This is perhaps the most dramatic autoimmune experiment I’ve conducted to date.
We’re moving to the Great Karoo in South Africa for 3 months.
As you probably know by now I have ankylosing spondylitis, an autoimmune disease that affects the spine and large joints in the body.
It can also present a range of other symptoms and co-morbidities. These vary between individuals but can include skin problems, bowel trouble and fatigue and more.
I now manage my autoimmune condition entirely through diet – very successfully – but certain environmental factors do seem to have an impact on my overall health.
You can see just how profound the effect diet has had on my symptoms here.
However, with that said, I don’t always feel as good as I could.
What I call my ‘edge’ symptoms, such as dry skin, sinuses, cough, stiffness and general energy levels and brain fog, always appear elevated with the changing of the seasons.
Particularly colder, wetter, darker periods in the UK.
Here comes the inspiration for this experiment.
I noticed that when my partner and I travelled to certain, very specific, environments these edge symptoms, and my overall AS, seemed to vanish completely.
Diet beats the pain and the ‘flares’, but this change in environment took it to another level entirely.
No stiffness, no dry skin, no aches, no cough, no runny nose, nothing.
I experienced elevated mood, an abundance of energy, clearer thinking and just felt ‘normal’. Better than normal.
My joints felt supple. I could walk for longer. I felt like I could jump around like a happy gazelle.
I regularly keeps a diary and takes notes.
I have also, for extended periods, kept a borderline obsessive spreadsheet tracking my AS symptoms, diet and all sorts of metrics related to environment and lifestyle.
I do this to stay on top of things and keep improving my health outcomes (there’s no greater reward than feeling pain free!)
I also do this because I want to feel as confident, as is reasonably possible, that when I share information with you here that it’s from a good bedrock of research, personal experience and detailed record taking.
In my adult life there are two places in the world I’ve visited where I felt completely, utterly pain and symptom free.
Those places were large parts of Namibia (much of the country outside of the Northern regions and the Caprivi Strip) and a place called Mendoza in Argentina.
The effect was SO profound that I journalled about it frequently. It fascinated me.
What was it about these areas that seemed to ‘vanish’ my autoimmune disease symptoms?
My instinct was that it was the dry heat and lack of humidity,
It turns out this is a key part of the equation but my research led me down all sorts of interesting rabbit holes…
If you’re interested, I’ve published a podcast about this research as well as a written version.
I’ll summarise some of the key findings here.
These are from various studies on the effects of weather and the environment for people with arthritis (specifically rheumatoid arthritis, of which ankylosing spondylitis is a form).
✔️ Lower humidity is linked to a decrease in pain and stiffness
✔️ Higher atmospheric pressure is linked to a decrease in pain
✔️ Warmer temperatures are sometimes associated with decreased joint pain, especially in older patients
✔️ Higher wind speeds can lead to increased pain levels for people with arthritis
Let’s unpack some of those points.
Low humidity just means dry, rather than wet, climates.
Rainforests would be the most humid extreme, deserts would be the least humid.
This tallies with my findings in both Mendoza (effectively a desert region in Argentina) and the large parts of Namibia which straddle the great Namib desert or the Kalahari.
Atmospheric pressure is perhaps a less familiar term for most of us.
Low atmospheric pressure means unsettled weather. Think storms and drama. Hurricanes and typhoons at the extreme end but also everyday rain and windy conditions.
The UK, a windy and rainy island, is effectively a low atmospheric pressure hot spot, especially during winter.
Typically, you’ll find higher atmospheric pressure, which is what we want, at lower altitudes.
The higher up you go, the lower the atmospheric pressure gets.
If you’ve found, like I have, your autoimmune symptoms increase when you’ve been climbing (we enjoy trekking up mountains), this could explain why.
I’ve even heard of a patient whose autoimmune disease first ‘triggered’ after summiting Kilimanjaro.
Lastly we come to temperature.
The evidence here is less conclusive but it seems for some people – in some studies – that warm weather can ease symptoms.
This is a slightly trickier one to measure and there is conflicting evidence here. Even in the ‘warm weather is good for arthritis’ findings it’s worth taking into account whether the positive findings in part relate to improved mood (people tend to be happier in the sun).
So what are the ideal conditions?
Broadly speaking they are:
✔️ Dry conditions (not too much moisture in the air)
✔️ Settled weather (no storms and little rain or wind)
✔️ Low altitude (closer to sea level)
✔️ Warm weather and plenty of sun
I’m keeping the last one in because I think that regardless of the slightly inconclusive results, heat can be helpful for people with arthritis.
Many people, myself included, swear by sauna for example and we know that increased levels of vitamin D (from the sun) is great for people with autoimmune disease.
So that leads us back to our Great Karoo experiment.
Why I’m conducting this experiment in The Great Karoo
I spent several hours researching and pinpointing areas of the globe which fitted the criteria above.
Hot, dry, arid conditions: low altitude, settled weather.
There are actually a lot of areas which fit this criteria but we also had a few personal elements we wanted to add, namely:
As close as possible to the UK’s timezone (GMT) so that we could work our jobs remotely without too much disruption. Somewhere with an affordable cost of living. Somewhere we wanted to visit (a big one!).
Finally, somewhere which we felt would be low stress and had a sense of community. (We live in London and didn’t want to replace one jostling, stressful city with another).
I came up with a list of 22 countries in total and many regions within those countries that fit the climate criteria. I then whittled these down further with the personal criteria I just outlined.
The 4 front runners were Portugal, Sardinia, Sicily and South Africa.
Given that both my partner and I are obsessed with subsaharan Africa (the people and its landscapes) and given that we wanted to be away during some of the coldest wettest months in the UK (January to March), South Africa made sense.
Places like Portugal would be great but January, like in the UK, is winter there. South Africa is in the Southern Hemisphere and so it would be summer.
Where in South Africa?
I pinpointed a few areas, but we found a little town called Prince Albert in the Great Karoo which ticked almost all of the boxes.
Dry, hot, arid climate. Settled weather. A friendly community and a safe environment. Great access to fresh food suitable for the diet I follow and most importantly somewhere we were excited to visit.
A place of big skies and changing landscapes.
The only box it didn’t quite tick is altitude. The Great Karoo is not a particularly low altitude region.
Where we planned to stay – a town called Prince Albert – was around 635m above sea level. However, I didn’t see this as a red flag. Mendoza, where I experienced some of my best symptom relief, is around 746m above sea level.
So that is the Great Karoo experiment.
There is a lot to unpack and hopefully there will be interesting discoveries along the way which I can share with you.
I plan to make this a series of articles where, for example, I discuss things like:
✔️ My initial early findings
✔️ What seems to be helping (and what doesn’t)
✔️ How I navigate the diet out here
✔️ Anything else that seems relevant
Thank you for reading. Please feel free to share your thoughts, your own experiences, and any questions in the comments below.
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