Drinking with Rheumatoid Arthritis
In early June, and for weeks since, news outlets have been writing about a study showing that responsibly drinking five or more servings of wine or other alcohol a week cuts the risk of developing rheumatoid arthritis by up to 50%. Those who drank 1-4 drinks per week cut their risk by about 20%. The researchers believe this is because alcohol is a mild anti-inflammatory. The study was performed by researchers at the Institute of Environmental Medicine at the Karolinska Institute in Stockholm, Sweden and was published in the Annals of the Rheumatic Diseases.
The data consisted of two studies in Sweden and Denmark and included 2,750 men and women, 1,650 of whom had rheumatoid arthritis. The researchers found that those who drank regularly, meaning more than three drinks per week, were less likely to develop RA. The effect appeared to be greater for smokers with genetic risk factors for developing the disease. For people with a genetic predisposition to developing RA or other autoimmune disorders, smoking is an environmental factor that greatly increases that risk because it creates a systemic inflammatory response.
I am writing about it now because news outlets are still reporting the study and there were several aspects of the studies that I don’t think many of the news outlets covered in real detail.
First, was that an average drinker in Sweden consumed 3.8-5 drinks per week, while an average drinker in Denmark consumed 8.5-12 glasses of wine or other drinks per week? Moderate drinkers were classified as drinking above the average, but under the 75th percentile. High drinkers were above the 75th percentile. In any study or questionnaire that I have filled out here in the U.S., moderate drinking was considered to be anywhere from more than once per week to 3-4 drinks per week. So perhaps the studies are skewed slightly for countries who typically consume more alcohol per capita than the U.S.
Second, the study is about preventing rheumatoid arthritis, it really doesn’t help anyone who already has developed rheuamtoid arthritis. Drinking with RA is contraindicated for people taking some RA medications. Alcohol also dehydrates the body and drinking too much at once can cause flare-like symptoms, including swollen joints and stiffness.
Finally, the study authors conceded that the study results don’t meant that everyone should run out and drink all the time, since there are serious hazards associated with alcohol intake. Alcohol has been linked to the obvious: alcohol abuse, liver cirrhosis and fetal abnormalities; as well as to cardiovascular disease, chronic inflammation of the stomach, and cancers of the head, neck, breast and digestive tract. Heavy drinking has also been shown to increase the risk of hemorrhagic stroke because of alcohol’s anti-clotting effects. It also increases high blood pressure. Since people with RA are already prone to high blood pressure, heart attacks and strokes, regular heavy consumption of alcohol is an unnecessary added risk factor. On the positive side, alcohol consumption has also been associated with a decreased risk of peripheral vascular disease. Also, low to moderate consumption of red wine, specifically pinot noir, has been shown to lower the risk of coronary artery disease.
So it is really up to doctors and individuals on our site to make of this what they will. While most doctors would probably recommend that their patients stop smoking in order to cut the risk of developing RA, it isn’t so clear that they should or would recommend cutting out alcohol altogether. On the other hand, for those of us who already have RA, responsible consumption and careful attention to its immediate and longer lasting side effects is very important, when deciding how much and how often to partake.
Christine Miller wrote about rheumatoid arthritis as a Patient Expert for HealthCentral. She was diagnosed at 16 months old with polyarticular juvenile rheumatoid arthritis and has gone through the ebbs and flows of disease activity — many medications, much time spent in physical and occupational therapy, surgeries, and periods of relative remission.