Aspartame and arthritis pain

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

This is a controversial topic and there appears to be no pat answer.

One person claimed that aspartame helped his arthritis and another stated it made his arthritis worse. Here's the back story...

A scientist noticed that when he got out of his chair after watching a football game, his arthritis pain was significantly lessened.

During the game he had consumed a six-pack of diet soda containing aspartame. Therefore, he thought this artificial sweetener might have contributed to his relief. (A six pack of diet soda???)

He organized a placebo-controlled trial involving aspartame (aka Equal, NutraSweet) and confirmed that doses of 76 to 152 mg did indeed provide pain relief, roughly comparable to anti-inflammatory agents.

This research was published in the journal, Clinical Pharmacology and Therapeutics.*

*Edmundson, A. B., and C. V. Manion. "Treatment of Osteoarthritis with Aspartame." Clin. Pharmacol. Ther. 1998; 63:580-593.

On the flip side, this observation was published …JOINT PAIN ASSOCIATED WITH ASPARTAME USE
by H. J. Roberts, M.D. West Palm Beach, Florida
from the Townsend Letter for Doctors May 1991


Joint pain requiring analgesics was experienced by 58 patients who consumed moderate to large amounts of aspartame, a popular sweetener. This association seems convincing in light of (1) the prompt improvement of both these pains and other aspartame-associated complaints after abstinence from aspartame, and (2) their prompt recurrence following aspartame re-challenge.

Bottom line: Clinicians should inquire about aspartame use in all patients who present with unexplained join pain or the exacerbations of their arthritis.

An impressive, but unexpected, finding in a national analysis of complaints associated with aspartame was submitted.

Aspartame-induced joint symptoms were incorporated in both the routine questioning of apparent aspartame reactors and a computerized nine-page nationwide survey of such individuals.


Data were obtained from 551 persons having apparent systemic reactions to aspartame. They consisted of 160 private patients and individuals who were personally interviewed, and 391 persons who described their adverse side effects in a questionnaire - including observations after rechallenge.The names of the latter group were supply by Aspartame Victims and Their Friends (courtesy of Mrs. Shannon Roth), the Community Nutrition Institute (courtesy of Mr. Rod Leonard), and Dr. Woodrow Monte of Arizona StateUniversity.

The completed questionnaires were analyzed with assistance of theManagement Information System staff at the Good Samaritan Hospital, West PalmBeach.


Joint pain was a major complaint in 58 (10.5%) of 551 aspartamereactors. Its convincing association with aspartame is derived from the following clinical evidence.

These patients suffered "severe joint pain" as a recent complaint, requiring analgesics in most instances.

They also experienced many of the symptoms reported by other aspartame reactors.

Both the joint pain and non-rheumatic complaints subsided whenaspartame-containing products were avoided...generally withinseveral days or weeks. The most notable exceptions were severe visual and neuropshychiatric disturbances.

These symptoms promptly and predictably recurred on rechallenge with aspartame, known or inadvertent.

The average age was 45 years. Females outnumbered males 3:1.

Representative Case Reports

Case 1. A 55-year old secretary developed "arthritis" and aching of the lower extremities one week after she began drinking an aspartame-flavored tea mix. Concomitant symptoms included memory loss, severe dizziness and depression. These features subsided within one week after stopping the aspartame product. After each of several rechallenges, "my whole body ached from my toes to the neck. I felt as though I had arthritis in my whole body and it hurt to move an arm or even my hand....Since that time, I have not touched anything sweetened with aspartame, and have experienced no unusualaches, memory loss or dizziness.

Case 2. A 45-year old technician consumed two packets of an aspartame tabletop sweetener daily for three weeks. He became markedly impaired because of "severe joint irritation" and "less that 1/4 my normal strength." These complaints improved within one day after avoiding aspartame. The joint symptoms recurred within one day after retesting himself with this product on three separate trials.

Case 3. A 62-year old supervisor complained that "all my joints ached all the time" while consuming aspartame. He used eight packets of an aspartame tabletop sweetener in his coffee, one glass of aspartame hot chocolate, and two services of aspartame puddings or gelatins daily. Other aspartame-associated symptoms included loss of vision in one eye, marked sensitivity to noise in both ears, intense headache, severe drowsiness, paresthesias of the limbs, atypical facial pains, extreme irritability, and aparadoxic weight gain of 30 pounds. His joint pains and other complaints regressed within five weeks after stopping aspartame. All recurred within eight hours during two re-challenges.


Experienced clinicians understandably will balk at the suggestion that a correlation exists between joint pain and consumption of a popular RDA-approved sweetener for several reasons. First, they have not heard or reach of such an association. Second, the frequency of rheumatologiccomplaints in the general population is likely to be superimposed upon the use of any drug, food or additive. Third, this pilot investigation lacks "controls" and objective quantifiable measurements during prospective double-blind studies. Fourth, the proposition that foods and additives caninduce joint symptoms in not novel.

On the other hand, the occurrence of joint pain, generalized or focal, in 58 individuals so closely associated with aspartame use ought not be dismissed as "anecdotal" or "idiosyncratic." The prompt regression of such complaints after abstinence from this chemical, and their prompt and predictable precipitation on re-challenge seems convincing. In effect, such patients served as their own controls.

These observations offer intriguing insights concerning variousrheumatologic disorders. A case in point was the occurrence of transient "dry eyes" in 46 (8.3%) of 551 reactors while taking aspartame. The frequent occurrence of arthropathy in the Sjogren syndrome is recognized.

Other interesting rheumatologic associations were encountered inaspartame reactors.

Some patients emphasized the prompt exacerbation of their long-standing arthropathies after using aspartame, and improvement within several days after stopping it.

Resort to considerable aspirin for the relief of joint pain intensified aspartame-associated ear and neurologic problems - especially tinnitus, dizziness and hearing impairment.

Several patients with polymyalgia rheumatica who had been well controlled on small doses of a corticosteroid experienced severe exacerbations after ingesting aspartame. They also promptly improved when it was avoided.

The probably underlying pathogenetic mechanisms of aspartame reactions included direct effects of its three ingredients (phenylalanine, aspartic acid, methanol), altered neurotransmitter metabolism, decreased tissue substrate due to the combination of increased insulin release and decreasedfood intake by persons attempting to lose weight, and immunologic reactions to aspartame or its metabolites - perhaps acting as haptenes. Concerning the latter, the following allergic-type reactions were encountered among 551 aspartame reactors: severe itching without a rash - 44 (8.0%); severe lipand mouth reactions - 21 (5.3%), urticaria - 25 (4.5%); other eruptions - 48 (8.7%); and the aggravation of respiratory allergies - 10 (1.8%)

H. J. Roberts, M.D.
300-27th St.
West Palm Beach, FL 33407

You be the judge!

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