Ankylosing Spondylitis

Question 1

Ankylosing Spondylitis

Answer 1

Axial Spondyloarthritis in an umbrella term for types of chronic inflammatory arthritis primarily affecting the spine and sacroiliac joints (SIJs). It includes ‘non radiographic axial spondyloarthritis ’ (no x ray findings)
and ankylosing spondylitis’
* AS commonly begins between 20 and 30 years of age, and has a male to female ratio of ~ 3:1.
* This is a common AI condition that is certainly under diagnosed.

Question 2

Ankylosing Spondylitis: Signs and symptoms

Answer 2

• Chronic back pain and stiffness (especially in mornings, > 30 minutes). Often improves with movement. Typically starts as sacroilliac joint pain.
• Peripheral enthesitis (e.g., Achilles tendonitis, plantar fasciitis) and arthritis.
• Extra articular manifestations: Uveitis (~25%), psoriasis (~10%), IBD (~6.5%).
• Systemic symptoms (e.g., fever, fatigue).
• In advanced stages, a loss of lumbar lordosis and an exaggerated thoracic kyphosis.

Question 3

Ankylosing Spondylitis: Causes and risk factors

Answer 3

• Genetics: HLA- B27 over 90%
• Biomechanical stress
• Microbial cross-reactively
• GI inflammation: IBD
• Gut dysbiosis: Klebsiella
• Intestinal permeability: Zonulin, LPS

Question 4

Ankylosing Spondylitis: Natural approach

Answer 4

• CNM Naturopathic Diet; dairy exclusion
• ‘low starch diet’: dysbiosis
• Fasting: reduce inflammatory cytokines)
• Restore gut health - 5R

Question 5

Ankylosing Spondylitis: Supplements

Answer 5

Vitamin D
Resveratrol
Omega-3
Devil’s Claw
Turmeric
Ginger
Boswellia

Question 6

Ankylosing Spondylitis: Vitamin D

Answer 6

Increases T-reg activity
Suppresses Th17 and Th1

Question 7

Ankylosing Spondylitis: Resveratrol

Answer 7

Reduces Th17
Downregulates NFkB and Cox2