotos / IBS I’d bet you are all highly gluten sensitive. (I have hashimotos, it is highly linked with celiac / gluten) I’ve written about this too
      Strict gluten free would be a must for life for the whole family. And yes paleo / starch free should help those with HLAB27.

      Keep me posted as to how you get on

      January 15, 2013 at 5:06 pm Reply
  14. ben #

    HI, i have been diagnosed with AS 5 years ago, currently began taking Humira after my condition worsened to the point of complete fatigue and i couldnt take any more Voltaren during the day.
    I have been training regularly over the last few years and struggle with weight gain, mostly due to sporadic flare ups preventing my progress meaning long stretches of time out of the gym.
    Since taking Humira the pain in my joints is 90% gone and i can trian harder for longer, there are side effects to consider however; i get short of breath very quickly, (known side effect of Humira), it can wear off before the next dose is due, meaning i have ot go back on Voltaren form time to time. the biggest side effect seems ot be consistent weight gain, about 7 kg in as many months. this too seems to be a side effectfor some who take Humira, I am now considering a Paleo diet to try and reign this extra weight in. I feel my self getting stringer now im effectively treating the pain rather than the Voltaren masking it, but extra weight is no good.

    February 1, 2013 at 3:47 pm Reply
    • I’d highly recommend you try a starch free paleo diet for your AS, if you do – please keep me updated as to how you got on.

      February 1, 2013 at 4:07 pm Reply
      • Christine #

        After ten years of mystery about the source of my pain, I found that I have genetic markers for A.S. on 23andme.com. In googling what it was, I discovered that the symptoms and the progression of the illness since I was young exactly follows this illness. I had already gone gluten free, and was pain free without NSAIDs for a month. I’ve fallen off the startch free a little bit, and I’m paying for it. I can’t run anymore, but I’ve discovered swimming. Going back on the paleo diet, which I find incredibly helpful. Just have to get used to not eating starch. It’s nice to have an answer to what it is, finally. Swimming, though, helps a lot.

        February 4, 2013 at 7:32 pm Reply
        • Thanks for sharing your story.

          February 5, 2013 at 12:55 pm Reply
  15. i am Indian,my age 29.last 3years i had suffer back pain but 6months ago when i test my SI JOINTS by MRI then i saw my boh SI JOINTS are sacrolities after few days i had test HLA-B 27 but the report was HLA-B27 negetive but still now at present i cant suffer to chronic back pain and spinal cod pain.plz tell me anyone person what do i free to live by medicine from cronic pain and also solution this diseases.plz tell me.my email id is ‘liketodutta84@gmail.com’..

    April 27, 2013 at 6:38 pm Reply
  16. my name is Tarak Dutta from India.i suffered past 3year as and still now i have meditation but no improove my spine and back pain(s.i. joint).i dont know what i m do it.please give me any suggesion and give me a chart of no starc diet.

    August 4, 2013 at 7:42 am Reply
    • Here is a list of foods to avoid and ones to eat
      REDUCE or remove THE FOLLOWING:

      Bread and flour products:
      Bread (white, brown, wholemeal, etc.) in very limited amounts.
      Crispbreads, biscuits, cream crakers, twiglets.
      Cakes, puddings and pies.
      Pastas, spaghetti, noodles, macaronis, pizzas, chappati, pitta bread, popcorn.
      Brown, white, boiled, fried or in puddings.
      All grains and root vegetables and pumpkins

      Chips, baked, boiled, roasted or mashed potatoes, and potato crisps to be avoided.


      Beef, pork, lamb, sausages, bacon, salami, pate, corned beef, potted meats, ham and veal. Venison. Chicken, turkey, duck or any other poultry meats.
      White fish: Cod, haddock, plaice, dover sole.
      Herring, salmon, mackerel, tuna, sardines fresh or tinned in oil, brine, or tomato.
      Shellfish: Crab, lobster, prawns, scampi, cockles mussels, oysters.
      Milk and Milk Products
      Prepared in any manner.
      All green vegetables, cabbage, cauliflower, sprouts, courgettes, peppers, mushrooms, spinach, broccoli or carrots.

      All kinds of fruits.


      NO RESTRICTIONS ON BEVERAGES OR SPICES (Pepper, salt or herbs)

      Taken from http://www.kickas.org/londondiet.shtml

      August 4, 2013 at 2:17 pm Reply
      • Bee #

        I thought cabbage, Zucc, carrots, green beans, squash, rutabaga, and turnips, and cauli all contain starch?

        I have stage 4 klebsiella tthat causes severe gut, joint, and muscle isssues and we’ll as other AI problems. I need to do a nsd, nut not sure how exactly.

        Also, what is the starch content of pumpkin seeds and sunflower butter?

        Does fermenting cabbage make it no starch?

        March 6, 2014 at 6:01 pm Reply
        • Carol Sinclair’s book is useful and shows how to do a low starch diet. The best way to eliminate starch is to test the foods you eat.

          March 8, 2014 at 1:59 pm Reply
  17. scyren #

    I actually did Paleo for 4 months along with Cross fit (had a trainer 3 days a week exercised on my own 2 other days) and I lost nothing (not even inches). My trainer was astounded. My husband and I did it at the same time and he lost 25. And everyone else there (female) was losing. However, I will say that I definitely do better without starch. My body feels better. I had extreme back pain in late high school and into college (had a sports accident and that is when I found out about AS – father has it. I am female). About 7 years ago, after my extreme back pain stopped completely and hasn’t come back. But, I have Uveitis/Iritis badly. It’s very difficult for me to lose weight unless I do low calorie and cut out all starches which helps with my inflammation. The hard part is trying to find what will work for you and I really wish I didn’t have to the extreme but at this point it is what it is.

    February 12, 2014 at 5:41 am Reply
    • Auto-immune disease is stressful for the body – I’ve stopped CrossFit even though I love it, and do shorter workouts at a local gym now.
      I suggest you look at trialling an auto-immune paleo diet – but starch free and see if that helps. Make sure you are taking plenty of omega 3 or oily fish and vitamin D

      February 12, 2014 at 11:37 am Reply
  18. Ian Lowe #

    Thanks Julianne, that’s one of the best write ups on AS/Paleo/No Starch that I have come across – I’m HLA-B27 with a positive AS diagnosis back in 2012. I have been following a Paleo low/no starch diet that has brought me incredible relief – reduced to a very low level of painkillers only when I get the odd flare and able to lead a normal life again.

    I found your page because I was looking for Vit D3 supplements which don’t have starch fillers. not easy.

    I have noticed that I get more flares in Winter, and living in Scotland, we don’t get much sun in the winter months!

    There seems to be a relation between VitD levels and leaky gut, which itself allows more of the Kleb produced proteins to get into the bloodstream… that’s my theory anyway.

    best of luck, and thanks again for the article.


    March 14, 2014 at 3:56 am Reply
    • Thanks, and yes optimising vitamin D levels are very important for any autoimmune disease. Go for levels at least 80 nmol/l (32) up to 120nmol/l (50) Vitamin D is safest no higher than 100nmol per litre otherwise you might absorb too much calcium.

      June 6, 2015 at 2:36 pm Reply

    I am 51 I did not know I was HLA-B27 until an iritis event was diagnosed at Greenlane hospital Auckland. I suffer from bouts of severe spinal inflammation during one event I was hated on by a nurse when admitted to emergency. I could hardly move they gave me morphine, I could not toilet myself at home and was vomiting during my worst event. Ambulance officers refused to leave me in my home. The young male nurse only saw me as non life threatening and taking up space, the pain was excruciating and when discharged I almost passed out several times I could hardly walk. In other events I was weeks off work. I did not identify starch as a problem until I read your article. The inflammation events can flare in my spine, can cause my heart to race and I now live with an irregular heart beat. Foods I identified personaly as auto immune triggers were aspartame (worst reaction) and most sweeteners within minutes of consumption. SYMBIO yoghurt, Fresh n Fruity yoghurt caused the pain to return. Sugary SODA drinks react fast, tonic water all alcohol except whisky. Too much bread triggered my system as well. During one severe event I was bed ridden with slipped disk almost 3 weeks. Then I took NZ Greenlipped mussels. Within 30 minutes 8-12 fresh cooked mussels stop all my inflammation. The discovery for me has lead me to control my attacks. Your article also was like a light bulb turning on for me. thank you so very much, I have been to hell and back some years.

    March 14, 2015 at 12:29 am Reply

      Re taking vitamins. I was taking ester c this I now realise triggers severe events, I tried taking it recently and had a severe attack. Cheers and thanks for your findings.

      March 14, 2015 at 12:34 am Reply

        Drinking copious amounts of water also has stopped my events overnight.

        March 14, 2015 at 12:37 am Reply
        • Thanks for your insights John.
          Would you like to join a small group of people strictly trialling the auto-immune paleo diet. There is another HLA B27 person on the trial too – no cost – just for Kiwis pref Aucklanders

          March 14, 2015 at 9:43 am Reply
          • Fazal #

            Interestng to note, thanks for your advise, can i not join the small group of people strictly trialling the auto-immune paleo diet? I just want to know how they are getting on, it will help me a great deal as i have AS

            Sorry i am not a Kiwi but a Brit! Lol

            June 11, 2015 at 8:59 pm
  20. Sunny #

    Hi julianne,

    Very informative ideas. I read through almost all comments and somehow feel I fall in similar bucket.
    I have HLA B27 positive ( auto immune problem). Doctors tried to diagnose me for AS or RA. But I donot fall in any bucket.
    However, I keep experiencing occasional swelling towards knee and goes off automatically after ~ 3 weeks.HIP Muscles stiffness is most common problem with me. Sometime, i cannot even walk with body weight on my legs and need cruches for some days.

    Doctors have done all sort of testing on blood sample trying to figure out if his is because of Arthritis. Bu I looks like, after reading over web and your posts/comments, this could be Auto Immune reaction.

    I have shifted to No- Startch diet , just one day before. I definitely need a healthy GUT and need to suppresse my auto immune reaction.

    However, Paloe and NS diet will react to sudden weight loss. My am already lean and DONOT want to loss weight, while still want to restrict my diet with No Starch and GUT free food.

    Julianne, et All,
    what ca you suggest me here ? I think I have a leaky gut and auto immune reaction that triggers this flare and stiffness.

    — Thanks Guys !

    April 12, 2015 at 11:19 am Reply
    • Best is to eat as much calorie dense food as you can manage so you don’t lose weight, protein and healthy fats. Non Starch fruits and even pure glucose / dextrose in small amounts. Try to increase muscle mass by lifting weights as you tolerate it.

      April 12, 2015 at 5:38 pm Reply
  21. Jim #

    Wow, I found out last year that I was HLA b27 pos. because I stubbed toe REALLY hard and triggered psoriatic arthritis then came the psoriasis. The arthritis part is terrible and I notice sometimes pizza or bread and pasta really hurts the next day and other times I can eat lots of it and feel great the next day. I have tried this type of dieting but it has not seemed to help. My feet are hurting so bad as well as several other places but the feet are the worst. I am going back to rhumey tomorrow to try and get put on Otezla and will attempt this dieting once more to help this condition. Achilles’ tendon also hurts bad.

    April 23, 2015 at 12:23 pm Reply
    • I’d suggest looking at the auto-immune paleo diet and follow that strictly for at least 30 days. thepaleomom.com has a lot of info on it.
      I know a couple of people with psoriatic arthritis this has worked well for.

      April 23, 2015 at 12:28 pm Reply
  22. Fazal #

    HI Thanks Julianne#

    My doctor is suggesting i go on humera because i have AS

    but i am worried, i will try the NSD but its difficult to keep up with, when do you begin to see any difference when starting the diet?


    May 22, 2015 at 11:31 pm Reply
    • You should start to see a difference pretty fast – in a few days.
      RE probiotic – I’m not sure the best one for AS sorry.

      May 24, 2015 at 3:36 pm Reply
      • Fazal #

        Thanks again Julianne, i have been on the NSD for 3 days and so far havent seen a difference, but i will stick with it!

        i have though now

        > Increased proteins including Eggs
        >Increased vegtables eg, Kale, pinappelle, spinish, cucumber

        avoided all starches

        However i have one question, can i get my energy form DEXTROSE powder?

        i have heard that is is a glucose drink but worried it contains starch, can you let me know please as i want to get my energy levels up without starch

        thanks again for your kindness


        May 26, 2015 at 7:48 pm Reply
        • Yes – dextrose is pure glucose and is good if you need more carbohydrates. It has no starch.

          June 6, 2015 at 2:38 pm Reply
  23. Fazal #

    Sorry, i had one last question, what do you think i can take to improve my stomach and gut

    a probiotic?

    May 22, 2015 at 11:33 pm Reply
    • Carol Sinclair in her book gives advice on probiotics

      June 6, 2015 at 2:39 pm Reply
  24. Barbara Crumpton #

    Hi! I have a positive HLA-B27 diagnosis with AS and a suspicion of RA. I have begun to use Humira because I have been battling Scelerits/Uvetis since January. I went to the dr this past Monday and she feels Humira is not working and would like for me to try something stronger, Remicaide. I came home and researched this no starch diet and began it immediately. My question is what vitamins should I take? How do I know if they have starch in them? Do you know of any brands that do not?

    July 24, 2015 at 12:04 am Reply
  25. Tammy #

    Julianne, I am a 36 year old female recently diagnosed with the hla b27 gene. I have been told nothing about this gene by my dr and just dont know where to turn. Is there any way you can help me?

    August 2, 2015 at 12:12 pm Reply
    • Check out the links and the book in this post – you should find what you need

      August 8, 2015 at 1:28 pm Reply
  26. Brown #

    Thank you for sharing your story with that handicap gene HLA B 27. You are saving a multitude of lives including my life. I found that I am possessed with the gene after being exposed to indoor toxic mold for a lengthy period of time. Thanks again!

    August 19, 2015 at 2:01 pm Reply
  27. fazal #

    Hi Julianne…..I have a quick question…I have AS but going on a low starch diet has reduced pain levels…However. .They measured my ESR levels and it had gone up from 10 to 21…In a year, so the consultant was concerned and said you should look at going on these biological drugs (humera) I said but my pain levels are very low but they were not really interested…ESR levels.? ..could it have been that on the day they took my blood I may have had an infection and it may have raised ESR levels?….do you have any comment you can make or advice…?…..Thanks Fazal London

    August 19, 2015 at 6:05 pm Reply
  28. Ken #

    I’ve just been through a horrendous experience with an Emergency hospital admission 6 weeks ago. One week later diagnosed with Reactive Arthritis and a blood test has confirmed I have the HLA B27 gene.
    Thanks for the above articles and follow up advise to other sufferers.
    My next mission now this RA has stabilised is to follow up with a starch free/paleo diet.
    Is the trial – for auto immune/paleo still open ? I live in Auckland. Regards Ken.

    October 3, 2015 at 10:19 am Reply
  29. Sanjib mondal #

    I have hlab – 27 positive. And I am suffering from severe pain from last 1 year. Dr told no medicine for As. Pls advise me how I will reduce my pain and stiffness
    . Thank you

    November 1, 2015 at 3:31 am Reply
  30. Isha #

    Hi Julianne,

    First of all would like to thank you for the wonderful article, I am also suffering with AS, hlab27 positive..I have too much pain in my SI joint..just saw your article..would say complete no to Starch foods…however just wanted to know that I am a pure vegetarian and do not take egg as well…i will stop taking all the starch related food but can i take chapati ( wheat flour )or not!! or what all meal i can take being a vegetarian!!

    Kindly suggest!!


    December 28, 2015 at 8:42 pm Reply
    • Any grains are starch – so unfortunately grain based chapati would not be possible. It is a more difficult programme if you are vegetarian. Eggs and dairy – cheese might be okay. Then non starch vegetables and fruit. I’d suggest read the recommended book for further information

      January 10, 2016 at 2:02 pm Reply
  31. Elly #

    Hi Julianne
    My name is Elly i live in Australia and i have been suffering from Iritis for the last 3 years. I eat pretty healthy but something is triggering my Iritis and i dont know what to do to help me decrease my attacks.
    I usually eat pretty healthy but not sure whether some food is not agreeing with me – so how do i find out what they are? should i try the Paleo diet minus the starch?
    I used to diet for my bodybuilding comps and had no sign of Iritis until i stopped. Not sure whether food is causing my disease or whether i train too hard at the gym with heavy weights?
    Any information recommendations from you would be wonderful and i thank you so much. Regards Elly

    January 13, 2016 at 5:29 pm Reply
    • A body building diet is very close to paleo / and is typically gluten free and low in starch – try changing your diet back to that – or try paleo with minimal or no starch and see what happens

      January 17, 2016 at 10:41 am Reply
  32. Jonathan #

    Hi ,I’m Jonathan and I suffer wit uveitis ,I’m Hla b27 +, my first flare up was 1 year ago ,I was 28 years old , it was worse experience of my life ,top doctor in the eye and ear hospital in Ireland said it was as bad as she seen in years ! Steroid tabs controlled it and brought a lot of relief ,but I was all over the place while taking them and really never wana take them again! It flares up here and ther in times of work load building up but not as bad as my original flare up ! I don’t really have joint pain ,just the usual stuff as I play soccer and have damaged ligaments over the years. I’m aware tho off inflammation in my body in a way of short tingly pain ,mainly wen I’m tired and I suspect wen I eat certain foods! Iv never varied my food and would be open to trying a diet that wudnt loose me to much weight as I’m thin anyway !anything u could suggest would b much appriciated ✌️✌

    February 8, 2016 at 4:27 am Reply
    • Take a look at the information in the links – like the book suggested and have a read

      February 10, 2016 at 9:43 am Reply
  33. Lynn #

    I have the Hbla -27 gene.. we found out a year ago after i ate something that was not washed or cooked properly at a local eatery and became horribly sick. I am in USA on the east coast,
    I was diagnosed with Reactive/Reiters arthritis… the arthritis affected one toe on left foot, 3 toes on right foot, 2 fingers on left hand and 1 finger on right hand… i walk with a limp, xrays show my toes have fused together…
    I do not test for RA or ESR, SED rates are all normal,
    Every doctor i have seen said they have never seen anything like me…
    My rheumy wanted me to do biologics.. i will not at this point… there has to be a way to beat this ….i did methotrexate and became very sick after 6 weeks…
    i just wish i could figure out how to get the swelling to go down… i can wear a tennis shoe but by time i get home at night after working 12 hours my ankle and toes are swollen… i take a probiotic for my stomach…. any suggestion.. and i see everyone talking about vitamin d???? how much… I am so worn out by end of day , i go home and literally go to bed… any suggestions?

    February 13, 2016 at 11:45 am Reply
    • I would suggest you try auto-immune paleo diet and use a starch free version.

      February 26, 2016 at 3:12 pm Reply
  34. RANA #

    My Esr is 24 and i have shoulder pain last two half years. so what i can do for this pls tell me

    May 20, 2016 at 10:25 pm Reply
    • Check the book mentioned in the article. Follow a paleo diet to see if it makes a difference

      May 28, 2016 at 1:46 pm Reply
  35. KARMA #

    i recently discovered i have hla b27 positive. i have been taking alot of medicines and the pain has decreased by about 90%. i have been working out and started gymming. i have been taking whey protein and other supplements. do you think it will have any bad effects on my hla b27?


    July 13, 2016 at 8:41 pm Reply
    • I really don’t know, I think people need to do careful elimination and re-introduction of foods to see what their effect is. You will need to experiment for yourself.

      July 14, 2016 at 10:23 am Reply

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