What to eat when you have giant cell arteritis?

Horton’s disease also known by the scientific name ofgiant cell arteritis (GCA) is a vascularity of the large trunks which mainly affects elderly subjects. In other words: a inflammation of the artery wall (vessels that carry blood from the heart to the organs).

According to the Orphanet Encyclopedia (source 1), “it is most likely a disease linked to autoimmune mechanismsthat is to say, a disruption of the body’s defense system (the immune system) (…) even if we do not yet know why the immune defenses become disrupted, several factors (environmental, infectious and genetic) are probably involved.

The most common symptoms of Horton’s disease may include:

• ” of the headache unusual at the temples (called temporal headaches) » notes Fai2r, the health sector for rare autoimmune and autoinflammatory diseases (source 2).
• a pain when chewing (jaw claudication).
• a temporal artery that is painful to palpation and visually inflamed.
• a hypersensitivity of the scalp (also called the comb sign because the scalp is so sensitive that combing your hair becomes painful).
• of the visual symptoms, eye disorders recent and sudden onset, such as a drop in visual acuity in one or both eyes, or double vision (diplopia).
• fever.
• joint pain in the shoulders and hips (we will talk about pseudopolyarthritis rhizomelic, also named PPR an associated disease in half of cases of Horton’s disease).
• ” a aortitis (inflammation of the aorta), visible only with imaging tests (scan or MRI for example)” (source 2).

According to figures provided by Orphanet, an information portal dedicated to rare diseases and orphan drugs with open access to all audiences, “Giant arteritis usually affects people over 50 years oldwith a peak frequency around 75-80 years of age” (source 1). However, rare cases of people developing the disease around the age of 40 have been reported.

“To date, there is no no direct link between what it would be recommended to eat to prevent or at least promote the development of this disease,” says Dr. Clavel-Refregiers, rheumatologist. On the other hand, diet can help on the side effects of treating Horton’s disease (treatment with high doses of corticosteroids). And among these side effects we can cite: diabetes, high blood pressure, weight gain, sleep disorders, mood disorders, osteoporosis, etc.

The doctor also recalls the importance of having A balanced diet, especially since we are dealing with a type of patient who is already fragile, with a risk of falling and bone fractures linked in particular to osteoporosis.

“The great classic: limit your consumption of salty products based on sodium chloride (NaCI)” warns Dr. Clavel-Refregiers. Industrial preparations, cold meats, certain cheeses that are naturally too salty (Pecorino, Edam, etc.) should be avoided, for example, “without falling into the rigidity of a diet that could, on the contrary, promote malnutrition given that we are dealing with patients who are already malnourished.

As for table salt, it is quite possible to use it in cooking. “It is the re-salting on the plate that should be avoided, however,” qualifies the rheumatology specialist. Also note: salts based on potassium chloride commonly called diet salts not forgetting spices are potential alternatives to enhance the taste of recipes without compromising the proper functioning of the body.

Foods high in fast sugars should also be reduced. This includes hot and cold sugary drinks including energy drinks, carbonated drinks, fruit drinks, fruit juices, pastries and desserts.

“We will also tend to recommend to patients a vitamin-calcium supplementation to cover some of their insufficient calcium or vitamin D intake,” continues Dr. Clavel-Refregiers.

Still in line with this recommendation, adopt a regular and moderate physical activity will also be important in particular for strengthening joints and bones.

“Given that to limit certain side effects caused by corticosteroid therapy such as hypertension, it will be preferable to limit its consumption of bread, rich in salt. » It is also important to “be aware of how we eat it,” says the rheumatologist. Eating a slice of bread to accompany your meal or consuming it several times a day by spreading it with semi-salted butter and/or cheese, for example, will not have the same impact on health.

Hydration is an essential pillar of the proper functioning of the body. In the case of Horton’s disease, which requires a low-salt diet, wewill imitate his consumption of sparkling water in favor of less salty still water (16.3 mg/100 g of sodium compared to 5.02 mg/100 g) (source 3).

“Due to a calcium deficiency They will also be recommended a mineral water rich in calcium such as Hépar or Courmayeur. This will be even more the case if they are reluctant to consume dairy products or certain oily fish (Editor’s note: sardines, salmon, etc.)”, adds Dr. Clavel-Refregiers.

“The consumption of alcohol in medicine is never recommended, but here too it is common sense, without being formally contraindicated,” notes Dr. Clavel-Refregiers. Basically, it is up to each individual to find their way, provided of course that they follow the usual moderation advice.

“No, even if we are starting to have biotherapy treatments whose tolerance in patients is much better than that of corticosteroids (in particular to avoid the side effects linked to them: mood disorders, diabetes, etc.)”, explains Dr. Clavel-Refregiers. Today it is mainly and Tocilizumab. And more are expected to arrive in the coming years.

At the end of the day : it is not so much Horton’s disease itself that can be treated with a specific diet but more the side effects that result from it. Also note: although the patient has regular monitoring with his rheumatologist, who is responsible in particular for readjusting his nutritional needs, the patient can also benefit from more specific support with a nutritionist.