Precision Lifestyle Rx: Dr. Diana Girnita’s Insights on Rheumatoid Arthritis from the Hormones & Hopes Podcast
The recent episode of the Hormones & Hopes podcast, hosted by Dr. Chhaya Makhija, featured Dr. Diana Girnita—a leading rheumatologist and founder of Rheumatologist On Call. The conversation offered a blend of scientific clarity and practical wisdom, focusing on the realities of rheumatoid arthritis (RA) and the transformative power of lifestyle choices.
Rheumatoid Arthritis: More Than a Joint Disease
Dr. Girnita began by addressing a common misconception:
“That’s false. Rheumatoid arthritis is a systemic disease. Systemic means that it can affect many other organs, and it does affect the eyes, it can affect the brain, it can affect the heart, it can affect the lungs, and it can affect the skin and even the kidneys”.
Dr. Diana Girnita—a leading rheumatologist and founder of Rheumatologist On Call.
She emphasized that untreated RA is not just a matter of joint pain. The disease can increase cardiovascular risk dramatically over a decade, making early and comprehensive treatment essential:
“If you don’t care about your joints, you should care about your heart because the heart will also be affected and the cardiovascular risk. If you don’t treat rheumatoid arthritis, it’s increasing to two times or three times or four times in 0 years of disease” .
The Power of Movement: “Motion is Lotion”
Physical activity emerged as a cornerstone of Dr. Girnita’s advice. She challenged the myth that people with RA must avoid exercise:
“That’s a misconception. I actually encourage all my patients to remain active and to incorporate any sort of exercise, anything that will bring them pleasure and will keep those joints moving. I actually tell them that motion is lotion. So if they continue to walk or swim or dance, they will maintain the function of the joints. They will preserve the strength of their joints. So 100% I encourage everyone with arthritis, any type of arthritis, to keep moving” .
Medication and Lifestyle: A Balanced Approach
Dr. Girnita described her experience with thousands of RA patients over 5 years, observing that those who integrated lifestyle changes with medication often achieved better outcomes:
“I did notice that those people that were incorporating certain things in their lifestyle will do much better on medication than others, and in many cases, we were able to taper down medication and even stop some of the medication” .
However, she cautioned against stopping medication without medical supervision:
“I have seen patients that will decrease the doses of medication and I have seen patients that they stop the medication. However, I don’t encourage anyone to stop it without talking to their physician... there is more and more data coming out... people that were stable on certain medications, like biologic medications... once they were stable, after a while, they are able to taper down and get rid of the medication. We’re just scratching the surface to figure out which are those people, what differentiates them, but it is possible to stop the medication at some point” .
Lifestyle Rx: Food, Mindset, and Sleep
Dr. Girnita’s “Precision Lifestyle Rx” is built on three pillars: nutrition, mindset, and sleep.
Nutrition:
“What you eat is going to impact how you feel. If we have to restrict our huge knowledge about foods into a couple of categories, the things that I would remove first will be anything that has added sugar... Then the second thing, I would try to remove gluten, but not all the patients will be sensitive to gluten, but many will... The other thing is that it’s also important to remove processed foods. Anything that is processed, anything that is in a box, it’s clearly not natural” .
She encourages patients to shop for foods without labels and multiple ingredients, focusing on legumes, vegetables, and fruits.
Mindset:
“If you have that perspective that everything is dark, this is done, you are sentenced to a very chronic disease or autoimmune disease... you put a lot of stress on your mind, a lot of stress on your body, and also your mind is connected to your body” .
She recommends practical shifts, such as gratitude journaling:
“Write three things that you are grateful for every single day. That changes the mindset. Stop complaining. Finding solutions instead of complaining about your problems. That brings you to the next level of changing the mindset” .
Breathwork and pain assessment are also part of her coaching, helping patients manage anxiety and depression linked to chronic pain.
Sleep:
“I did not understand how powerful sleep is until patients will tell me, you know, I had a rough night and the next morning I felt horrible. My joints were hurting... when I read about the science of sleep, I started to understand how sleep is connected with more inflammation” .
Personalized, Stepwise Change
Dr. Girnita stresses that every patient is unique:
“Every single patient is different. So what works for some people might not work for others... If I give a patient a list of 0 things to do, they will not do it. Or they will do it for a week, two weeks, three weeks, and then they will stop because it’s too hard. Changing habits, I think is the hardest thing that we can do” .
Her approach involves gradual changes, reintroducing foods to identify triggers, and coaching patients step by step.
Medication: Science and Shared Decision-Making
Dr. Girnita advocates for a partnership between patient and physician:
“The book unites the two worlds. As I begin the conversation, I tell patients that one world should not exclude the other one. They should complement each other because there is a lot of value in science and the scientific evidence is there that certain drugs that we have today, they really change the history of rheumatoid arthritis” .
She reassures patients about medication safety:
“The majority of my patients do not have side effects... usually those patients that do not have side effects, they don’t go on the Internet to complain that their disease is doing great... But I don’t want everybody else to take that experience and think, that is going to happen to me. Because the big chunk of population or the big numbers of population that are on these medications are not experiencing side effects” .
Patients are invited to participate in decisions:
“I let my patients choose together with me what I think will be best for them. I’m there to tell them what I think is best for them. But ultimately, I let my patients to decide what they want to try”.
Conclusion: Hope and Practical Tools
Dr. Diana Girnita’s appearance on the Hormones & Hopes podcast highlighted the importance of integrating science with lifestyle, offering hope and actionable strategies for those affected by RA. Her message is clear: small, consistent changes in nutrition, movement, mindset, and sleep—combined with evidence-based medical care—can transform the experience of living with rheumatoid arthritis
Watch the entire interview here
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