# Arthritis

Category: Conditions

Also known as: rheumatoid arthritis, osteoarthritis, joint pain

Arthritis, whether diagnosed as rheumatoid or osteoarthritis, is not a distinct disease category but a manifestation of a systemic degenerative process driven by low metabolic energy and hormonal imbalance. Ray Peat argued that he does not make a clear distinction between any…

11 passages · 1 author · 1997–2022 · Most-cited: [Ray Peat](https://bioenergeticoracle.com/md/voices/ray-peat/index.md)

Canonical page: https://bioenergeticoracle.com/concepts/arthritis

## Synthesis

**Arthritis**, whether diagnosed as rheumatoid or osteoarthritis, is not a distinct disease category but a manifestation of a systemic degenerative process driven by *low metabolic energy* and hormonal imbalance. [Source 1, 8] Ray Peat argued that he does not make a clear distinction between any kind of arthritis, or even between heart failure, atherosclerosis, and other degenerative diseases, viewing them all as consequences of inefficient energy production. [Source 1, 8] The condition is fundamentally linked to hypothyroidism, which impairs glucose utilization, increases the mobilization of fatty acids, and makes more events physiologically stressful. [Source 6] This metabolic failure creates a cascade where **endotoxin** absorbed from the intestine activates inflammatory mediators like nitric oxide and prostaglandins, while simultaneously stimulating the **aromatase** enzyme. [Source 6, 8]

The central hormonal driver of arthritic inflammation is an excess of **estrogen** relative to **progesterone**. [Source 6] Peat cited research by Cutolo showing that estrogen is produced locally at very high concentrations within the inflamed joint itself. [Source 4, 7] Estrogen structurally weakens joint tissues by binding to estrogen-sensitive receptors and contributes to a variety of inflammatory degenerative diseases, directly aggravating osteoarthritis. [Source 3] This estrogen excess is often relative rather than absolute, resulting from a failure to produce protective hormones. With aging or ovarian stress, the body's production of progesterone drops sharply while systemic estrogen production continues in peripheral tissues, creating a dangerously high estrogen-to-progesterone ratio. [Source 6] Peat observed that women whose rheumatoid arthritis began shortly after starting estrogen therapy often recovered quickly and completely upon discontinuing the drug. [Source 6, 7, 9]

Progesterone functions as the primary physiological antagonist to estrogen in this context, possessing both *anti-inflammatory and anesthetic actions*. [Source 2] Peat described cases where topical application of **progesterone** dissolved in vitamin E and olive oil resolved red, swollen, and painful joints within hours, an effect he attributed to the hormone's ability to inactivate aromatase at the site of inflammation. [Source 4] In one documented case, a plumber with x-ray evidence showing no cartilage layer left in his knees—only "rubble"—applied progesterone topically and was able to run up stairs without pain the next morning, with the recovery being so complete that he later forgot he ever had arthritis. [Source 11] Peat maintained that such recoveries represent a true cure, as restoring the balance of adaptive hormones eliminates the cause rather than merely suppressing symptoms. [Source 5] The protective steroids abundant in pregnancy, including progesterone and **pregnenolone**, can substitute for the anti-inflammatory effects of cortisone while simultaneously protecting against the toxic side-effects of excessive adrenal hormones. [Source 2, 5]

Additional therapeutic factors include the reduction of intestinal inflammation and the correction of thyroid function. Peat noted that fasting relieves rheumatoid arthritis and that a variety of bowel bacteria are involved in "autoimmune diseases," making intestinal health an integral part of hormone therapy. [Source 5] Raw carrots, by stimulating the intestine, often help lower estrogen and increase progesterone. [Source 5] **Aspirin** supports recovery by turning down estrogen production and shifting the balance toward progesterone. [Source 7] Peat also warned against dietary factors that exacerbate the condition, including the lactic acid added to some cottage cheese and the iron-rich marrow from long bones in bone broth, as excess iron is undesirable in arthritis. [Source 7] An antigenic overlap between certain gut bacteria and joint tissue may explain why some individuals react to specific foods like milk. [Source 10] Ultimately, Peat insisted that correcting the underlying **thyroid** deficiency is essential, as thyroid hormone is required to maintain blood glucose, produce carbon dioxide, and reduce the lactic acid and histamine that perpetuate the inflammatory cascade. [Source 4, 5]

## People also ask

### How does estrogen contribute to arthritis according to Peat?

Peat argued that estrogen is the central hormonal driver of arthritic inflammation, produced locally at high concentrations within the inflamed joint itself, where it weakens tissues and aggravates degeneration.

### Why did Peat recommend topical progesterone for joint pain?

Peat described progesterone as a physiological antagonist to estrogen with anti-inflammatory actions, and reported cases where topical application resolved swollen, painful joints within hours by inactivating aromatase at the site of inflammation.

### What role does thyroid function play in arthritis?

Peat insisted that correcting underlying hypothyroidism is essential because thyroid hormone maintains blood glucose, produces carbon dioxide, and reduces lactic acid and histamine that perpetuate the inflammatory cascade.

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## Cited passages

Passage numbers match the `[Source N]` markers in the synthesis above.

### Source 1 — Ask the Herb Doctor: Rheumatoid Arthritis

Ray Peat · Interview · Oct 21, 2016

> **Sarah Murray:** So you can look at osteoarthritis as just a wear-and-tear breakdown of the joint with years of use, and rheumatoid as an autoimmune condition where the body is attacking itself.
>
> **Andrew Murray:** RA is three times more common in smokers than non-smokers, and Vitamin D deficiency is more common in people with RA than in the general population. Dr. Peat, thanks so much for joining us.
>
> **Ray Peat:** Yes, thank you.

### Source 2 — From PMS to Menopause: Female Hormones in Context

Ray Peat · Book · 1997

> **Ray Peat:** According to the Physicians' Desk Reference, hormones similar to cortisone are useful for treating rheumatoid arthritis, post-traumatic osteoarthritis, synovitis of osteoarthritis, acute gouty arthritis, acute nonspecific tenosynovitis, psoriatic arthritis, ankylosing spondylitis, acute and subacute bursitis, and epicondylitis. Although cortisone supplementation can help in a great variety of stress-related diseases, no cure will take place unless the basic cause is discovered. Besides the thyroid, the other class of adaptive hormones which are often out of balance in the diseases of stress, is the group of hormones produced mainly by the gonads: the "reproductive hormones." During pregnancy these hormones serve to protect the developing baby from the stresses suffered by the mother, but the same hormones function as part to the protective anti-stress system in the non-pregnant individual, though at a lower level. Some forms of arthritis are known to improve or even to disappear during pregnancy. As mentioned above, the hormones of pregnancy can make up for a lack of adrenal cortex hormones. During a healthy pregnancy, many hormones are present in increased amounts, including the thyroid hormones. Progesterone, which is the most abundant hormone of pregnancy, has both anti-inflammatory and anesthetic actions, which would be of obvious benefit in arthritis. There are other naturally anesthetic hormones which are increased during pregnancy, including DHEA, which is being studied for its antiaging, anti-cancer, and anti-obesity effects. (One of the reasons that is frequently given for the fact that this hormone hasn't been studied more widely is that, as a natural substance, it has not been monopolized by a drug patent, and so no drug company has been willing to invest money in studying its medical uses.) These hormones also have the ability to control cell division, which would be important in forms of arthritis that involve invasive tissue growth.

### Source 3 — From PMS to Menopause: Female Hormones in Context

Ray Peat · Book · 1997

> **Ray Peat:** Studies of both animals and humans show that estrogen contributes to a variety of inflammatory degenerative diseases, and one condition known to be aggravated by estrogen is osteoarthritis. Osteoarthritis is sometimes referred to as a matter of "wear" of the joints, but estrogen's contribution seems to be that it structurally weakens the joint tissues, after binding to estrogen-sensitive receptors. This research should be kept in mind when listening to the claims about its "protecting the bones." Other studies have implicated estrogen in other types of arthritis. Several years ago it was noticed that estrogen treatment caused changes in the types and amounts of fat carried in the blood. Ordinarily, unexpected changes caused by drugs are treated as abnormalities, and bring the drug into question. But with estrogen, the situation is different: Recently, a reviewer noted that estrogen alters the triglyceride (simple fat) levels in the blood, but dismissed the change as "probably benign." In the case of cholesterol, the abnormality was interpreted as a virtue. Estrogen increased the ratio of HDL (high density lipoprotein--"good"-- cholesterol) to LDL (low density lipoprotein-"bad"--cholesterol). In other situations, a high ratio of HDL to LDL has been found to be associated with a lower incidence of heart attacks (but a higher incidence of cancer), and this single trait has been considered alone, out of context, to allow many people to claim that estrogen "protects against heart attacks," since it shifts that indicator in the direction associated with fewer heart attacks. But estrogen also does many things that are more directly associated with heart attacks: It increases the tendency to form blood clots, and it increases the tendency of blood vessels to go into spasm during stress (synergizing with adrenalin). When men were given estrogen following a heart attack, it was found to increase--rather than decrease--the risk of another heart attack.

### Source 4 — One Radio Network — Peat Ray (July 2021)

Ray Peat · Interview · Jul 19, 2021

> **Ray Peat:** I don't really know all of the things involved, but studies of knee joints, for example, with rheumatoid arthritis, an Italian named Cutolo, is his last name, has done detailed studies and found that estrogen is being produced in the arthritic joint at this very high concentration there. And I think what's happening is most likely that the progesterone is inactivating the progesterone aromatase intrinsic to the inflamed joint when you anoint the joint with progesterone vitamin E and olive oil or as a whole leg around the joint sometimes the inflammation and redness and pain will be gone within an hour or two after anointing the whole whole leg with a progesterone solution. And I think the only way it can explain such a rapid and complete effect is that it's knocking out the aromatase, which is the center of the problem. A friend of mine used, I think it was 500 milligrams applied to his whole leg. He had had a huge red inflamed joint that disabled him every afternoon for several weeks at that time. That afternoon, the joint cleared up before bedtime. Next day, he didn't have any soreness in his knee. And I knew him 40 years after that. He had never had a return of arthritis.

### Source 5 — From PMS to Menopause: Female Hormones in Context

Ray Peat · Book · 1997

> **Ray Peat:** Though she used only a small amount, an hour after she had applied it to her hands and feet, she enthusiastically reported that her ankle had stopped hurting, but after this she said she had no noticeable improvement. We often hear that "there is no cure for arthritis, because the causes are not known." If the cause is an imbalance in the normal hormones of adaptation and resistance, then eliminating the cause by restoring balance will produce a true cure. But if it is more profitable to sell powerful drugs than to sell the nutrients needed to form natural hormones (or to supplement those natural hormones) we can't expect the drug companies to spend any money investigating that sort of cure. And at present the arthritis market amounts to billions of dollars in drug sales each year. Fasting has been found to relieve rheumatoid arthritis, and there is good evidence that a variety of bowel bacteria are involved in arthritis and other "autoimmune diseases." Bacterial toxins and antigens interact with hormones and the immune systems, and intestinal health should be considered as an integral part of hormone therapy. Raw carrots, by stimulating the intestine, often help to lower estrogen and increase progesterone. One of the thyroid hormone's important functions is to improve digestion and bowel health. Rheumatoid arthritis, osteoarthritis, lupus, scleroderma, and a variety of other "autoimmune" diseases and connective tissue diseases respond well to these hormonal treatments. [references]

### Source 6 — Arthritis, Autoimmunity, & Aging

Ray Peat · Newsletter · 2016

> Women whose rheumatoid arthritis began shortly after they started using estrogen often insisted on continuing it or even increasing the doses, because they and their doctors believed the claims in the medical journals. When they could be convinced to take a vacation from the estrogen treatment, their recovery was usually quick and complete.
>
> In the 1970s, after I had learned to think of progesterone as the antagonist of estrogen, rather than as merely its complement during gestation, I suggested that some people with swollen, red, painful stiff joints try applying some progesterone topically. The first woman who tried it was in menopause, and her ratio of estrogen to progesterone was 1 to 1, many times higher than it should be. Her index finger that had looked like a stiff red sausage became flexible, painless and normal a few days after dipping it into a solution of progesterone in olive oil. Over the next ten years I saw similar immediate, complete, and permanent recoveries in a series of people who had been diagnosed with either rheumatoid or "osteoarthritis."
>
> At that time osteoarthritis was treated as a separate disease resulting from the wear and tear of aging, even though it was much more prevalent in women, and was associated with excessive estrogen. There are many reasons for an imbalance between estrogen and progesterone. With aging, the amount of aromatase in the ovaries increases (Shaw, et al., 2015), but the failure to form the progesterone-producing corpora lutea at menopause causes a sudden decrease in progesterone, leaving a relative excess of estrogen.
>
> In rats, removal of the ovaries doesn't lower estrogen (Dimitrijevic, et al., 2013; Stanojevic, et al., 2015), but it does lower progesterone. Ovaries are a minor part of the body's estrogen production, but a major part of its progesterone production. The adrenal glands, brain, and skin can produce progesterone, but the ovaries are specialized to produce large amounts of it, using the abundant cholesterol in the blood stream as its raw material. Injury to the ovaries, or systemic stress, tends to decrease the production of progesterone, while the body's production of estrogen is increased.

### Source 7 — One Radio Network: Natural Healing

Ray Peat · Interview · Apr 29, 2019

> ## Rheumatoid Arthritis
>
> **Patrick Timpone:** What would you recommend for rheumatoid arthritis? This listener eats organic, bone broths, and cottage cheese.
>
> **Ray Peat:** With cottage cheese, make sure it doesn't have added lactic acid, as that is pro-inflammatory. Regarding bone broth, the collagen—which is the main benefit—is around the knobby end bones and joints, not the long bones. The long bone contains marrow which is rich in iron, and you don't want excess iron with arthritis. I met a woman who was convinced her doctor was right to prescribe estrogen for her rheumatoid arthritis, yet she couldn't get off the couch. When she finally tried giving up her estrogen pills, she immediately recovered. Another woman with joint replacements used progesterone topically and her symptoms vanished. An Italian researcher named Cutolo has shown that estrogen is produced in the arthritic joint and the problem is to reduce the estrogen. Aspirin helps because it turns estrogen production down and progesterone up.

### Source 8 — Ask the Herb Doctor: Rheumatoid Arthritis

Ray Peat · Interview · Oct 21, 2016

> ## Estrogen, Progesterone, and Inflammation
>
> **Andrew Murray:** That's not what you want.
>
> **Ray Peat:** Rheumatoid arthritis, which tends to involve overgrowth of the bone around the joint, eventually shades over into breaking of the bones from osteoporosis. I started reading about osteoarthritis and saw studies published in books—not medical journals—making a clear association between estrogen and osteoarthritis. Even though journals consistently say osteoarthritis is caused by estrogen deficiency, looking at the research on what activates the osteoclasts that cause bone breakdown, endotoxin is a major activator.
>
> **Sarah Murray:** So that would have a role to play in both osteoarthritis as well as osteoporosis?
>
> **Ray Peat:** Yes, and in all of the degenerative diseases. Once you start having endotoxin absorbed in your system, you begin overproducing nitric oxide and prostaglandins.

### Source 9 — One Radio Network — Peat (August 2022)

Ray Peat · Interview · Aug 15, 2022

> **Patrick Timpone:** Go ahead.
>
> **Ray Peat:** Despite that, he never got another bottle, never used it again. And I saw him, oh, 10 years anyway later, still... working full-time, even though his knee was supposedly finished previously. He had totally forgotten that he ever had arthritis.
>
> **Patrick Timpone:** My goodness. So that would be an argument for a lot of people that believe, and I'm just, you know, give me some leeway here, but that believe that something's going on with their shoulder or knees or, you know, their joints are gone, that people are, you know, bone on bone or whatever. It could be a hormone issue that they don't know.
>
> **Ray Peat:** Oh, sure. Low thyroid, high estrogen are the worst things. I've known several women who were absolutely sure that if they took less menopause estrogen treatment, that they would have even worse rheumatoid arthritis. But since they were totally disabled, I finally convinced them to try it. And in a week... symptoms were gone. The red inflammation of the joint simply faded away.
>
> **Patrick Timpone:** Just by cutting out the estrogen. Wow. Wow. So that's why you've been a fan of this product that you helped develop called Progest-E. Take a little dab of that two or three times a week or whatever. You think it's beneficial for us, for most of us. I do that. I don't know what I'm doing, but I like it. So we have a fellow here, or a lady, Dr. Peat. Her name is Amy, and she's got an 87-year-old mom. who has recently been experiencing hearing loss in one ear and dizziness when standing. The doctor said it was fluid in her ear and diagnosed her with Meniere's disease. The treatment is diuretics and low-salt diet, which she already eats. Do you know what could cause Meniere's disease and would you recommend she does this treatment?

### Source 10 — Ray Peat Email Advice Depository — Post 499

Ray Peat · Email · Jun 17, 2018

> **Question:** Is my introduction of milk causing my arthritis?
>
> **Ray Peat:** Many years ago someone noticed an antigenic overlap of lactobacilli with joint tissue, and suggested that it could explain the high incidence of rheumatoid arthritis during women’s fertile years. Another person noticed an overlap of thyroglobulin with joint tissue. Maybe the milk increased the growth of that kind of bacteria. I think the already increased circulation in your thyroid means that progesterone won’t increase its activity. Have you used a little olive oil on your skin to make it easier to spread? Covering your whole leg would increase the effect on your ankle. Is there enough sugar in your diet? Have you tried breathing in a bag occasionally, to increase your CO2? [references]

### Source 11 — One Radio Network — Peat Ray (June 2022)

Ray Peat · Interview · Jun 20, 2022

> **Ray Peat:** No, but I've seen lots of annoying people who were exaggerated fans of it. Yeah, there's no doubt about that.
>
> **Patrick Timpone:** Is it possible to grow back joints that have been damaged by osteoarthritis?
>
> **Ray Peat:** Oh, yeah, definitely. I've seen it happen. probably the first one I saw supported by x-ray evidence was our plumber who was 65 and had had x-rays of his knees showed there was no whole cartilage layer left, just crumbles. And He said he was retirement age, so he was not going to have his knee joints replaced. But I gave him a bottle of Progest-E, which he, while working on the bathroom plumbing, applied it all over his worst knee and went on working. And an hour later, I managed that he seemed to be having less trouble coming up the steps from his truck. And he said, yeah, he thought he was. But the next morning, he knocked on the door and said, I just wanted to show you this. And he ran down the steps and back up. Oh, no kidding. about a year later he had said that he and his wife both needed aspirin to get through the night and he said that night was their first time in years that they hadn't needed aspirin but then several months later I hadn't heard from him again I phoned his office. His wife answered. I said, I just wanted to find out about his knees. And there was a long pause. And he said, oh, that's right, he did have that knee. And then I guess it was about 10 years later, I kept seeing his truck around town and got him for another job and asked him how his knee had turned out. He had totally forgotten that he ever had a knee problem.

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