What is Rheumatoid Arthritis (RA)?
RA is an autoimmune disorder that causes inflammation of the lining of the joints. The body tissue is mistakenly attacked by its own immune system. RA may also affect the skin, eyes, lungs, heart, blood, or nerves. Rheumatoid arthritis is a chronic disorder, meaning that although there may be occasional symptom-free periods, the disease can worsen over time and may never go away. Early, aggressive treatment is key to slowing or stopping its progression.
Joint inflammation from Rheumatoid Arthritis (RA) comes with pain, warmth, and swelling. The inflammation is typically symmetrical, occurring on both sides of the body at the same time (such as the wrists, knees, or hands). Other symptoms of RA include joint stiffness, particularly in the morning or after periods of inactivity; ongoing fatigue, and low-grade fever. Symptoms typically develop gradually over years, but can come on rapidly for some people.
Immune cells normally protect the body from foreign invaders. What causes them to target healthy joints and tissue is unknown. Researchers believe some combination of genetics and environmental factors may play a role. There may be a genetic tendency in some people who, if they develop an infection with a particular bacterium or virus, go on to develop the condition. But to date, no specific infection has been identified.
RA’s Toll on the Joints
Inflammation of the lining of the joints can destroy cartilage and bone, causing deformity of the joints. As the condition progresses, joints can develop considerable pain and loss of function.
RA’s Toll on the Body
RA can affect organs and areas of the body other than the joints, including:
- Rheumatoid nodules (shown here): firm lumps under the skin and in internal organs
- Sjogren’s syndrome: inflammation and damage of the glands of the eyes and mouth; other parts of the body can also be affected
- Pleuritis: inflammation of the lung lining
- Pericarditis: inflammation of lining surrounding the heart
- Anemia: reduction of red blood cells
- Felty syndrome: reduction of white blood cells, associated with enlarged spleen
- Vasculitis: blood vessel inflammation, which can impair blood supply to tissues
Diagnosing RA: Evaluating Symptoms
Because symptoms may come and go, diagnosing RA in its early stages is challenging. If you have these symptoms, your doctor may order further tests:
- Morning joint stiffness
- Swelling/fluid around several joints at the same time
- Swelling in the wrist, hand, or finger joints
- Same joints affected on both sides of your body
- Firm lumps under the skin (rheumatoid nodules)
Diagnosing RA: Blood Tests
If RA is suspected, your doctor may order blood tests to check for markers of inflammation in the body. Other common tests are for rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP), which is present in most people with RA.
Diagnosing RA: Imaging Tests
X-rays are helpful in diagnosing RA, to provide a baseline for comparison later as the disease progresses. An MRI or ultrasound may also be done to help detect joint damage and inflammation.
There is no known cure for RA. The goal of treatment is to reduce joint inflammation and pain, prevent joint damage, and maximize joint function. Aggressive treatment should be started as early as possible. Treatment includes a combination of medication and exercises to strengthen supporting muscles around the joints. Treatment may also include surgery. Treatment is tailored to the individual, taking into account their age, affected joints, and the progression of the disease.
Medications used to treat RA include disease-modifying antirheumatic drugs (DMARDs) which include biologics, nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, and pain relievers. DMARDs slow progression of disease and are usually used with NSAIDs and steroids in treatment.
Other Treatments for RA
Some RA patients find relief in the following: moist heat, relaxation remedies, and acupuncture. Supplements that have been shown to possibly help RA are fish oil, borage seed oil, and cat’s claw. Check with your doctor before taking supplements as they can cause side effects and may interact with your medications.
RA and Diet
The most important diet is a healthy one that is balanced in nutrients. Although there’s no “arthritis diet” per se, many RA sufferers report that eating or avoiding certain foods helps their symptoms. Foods high in saturated fats (bacon, steak, butter) have been shown to increase inflammation in the body. Some people with RA find a diet high in omega-3 fatty acids (salmon, tofu, walnuts) helpful. Some people feel that other foods — such as tomatoes, citrus fruits, white potatoes, peppers, coffee, and dairy — worsen RA symptoms.
Foods to Avoid
I already mentioned that being overweight puts extra stress on the joints, which escalates the risk of wear and tear. But there is another reason being overweight is a problem. Body fat is not an inert substance; it is metabolically active, capable of producing hormones and chemicals that actually increase levels of inflammation. By losing weight — and avoiding excess calories that can cause weight gain — you’ll automatically reduce inflammation in your body.
Specific food groups that increase inflammation include:
- Saturated Fats: This category includes fats in and from animal products, such as fatty beef or pork, poultry skin, and full fat dairy foods. Saturated fats are also found in palm oil and palm-kernel oil, which you may find in the ingredient lists of any number of items on your shelves, including crackers, cookies, bars, nondairy creamers, and other packaged baked goods. Try to dramatically limit your intake. In addition to carefully reading labels, choose reduced-fat or fat-free dairy products, lean cuts of beef and pork, and skinless chicken and turkey.
- Trans Fats: Trans fats were created by scientists to give baked goods a longer shelf life. Trans fats are thought to be at least as damaging as saturated fats in terms of inflammation and other health problems. They may even be worse. You won’t have to go to great lengths to determine whether a food contains trans fats or not. Manufacturers are now required to list the amount of trans fats right after listing the saturated fats on the nutrition label.
- Simple and Refined Carbs: Sugary foods, white-flour baked goods, white rice, bread, crackers, and other refined carbohydrates set up a state of inflammation in the body, causing increases in pro-inflammatory compounds. Limit these foods if you want the best chance of reducing arthritis pain and limiting its progression.
Foods to Add
These Food Cures all help to reduce some aspect of inflammation:
- Omega-3 Fatty Acids: The healthiest of fats for people with arthritis or other inflammatory disorders are omega-3 fatty acids. More than a dozen studies have demonstrated that omega-3 fish oils can drastically reduce symptoms of RA. I recommend an omega-3-rich diet (and in some instances, fish-oil supplements) to all my clients with arthritis. I’ve seen some amazing success stories. Some of the best foods for omega-3 fatty acids include salmon (wild, fresh, or canned), herring, mackerel (not king), sardines, anchovies, rainbow trout, Pacific oysters, ground flaxseeds, chia seeds, walnuts, seaweed, and soybeans (edamame).
- Extra-Virgin Olive Oil: In addition to healthy monounsaturated fats, olive oil contains a natural compound called oleocanthal which may help prevent arthritis-related inflammation.. These compounds block the same inflammatory pathways as ibuprofen and aspirin, medications commonly used to fight arthritis pain. I recommend using olive oil when cooking instead of vegetable oil or butter (substitute in equal or lesser amounts). For the highest antioxidant content, choose “extra virgin” olive oil; the stronger the taste, the higher the amounts of oleocanthal the oil is likely to have.
- Antioxidants — vitamin C, carotenes, bioflavonoids: Antioxidants protect the body from the effects of cell-damaging free radicals and are a critical part of an anti-inflammation diet. Research has also demonstrated that certain antioxidants may help prevent arthritis, slow its progression, and relieve pain. The best are: Vitamin C — found in guava, bell peppers, oranges, grapefruits, strawberries, pineapples, kohlrabi, papayas, lemons, broccoli, kale, potatoes, and brussels sprouts. Beta-carotene — found in sweet potatoes, carrots, kale, butternut squash, turnip greens, pumpkins, mustard greens, cantaloupes, sweet red peppers, apricots, and spinach. Beta-cryptoxanthin — found in winter squash, pumpkins, persimmons, papayas, tangerines, peppers (red chili and red bell), corn, oranges, apricots, carrots, nectarines, and watermelon. Quercetin — found in onions, kale, leeks, cherry tomatoes, broccoli, blueberries, black currants, elderberries, lingonberries, apricots, red apples with skin, and red/purple/black grapes. Anthocyanins — found in blackberries, black currents, blueberries, eggplant, elderberries, raspberries, cherries, boysenberries, red/black/purple grapes, strawberries, plums, cranberries, rhubarb, red onions, and apples.
- Vitamin D: Studies have shown that getting adequate amounts of vitamin D reduces the risk of both rheumatoid arthritis and osteoarthritis. Among people who already have osteoarthritis, those who have a vitamin D deficiency are more likely to develop worsening disability over time. Getting even the basic daily requirement of vitamin D (at least 600 IU until age 70, and at least 800 IU for folks 70 and older) leads to greater muscle strength, improvement in physical functioning, and preservation of cartilage. Some of the best foods for vitamin D include wild salmon, mackerel (not king), sardines, herring, milk (skim or 1 percent low-fat), soy milk, egg yolks, and UV-treated mushrooms.
- Spices — ginger and turmeric: Certain spices seem to have anti-inflammatory effects and therefore should be considered for arthritis treatment. Among the most promising are ginger and turmeric. Ginger has been shown to lessen the pain of knee osteoarthritis when taken in highly purified, standardized supplement form. Scientific studies have shown that turmeric may help arthritis by suppressing inflammatory body chemicals. The research isn’t strong enough yet to support taking ginger or turmeric in supplement form, but I highly encourage adding generous amounts of these spices to food (they’ll add delicious flavor, too!).
source: Joy Bauer.com