Rheumatoid Arthritis
Diet & food supplements for rheumatoid arthritis
Magazines and books give a lot of confusing advice about diet and food supplements that are claimed to help with arthritis. Some people notice that certain foods make their arthritis flare up and it does make sense to avoid these foods as long as essential nutrients aren't excluded.
She was diagnosed a few months ago and would welcome clear advice about diet and lifestyle.
She was diagnosed a few months ago and would welcome clear advice about diet and lifestyle.
And tell me, have you noticed anything difference, giving up caffeine?
It's probably not helping with my tiredness [laughs].
I was going to say that.
[Laughs] It's probably not helping with that. Otherwise not, no not at all. I think I didn't really drink a massive amount of coffee anyway I drink more now that I have decaf I think than I have ever. So, no, I haven't. But then I've been on the medication and had steroid jabs and stuff so you, it's impossible to measure if it's the caffeine or, I'm sure it's the drugs rather than the caffeine [laughs].
Diet, exercise, yeah, just general activities I think, because there's so much, and I worry like, it sounds ridiculous but if I'm carrying a heavy bag on my shoulders I think, 'Oh,' you know, I don't' want to get that pain again that I had in my shoulders so I think, 'Oh is that going to set something off?' And I'm sure it's, you know, medically it's not going to at all but, you know, I have those worries. You, you're always thinking about things because you just don't, I'm sure that anyone's who's got RA can remember when they first got and just the pain and the immobility you have and everything else, you just, your worried that you don't want to set that off again. And so I get, when I go to aerobics and I can feel my shoulder starting to go I kind of stop doing things with my arms and everything. And it's probably more paranoia than anything else, I'll be honest with you. But just again. Just having that type of information found out would be really helpful.
Yeah. I think, well I think the only thing that's managed to control mine was initially the steroid jab which just took away the symptoms and that just gave me a new lease of life. And the Methotrexate again has just given me a new lease of life.
And, in terms of diet, as I said, I don't know how effective that it, there aren't many, even any studies to say, I don't think, how effective that is. And I think just looking after yourself and just not overdoing it, I think before I wouldn't worry about being overtired and things whereas now I do worry about it because I don't, I worry about I'll get a flare up and I'm going to run myself into the ground and end up having to go for more blood tests and all the rest of it. So just looking after yourself I think.
Most doctors, however, believe that people with arthritis should eat a balanced diet, including lots of fruit, vegetables, pasta, fish, and white meat, while avoiding too much sugary, fatty food. It is important not to be overweight, since too much weight can put an extra burden on strained or damaged joints.
Many of those we interviewed recognised the importance of a healthy balanced diet. Those people who had noticed no ill-effects said they would rather enjoy whatever food they chose to eat.
Recommends a healthy balanced diet and avoids food that might increase her weight.
Recommends a healthy balanced diet and avoids food that might increase her weight.
I certainly don't think that if you are, you know, you've got to think about things like being overweight. If you're very overweight and you've got rheumatoid arthritis then it's putting more load on your joints than you should be so it's, it's good to try and, you know, eat a balanced diet and, and not to eat to much of the sort of foods that are going to put weight on.
On the other hand, various foods apparently upset some people. For example, one woman found that her arthritis was badly affected by peppers, carrots, potatoes, tomatoes, dairy produce and Chinese food. Red meat also upset her and so did red wine unless it was organic.
She avoids certain foods which she thinks make her arthritis worse.
She avoids certain foods which she thinks make her arthritis worse.
Red wine was a thing I couldn't tolerate, but if it was organic I was fine, I wouldn't, I wouldn't have a reaction at all, not even a hangover! [laughs] So that was quite good, I couldn't drink gin but I could have brandy or whisky and that was fine, but it's something I don't even have now I don't even drink but yeah.
I think it's something that people will have to explore themselves. I couldn't even, one of the things I couldn't even take carrots, that would affect me, and carrots you think what, I don't what it would be within, again may be it's the pesticides, maybe its something I should have explored with the organic, in organic. but yes, people if they have a bit of a flare up, just look back and see what's happened over the, maybe 24 hours.
I used to find that the food used to affect me within a short space of time and it was so obvious that it was certain foods. Chinese meals, going out to eat, horrendous, never have one, you know, I love Chinese, God love 'em but I went out for a meal and I flared up and it was the monosodium glutamate in it so yeah. But some people are fine you know they sail through without food being a problem so but, people say, 'How do you survive, how do you manage it?', I'm thinking well I'd rather have a strict diet, not that it is now, but I would rather have that strict diet and be able to control the pain rather than having a bacon sandwich and know within 20 minutes I'm going to be in bed having everybody looking after me and not be able to move.
She is a vegetarian but recently started to eat fish. She has noticed that dairy products and...
She is a vegetarian but recently started to eat fish. She has noticed that dairy products and...
Now, let us talk a little bit about lifestyle in terms of diet, alcohol, drinking alcohol, or smoking or. Have you made any changes to your diet or?
I've always been vegetarian since my early twenties. I have noticed, if I eat a lot of dairy, it gives me a lot of pain in my wrists and my fingers. So I've been trying to avoid dairy as much as possible. I also know, if I drink wine, that it gives me more pain than normal, in my fingers, in my joints, in my wrists. Although I still have the odd glass of wine.
But, no, I was never a binge drinker. I would never go out and, and, and drink loads but to have a, a bottle of wine of a weekend, you know, and have a few drinks, but like I say, with my sickness, and with the methotrexate, I really feel like I can't have more than three glasses anyway, I just feel like I'd be too ill and I feel really, really bad the next morning so it's just not worth it. It's really not worth it.
I have tried to go gluten free recently, well last year, and that kind of helped a little bit. I wasn't gluten free long enough to find out how much it helped, but it, kind of, helped a little bit with sort of, weight loss which makes me think I've probably got an allergy to it, weight loss and joint wise, it wasn't so bad on my joints.
So it's something I'm going to look into again this year, and try and do exclusions and see how I get on. But I know the dairy is definitely a problem but so, I've been trying to avoid that and drink soya milk and have soya yoghurts etc.
And. But like I say, I've always been a vegetarian so and I've always recent, for the last year or two, I've had organic food as well, organic box scheme, so I think I eat pretty healthily [laughs]. So, I don't know whether, really, there's anything one that causes pain or whatever, but I feel the dairy and the wines affect, affect me.
My weight has always been an issue. I've always had a problem with it. I went to a dietician before I was diagnosed with rheumatoid arthritis and, as far as they were they were concerned, I was eating the right portions, the right sizes, I was eating the right stuff, but I just wasn't losing any weight at all. I was exercising. I was going to the gym three or four times a week, you know, on top of just normal everyday exercising, walking and cycling and I really wasn't losing any weight, so I, kind of, then decided it was probably down to allergies which is why I looked into the allergy part, and seemed to have found that, it looks like I could be allergic to some sort of gluten, and maybe dairy if it's causing me the pain so.
I was advised at the hospital to start eating fish again because fish, fish oils are meant to be good for the joints, which I do do, but it's not something that I particularly want to do [laughs]. But I do do it for health reasons but I don't think it's made much difference at all really [laughs].
Some people felt better when they cut out certain foods, particularly acidic foods, eg citrus fruits, tomatoes, strawberries, rhubarb as well as red meat, alcohol, tea and coffee. Eating them led to more pain the next day but some people did not resist the temptation of foods they really liked, especially chocolate.
She is sure that tomatoes make her arthritis worse.
She is sure that tomatoes make her arthritis worse.
And when you say it goes to your joints - pain, stiffness or?
Yeah, just, you just, I think, I don't know how you know but you just know you've eaten so I just avoid them if possible but I do still eat them but just not as many.
Several people said they avoided processed food and another person particularly avoided 'junk' food. One woman's arthritis improved when she omitted processed foods. If she had a 'flare' she would cut out all solid food for 48 hours to give her system a chance to 'calm down'.
She feels better without processed food. When she has a 'flare' she fasts for 48 hours to give...
She feels better without processed food. When she has a 'flare' she fasts for 48 hours to give...
But I do think the Stone Age diet was a lot healthier than our processed throwaway.
Oh, I'm hopeless on that.
Well I have my moments but the, the more natural I am, it's like today, I haven't eaten today because I was flaring and I'll automatically fast for 48 hours if I'm flaring.
Gosh.
Yeah, and when I say fast, I'll drink juices and vegetable juices and things like that but I won't eat solids. I'll just give my whole system a chance to calm down. And that actually stops it going from feeling like all niggly to next level up. And as I've got plenty of padding on me, I mean, I can afford to do it.
Many participants mentioned alcohol. Some used it only in moderation or stopped drinking altogether. Some said one or more of red wine, white wine, beers and spirits increased joint stiffness or led to a flare the next day. A few avoided alcohol because it interacted with medicines they were taking.
Several other people, however, had tried various diets to no avail. One woman found that dieting made her feel isolated and miserable, partly because she missed her favourite foods and partly because when dieting she couldn't join in normal social activities. She also had allergy tests for certain foods.
He tried many diets but none of them helped his arthritis.
He tried many diets but none of them helped his arthritis.
There were different, different sorts of diets where you sort of go like on perhaps a fish type based background and things like that, or certain types of vegetables. There was a whole mish mash of different things that, that came out and were recommended that you could try them until you found one that was suitable for you. But none of the ones that I ever tried have had any success and I gave that up as a bad [laughs] job to be fair.
Many diets recommend eliminating dairy produce and one woman tried a number of 'exclusion' diets. Some began by having enemas to clear out the digestive system. On one diet she could eat only grapes for two weeks; then different foods were added one at a time. But these diets made her feel unwell and the pain persisted. Another woman thought that the exclusion diet she ate for two years did help to some extent and she still avoids some of those foods.
She tried an 'exclusion' diet, which involved lots of raw fresh food, but the pain persisted.
She tried an 'exclusion' diet, which involved lots of raw fresh food, but the pain persisted.
And I think I got to the stage where I realised that the pain wasn't, wasn't going and that it was still, still very difficult to cope with and he started to mention things like that, for instance I could have a hip replacement. I suppose my hips were the worst thing then and so I realised then that it wasn't going to fulfil all my expectations of a cure.
His diet involved a lot of raw fresh food. At the beginning the whole diet was raw food. After a couple of months, I was allowed to have a cooked meal in the evening. It excluded wheat and dairy products, cow's dairy products, you could have goat's milk. Also excluded meat, all red meat, you could have chicken and fish. That was basically his diet.
A man we interviewed tried a gluten free diet, but it didn't help so he resumed a normal diet. A woman tried a 'fish' diet, but it made her condition worse and her doctor told her to abandon it.
Two women tried the Dong diet, which excluded all additives, red meat, fruit, and dairy products, and only allowed a few foods, such as fish, rice, nuts and seeds. One tried it for six weeks but hated it. Her arthritis didn't improve and she said her 'insides were completely at war' for two months after she stopped the diet. The other also said it had made her feel unwell.
The Dong diet was hard to follow and didn't appear to help her joints.
The Dong diet was hard to follow and didn't appear to help her joints.
So you could have fish and vegetables, but with nothing on them which obviously contained any dairy products. You could eat nuts and that was about it. It was a mad diet and I spoke to my rheumatologist and he said well, it won't do you any harm but it won't do you any good. But if you feel that you like to try it, you try it and I did. I tried it for six weeks and it was awful. Just imagine - what you will take for your packed lunch then. Well I can't have any bread, 'cos you couldn't have anything, well, could have any flour? You could have flour, I can't remember whether you could eat flour, wheat or not, now. But I mean it was hopeless.
So you couldn't have an egg sandwich or you couldn't, I remember taking a tin of sardines and a packet of nuts to the hospital for my packed lunch [laugh]. Well, you can imagine, [laugh] well if I was to say that I lost a lot of weight and my insides were completely at war, for about two months after I stopped the diet and my joints were just the same [laugh]. But at least I'd tried it. Some, it worked for some people I think.
I never actually met anybody but well, you think if it means you don't take the drugs, you can try the diet. I thought, oh I don't know how I was gonna manage long term on this diet, mind you, but I haven't tried anything else, no. That was my one flirtation with an alternative [laugh] and I went straight back on the hard drugs then. I thought, no I'll just take the drugs, thanks.
Most people were taking or had tried various food supplements hoping to relieve their symptoms. They included vitamin A, B, C, E, glucosamine sulphate, chondroitin, selenium, zinc, magnesium, cod liver oil, herbs, green lipped mussels, black molasses, aloe vera, cider vinegar, ginger and honey, devil's claw, royal jelly, nettle tea, comfrey tea and evening primrose/starflower oil. For more information on some of these food supplements see Arthritis Research UK.
One woman stressed the importance of telling her doctor and the rheumatology clinic about the various supplements she was taking.
She has tried many food supplements but always tells her doctors exactly what she is taking.
She has tried many food supplements but always tells her doctors exactly what she is taking.
You obviously feel they have, the others have an effect?
I don't really know. I find it very hard to tell with this disease because it doesn't follow a set pattern. The only thing that's guaranteed to make me feel better is to go on holidays somewhere warm and dry and sunny and swim in the sea you know its... I think a lot of rheumatic pain can be related to this damp, dreary climate that we have here and I don't like the cold. Yes, so it's very difficult to tell, for me to tell whether somethings actually having a, a dramatic effect.
Did you find any of the things that you took had a bad effect?
No, because I've always been very careful not to just pop a pill without considering and I considering what I'm taking and also I've made a point of telling my GP and or the rheumatology clinic exactly what I'm taking, I'm a great believer in everyone knowing what, what I'm doing. So no I don't think I ever had any negative side effects.
Some people were sure that cod liver oil helped, some found no difference, but one woman said that it made her arthritis worse. Cod liver oil capsules made another woman feel sick. Some people ate more oily fish in their diet, eg. mackerel.
Most people were not sure whether or not food supplements made any difference to their condition and didn't feel worse if they stopped. Some concluded a healthy diet provided the nutrients they required. A few had taken part in trials of supplements such as evening primrose oil and aloe vera liquid, but didn't report the results.
Some people concluded that most food supplements were a waste of money. A 55 -year old man had spent hundreds of pounds on herbal remedies to no avail, but thought that cod-liver oil, glucosamine and chondroitin were helpful. However, someone else thought that glucosamine hurt her joints.
He tried many food supplements and says he wasted money, but thinks that cod liver oil,...
He tried many food supplements and says he wasted money, but thinks that cod liver oil,...
Probably the biggest cost has been me trying out every single herbal medication you can find on the internet that's got anything remotely to do with rheumatoid arthritis. And they're not cheap, and I bet you I've spent a few hundred or thousand pounds on those over the years, to no avail.
I take the ones, what I do take is I'm pretty convinced that things like cod liver oil are actually good, I mean one of the diets for rheumatoid arthritis and I've never tried a proper diet regime either, that's one of my, it'd be difficult for me that, but it seems to be that those, that type of cod liver oil or oily fish like mackerel and things, seem, the doctors seem to think that does something and as does the gluco, glucosamine, crondite I think, I don't know how you pronounce it, chrondroitin I think isn't it, that seems to have some benefit as well. So I've dropped it down now to just basically those, I've gone through all the others and they're no good, so there's none left to try [laughs].
People with arthritis have a risk of developing osteoporosis, particularly if they are elderly or have been on a corticosteroid for a long time. A few people were taking calcium tablets, such as Osteocare, and Vitamin D to prevent this problem and others included more calcium rich foods in their diet.
(Also see 'Complementary and alternative approaches'. For more on homeopathic remedies see 'Steroid tablets, injections and intravenous pulses'.)
Last reviewed August 2016.
Last updated September 2010.
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