Avoiding/Managing Rheumatoid Arthritis

Arthritis is the umbrella term for a cluster of joint diseases involving inflammation of the joints, hence “arthr-” (joint) “-itis” (suffix used to denote inflammation). These are mostly, but not all, autoimmune diseases, in which the body’s immune system mistakenly attacks our own joints.

Inflammatory vs Non-Inflammatory Arthritis

Arthritis is broadly divided into inflammatory arthritis and non-inflammatory arthritis.

You may be wondering: how does one get non-inflammatory inflammation of the joints?

The answer is, in “non-inflammatory” arthritis, such as osteoarthritis, the damage comes first (by general wear-and-tear) and inflammation generally follows as part of the symptoms, rather than the cause. So the name can be a little confusing. In the case of osteo- and other “non-inflammatory” forms of arthritis, you definitely still want to keep your inflammation at bay as best you can, but it’s not as absolutely critical a deal as it is for “inflammatory” forms of arthritis.

We’ll tackle the beast that is osteoarthritis another day, however.

Today we’re going to focus on…

Rheumatoid Arthritis

This is the most common of the autoimmune forms of arthritis. Some quick facts:

• It affects a little under 1% of the global population, but the older we get, the more likely it becomes
• Early onset of rheumatoid arthritis is most likely to show up around the age of 50 (but it can show up at any age)
• However, incidence (not onset) of rheumatoid arthritis peaks in the 70s age bracket
• It is 2–4 times more common in women than in men
• Approximately one third of people stop work within two years of its onset, and this increases thereafter.

Well, that sounds gloomy.

Indeed it’s not fun. There’s a lot of stiffness and aching of joints (often with swelling too), loss of joint function can be common, and then there are knock-on effects like fatigue, weakness, and loss of appetite.

Beyond that it’s an autoimmune disorder, its cause is not known, and there is no known cure.

Is there any good news?

If you don’t have rheumatoid arthritis at the present time, you can reduce your risk factors in several ways:

• Having an anti-inflammatory diet. Get plenty of fiber, greens, and berries. Fatty fish is great too, as are oily nuts. On the other side of things, high consumption of salt, sugar, alcohol, and red meat are associated with a greater risk of developing rheumatoid arthritis.
• Not smoking. Smoking is bad for pretty much everything, including your chances of developing rheumatoid arthritis.
• Not being obese. This one may be more a matter of correlation than causation, because of the dietary factors (if one eats an anti-inflammatory diet, obesity is less likely), but the association is there.

There are other risk factors that are harder to control, such as genetics, age, sex, and having a mother who smoked.

See: Genetic and environmental risk factors for rheumatoid arthritis

What if I already have rheumatoid arthritis?

If you already have rheumatoid arthritis, it becomes a matter of symptom management.

First, reduce inflammation any (reasonable) way you can. We did a main feature on this before, so we’ll just drop that again here:

Keep Inflammation At Bay

Next, consider the available medications. Your doctor may or may not have discussed all of the options with you, so be aware that there are more things available than just pain relief. To talk about them all would require a whole main feature, so instead, here’s a really well-compiled list, along with explanations about each of them, up to date as of this year:

Rheumatoid Arthritis Medication List (And What They Do, And How)

Finally, consider other lifestyle adjustments to manage your symptoms. These include:

• Exercise—gently, though! You do not want to provoke a flare-up, but you do want to maintain your mobility as best you can. There’s a use-it-or-lose-it factor here. Swimming and yoga are great options, as is tai chi. You may want to avoid exercises that involve repetitive impacts to your joints, like running.
• Rest—while keeping mobility going. Get good sleep at night (this is important), but don’t make your bed your new home, or your mobility will quickly deteriorate.
• Hot & cold—both can help, and alternating them can reduce inflammation and stiffness by improving your body’s ability to respond appropriately to these stimuli rather than getting stuck in an inappropriate-response state of inflammation.
• Mobility aids—if it helps, it helps. Maybe you only need something during a flare-up, but when that’s the case, you want to be as gentle on your body as possible while keeping moving, so if crutches, handrails etc help, then by all means get them and use them.
• Go easy on the use of braces, splints, etc—these can offer short-term relief, but at a long term cost of loss of mobility. Only you can decide where to draw the line when it comes to that trade-off.

You can also check out our previous article:

Managing Chronic Pain (Realistically!)

Take good care of yourself!

Good For The Eyes; Good For The Brain

We’ve written before about omega-3 fatty acids, covering the basics and some lesser-known things:

What Omega-3 Fatty Acids Really Do For Us

…and while we discussed its well-established benefits against cognitive decline (which is to be expected, because omega-3 is good against inflammation, and a large part of age-related neurodegeneration is heavily related to neuroinflammation), there’s a part of the brain we didn’t talk about in that article: the eyes.

We did, however, talk in another article about supplements that benefit the eyes and [the rest of the] brain, and the important links between the two, to the point that an examination of the levels of lutein in the retina can inform clinicians about the levels of lutein in the brain as a whole, and strongly predict Alzheimer’s disease (because Alzheimer’s patients have significantly less lutein), here:

Brain Food? The Eyes Have It!

Now, let’s tie these two ideas together

In a recent (June 2024) meta-analysis of high-quality observational studies from the US and around the world, involving nearly a quarter of a million people over 40 (n=241,151), researchers found that a higher intake of omega-3 is significantly linked to a lower risk of macular degeneration.

To put it in numbers, the highest intake of omega-3s was associated with an 18% reduced risk of early stage macular degeneration.

They also looked at a breakdown of what kinds of omega-3, and found that taking a blend DHA and EPA worked best of all, although of people who only took one kind, DHA was the best “single type” option.

You can read the paper in full, here:

Association between fatty acid intake and age-related macular degeneration: a meta-analysis

A word about trans-fatty acids (TFAs)

It was another feature of the same study that, while looking at fatty acids in general, they also found that higher consumption of trans-fatty acids was associated with a higher risk of advanced age-related macular degeneration.

Specifically, the highest intake of TFAs was associated with a more than 2x increased risk.

There are two main dietary sources of trans-fatty acids:

• Processed foods that were made with TFAs; these have now been banned in a lot of places, but only quite recently, and the ban is on the processing, not the sale, so if you buy processed foods that contain ingredients that were processed before 2021 (not uncommon, given the long life of many processed foods), the chances of them having TFAs is higher.
• Most animal products. Most notably from mammals and their milk, so beef, pork, lamb, milk, cheese, and yes even yogurt. Poultry and fish technically do also contain TFAs in most cases, but the levels are much lower.

Back to the omega-3 fatty acids…

If you’re wondering where to get good quality omega-3, well, we listed some of the best dietary sources in our main omega-3 article (linked at the top of today’s).

However, if you want to supplement, here’s an example product on Amazon that’s high in DHA and EPA, following the science of what we shared today 😎

Take care!