I am delighted to read the article above from one of our experts in the field of Rheumatology. I have been successfully using diet and alternative therapies for my patients over the years. The challenges are several fold. There will always be lack of evidence bc there is no financial incentives to study food, supplements, and herbs. We play a role in impairing the patient's immune system by prescribing immunosuppressants eventhough we are helping the patients disease process. We get no training in nutrition. Finally, we are dismissive of ideas that are outside of our doctrine and training without understanding.