Alcohol and rheumatoid arthritis

How does alcohol affect rheumatoid arthritis?

Share on PinterestDrinking in moderation should not negatively affect people with RA.

Until recently, little research has directly assessed the effects of drinking on RA.

Currently, the research is mixed, and it appears that the link between alcohol and RA differs, depending on how much a person drinks and the medications they are taking.

The following sections of this article look at what the research says about alcohol and how it affects RA.

Does alcohol affect inflammation?

Inflammation causes the symptoms of RA, including joint pain, stiffness, and fatigue. Heavy alcohol use can increase inflammation in the body, while moderate drinking may actually reduce inflammation.

A 2015 review states that moderate drinking can reduce certain markers of inflammation, which may include c-reactive protein, interleukin-6, and tumor necrosis factor (TNF)-alpha receptor 2. Binge drinking, on the other hand, increases inflammation.

When a person drinks excessively, alcohol can damage the gut and liver, leading to body wide inflammation. Scientists alcohol-related medical conditions with chronic inflammation.

When taken in moderation, however, alcohol should not negatively affect people with RA.

Can alcohol reduce RA symptoms?

Some small research studies suggest that drinking a moderate amount of alcohol could reduce RA symptoms, possibly because alcohol reduces certain types of inflammation. However, more research is needed to uncover the true effects of alcohol on RA symptoms.

A 2010 study looked at the effects of drinking alcohol in 873 people with RA. The researchers reported that “alcohol consumption is associated with reduced disease severity.”

A 2018 study of 188 people with early RA found no difference in the severity of joint inflammation when the researchers looked at their MRI scan results. They suggested the anti-inflammatory effects of alcohol could be systemic and not involve the joints specifically.

However, the Centers for Disease Control and Prevention (CDC) say that nobody should start drinking alcohol for any potential health benefits. Alcohol can cause both short and long term health problems, even if it does not exacerbate symptoms of RA.

Can alcohol reduce the risk of RA?

Another strand of evidence suggests that drinking a moderate amount of alcohol could actually reduce the risk of developing RA in people who do not have the condition.

In a 2014 study, researchers looked at survey results and medical records from more than 200,000 people over multiple decades. They found “a modest association between long term moderate alcohol drinking and reduced risk of RA.” This means that people who drank alcohol in moderation had a lower risk of developing RA.

Researchers need to conduct further studies to explain, understand, and confirm the link between drinking alcohol and the risks of developing RA

If you enjoy a glass of wine or pint of beer with dinner, you might wonder whether alcohol is a friend or foe to arthritis. The answer is, it’s a bit of both. While moderate drinking may reduce some risks of developing arthritis, if you already suffer from arthritis or a condition like gout, it may do more harm than good.
Anti-inflammatory Benefits
Enjoying a drink with some regularity might reduce your risk of developing rheumatoid arthritis (RA), according to a few studies. “Moderate alcohol consumption reduces biomarkers of inflammation, including c-reactive protein (CRP), interleukin-6, and TNF-alpha receptor 2,” says Karen Costenbader, MD, MPH, a rheumatologist at Brigham and Women’s Hospital in Boston. Alcohol’s anti-inflammatory effects are also thought to be one of the reasons it appears to lower cardiovascular disease risk in moderate drinkers. The key word is moderate, which most people overestimate when it comes to alcohol. “We saw that for women who drank between 5 and 10 grams of alcohol a day, there was a reduced risk of RA,” says Dr. Costenbader. But that works out to less than a glass of wine or beer daily.
Medication Interactions
Once you already have arthritis, drinking may have more downsides than pluses. Many of the medicines your doctor prescribes to relieve sore joints don’t mix well with alcohol – including non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin) or naproxen (Aleve), which carry a greater risk for stomach bleeding and ulcers when you drink. Taken with acetaminophen, methotrexate or leflunomide (Arava), alcohol can make you more susceptible to liver damage.
Gout Attacks
Alcohol is particularly problematic if you have gout. “Gout attacks can be brought on by purine-rich foods or drinks, and beer is high in purines,” Dr. Costenbader says. Distilled liquor, and possibly wine, can also cause problems for those with gout.
Additional Risks
If you have arthritis and want to drink, talk to your doctor. Even with a doctor’s ok, limit yourself to one drink a day. That’s about 12 ounces of regular beer, 5 ounces of wine and 1.5 ounces of spirits.
Excess drinking can damage your body in many other ways. “The risk of other kinds of diseases goes up with higher alcohol consumption,” says Dr. Costenbader. Conditions linked to drinking more than moderate amounts of alcohol include cancers of the breast, colon, esophagus, mouth and throat, as well as diseases like diabetes and stroke.
If you choose to drink, alcohol should only be one small part of a healthy diet. Eating healthy, exercising, controlling your weight and not smoking are better ways to protect your joints and the rest of your body, says Dr. Costenbader.

Rheumatoid Arthritis and Alcohol


Chris Illiades Was this helpful? (21)

For years, the RA experts have debated about the link between alcohol and rheumatoid arthritis. On one hand, many studies show that moderate alcohol use may protect you against RA or ease your symptoms. On the other hand, alcohol can increase your risk of RA complications and may interact badly with some RA drugs.

Recent studies have added fuel to the fire. Research published in the journal Rheumatology found that people with RA who said they drank frequently had less severe RA symptoms compared to people with RA who said they rarely or never drank alcohol.

Another recent study done in Sweden found that women who had more than three alcoholic drinks a week, for at least 10 years, cut their risk of developing RA by 50%. Researchers think alcohol may ‘turn down’ the body’s immune system and reduce inflammation. This sounds logical because RA is a disease in which a disordered immune system attacks joint tissue and causes inflammation. But before you pop that cork, know that RA experts still urge caution, despite these findings.

Dangers of Alcohol in RA

Although most RA experts agree that drinking alcohol in moderation is probably safe and may even prevent some symptoms of RA, heavy drinking is not recommended. Alcohol in moderation means no more than one drink a day for women and two drinks a day for men.

Here are the dangers of heavy alcohol use:

  • Falls. RA symptoms, such as poor balance, weakness, fatigue, and stiffness, can contribute to falls. Drinking alcohol can increase the risk of these dangers.

  • Osteoporosis. Osteoporosis, a condition that causes thinning bones, is a known complication of RA. People with RA are at higher risk for osteoporosis because of being inactive due to painful RA symptoms, and from taking steroid medications over the years. Studies show that drinking alcohol may increase bone loss.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs are commonly used to reduce RA pain and swelling. The biggest side effect of these drugs is stomach bleeding. Alcohol can also cause stomach bleeding, making alcohol and NSAIDs a bad combination.

  • Methotrexate. Liver damage is the most serious side effect of this commonly used disease-modifying drug for RA. Alcohol is also toxic to the liver, so you do not want to mix these two.

  • Muscle weakness. RA symptoms like pain and stiffness can lead to muscle loss. Studies show that chronic alcohol use can break down muscle tissue, causing muscle wasting.

  • Smoking. Smoking may increase your risk of developing RA, and affect the severity of RA once it develops.

  • Sleep. Getting enough sleep is often a problem for people with RA because pain and stiffness can make it difficult to sleep comfortably. Fatigue is another major RA symptom, so getting the sleep you need is important. Alcohol may disrupt sleep and make fatigue worse.

  • Depression. RA can cause depression because it is a chronic, painful condition. Alcohol acts as a depressant which can compound symptoms of depression.

The bottom line on alcohol and RA is moderation. Alcohol is not a substitute for RA treatment. Ask your doctor how much alcohol is safe for you, especially if you are taking medication for RA. Don’t drink any alcohol until you have checked with your doctor.

Key Takeaways

  • Studies have found that drinking a moderate amount of alcohol may help prevent or decrease RA symptoms.

  • Experts warn that people who have RA must use alcohol cautiously.

  • Too much alcohol can contribute to RA complications such as falls, weakness, fatigue, and depression.

  • Alcohol may interfere with some common RA medications.

  • Ask your doctor how much alcohol is safe for you before you drink.

Does Drinking Alcohol Help Improve RA Symptoms? Here’s What a New Study Says About It

You’ve probably heard that moderate drinkers have a lower risk of certain health problems, including heart disease and Alzheimer’s. Studies have similarly suggested that a few drinks a week might cut your chances of developing rheumatoid arthritis (RA), and that RA patients who drink moderately are less likely to have severe symptoms. But is the alcohol actually causing these health benefits?

At least when it comes to RA, the answer seems to be no.

In a new study, published in the journal Arthritis Care & Research, researchers tried to tease out whether there was a true cause-and-effect relationship between alcohol and RA symptoms by tracking when patients shifted their habits to drink more or less and matching those changes up with measures of disease activity. The researchers relied primarily on semi-annual surveys of nearly 17,000 participants.

After analyzing the data, the researchers concluded that patients who were currently dealing with more severe disease were more likely to stop drinking and less likely to start if they weren’t already drinking. They also determined that current drinkers with greater RA-related disability and a poorer quality of life were less likely to continue using alcohol. The flip side: Healthier RA patients were the ones more likely to be regularly consuming some beer, wine, or liquor.

“Our data shows that when people aren’t feeling well, they tend not to drink alcohol. While this makes it appear that people who drink are better off, it’s probably not because the alcohol itself is helping,” lead author Joshua Baker, MD, of the University of Pennsylvania, told ScienceDaily.

His group’s official conclusion is that alcohol doesn’t make RA better. “Active use and changes in use were not associated with disease activity or mortality… suggesting no clear benefit of alcohol consumption in RA,” they wrote.

Keep Reading

  • Alcohol and Arthritis: How Drinking Affects Your Joints
  • Methotrexate and Drinking Alcohol: How Risky Is It?
  • What It’s Really Like to Try an Elimination Diet

When Is Alcohol Safe for RA?


Evelyn Creekmore Was this helpful? (89)

Rheumatoid arthritis (RA) is a chronic autoimmune disorder that causes inflammation of the joints. As with many chronic conditions, the lifestyle choices you make are an important part of your treatment plan. The general consensus of the medical community is that arthritis and alcohol don’t mix. Those living with RA should drink alcohol only in moderation (one drink a day), and it’s better not to drink at all. Learn why and remember your doctor is here to help you with all aspects of treatment, including lifestyle changes that may be challenging for you.

Alcohol and Inflammation

Alcohol makes your liver work harder and can promote inflammation—the core symptom RA treatment plans are designed to relieve. While you may have heard that some studies have linked drinking red wine in moderation to reduced inflammation, it’s always worthwhile to dig a little deeper and understand such studies in context. For example, some of these studies are based on the drinking habits of those who do not yet have RA. The results don’t apply to those who already have it. A general guideline is if you have RA and don’t drink, don’t start. Always look to your doctor as your best resource for interpreting information related to your condition.

Alcohol and RA Medication

Be aware that drinking alcohol while taking these common medications to relieve joint pain can lead to serious problems.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), combined with alcohol, can increase your risk for ulcers and bleeding in your stomach. Examples are naproxen (Aleve) and ibuprofen (Motrin).

  • Acetaminophen (Tylenol), leflunomide (Arava), and methotrexate (Trexall, Rasuvo) can increase the risk of damage to your liver when combined with alcohol.

Talk with your doctor about your current drinking habits and how alcohol may interact with your specific medications.

Alcohol, RA and the Risk of Related Conditions

Nearly 23% of adults in the United States have been diagnosed with some form of arthritis. When you’re diagnosed with a chronic condition, it’s essential to take care of yourself — not just take your medication. Otherwise, you may contribute to a domino effect of related issues unintentionally. For example:

  • Those living with RA are at greater risk of developing osteoporosis, a thinning of the bones that makes bones more prone to break. Drinking alcohol excessively also increases the risk of osteoporosis.

  • Up to 40% of those living with RA also have symptoms of depression, which can be made worse by using alcohol, a depressant, to cope with a chronic condition.

  • Some doctors have reported sleep problems in the majority of their RA patients. Causes of poor sleep for those with RA include pain, medication side effects, or anxiety related to managing RA. Alcohol, along with caffeine, also interferes with quality sleep.

Living with rheumatoid arthritis doesn’t mean living with all the pain and stress that can come with it. The key is treating the symptoms — from pain to depression to poor sleep — safely and effectively. Talk with your doctor as a partner who needs to understand the effects of RA on your life as a whole, so you can work together toward living your best.

Alcohol Abuse And Joint Pain

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Side Effects, Risks And Dangers Of Mixing Alcohol With Medications

Mixing alcohol with medications, especially certain pain meds, can be a risky combination. Both over-the-counter and prescription medications can interact with alcohol in a harmful way. Additionally, certain drugs are less effective when combined with alcohol.

The Risk Of Mixing Over-The-Counter Medications With Alcohol

Many people mistakenly think that because a medication is sold over the counter that it carries no risk or that it’s safe to mix with alcohol. But the truth is, even over-the-counter drugs can be dangerous when mixed with alcohol.

Some of the most common over-the-counter medications used to treat pain can stress vital organs and cause serious complications when taken with alcohol.

The following non-steroidal anti-inflammatory drugs (NSAIDs) may increase the risk of ulcers and stomach or GI bleeding:

  • aspirin (Bayer, Bufferin, Excedrin)
  • ibuprofen (Advil, Motrin)
  • naproxen (Aleve)

Acetaminophen (Tylenol), another popular over-the-counter pain reliever, can increase the risk of liver problems.

The Danger Of Combining Prescription Medications With Alcohol

Various prescription medications used to treat joint pain or other symptoms of diseases that cause joint pain may interact with alcohol, including opioid painkillers:

Non-Opioid Prescription Medications That May Be Harmful When Used With Alcohol

Used with alcohol, certain prescription medications can increase the risk of GI bleeding, such as:

  • celecoxib (Celebrex)
  • prednisone

When taken with alcohol, the following prescription medications could cause liver damage or raise the risk of irreversible cirrhosis (liver scarring and failure):

  • methotrexate (Rheumatrex, Trexall)
  • mycophenolate (CellCept, Myfortic)
  • leflunomide (Arava)

Opioid Medications That Are Dangerous When Used With Alcohol

Mixing opioid painkillers and alcohol can cause central nervous system depression. More specifically it can cause respiratory depression, a potentially fatal condition that causes difficult and slowed breathing.

The following opioids may be prescribed to manage pain caused by osteoarthritis:

  • codeine (Tylenol 1, 2, 3 or 4)
  • hydromorphone (Dilaudid)
  • morphine
  • oxycodone (Percocet, Percodan)

Opioids can cause dependence if misused or used for long periods of time. Because of this, many doctors may prefer to try different alternatives for pain management.

Treating Alcohol-Related Joint Pain And Alcohol Abuse

The treatment for alcohol-induced joint pain will vary per person and per medical condition. It will also be dependent on the particulars of their alcohol use disorder. Before selecting a treatment center, it’s important to find out if they’re equipped to handle a certain medical problem during the course of treatment.

Medical treatments that seek to reduce and manage pain should be delivered. If a person has developed an addiction to an opioid painkiller, appropriate treatment for this addiction should also be integrated into treatment. Non-addictive medications may be used as needed. Some rehab programs offer holistic therapies that treat both pain and substance use disorders, including massage and acupuncture.

The exact length and form of treatment is different person to person. Struggling with chronic pain and addiction can deeply change a person’s life and cause negative emotions, thoughts, and behaviors. To counter this, and to build more positive mindsets, intensive therapies may be used.

Inpatient drug rehab centers can help a person to regain a more healthful life. These residential programs also teaching sober living skills that can help a person better manage their pain and recovery journey.

Reach out to Addiction Campuses for more info on joint pain, other health problems caused by alcohol abuse and treatment options.

Written by Addiction Campuses Editorial Team

© 2020 All rights reserved.

This page does not provide medical advice.

Article Sources



Cochrane –

Huffington Post –

Mayo Clinic –

The National Research Center on Lupus –

ScienceDaily –

US National Library of Medicine –

Beer protects women from rheumatoid arthritis, suggest Harvard researchers

Image: Thinkstock

Published: July, 2014

We don’t have a way yet to cure or prevent rheumatoid arthritis (RA)—the condition that occurs when the body’s immune system mistakenly attacks healthy tissue, leading to painful inflammation of the joints and surrounding tissues. But Harvard researchers say that drinking beer may offer protection against developing the condition. Their research, published online April 11, 2014, in Arthritis & Rheumatism, found that women who drank two to four beers per week had a 31% lower risk of developing RA compared to women who never drank. Moderate consumption of any type of alcohol was associated with a 21% lower risk. Women are much more likely than men to get RA, which usually develops between ages 30 and 60. Studies of this type cannot prove that drinking alcoholic beverages protects against getting RA, but they suggest it might. If you already have RA, don’t drink alcohol without first talking to your doctor. Alcohol doesn’t mix with certain RA drugs such as methotrexate (Rheumatrex). 

As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

What You Should Know About Rheumatoid Arthritis and Alcohol Consumption

Rheumatoid Arthritis and Alcohol Consumption

While there are a handful of non-modifiable risk factors for rheumatoid arthritis, such as your age and your genetics, the list of modifiable risk factors is surprisingly long. From your diet to your occupation to habits like smoking, many of your daily activities and actions play a role in your arthritis risks, pain management, joint mobility, and general wellbeing and happiness.

Alcohol is one such lifestyle factor. Whether you enjoy a James Bond-style martini or a simple glass of Merlot, knowing how alcohol affects your rheumatoid arthritis, and how much you can enjoy safely, is essential for your journey towards total joint health.

How Alcohol Impacts Your Arthritis

Rheumatoid arthritis is an autoimmune disease where your immune system actively and incorrectly attacks your joints. This immune system barrage sparks inflammation within the lining of your joints, leading to stiffness, loss of mobility, chronic pain and in more severe cases, permanent damage to your joints.

Thus, the big question with alcohol is how alcohol impacts inflammation, and therefore your arthritis.

The answer may surprise you.

A Study on Rheumatoid Arthritis and Alcohol Consumption

While alcohol is often painted as a villain within many health communities, a handful of studies say it may not be as bad as you may think when it comes to arthritis. In fact, alcohol may have a surprisingly positive impact on arthritis!

In one comprehensive study published in the journal Rheumatology, researchers studied 873 patients with rheumatoid arthritis and 1,004 healthy people without arthritis. “Although there are some limitations to this study, our data suggest that alcohol consumption has an inverse and dose-related association with both risk and severity of RA,” concluded the researchers.

To put it in simpler language, the study found that drinking alcohol decreased both your risk of having rheumatoid arthritis, as well as the severity of your arthritis if you have it.

A team of researchers at Brigham and Women’s Hospital looked into it further. Specifically, the researchers looked at examining how drinking alcohol affected women and their arthritis. The study discovered that drinking a moderate amount of beer (wine and other forms of alcohol weren’t included) had a positive effect on their rheumatoid arthritis.

“Long-term, moderate alcohol drinking may reduce future rheumatoid arthritis development,” explains principal investigator Bing Lu, in a press release from the hospital. “The study found that moderate use of any form of alcohol reduced the risk by 21 percent, but moderate beer drinking – between two and four per week – cut women’s odds by nearly a third.”

Alcohol’s positive effects on arthritis may be due to its ability to reduce some of your chronic inflammation, which ties into both arthritis risks and arthritis severity.

Moderation Is Key When It Comes to Rheumatoid Arthritis and Alcohol Consumption

While multiple studies have indicated that there may be some positive benefits to drinking alcohol if you have rheumatoid arthritis or want to lower your risks of arthritis, this isn’t an invitation to go on a bender or polish off a bottle of red every evening.

Researchers warn that moderation is key, and moderation may not look exactly like what you’re thinking. According to the Arthritis Foundation, moderation in one study was 5 to 10 grams of alcohol a day, which translates to less than a glass of wine or a pint of beer a day.

The Dangers of Rheumatoid Arthritis and Alcohol Consumption

Drinking more than this negates many of the benefits of alcohol.

Clouding the picture, even more, is the risk of side effects with common medications used to treat arthritis and arthritic pain.

“Once you already have arthritis, drinking may have more downsides than pluses,” warns the Arthritis Foundation. “Many of the medicines your doctor prescribes to relieve sore joints don’t mix well with alcohol – including nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin) or naproxen (Aleve), which carry a greater risk for stomach bleeding and ulcers when you drink. Taken with acetaminophen, methotrexate or leflunomide (Arava), alcohol can make you more susceptible to liver damage.”

Finally, alcohol can affect other conditions that men and women with arthritis have. For example, many people with arthritis also struggle with gout, and alcohol can cause gout to flare up and worsen.

The Bottom Line…

The final verdict? Is alcohol something to cheers over, or something that someone with arthritis should absolutely avoid?

Studies suggest that small servings of beer or wine (other forms of alcohol are less studied) may have more pros than cons when it comes to rheumatoid arthritis, but that’s not the only thing to consider.

Because alcohol isn’t benign and comes with other risks and benefits, it’s important to talk to your doctor. While drinking a tiny amount of wine or beer may have beneficial impacts on your arthritis, you also want to take into account factors like any medications you have and other pre-existing conditions you’re experiencing. Only a complete review by a medical professional can guide you towards the right decision.

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