RA is an autoimmune disease which, according to Versus Arthritis, occurs when “the body’s natural self-defense system gets confused and starts to attack your body’s healthy tissues. In rheumatoid arthritis, the main way it does this is with inflammation in your joints.”
“I’ve lived with rheumatoid arthritis for nearly 20 years and have four joint replacements to prove it. Every day is tough, with some worse than others when flare-ups strike. But I’ve spent time researching the nutrients that can best help my condition, based on credible scientific research. Along with exercise and a healthy diet, it means good days outnumber the bad ones. I can’t promise my routine will work for everyone, but it helps me and is helping others.” Sandra Witzel, Founder, Positive Science People
Sadly, there is no cure to the disease yet and medical treatments can be quite severe. In addition to conventional approaches, there is growing evidence diet plays a role, in particular ensuring sufficient amounts of certain nutrients are consumed. Unfortunately, many people with RA have deficiencies in the very vitamins and minerals now linked with more positive outcomes. To make matters worse, some of the drugs prescribed for the disease can make the need for nutrients greater and absorption of vitamins and minerals worse. A terrible double whammy.
There is no guarantee boosting levels of certain nutrients will help everyone with RA, as everybody’s body and condition is different. But research more and more shows it might help. Our outline of the nutrients most strongly linked to positive outcomes for people with RA, based on research sourced by in-house Registered Dietitian, follows:
Vitamin C - nutrient no-brainer
Probably the best-known vitamin of all, Vitamin C is a powerful anti-oxidant linked with several positive health outcomes, with anti-inflammatory and immune supporting properties.
Patients with RA have been found to have reduced blood concentration of Vitamin C and other anti-oxidants, alongside increased markers of oxidative stress, when compared to healthy controls. However, after 12 weeks supplementation of Vitamin C and other antioxidants, blood concentrations improved significantly with an associated reduction in markers of oxidative stress. For people considering adding this nutrient to their diet, there are three important things to consider.
Vitamin D - search for the sun
Freely available from the sun, in theory, Vitamin D is in general linked with maintenance of normal muscles, bones and immune system, according to the EU claims register. But in the UK, not known for all year-round sun, many people have a deficiency, which is why Public Health England recommend that people consider taking a supplement in autumn and winter (extended to all year around for people who don’t get much sun exposure).
Vitamin D has been shown to down regulate pro-inflammatory compounds responsible for inflammation and, in Rheumatoid Arthritis in particular, serum Vitamin D is inversely associated with disease activity.
Calcium - not just for teeth
Well known as an addition to toothpaste, calcium has an important broader role in maintenance of bones and muscles, amongst other things.
One study also found that routine supplementation of calcium and vitamin D decreased the risk of bone mineral density (BMD) loss and concluded it should be recommended for all patients with Rheumatoid Arthritis.
Selenium - magic mineral
Selenium is an important mineral and co-factor for essential anti-oxidant enzymes, recognized for its contribution to the protection of cells from oxidative stress and to the normal functioning of the immune system.
The evidence connecting selenium with specific inflammatory conditions is still in its infancy, but patients with rheumatoid arthritis do more often show signs of selenium deficiency. Similarly, a major Finnish study did show that “low selenium status may be a risk factor for factor-negative rheumatoid arthritis”.
Zinc - not to be forgotten
Always last in an A-Z of nutrients, Zinc offers protection to cells from oxidative stress and to the normal maintenance of bones. It also has a critical role in regulating the immune system. Yet, a recent systematic review of 62 studies identified a consistent pattern of zinc deficiency in patients with autoimmune conditions, including Rheumatoid Arthritis, when compared to healthy controls.
Rheumatoid Arthritis booklet, Versus Arthritis
Micronutrients Deficiencies in Rheumatoid Arthritis Patients, International Journal of Pathology and Clinical Research, 2016
Antioxidant status in rheumatoid arthritis and role of antioxidant therapy, Clinica Chimica Acta, 2003
Vitamin D as a Principal Factor in Mediating Rheumatoid Arthritis-Derived Immune Response, Biomed Research International, 2019
Bone Mineral Density in Patients With Rheumatoid Arthritis and 4-Year Follow-up Results, Journal of Clinical Rheumatology, 2016
Zinc Status and Autoimmunity: A Systematic Review and Meta-Analysis, Nutrients Journal, 2018