How to Prevent Symptoms of Rheumatoid Arthritis
Avoid These 8 Factors for Arthritis Prevention
By Carole Jacobs, Special to Lifescript
Published May 23, 2011
Reviewed By Edward C. Geehr, M.D.
Rheumatoid arthritis (RA), a chronic autoimmune condition that affects 1%-3% of U.S. women, is on the rise – and can be triggered by everything from caffeine to car exhaust fumes. But researchers around the world are discovering new ways to reduce your risks. Learn about the top 8 things that could raise your chances of needing RA treatment, and get expert advice on how to avoid them...
Women are three times as likely to get rheumatoid arthritis (RA) as men, according to the American College of Rheumatology – and the numbers are growing.
The prevalence of RA in women increased by 2.5% between 1995 and 2007, according to Sherine Gabriel, M.D., professor of medicine and epidemiology with the Mayo Clinic, who co-authored a 12-year study on the subject.
Unfortunately, no RA cure is in sight, and research is divided on the exact causes – but scientists are beginning to connect the dots.
Studies show a correlation between RA and family genes, smoking, pollution, environmental toxins, lower estrogen levels and viral infections, says RA researcher Katherine Molnar-Kimber, Ph.D., founder of Rheumatoid Arthritis Decisions, a website for women with RA.
“Studies suggest factors that affect your overall health also contribute to symptoms of rheumatoid arthritis,” Molnar-Kimber says.
Read on for 8 possible reasons behind the rise of RA – and how you can reduce your risks.
Arthritis prevention method #1: Get tested early.
If one or both of your parents have RA, you have a greater risk of developing the disease – but odds are still small, says Steven Soloway, M.D., a rheumatologist and RA advocate in Vineland, N.J.
What to do: While you can’t change your parents, getting diagnosed and treated early and aggressively is the best way to minimize symptoms of rheumatoid arthritis.
“See a rheumatologist at least twice a year to get checked out, even if you have no symptoms,” Soloway says.
“That includes getting an MRI, which can detect joint disease much earlier than an X-ray.”
New medications can even halt RA when it’s caught early.
“Today’s cutting-edge biologic drugs can reverse the course of the disease and stop the destruction and erosion of bone. If caught and treated early, RA is more likely to go into remission,” Soloway says.
Arthritis prevention method #2: Increase estrogen.
Estrogen has been shown to help protect against RA.
The recent rise in women affected by the disease could be a result of lower estrogen levels in newer birth-control pills and hormone replacement therapy, according to the 2010 Mayo Clinic study.
Half of a group of pregnant women experienced relief from RA symptoms during pregnancy because of naturally higher estrogen levels, a 2008 study conducted in the Netherlands found.
What to do: If you want to have kids, no problem.
“Getting pregnant and breastfeeding puts many women with RA into a sustained or even a permanent remission,” Soloway says.
If not, birth control pills, while reformulated, “may also help reduce risk,” says Nathan Wei, M.D., a rheumatologist in Frederick, Md.
Already in menopause? Ask your physician about short-term estrogen therapy. While the landmark Nurses’ Health Study at Harvard University found an increased risk of breast cancer in women who took hormone replacement therapy (estrogen plus progesterone), estrogen therapy alone doesn’t increase the risk when taken for less than 10 years, according to the American Cancer Society.
Arthritis prevention method #3: Don’t smoke.
“Smoking can double your risk of RA,” says Fred Wolfe, M.D., a Kansas-based rheumatologist and former director of the National Data Bank for Rheumatic Diseases.
A series of recent studies bears this out.
Environmental pollutants like cigarette smoke and car and truck exhaust increased both inflammation and the risk of RA, a 2009 Harvard study conducted on 90,297 women found.
Women who smoked for at least 20 years were nearly twice as likely to develop RA than lifelong nonsmokers, according to a 2011 analysis at Kobe University Graduate School of Medicine in Japan. Women who had smoked at any time (including those who quit) were also more likely to develop RA than women who never smoked.
“Any type of smoking constitutes a significant risk factor for the development of RA,” notes study author Shunichi Kumagai, M.D., Ph.D., a professor of clinical pathology and immunology at Kobe University.
The risk of developing RA increased proportionally with the number of “pack-years” smoked, defined as one pack of cigarettes or 20 cigarettes daily for each year, a 2007 study at Denmark’s Danish Epidemiology Science Centre found.
What to do: Quit smoking.
Ask your physician about nicotine replacement therapy, antidepressants like bupropion (Zyban) that decrease your desire to smoke, and hypnosis – all of which have been shown to help smokers quit.
Even if you’re already experiencing symptoms of rheumatoid arthritis, you’ll boost the effectiveness of your RA treatment by kicking the habit. Smoking hurt the effectiveness of most RA meds, including methotrexate and biologic treatments, in a 2011 study on nearly 1,500 people conducted at Karolinska University Hospital in Stockholm, Sweden.
Arthritis prevention method #4: Boost your vitamin D.
A vitamin-D deficiency could increase your risk of RA.
“Vitamin D is a powerful antioxidant and hormone, and deficiencies can lead to a host of diseases, including RA and multiple sclerosis,” says Michael Holick, Ph.D., M.D., a vitamin-D researcher, professor of medicine, physiology and biophysics at Boston University and author of The Vitamin D Solution (Hudson Street Press).
Women who live in northern latitudes, which get less D-producing sunlight, are more likely to develop symptoms of rheumatoid arthritis, according to a 2010 study conducted on 13,000 women at several universities, including Boston University and Harvard.
Another 2010 report, from Tufts Medical Center, noted that a vitamin-D deficiency has been linked to several autoimmune disorders, including RA.
And several other studies, conducted at Penn State University, Brigham Young University and the University of Genoa in Italy, found that women who suffered vitamin-D deficiency had an increased risk of inflammatory diseases, including RA, lupus, arthritis and Crohn’s.
What to do: The reaction of sunlight on your skin is the key source of vitamin D. Only a few foods contain vitamin D, including egg yolks, salmon, some mushrooms, and vitamin-D-fortified foods, Holick says.
If you don’t eat a lot of foods with D and/or you live in a cloudy climate or regularly use sunscreen (which blocks out most vitamin D), you should take a daily supplement, he adds.
The Institute of Medicine, a branch of the National Academy of Sciences, recommends 600 International Units (IU) a day for women under age 71 and a maximum 800 IU for women age 71 and older.
(For more information, read Are You Deficient in Vitamin D?)
Arthritis prevention method #5: Limit caffeine.
Too much caffeine can do more than give you the jitters.
A 2010 study conducted at the University of Oslo in Norway found that heavy caffeine consumption increased RA risk, and a 2006 study conducted at the Danish Epidemiology Science Centre said the same thing about heavy coffee drinkers.
Interestingly, women who drank decaffeinated coffee also had an increased risk, according to a 2002 study conducted at the University of Alabama at Birmingham.
What to do: Cut back to three or fewer cups daily. Moderate caffeine consumption (about 300-400 milligrams daily, or about three cups of coffee) isn’t likely to cause negative health effects, according to the Mayo Clinic.
Prefer to cut caffeine out of your life altogether?
Don’t go cold turkey. Even light coffee drinkers can suffer withdrawal symptoms, while heavy drinkers could experience a killer headache, according to John Hughes, Ph.D., director of the Human Behavior Pharmacology Laboratory at the University of Vermont.
It’s safer to give it up gradually over several weeks.
Arthritis prevention method #6: Eat more fish.
If you’re not eating enough fatty fish, along with olive oil or nuts and seeds, you could be increasing your risk for RA.
The chance of getting RA was reduced by 20%-30% in women who consumed fatty fish at least 1-3 three times a week, a landmark 1990 study of nearly 2,000 patients at Scotland’s University of Glasgow found.
Omega-3 fatty acids reduce the inflammatory response, says study author Gail Darlington, M.D., a researcher with Epsom General Hospital in Glasgow.
What to do: Eat plenty of cold-water fish high in omega-3 fatty acids, including salmon, tuna, lake trout, herring and mackerel – or else take 1-2 grams of fish-oil supplements per day. Extra virgin olive oil is another good source of omega 3’s, Darlington says.
Arthritis prevention method #7: Prevent viral infections.
“Several studies have shown that infection can be one of the initial causes of rheumatoid arthritis,” Molnar-Kimber says.
Some likely suspects include the hepatitis C virus, Epstein-Barr Virus, herpes simplex virus, human herpes virus type 6, cytomegalovirus, and parvovirus B19.
In a 2009 study conducted at Institute of Experimental Immunology at the University of Zurich, researchers found that viral infection often triggered autoimmune diseases like RA.
Infections were responsible for RA symptoms in about 20% of patients, a 2005 study at Finland’s Helsinki University Central Hospital found.
What to do: Wash your hands frequently and thoroughly. When possible, avoid places germs are likely, such as public rest rooms, drinking fountains, public tables and shopping carts – or clean surfaces with antibacterial wipes.
“See your physician if you’re feeling ill, so infections don’t get out of control,” says Molnar-Kimber.
Arthritis prevention method #8: Avoid environmental toxins.
Scientists are investigating the link between RA and exposure to toxins such as man-made pesticides, organic solvents, compounds like formaldehyde, and heavy metals like cadmium and mercury, Molnar-Kimber says.
Exposure to insecticides was associated with the risk of autoimmune rheumatic diseases such as RA in postmenopausal women, according to a 2010 study at the National Institute for Environmental Health Science in Durham, N.C.
The 2009 Harvard study of 90,297 women found that those who lived within 55 yards of a large road frequented by cars and trucks had a 31% increased risk for RA, compared with women who were less exposed to exhaust fumes.
What to do: “Several studies have shown that rheumatoid arthritis patients have less ability to rid their bodies of toxins due to low levels of glutathione, a protein produced by your liver that plays a key role in neutralizing [harmful] substances in the body,” Molnar-Kimber says.
To beef up your glutathione activity, take a glutathione supplement; an amino acid called L-carnitine may also help raise levels. Also eat foods rich in antioxidants, such as blueberries, raspberries, blackberries, strawberries, prunes, beans and pecans, which help repair cell damage, she says.
MY THOUGHTS
I think I may be at risk. This runs in the family. I hate beans. But I love all those berries. Better go see a doctor first.
