Experiencing painful ears, nose, eyes, or joints?
Wondering if it’s Relapsing Polychondritis? Interested in available treatments?
Understanding Relapsing Polychondritis: Causes, Symptoms, and Treatment Options
What Is Relapsing Polychondritis?
Relapsing polychondritis (RP) is a rare autoimmune disorder with an unknown cause, affecting 0.71 to 3.5 people per million each year. This condition leads to repeated episodes of inflammation in the body’s cartilage, affecting areas like the ears, nose, larynx, trachea, eyes, joints, kidneys, or even the heart. RP can cause debilitating changes to appearance and functionality, leading to “cauliflower” ears, saddle-nose, and in severe cases, damage to eyesight, hearing, and respiratory health. RP occurs equally in men and women across racial backgrounds, with a slightly higher prevalence among women.
The onset of RP typically occurs between ages 40 and 50 but can appear at any age. Many people with autoimmune diseases are at risk of developing other autoimmune conditions, and up to 30% of RP cases occur alongside other connective tissue disorders, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and Sjögren’s syndrome.
Due to its remitting, variable nature and non-specific early symptoms (such as fever, weight loss, night sweats, fatigue, and lymph node swelling), RP often goes undiagnosed for years—on average, about 2.9 years. [1,2]
Diagnosing Relapsing Polychondritis
There is no specific blood test for RP; diagnosis is based on clinical signs and may involve biopsies or imaging. For an RP diagnosis, patients typically meet at least three of the following six criteria:
Recurrent chondritis of both ears (up to 90% of cases)
Nonerosive inflammatory arthritis (50–85%)
Chondritis of nasal cartilage (53%)
Inflammation in ocular structures (50–60%)
Respiratory tract chondritis (laryngeal, tracheal cartilage)
Cochlear or vestibular damage, such as hearing loss or vertigo
Treatment Options for Relapsing Polychondritis
Because of the rarity of RP, there is no one-size-fits-all treatment plan, and options depend on symptom severity.
Medication-Based Treatments for Relapsing Polychondritis
For mild cases, doctors may prescribe glucocorticoids (e.g., prednisone) or dapsone. More severe cases might require immunosuppressants, such as methotrexate or cyclophosphamide. Some patients may also receive biologic drugs (medications that target the immune response) like Infliximab (a TNF inhibitor). Other biologics like adalimumab, etanercept, abatacept, tocilizumab have been tried with variable results. The use of rituximab for RP was unsuccessful. [3] However, drugs primarily mask symptoms without addressing underlying causes, and they often have side effects, including blurred vision, irregular heartbeats, and breathing issues.
Surgical Options
In cases of airway collapse, procedures like airway stenting, dilation, tracheostomy, or reconstruction may be necessary.
The Root Causes of Relapsing Polychondritis
The exact cause of RP remains unknown, but studies suggest genetic predisposition combined with environmental factors—especially diet—may trigger autoimmune conditions. While RP-specific dietary studies are limited, diet and lifestyle changes have been shown to improve other autoimmune conditions. Here’s how RP might develop:
Genetic predisposition sets the stage.
Environmental factors cause barrier permeability (such as leaky gut), allowing particles to enter the bloodstream and trigger an immune response.
The immune system starts attacking these “invaders,” which may resemble cartilage or other tissues, leading to “molecular mimicry”—a process where the immune system mistakenly attacks the body’s own tissues.
Healing Through Diet and Lifestyle
Research supports that genes alone don’t cause autoimmunity; environmental factors often “pull the trigger.” By addressing gut health and minimizing exposure to inflammatory foods and substances, we can reduce the likelihood of autoimmune flare-ups.
If you look up the term Relapsing Polychondritis (RP) in the National Library of Medicine, the largest medical library in the world, you will find close to 2,000 studies. None of them offers much hope or mentions a connection between RP and food. And yet, food might be the key to solving this medical mystery.
The Anti-Inflammatory Diet for Relapsing Polychondritis and other autoimmune diseases
Following a whole food, plant-based diet has shown promise in managing symptoms of inflammatory diseases.
No processed foods, animal products, dairy, oil, or gluten (try a gluten-free approach while healing the gut) with the addition of vitamin B12.
High fiber, high-raw, plant-based meals, rich in antioxidants.
Avoidance of alcohol.
An elimination diet may help pinpoint flare-triggering foods, while a supervised water-only fast can reset immune and gut health.
Additional Considerations include:
Regular routines, adequate sleep, no smoking, physical activity, sun exposure, and probiotics, especially strains like Lactobacillus rhamnosus. [4]
Stress management techniques like yoga, meditation, and mindfulness.
Avoiding piercings (see a case study of severe RP induced by ear piercing). [5]
Avoiding other environmental triggers (toxins, mold, GMOs, pesticides, viruses, bacteria, fungi, food additives, plastics).
Getting regular exercise and fostering positive relationships all support healing.
Avoiding antibiotics, and other medications that cause inflammation.
Avoiding unnecessary vaccines, including the Covid vaccine [6,7,8,9].
Avoiding triggers, including inflammatory foods and stress, is crucial in managing symptoms and achieving long-term health.
Scientific Support for the Diet Approach
Several studies support the benefits of a plant-based, gluten-free diet for autoimmune conditions: [10,11,12,13,14,15,16,17,18,19,20,21,22,23]
A plant-based diet can reduce inflammation, joint swelling, BMI, and improve gut health.
A very low-fat, vegan diet may improve symptoms in patients with autoimmune arthritis.
A raw vegan diet high in antioxidants and fiber has been shown to reduce joint stiffness and pain.
Herbal remedies that lower inflammation such as turmeric, ginger and cinnamon are useful adjuvants, however it is the overall dietary pattern that will make a change.
Conclusions
While we can’t change our genes, adopting a whole food, high-fiber, vegan, gluten-free diet has the potential to improve gut health and manage autoimmune symptoms. This approach may help by:
Improving gut health, which in turn calms the immune system.
Minimizing inflammatory triggers from both diet and environment.
Strengthening overall resilience through healthy lifestyle practices.
Other strategies, like maintaining a positive outlook, staying active, prioritizing quality sleep, and managing stress, can support health and are often beneficial to those with autoimmune diseases.
Having experienced an autoimmune diagnosis, I empathize deeply with those affected and am dedicated to helping others find relief. If you’re ready to take control of your health, adopting these changes may lead to fewer flare-ups, improved symptoms, and an overall healthier life.
If you give me the privilege to guide you on your way to recovery,
I will be happy to assist you.
Resources: [1] Borgia F, Giuffrida R, Guarneri F, et al. “Relapsing Polychondritis: An Updated Review.” Biomedicines. 2018 Sep; 6(3): 84. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6164217/ [2] Chauhan K, Surmachevska N; Hanna A. “Relapsing Polychondritis.” StatPearls Publishing; 2020 Jan [3] Alqanatish JT, Alfarhan BA, Qubaiban SM. “Limited auricular relapsing polychondritis in a child treated successfully with infliximab.” BMJ Case Rep. 2019; 12(5): e227043. [4] Martín R, Chamignon C , Mhedbi-Hajri N et al. “The potential probiotic Lactobacillus rhamnosus CNCM I-3690 strain protects the intestinal barrier by stimulating both mucus production and cytoprotective response.” Sci Rep. 2019; 9: 5398. [5] Serratrice J, Ené N, Granel B et al. “Severe Relapsing Polychondritis Occurring After Ear Piercing.” J Rheumatol. 2003 Dec;30(12):2716-7. [6] Seida I, Alrais M, Seida R, et al. Autoimmune/inflammatory syndrome induced by adjuvants (ASIA): past, present, and future implications. Clin Exp Immunol. 2023;213(1):87-101. doi:10.1093/cei/uxad033
[8] Buchan SA, Seo CY, Johnson C, et al. Epidemiology of Myocarditis and Pericarditis Following mRNA Vaccination by Vaccine Product, Schedule, and Interdose Interval Among Adolescents and Adults in Ontario, Canada. JAMA Netw Open. 2022;5(6):e2218505. Published 2022 Jun 1. doi:10.1001/jamanetworkopen.2022.18505
[9] Vojdani A, Kharrazian D. Potential antigenic cross-reactivity between SARS-CoV-2 and human tissue with a possible link to an increase in autoimmune diseases. Clin Immunol. 2020;217:108480. doi:10.1016/j.clim.2020.108480
[10] Barbaresko J, Koch M, Schulze MB et al. “Dietary pattern analysis and biomarkers of low-grade inflammation: a systematic literature review.” Nutr Rev. 2013 Aug;71(8):511-27. [11] Alwarith J, Kahleova H, Rembert E, et al. “Nutrition interventions in rheumatoid arthritis: The potential use of plant-based diets. A review.” Front Nutr. Published online September 10, 2019 [12] HafströmI, Ringertz B, Spångberg A. “A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens.” Rheumatology (Oxford). 2001 Oct;40(10):1175-9. [13] McDougallJ, Bruce B, Spiller G et al. “Effects of a very low-fat, vegan diet in subjects with rheumatoid arthritis.” J Altern Complement Med. 2002 Feb;8(1):71-5. [14] Hänninen, Kaartinen K, Rauma AL, et al. “Antioxidants in vegan diet and rheumatic disorders.” Toxicology. 2000;155:45-53. [15] Müller H, de Toledo FW, Resch KL. “Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systematic review.” Scand J Rheumatol. 2001;30:1-10. [16] Lithell H, Bruce A, Gustafsson IB, et al. “A fasting and vegetarian diet treatment trial on chronic inflammatory disorders.” Acta Derm Venereol. 1983;63:397-403. [17] Kjeldsen-KraghJ, Haugen M, Borchgrevink CF, et al. “Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis.” Lancet. 1991 Oct 12;338(8772):899-902. [18] PeltonenR, Kjeldsen-Kragh J, Haugen M, et al. “Changes of faecal flora in rheumatoid arthritis during fasting and one-year vegetarian diet.” Br J Rheumatol. 1994 Jul;33(7):638-43. [19] Goldner B. “Six Week Raw Vegan Nutrition Protocol Rapidly Reverses Lupus Nephritis: A Case Series.” International Journal Of Disease Reversal And Prevention. Vol 1 No 1 (2019) [20] Gershteyn IM, M.R.Ferreira LMR. “Immunodietica: A data-driven approach to investigate interactions between diet and autoimmune disorders.” Journal of Translational Autoimmunity. Volume 1, April. [21] B. Chandran, A. Goel. “A randomized, pilot study to assess the efficacy and safety of curcumin in patients with active rheumatoid arthritis.” Phytother Res. 2012 26(11):1719 – 1725. [22] Aryaeian N, Mahdi Mahmoudi M, Shahram F et al. “The effect of ginger supplementation on IL2, TNFα, and IL1β cytokines gene expression levels in patients with active rheumatoid arthritis: A randomized controlled trial.” Med J Islam Repub Iran. 2019 Dec 27;33:154. [23] Shishehbor F, Safar MR, Rajaei E et al. “Cinnamon Consumption Improves Clinical Symptoms and Inflammatory Markers in Women With Rheumatoid Arthritis.” J Am Coll Nutr. 2018 May 3;1-6.