6 Sneaky Triggers of Rheumatoid Arthritis

by Jerilyn Covert Health Writer

You may be able blame your parents for this one. Chances are if you have this common autoimmune disorder that can cause swelling and stiffness of the joints it’s in your genes. So if your mom (or dad or other close relative) has rheumatoid arthritis (RA), you are more likely to suffer from it too. But as it often goes with nature, it’s complicated. Heredity only raises your risk by about 20 percent, explains Weijia Yuan, M.D., a rheumatologist at the Hospital for Special Surgery in New York. A secondary factor—a trigger—may be needed to activate the disease.

Young woman holding knee in pain

What Is a Trigger?

In the case of RA, a trigger is simply something that drives the development of the disease in people who are genetically predisposed to it. It can be an infection, a behavior, even a hormonal change. Whatever it is, the trigger sets off production of abnormal proteins called citrullinated peptides, explains Robert Hylland, M.D., a rheumatologist in Muskegon, MI. Our immune system identifies these proteins as foreign invaders and mounts an attack of antibodies, resulting in inflammation. Some inflammation is a good thing: After all, it’s our body’s natural weapon against viruses, wounds, cancer cells, or other foreign invaders. But with RA, Dr. Hylland explains, the body starts attacking its own cells in our joints, causing swelling, stiffness, and a host of other symptoms. Luckily, scientists have ID’d several triggers for RA so you can avoid flare ups and live as pain-free as possible.

Young woman smoking cigarette

Trigger 1: Smoking

Another reason to never start or to kick the habit now: A large study in Arthritis Care & Research shows that women who smoke cigarettes are 46 percent more likely than nonsmokers to develop RA. Chemicals in the smoke may promote the development of those harmful antibodies, says Dr. Hylland. The sooner you quit, the better. Subjects who stopped smoking 30 years ago were 37 percent less likely to develop seropositive RA (the most common form of the disease) compared with those who’d quit less than five years ago.

Fruits and vegetables being put in a blender

Trigger 2: 'Bad' Gut Bacteria

Did you know you have up to three pounds of microbes—as many as 1,000 species—living in your gut? The good news is that most of them are healthy bacteria. But several families of microbes have been linked to RA. That may be why some patients respond positively to dietary changes. Your best bet: Adopt an anti-inflammatory diet, says Dr. Yuan. That means a diet of fruits, vegetables, lean proteins, whole grains, and healthy fats. (Think Mediterranean .) And we have to say it: Go easy on the processed foods and refined sugar. Both have been linked to inflammation.

Young woman brushing her teeth in the mirror

Trigger 3: Poor Dental Health

Brush, floss, and schedule regular dental exams. For years, scientists have observed a link between gum disease and rheumatoid arthritis, and new evidence from Johns Hopkins suggests why. Turns out, both conditions are triggered by a common factor: the bacterium A. acitnomycetemcomitans, which attacks immune cells and causes chronic inflammation. Almost half of RA patients have been infected by this type of bacteria, compared with 11 percent of healthy people. So take good care of your teeth; it just might save your joints, too.

Stressed woman with head in hands

Trigger 4: Stress

The mind-body connection is no joke. Persistent stress can lead to chronic inflammation which can set off RA, Dr. Yuan explains. RA sufferers often have flares surrounding stressful life events, and research shows that post-traumatic stress disorder may boost autoimmune risk by 17 percent, while suffering multiple childhood traumas can double it. You can’t change your past, but you can adopt healthy stress management habits today; start with these useful tips.

Traffic jam

Trigger 5: Environmental Toxins

Environmental toxins are an unfortunate fact of modern life, and they can wreak havoc on our health-- especially if you are continuously exposed to them at home or at work. Air pollution from traffic exhaust has long been thought to be a trigger for RA. Interestingly, women living in the Midwest and New England are up to 45 percent more likely to develop the disease than those in the western mountain and Pacific regions of the U.S. Researchers suggest that may be because air pollution is higher in those more densely populated regions. The use of insecticides in the home or on the job as well as exposure to other potential culprits such as mercury, lead, solvents, viruses, and silica can also potentially increase your RA risk. A Swedish study showed that workers in jobs dealing with bricklaying or concrete were up to three times as likely to develop RA compared to those in an office setting, due to the exposure to harmful airborne substances.

Trigger 6: Hormones

This one is harder to avoid, especially for women, who are two and a half times more susceptible to RA than men. During pregnancy, many women with RA actually experience an improvement in their symptoms-- only to have them flare back up postpartum. Similarly, menopause brings not only hot flashes but an uptick in symptoms too, according to research from the University of Nebraska Medical Center in Lincoln.

Two senior women power walking and talking

What You Can Do

If you have a family history of RA, be good to your body. Exercising regularly and sticking to a healthy diet will strengthen the parts of your immune system responsible for keeping inflammation in check, says Dr. Hylland. This may also help you avoid obesity, mitigating the overall inflammatory burden on your body. If you do notice symptoms (stiff or swollen joints in the morning, extreme fatigue, or brain fog), talk to your doctor. Early diagnosis and treatment are key to keeping this chronic disease under control so you can live a happy, healthy life.

Jerilyn Covert
Meet Our Writer
Jerilyn Covert

Jerilyn Covert is a writer, editor, and copy editor with 15 years of publishing experience. She’s written hundreds of articles for Men’s Health (where she was an editor for more than 10 years), Women’s Health, Runner’s World, ONE37pm, Whiskey Advocate, Silver Sneakers, and many more. She’s insatiably curious and loves interviewing people who know a lot more than she does. She shares their insights and advice so others can use them to improve their lives.