---
title: "Osteoarthritis and the Gut Microbiome: Is There a Link?"
description: Osteoarthritis affects more than 60 percent of older adults and may be linked to gut microbiome imbalances that certain probiotics could help address.
image: https://www.casi.org/hubfs/casi/archive/tuesblog_13.jpg
---

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# Osteoarthritis and the Gut Microbiome: Is There a Link?

CA Cory Ambrose, ND, MAT Jul 12, 2022

![Osteoarthritis and the Gut Microbiome: Is There a Link?](https://www.casi.org/hs-fs/hubfs/casi/archive/tuesblog_13.jpg?width=960)

Osteoarthritis (OA) is a joint disease associated with factors related to age, the inflammatory response, metabolic changes, and [oxidative stress](https://pubmed.ncbi.nlm.nih.gov/34925695/). It affects more than 60% of [older individuals](https://pubmed.ncbi.nlm.nih.gov/34925695/) and has become a growing economic burden at both individual and societal levels. Recent research has explored the potential link between OA, nutrition, and the gut microbiome.

The full etiology of OA remains unclear; however, a review by [Tan and colleagues](https://pubmed.ncbi.nlm.nih.gov/33961348/) investigates the potential connection between the gut microbiome and bone health. The authors describe a potential link between the gut microbiome and pathogenesis of OA. Risk factors for OA, such as metabolic syndrome and other chronic diseases, have been linked in research with the [gut microbiome](https://pubmed.ncbi.nlm.nih.gov/33961348/). Imbalances in the gut microbiome may be related to age, diet, and certain diseases. These imbalances may contribute to the [pathogenesis of OA](https://pubmed.ncbi.nlm.nih.gov/33961348/) through certain biochemical pathways.

Cartilage has been shown to contain [microbial DNA](https://pubmed.ncbi.nlm.nih.gov/33961348/). Animal studies have sampled cartilage from OA-susceptible mice and compared it to OA-resistant mice. These studies found that the cartilage samples differed in [microbial signatures](https://pubmed.ncbi.nlm.nih.gov/33961348/). Human studies have also shown differences in [cartilage microbial DNA](https://pubmed.ncbi.nlm.nih.gov/33961348/) signatures between individuals with OA and controls. One animal study showed a negative association between [knee joint damage](https://pubmed.ncbi.nlm.nih.gov/33961348/) and the presence of *Bacteroides*, *Bifidobacterium*, and *Roseburia*. A positive association was observed between knee joint damage, increased blood endotoxin levels, and the presence of *Clostridium leptum*, *Akkermansia muciniphila*, and *Faecalibacterium prausnitzii*.

An [animal study](https://pubmed.ncbi.nlm.nih.gov/33961348/) compared controls to antibiotic-treated mice and lipopolysaccharide (LPS)-treated mice. LPS is a molecule that induces an inflammatory response. In the LPS-treated mice, increased levels of pro-inflammatory macrophages and [articular cartilage structural damage](https://pubmed.ncbi.nlm.nih.gov/33961348/) were observed.

The administration of certain probiotics, including *Lactobacillus casei (L. casei)* and *L. acidophilus*, was shown in some animal studies to help support [cartilage integrity](https://pubmed.ncbi.nlm.nih.gov/33961348/) and help attenuate pro-inflammatory cytokine responses in synovial fluid. Another study involving the administration of [*Bifidobacterium longum*](https://pubmed.ncbi.nlm.nih.gov/33961348/) showed decreases in cartilage degradation and increases in cartilage matrix synthesis. The *Clostridium butyricum* species has been shown to produce butyric acid, a [short-chain fatty acid](https://pubmed.ncbi.nlm.nih.gov/33961348/) known to support many aspects of human health. *C. butyricum* administration was shown in an animal study to help preserve joint structure as compared to a placebo. [Butyric acid](https://pubmed.ncbi.nlm.nih.gov/33961348/) has also been shown to help inhibit pro-inflammatory cytokines, such as nuclear factor-kappa B and interleukin-1.

In human studies, a 24-week placebo-controlled, randomized trial involved supplementation with [*L. casei shirota*](https://pubmed.ncbi.nlm.nih.gov/33961348/) in individuals with knee osteoarthritis. Reductions in high sensitivity C-reactive protein and significant reductions in [pain scores](https://pubmed.ncbi.nlm.nih.gov/33961348/) and stiffness were observed.

More information is necessary before clinical conclusions can be determined. However, [Tan and colleagues](https://pubmed.ncbi.nlm.nih.gov/33961348/) suggest there may be a link between the gut microbiome and osteoarthritis. In addition, certain probiotics may support the body’s response to oxidative stress and inflammation.

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### Cory Ambrose, ND, MAT

Clinical Application

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#### [Research & Education How Akkermansia Supports GLP-1 Production and Metabolic Function May 27, 2026](https://www.casi.org/articles/akkermansia-supports-glp-1-production-metabolic-function)

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