Case Series

Remission of palindromic rheumatism through ketogenic and carnivore diets: A case report

Eric C. Westman, Jessica Fischer, Amy Berger
Journal of Metabolic Health | Vol 9, No 1 | a123 | DOI: https://doi.org/10.4102/jmh.v9i1.123 | © 2026 Eric C. Westman, Jessica Fischer, Amy Berger | This work is licensed under CC Attribution 4.0
Submitted: 09 September 2025 | Published: 28 April 2026

About the author(s)

Eric C. Westman, Department of Internal Medicine, School of Medicine, Duke University, Durham, North Carolina, United States
Jessica Fischer, Medical University of South Carolina, Charleston, South Carolina, United States
Amy Berger, Independent Researcher, Staunton, Virginia, United States

Abstract

The low-carbohydrate ketogenic diet (LCKD), developed a century ago to treat epilepsy, is now commonly used as a therapeutic intervention for obesity, type 2 diabetes and other conditions associated with insulin resistance. A growing body of literature supports the use of LCKDs for conditions associated with autoimmunity and inflammation. Here we present the case report of a 61-year-old man diagnosed with palindromic rheumatism (PR) – often a precursor to rheumatoid arthritis – whose condition was considered to be in remission after he adopted an LCKD and subsequently transitioned to an even lower-carbohydrate ‘carnivore’ diet. The patient was able to discontinue all arthritis-related medications, and currently, 7 years after initially starting the LCKD, he continues to follow a carnivore diet and reports no daily pain while remaining active in endeavours that require manual dexterity, such as woodworking and playing the guitar. Through anti-inflammatory effects and the removal of dietary irritants, dietary carbohydrate restriction may have potential therapeutic benefits for PR, a condition for which effective treatments and disease-modifying strategies remain elusive.

Keywords

palindromic rheumatism; rheumatoid arthritis; ketogenic diet; carnivore diet; low-carbohydrate diet; autoimmune disease; anti-inflammatory diet; case report

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