The average age of onset for rheumatoid arthritis (R.A.) is between 30 to 60 years of age. What is worse is that children can develop RA. About 1.3 million adults in the U.S. have rheumatoid arthritis. Women are three times more likely to get it than men.
Like so many autoimmune and inflammatory diseases, in RA the immune system attacks a person’s joints, muscles, bones, eyes, heart, and other organs. So, what can one do to get pain relief, to reduce flare-ups, the progression, and complications from this disease? The answer is a whole lot!
Reduce Your Risks:
Gum infection and periodontal disease can initiate or facilitate the beginnings of RA woes even before one’s joints are affected. A study showed that individuals who suffer from gum disease and have a severe form of rheumatoid arthritis, reduced their arthritic pain, number of swollen joints, and the degree of morning stiffness when they cured their dental problems.1
Smoking 1 to 7 cigarettes a day more than doubled this risk. One study showed that stopping smoking did decrease the chances of developing RA, with the risk continuing to decrease over time. Fifteen years after giving up smoking, the risk of RA had decreased by a third. However, when compared to people who had never smoked, this risk remained significantly higher 15 years after giving it up.2 Even exposure to secondhand smoke has been linked to increased risk for rheumatoid arthritis. Early studies suggest that second-hand smoke may increase pain perception.
Certain jobs increase one’s risk for RA. A study (which controlled for other RA risk factors) found that within the manufacturing sector, male electrical workers and electronics workers and material handling operators had a twofold increased risk of rheumatoid arthritis than the reference group. Bricklayers and concrete workers had a threefold increased risk. So, if one has a family history of RA, or has the condition itself, we would recommend a different job.3
Typical Western diets high in red meat, processed meat, refined grains, fried food, high-fat dairy, and sweets can increase a person’s risk of developing RA in comparison to Prudent diets made mostly of fruit, vegetables, legumes, whole grains, poultry and fish.4
1. Adopt a plant-based diet, preferably a vegetarian diet.
Why? Milk and beef commonly contain bacteria that act as a trigger for those who have a genetic predisposition to RA.5 A one-year vegetarian diet, after a period of fasting, may help to reduce inflammation and improve symptoms.6 The Mediterranean diet may also benefit individuals who have RA.7
Several studies show that diets free from animal products and low in fats improve symptoms of RA. An essentially whole food vegetarian diet increases the population of friendly gut bacteria that generate anti-inflammatory compounds. Dietary fiber in these plant-based foods can improve gut bacteria composition and increase bacterial diversity in RA patients, thus reducing their inflammation and joint pain.8
Appropriate amounts of carbohydrate, especially the dietary fiber of whole plant foods is important for maintaining the balance of intestinal bacteria, which could be beneficial for preventing autoimmunity.9 A well-balanced vegetarian diet can reduce some of the comorbidities of rheumatoid arthritis which are diabetes, heart and kidney diseases, and hypertension.
It is important for those consuming a vegetarian or vegan diet to be sure to get vitamin B-12 and vitamin D. B-12 is important for protein synthesis; deficient vitamin D is a risk factor for RA. It is wise to have a nutritionist or dietician help to coach you on menu planning to be sure you are getting adequate intake of nutrients.
2. Eliminate food allergies and sensitivities.
Gluten is not a toxin, but many people are sensitive to it. Early studies show that a gluten-free diet and a diet eliminating specific food allergies may help RA symptoms in some individuals.10 RA is a major risk factor for these cardiovascular diseases but a gluten-free vegan diet was shown to lower cholesterol, low-density lipoprotein, and oxidized LDL in individuals who have RA. This diet also raises the levels of natural antibodies against the damaging compounds in the body that cause symptoms of rheumatoid arthritis.11
With any restrictive diet, it is wise to seek the counsel of a dietician to insure that optimal amounts of nutrients are obtained. Vegetarians should be sure to get enough vitamin B-12 and vitamin D.
3. Whole plant foods contain a wide variety of anti-inflammatory compounds.
Blueberries, dried plums, and pomegranates have been show to decrease inflammation, reduce joint stiffness and pain, and improve the body’s ability to detoxify harmful chemicals.12 Extra virgin, cold-pressed olive oil suppresses inflammation in the joints.13
4. Seriously limit the sugar.
When compared to no consumption of sugar-sweetened soda or ≥ 1 soda per month, the consumption of ≥1 sugar-sweetened soda per day has a 63% increased risk of developing seropositive RA.14 Sugar encourages inflammation and lowers the threshold to pain. Excessive sugar consumption has been linked to increased risk for heart disease.15 There is a substantial risk for heart attacks and heart valve problems in RA.
5. Enjoy only good fats.
Animal fats are pro-inflammatory. Excess amounts of omega 6-fats also promote inflammation. Rodent studies suggest that cold-pressed olive oil might protect the joints. Mice fed extra-virgin olive oil had reduced cartilage destruction, joint edema, and arthritis development, suggesting that olive oil has the potential for preventing RA.16 Use oil sparingly and only cold-pressed oils. The more oil is reheated in processing, the more toxic it becomes! Chia, flaxseed, soybeans, and leafy greens provide the omega-3 fatty acid, alpha-linolenic.
6. Easy on the salt!
Excessive consumption of salt increases the risk of auto-immune disease and two comorbidities of RA—diabetes and hypertension. Do not wait to get these two complications before reducing your sodium intake.17
By actual lab measurement, a modified vegetable juice fasting program with vitamin and mineral supplementation substantially reduces inflammation in patients with RA.18 A vegetable broth fast (herbal teas, parsley, garlic, potato) and juice from carrots, beets, celery followed by controlled energy intake, followed by one year on a vegetarian diet is extremely helpful. In contrast to omnivore diets, the consumers of a vegetarian diet, or a Mediterranean diet, observed a remarkable decrease in swollen tender joints and pain. Additionally, they had a significant reduction in inflammation markers (erythrocyte sedimentation rate or ESR, and C-reactive protein). 19,20,21
There are cautions to fasting. https://wildwoodhealth.com/blog/the-satisfying-fast/ for more information. Before you fast, please discuss this option with your health care provider, who knows your medical history.
Keep Your Gums and Gut Healthy
Gut bacteria could contribute to autoimmune disease like RA. Keep your gut bacteria healthy by munching on high fiber foods and taking a vegan probiotic that is made especially for the mouth and gut. Antibiotics and antacid drugs might be needed occasionally, but they kill off beneficial bacteria in your gut which help to protect you from inflammation and certain autoimmune diseases including rheumatoid arthritis.22 Unless instructed by your dentist, only use mouthwash occasionally.
Lose Weight if Obese
Obesity has been reported to decrease the odds of achieving and sustaining remission in RA. When compared to non-obese RA patients, obese RA patients had a greater number of tender swollen joints, high inflammatory markers, and greater pain.23 Extra fat cells fuel inflammation and increase one’s risk for autoimmune disease. Obesity accelerates disability from RA. However, unexplained weight loss is also linked to disability in RA. Appropriate weight loss can improve the quality of life for those who have rheumatoid arthritis.24
Check your Vitamin D Levels
Vitamin D in its active state helps to quell inflammation and balance the components of the immune system so as to discourage autoimmune disease. Individuals who have RA often have low levels of vitamin D. However, once RA develops, the immune cells in the joints become less sensitive to vitamin D.25 Because both rheumatoid arthritis and vitamin D deficiency increase the risk for heart disease, one should have his/her vitamin D level checked. Any insufficiency should be corrected. Patients with active RA under steroid treatment may need supplementation with calcium and vitamin D to prevent osteoporosis and to improve the symptoms of anxiety and depression.26
Exercise for RA
Undertaking a supervised exercise program can have beneficial effects on improving the physical ability of the RA patient to function in the daily activities of life. This kind of program will reduce the need for daily corticosteroid and anti-inflammatory intake, and improve levels of depression and anxiety.27 Exercise can decrease joint inflammation in rheumatoid arthritis and suppress multiple pro-inflammatory compounds.28 Range-of-motion exercises are especially essential in RA. Exercise in a therapeutic pool might be easier. Physical therapy is judicious for individuals who have arthritis.
It is important for an RA patient to stand and move his legs for at least two to five minutes each hour. Why? Just sitting for over an hour substantially reduces the blood flow to the legs. Deep breathing also helps the venous return of blood and may assist in reducing the risk for undesirable clotting. Frequent short bouts of exercise throughout the day can help.
Since cold, clammy joints can mean trouble for arthritis. Joints should be kept warm naturally by a balanced circulation. It requires attention to insulating with proper clothing to have optimum circulation. Cold limbs or cold hands and fingers won’t do. Sensible dress with nice warm feet, legs, arms, and hands help the circulation, the microcirculation of capillaries, and small blood vessels do their job.
Keep the Time!
Disturbed circadian rhythms increase your risk for autoimmune disease. Your joints have their own 24 hour rhythm. Keep a regular schedule for meals, retiring, and waking. If you need a catnap, before lunch is the best time.
Watch Out for Complications!
Cultivate a Heart-Savvy Lifestyle Program.
Rheumatoid arthritis patients, overall, are much more likely, as the average person, to develop heart problems even after controlling for other cardiovascular factors. Indeed, individuals with RA are more prone to have underlying conditions such as high blood pressure, diabetes, high cholesterol, deadly blood clots, heart failure, and fractures, than were those in the comparison group.29 Inflammation plays a pivotal role in both rheumatoid arthritis and coronary artery disease. It is encouraging that the very same lifestyle practices that combat inflammation also reduce cardiovascular risks.
Protect The Kidneys in RA.
Rheumatoid arthritis patients are significantly more susceptible than the average person to develop chronic kidney disease.30 This is complicated more with the use of corticosteroids to control inflammation, and if hypertension is present. Individuals with RA should be periodically tested for signs of kidney problems. See https://wildwoodhealth.com/blog/stalking-the-new-silent-killer-chronic-kidney-disease/ for more information on how to reduce your risk for chronic kidney disease.
We should also mention that NSAIDs (non-steroid anti-inflammatory drugs) increase blood pressure. Persistent hypertension damages the kidneys. Individuals who take proton pump inhibitors for heartburn, acid reflux, or ulcers had an increased risk of kidney function decline, chronic kidney disease, and kidney failure. Individuals should consult their pharmacists and physicians to see what medication options they have.
Hydrotherapy for Pain Relief
Check Your Potassium!
Potassium levels can impact pain perception. For some reason, potassium levels often drop in individuals who have rheumatoid arthritis. So, if your pain worsens, have your health care provider check your potassium. If it is low, increasing your potassium can help to reduce the pain.33 Individuals with kidney disease would need to consult with a dietitian first before increasing their potassium. Fruits and vegetables are good sources of potassium.
Curcumin May Help!
Curcumin can help reduce pain and RA complications. Curcumin is the yellowish pigment found in turmeric and ginger. This phytochemical is a wonderful anti-inflammatory. Curcumin blocks the activity of certain T-memory cells that are involved in several auto-immune diseases, including multiple sclerosis and rheumatoid arthritis. One study found that 500 mg. of curcumin reduced the signs and symptoms of RA, including joint swelling and tenderness, significantly better than 50 mg.of diclofenac sodium, a non-steroidal anti-inflammatory drug.34 Curcumin exhibits some of same activities similar to recently discovered alpha- tumor necrosis factor blockers and other recently developed drugs used for RA.35
Another animal study suggests that ginger can be more effective than indomethacin in reducing the pain, improving adverse joint tissue changes, and reducing some of the complications (kidney disease, atherosclerosis, and anemia) resulting from RA.36
Exposure of turmeric to light destroys curcumin. It is not easily absorbed. However, there are curcumin supplements in which phospholipids or a lecithin or peperine is added to improve its absorption. These products have a standardized dose of curcumin. Consult your pharmacist first before using curcumin, ginger, or turmeric medicinally if you are taking either prescribed or over-the-counter medication, to avoid any potential drug-herb interactions. High dosages of curcumin decrease iron absorption.
Natural remedies can do much to alleviate RA pain as we have seen in our lifestyle center in Wildwood, Georgia. A good lifestyle program outlined above can reduce the complications from rheumatoid arthritis. RA is a serious chronic condition that requires the help of a physician, physical therapist, and sometimes a dietician. Consistent follow-up visits to your health care team are essential.
Key Words: the rheumatoid arthritis diet, vitamin D rheumatoid arthritis, natural remedies for rheumatoid arthritis, rheumatoid arthritis treatment, rheumatoid arthritis herbal remedies, curcumin rheumatoid arthritis, rheumatoid arthritis pain relief
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Disclaimer: The information in this article is educational and general in nature. Neither Wildwood Lifestyle Center, its entities, nor author intend this article as a substitute for medical diagnosis, counsel, or treatment by a qualified health professional.
- Ortiz et al. Periodontal Therapy Reduces the Severity of Active Rheumatoid Arthritis in Patients Treated With or Without Tumor Necrosis Factor Inhibitors. Journal of Periodontology, 2009; 80 (4): 535 DOI: 10.1902/jop.2009.080447
- Giuseppe, D.D. Cigarette smoking and smoking cessation in relation to risk of rheumatoid arthritis in women. Arthritis Research & Therapy, 2013; 15 (2): R56 DOI: 10.1186/ar4218
- IlarA. Occupation and Risk of Developing Rheumatoid Arthritis: Results from a Population-Based Case-Control Study. Arthritis Care & Research,. 2017; DOI: 10.1002/acr.23321.
- American College of Rheumatology (ACR). “Diet may determine your risk for rheumatoid arthritis.” ScienceDaily. ScienceDaily, 8 November 2015. <www.sciencedaily.com/releases/2015/11/151108084643.htm>.
- University of Central Florida. “Bacteria in milk and beef linked to rheumatoid arthritis.” www.sciencedaily.com/releases/2018/01/180130123743.htm
- Kjeldsen-Kragh J. Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. Lancet. 1991 Oct 12; 338(8772):899-902.
- Shweta Khanna. Managing Rheumatoid Arthritis with Dietary Interventions. Frontiers in Nutrition, 2017; 4 DOI: 10.3389/fnut.2017.00052
- Alwarith, Jihad et al. “Nutrition Interventions in Rheumatoid Arthritis: The Potential Use of Plant-Based Diets. A Review.” Frontiers in nutrition vol. 6 141. 10 Sep. 2019, doi:10.3389/fnut.2019.00141 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746966/
- Kayo Masuko. A Potential Benefit of “Balanced Diet” for Rheumatoid Arthritis. Front Med (Lausanne). 2018; 5: 141.
- Badsha H. Role of Diet in Influencing Rheumatoid Arthritis Disease Activity. Open Rheumatol J. 2018 Feb 8; 12:19-28.
- BioMed Central/Arthritis Research. “Gluten-free Vegan Diet May Protect Rheumatoid Arthritis Patients from Heart Attack, Stroke, Study Suggests.” ScienceDaily. ScienceDaily, 20 March 2008. www.sciencedaily.com/releases/2008/03/080317191445.htm.
- Frontiers. “Study lists foods for fighting rheumatoid arthritis symptoms and progression: Blueberries, canary seed, ginger, olive oil, and green tea are just some of the foods recommended for managing rheumatoid arthritis.” ScienceDaily. 8 November 2017.
- Shweta Khanna. Managing Rheumatoid Arthritis with Dietary Interventions. Frontiers in Nutrition, 2017; 4 DOI: 10.3389/fnut.2017.00052
- Hu Y. Sugar-sweetened soda consumption and risk of developing rheumatoid arthritis in women. Am J Clin Nutr. 2014 Sep; 100(3): 959–967.
- Rosillo MA. Dietary extra-virgin olive oil prevents inflammatory response and cartilage matrix degradation in murine collagen-induced arthritis. Eur J Nutr(2016) 55(1):315–25. doi:10.1007/s00394-015-0850-0
- Fraser D, Thoen J, Reseland J, Førre Ø, Kjeldsen-Kragh J. Decreased CD4+ lymphocyte activation and increased interleukin-4 production in peripheral blood of rheumatoid arthritis patients after acute starvation. Clin Rheumatol (1999) 18(5):394–401. doi:10.1007/s100670050125
- Kjeldsen-Kragh J. et al. Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. Lancet(1991) 338(8772):899–902. doi:10.1016/0140-6736(91)91770-U
- Michalsen A. et al. Mediterranean diet or extended fasting’s influence on changing the intestinal microflora, immunoglobulin A secretion and clinical outcome in patients with rheumatoid arthritis and fibromyalgia: an observational study. BMC Complement Altern Med (2005) 5(1):22. doi:10.1186/1472-6882-5-22.
- Müller H, de Toledo FW, Resch K-L. Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systematic review. Scand J Rheumatol (2001) 30(1):1–10. doi:10.1080/030097401750065256
- Helmholtz Centre For Environmental Research – UFZ. “GI tract bacteria may protect against autoimmune disease.” ScienceDaily. 17 January 2013. www.sciencedaily.com/releases/2013/01/130117133003.htm
- Badsha H. Role of Diet in Influencing Rheumatoid Arthritis Disease Activity. Open Rheumatol J. 2018; 12: 19–28.
- Liu Y. Impact of obesity on remission and disease activity in rheumatoid arthritis: A systematic review and meta-analysis. Arthritis Care Res. (Hoboken) 2017; 69(2):157–165. doi: 10.1002/acr.22932.
- Jeffery LE. Decreased sensitivity to 1,25-dihydroxyvitamin D3 in T cells from the rheumatoid joint. Journal of Autoimmunity, 2017; DOI: 10.1016/j.jaut.2017.10.001
- Badsha B. Role of Diet in Influencing Rheumatoid Arthritis Disease Activity. Open Rheumatol J. 2018; 12: 19–28.
- European League Against Rheumatism. “Exercise Improves Functional and Psychological Ability And Reduces Steroid Need In Rheumatoid Arthritis.” ScienceDaily. ScienceDaily, 23 June 2009. www.sciencedaily.com/releases/2009/06/090611110820.htm
- European League Against Rheumatism. “Regular exercise beneficial in suppressing inflammation in rheumatic disease.” ScienceDaily. ScienceDaily, 12 June 2014. www.sciencedaily.com/releases/2014/06/140612085353.htm
- European Society of Cardiology (ESC). “Rheumatoid arthritis patients at increased risk of surprise heart attack.” ScienceDaily.4 May 2015. www.sciencedaily.com/releases/2015/05/150504082556.htm
- Mayo Clinic. “Vigilance for kidney problems key for rheumatoid arthritis patients, study finds.” ScienceDaily. 10 April 2014.
- Al-Qubaeissy KY. The effectiveness of hydrotherapy in the management of rheumatoid arthritis: a systematic review. Musculoskeletal Care. 2013 Mar; 11(1):3-18.
- Hall J. A randomized and controlled trial of hydrotherapy in rheumatoid arthritis. Arthritis Care Res. 1996 Jun;9(3):206-15.
- Chandran B, A randomized, pilot study to assess the efficacy and safety of curcumin in patients with active rheumatoid arthritis. Phytother Res. 2012 Nov; 26(11):1719-25
- Aggarwal BB, Curcumin: the Indian solid gold. Adv Exp Med Biol. 2007; 595:1-75. Review
- Ramadan G. Protective effects of ginger-turmeric rhizomes mixture on joint inflammation, atherogenesis, kidney dysfunction and other complications in a rat model of human rheumatoid arthritis. Int J Rheum Dis. 2013 Apr; 16(2):219-29.