Beer Consumption And Rheumatoid Arthritis: Exploring The Link

Rheumatoid arthritis (RA) is an autoimmune condition that causes inflammation and swelling in the joints. While moderate drinking may have some benefits for people with RA, excessive drinking is not good for anyone's health. Research has produced conflicting results on the effects of alcohol consumption on RA. Some studies suggest that moderate alcohol consumption may reduce the risk of developing RA and alleviate symptoms

Alcohol and inflammation

Inflammation is an important part of the human immune system. When you get injured or your body is attacked by harmful bacteria or viruses, inflammation is part of your body's natural response. Think of swollen glands when you have a sore throat, or the way an infected cut becomes warm and red. It doesn't feel great, but these are signs of your body fighting off infection.

Your immune system sends blood, fluid, and protein to a damaged or infected area. Swelling and heat are stimulated to protect and repair damaged tissue. Once you heal, the inflammation should then vanish along with the infection. However, sometimes the body's healing process goes wrong, and the inflammation used to fight sudden infection or injury can become chronic. Some people experience a constant low level of inflammation, which can severely impact their overall health.

Chronic inflammation plays a role in cancer, diabetes, heart disease, arthritis, Alzheimer's, and possibly depression. It has also been linked to alcohol-related medical conditions, like liver disease. Recent research suggests that alcohol causes inflammation in the intestines and impairs the body's ability to regulate that inflammation. In turn, inflammation worsens alcohol-related organ damage.

The short answer is yes, alcohol can cause inflammation across the body. There are two main types of inflammation that alcohol can cause: acute and chronic inflammation. Acute inflammation caused by alcohol consumption may be evident through 'hangover' symptoms such as headaches, nausea, or vomiting. These symptoms usually don't last long and go away within a couple of days without any treatment. Chronic inflammation caused by alcohol, on the other hand, gets worse over time.

When you drink alcohol, your body breaks it down, leaving behind inflammatory compounds that can damage the gut, liver, and other organs. This damage triggers an inflammatory response in the body. Alcohol also disrupts the balance of "good" and "bad" bacteria in the gut, negatively impacting the immune system and promoting the overgrowth of bacteria, which further disrupts gut health.

In addition, alcohol consumption can increase intestinal permeability, allowing bacteria and toxins to infiltrate the bloodstream and spread to other organs. This can lead to bacterial and toxic infiltration of the liver and brain, causing further damage. Alcohol also inhibits the body's immune response by suppressing molecules and cells essential to immune function.

Joint pain is another symptom often connected to alcohol-induced inflammation and can affect any part of the body. This joint pain is partly due to dehydration caused by alcohol, as cartilage is mostly made up of water. The gut bacteria imbalance and inflammation, along with the body's inhibited immune response, can also contribute to joint pain.

Alcohol has been found to increase uric acid levels in the blood. If left untreated, high uric acid levels can lead to permanent damage to joints, bones, tendons, and ligaments. This is one reason why alcohol is a major risk factor for gout, a common and painful form of inflammatory arthritis.

While moderate drinking may have some benefits for people with rheumatoid arthritis (RA), heavy alcohol consumption can increase inflammation in the body. Research has shown that moderate drinking can reduce certain inflammation markers, while excessive drinking can have the opposite effect.

To reduce inflammation caused by alcohol, it is important to cut back on alcohol consumption or quit drinking altogether. Staying hydrated, exercising, sleeping well, and eating nutritious, anti-inflammatory foods can also help combat the inflammatory effects of alcohol.

Alcohol and RA benefit

Research has shown that moderate drinking may have some benefits for people with rheumatoid arthritis (RA). However, scientists are unsure why this is the case. Here is what we know so far:

Alcohol and Inflammation

RA is an autoimmune condition where the immune system overreacts and targets joints, causing inflammation and swelling, most often in the hands, feet, and knees. Most scientists believe that alcohol may help with RA by lowering inflammation. A study on nurses with RA showed that inflammation was lowest in those who drank a moderate amount of alcohol compared to those who drank more or less. Another study showed that alcohol might help with RA by affecting certain immune cells, preventing them from overreacting and causing inflammation.

There is some evidence that moderate drinking may help prevent RA. A Swedish study of over 34,000 women found that those who drank more than four glasses of alcohol per week were less likely to get RA compared to those who drank less than one glass per week or never drank. A US study of over 120,000 female nurses showed that those who drank beer two to four times a week were about a third as likely to get RA as those who never drank beer.

It is important to note that the benefits of alcohol for people with RA were only observed with moderate drinking. Excessive drinking can be harmful and is never a good idea. For women, experts say that one drink per day is usually safe, while men can safely have up to two drinks per day. It is also important to consider how alcohol may interact with medications, as it can interfere with many drugs, including common pain relievers and RA medications.

How alcohol mixes with RA medications

Alcohol can interact with many medications, including those used to treat rheumatoid arthritis (RA). It is important to consult a doctor about the risks of mixing alcohol with any drugs you take. Here are some ways alcohol can interact with medications:

• Altering metabolism: Alcohol can speed up or slow down the body's ability to metabolise a medication, affecting its clearance from the body and resulting in higher or lower blood levels of the drug.
• Influencing absorption: A medication can impact how the body absorbs and metabolises alcohol, potentially leading to higher blood alcohol levels and other adverse effects.
• Changing pharmacological effects: Alcohol can either increase or decrease the effects of a medication on the body.

Some common medications used to treat RA that are known to interact negatively with alcohol include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): These include ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and aspirin. Combining these medications with alcohol significantly increases the risk of gastrointestinal bleeding.
• Acetaminophen (Tylenol): This is the most widely used over-the-counter pain reliever. Combining it with alcohol can lead to complex and potentially lethal interactions. Acetaminophen is partially metabolised by the same enzyme that breaks down alcohol in heavy drinkers, increasing the risk of liver damage.
• Methotrexate (Rasuvo, Otrexup): This medication is used to treat RA, and alcohol use may increase the risk of liver damage when combined with it.
• Janus kinase inhibitors (JAK): This is a newer class of oral medications prescribed for RA, including tofacitinib (Xeljanz). While they pose a lower risk of liver toxicity than methotrexate, it is still recommended to monitor liver function regularly when taking these medications and avoid consuming high amounts of alcohol.

How much alcohol is safe?

If you have rheumatoid arthritis (RA), you might be wondering if it's okay to have a drink. The short answer is: most likely yes. However, it's important to consult with your doctor to determine a safe amount of alcohol consumption for you, as it may depend on various factors, such as your treatment regimen, health, and medications.

According to the Arthritis Foundation, drinking alcohol in moderation is typically safe and may even offer some benefits for people with RA. Moderate drinking is generally defined as up to one drink per day for women and up to two drinks per day for men. One drink is equivalent to 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of liquor. It's important to note that these are general guidelines, and individual tolerance may vary.

Excessive drinking should be avoided, as it can cause health problems and interfere with RA medications. Heavy alcohol use can increase inflammation in the body and damage the gut and liver, leading to chronic inflammation. Additionally, alcohol can negatively impact bone density, which is a concern for people with RA who are already at risk of osteoporosis and joint pain.

When it comes to RA medications, alcohol can interact with certain drugs, such as methotrexate, nonsteroidal anti-inflammatories (NSAIDs), acetaminophen, and Janus kinase inhibitors (JAK inhibitors). These interactions may increase the risk of liver damage and other health issues. Therefore, it's crucial to discuss alcohol consumption with your doctor to ensure it doesn't interfere with your treatment.

While moderate drinking may provide some benefits, it's important to note that the Centers for Disease Control and Prevention (CDC) advises against starting to drink alcohol for potential health benefits. Additionally, if you don't drink or drink very little, experts recommend against increasing your alcohol intake solely for perceived health benefits.

Alcohol's effect on the liver

Short-Term Effects

Excessive alcohol consumption over a short period can lead to acute alcohol-related hepatitis, which causes the liver to swell and become tender, killing liver cells. This condition has a high mortality rate and is often seen in people in their 30s or 40s. Symptoms include jaundice, ascites (fluid buildup in the abdomen), confusion, fever, and more.

Long-Term Effects

Years of regular and excessive drinking can cause sustained liver damage, leading to alcohol-associated liver disease and cirrhosis. Alcohol-associated liver disease is the progressive decline of liver function due to inflammation and destruction of liver cells. Cirrhosis is a scarring of the liver that occurs when the liver repeatedly tries to regenerate. This damage is often irreversible and can lead to liver failure.

Alcohol Metabolism and Toxins

When the liver metabolizes alcohol, it creates a chemical called acetaldehyde, which is directly toxic to the liver and contributes to DNA damage. The liver also breaks down and eliminates toxins created in the gut during digestion, including those from alcohol consumption.

Regeneration and Recovery

The liver is resilient and can regenerate itself by developing new cells. However, prolonged alcohol misuse over many years can reduce the liver's ability to regenerate, resulting in serious and permanent damage. Even after years of misuse, stopping alcohol consumption can allow the liver to recover, although the extent of recovery depends on the stage of liver disease.

Recommendations and Treatment

The best way to prevent alcohol-related liver disease is to abstain from alcohol or drink within the recommended limits:

• For women: one drink or less per day, not exceeding seven drinks per week.
• For men: up to two drinks per day, not exceeding 14 drinks per week.

If you have alcoholic fatty liver disease, abstaining from alcohol for at least two weeks can lead to liver recovery. For more severe forms of alcohol-related liver disease, lifelong abstinence is recommended to prevent further damage and increase life expectancy.

Treatment for alcohol-related liver disease often involves addressing alcohol dependence and making lifestyle changes. Support, advice, and medical treatment are available through local alcohol support services. In severe cases, a liver transplant may be required if the liver has stopped functioning and hasn't improved with abstinence.

Frequently asked questions