Does a Cold or Flu Make RA Symptoms Worse?

Medically Reviewed


Does a cold or the flu make your RA symptoms worsen? I have a cold that everyone else in the family got over quickly and I ache all over, have joint pain, and am very tired. I am finding it hard to accomplish simple daily tasks because I feel so poorly. I don't know if I am being weak or if an infection makes the RA worse. Thanks for your help.

— Theresa


Dear Theresa,

I’m sorry you are feeling so sick and tired. Rheumatoid arthritis (RA) can present a significant challenge in getting through your day. Being sick on top of it just makes everything worse.

First, you are not weak. You are describing symptoms that are very real and which are having a significant effect on you. Not being able to soldier through means that there’s something going on, not that you are weak.

RA is an autoimmune disease in which the immune system attacks tissues in your body. When you have a virus or infection, such as a cold or flu, your immune system tries to fight that, as well. When there is an increase in immune system activity, this kind of physical stress may make your RA symptoms worse, as well.

People with RA have a higher risk of infection. The level of your RA activity and the medications you take may make you more susceptible to infection. Second, you may all have had the same virus, but because of your RA and/or your meds, you may have developed complications, such as bronchitis or a lung infection.

Your symptoms could indicate a couple of things. One, you may have a different type of virus than the rest of your family, perhaps something more like the flu. Second, you may all have had the same virus, but because of your RA and/or your meds, you may have developed complications, such as bronchitis or a chest infection. I’d recommend that you visit your family doctor to make sure that you haven’t developed a complication to having a cold.

Another possibility is that being sick has caused a flare of your RA. The symptoms you describe — a persistent body ache, fatigue, joint pain — sound very much like symptoms of active RA. If your visit to your family doctor doesn’t indicate an infection, contact your rheumatologist to discuss what’s going on. They may choose to give you a prescription for a steroid burst to get you back to normal.

Whether you are on immunosuppressant drugs (like methotrexate or a biologic) or not, it's a good idea to be a bit extra vigilant in terms of avoiding people who are in the contagious stage of a virus.

All my friends and family know that I love them dearly, but if they're sick, I don't want to see them and they all respect that. It's not always possible to avoid illness — especially if you have a spouse and children — but try to not get too close to those who are sick and practice frequent handwashing. When you feel better, you may also want to talk to your doctor about making sure your vaccinations are up to date.

There are vaccines that are especially recommended for people with a immune system disease like RA, including the flu and pneumonia shots. Being current on these can help protect you when viruses and bacteria are going around. As well, eating a well-balanced diet with lots of fruits and vegetables will help make you as healthy as possible.

If you do feel yourself coming down with something in the future, don’t take immune-system boosters, such as echinacea or golden seal. They can cause a flare of RA and other autoimmune diseases. This is because making the immune system more active will make your condition more active.

Take good care of yourself. I hope you feel better soon.

See more helpful articles:

How to Cope With a Rheumatoid Arthritis Flare

15 Ways to Ease Rheumatoid Arthritis Fatigue

Answered by Lene Andersen, MSW