Arthritis and Alcohol
There is a longstanding debate regarding the effect of alcohol on the symptoms and risks of arthritis diseases. Learn how alcohol may cause or prevent arthritis.
by Brad Chase
One of the major steps to understanding the nature, progression and mechanism of arthritis diseases is to understand how lifestyle choices can affect the risks of developing arthritis later in life. With such knowledge, it is quite possible to advice people on what to do and what to avoid in order to reduce the incidence of arthritis in the population.
Besides diet, alcohol and smoking are the two lifestyle choices that are important to disease causation.
Conventional belief states that both of these forms of indulgence would increase the risk of developing arthritis. While there is an overwhelming evidence linking smoking to arthritis, there have been conflicting results from different clinical studies on the link between alcohol and arthritis.
The conflict is not whether alcohol has an effect on arthritis or not. Rather, it is whether the consumption of alcohol protects against or causes arthritis.
While there are no clinical studies directly linking alcohol consumption with increased risk of arthritis, it is easy to infer this link from the effects alcohol has on the body.
Alcohol dehydrates the body.
By removing moisture from the extracellular matrix making up muscles and other connective tissues, alcohol causes these tissues to grow stiffer and restrictive.
When this effect is carried over to the joints, it may cause the dehydration of the glycosaminoglycans making up cartilages. With the loss of moisture, glycosaminoglycans such as chondroitin lose their cushioning property. Therefore, the impact of regular movement wears down the bones at the joint quickly.
In addition, the dehydration caused by alcohol may affect the synovial fluid. This means that the synovial fluid becomes incapable of fulfilling its main role as the lubricant for joints.
Besides dehydration, alcohol can also cause weight gain.
Arthritis symptoms worsen with every pound of weight gained. This is because gaining weight increases the load that has to be carried by the bones while the joints work harder under the strain of additional burden.
Furthermore, alcohol promotes the elimination of certain essential nutrients from the body.
Some of these nutrients are needed for the maintenance of bone health and to support the functions of joints. Alcohol flushes out essential minerals such as magnesium and important vitamins such as thiamine.
It can also increase the risk of other diseases especially cardiovascular diseases. Hypertension, heart disease and stroke all significantly contribute to the development of arthritis.
Excessive alcohol consumption also promotes malnutrition which can increase the risk of arthritis.
Alcohol may also interfere with arthritis symptoms. It can cause chronic inflammation.
Alcohol can also worsen muscle aches and cause general body weakness. This effect is especially evident in arthritis patients suffering from fibromyalgia. Because alcohol interferes with sleep, it may cause sleeplessness and fatigue which worsens painful joint inflammation in people suffering from arthritis.
Furthermore, alcohol has been shown to cause bone loss.
It kills off osteoblasts which are cell lines responsible for creating new bones. Excessive consumption of alcohol also increases the risks of osteopenia and osteoporosis especially in post-menopausal women. It also suppresses the healing of fractures.
Yet another means by which alcohol is believed to worsen arthritis is by interfering with arthritis drugs.
Long-term consumption of alcohol can cause liver damage. When it reduces liver function, this means that alcohol can interfere with the metabolism and clearance of drugs. This could lead to either toxicity or reduction in the efficacies of these drugs.
Therefore, alcohol can increase the side effects of arthritis drugs or render them ineffective. Both scenarios are bad for arthritis patients because their pain and inflammation are then not well controlled.
The risk of liver damage through excessive alcohol consumption is significantly increased in arthritis patients who are also receiving DMARDs (disease-modifying anti-rheumatic drugs) such as methotrexate.
Similar risks are also present when alcohol is mixed with acetaminophen.
However, even non-steroidal anti-inflammatory drugs or NSAIDs, which are the most common drugs prescribed for arthritis, are affected by alcohol. People who mix alcohol and NSAIDs run the risk of gastrointestinal bleeding and stomach ulcers.
Just as excessive alcohol consumption can increase the risk of certain diseases, moderate drinking can reduce the risk of heart disease, stroke and diabetes.
However, a number of new studies are reporting a more direct link between alcohol and arthritis. This link is a strong correlation that suggests that moderate alcohol consumption actually reduces the chance of developing some forms of arthritis.
Two of these studies were done in Denmark and Sweden.
These two studies were published in a 2009 issue of Annals of Rheumatic Diseases. The Swedish study involved 1204 cases with 871 controls while the Danish study used 444 cases and 533 controls.
Both studies gave the same results: alcohol consumption was able to reduce the risk of rheumatoid arthritis by as much as 50%.
Experts argue that the ability of alcohol to reduce the risk of arthritis is not as counterintuitive as it sounds. In fact, alcohol is known to dull pain. Its mild painkilling effect is the reason most people take to it in the first place.
Therefore, although it is never recommended to be used this way, alcohol can help reduce arthritis pain.
Alcohol also produces a second positive effect: it depresses the immune system.
Most people believe this is why alcohol is especially effective for reducing the risk of rheumatoid arthritis.
Since rheumatoid arthritis is triggered by autoimmune reactions, it can be prevented by any agent that reduces immune activity. Therefore, alcohol consumption can prevent the body from attacking itself by keeping antibodies away from the cells of the cartilage.
In another study done in the UK, the drinking habits of 873 patients with rheumatoid arthritis were compared against those of 1004 people who were not diagnosed with the disease.
The result of the study showed that alcohol reduces the severity of the symptoms of rheumatoid arthritis. Compared to non-drinkers and those who did not drink frequently, patients who drank alcohol regularly experienced milder inflammation, less joint pains and the X-ray imaging of the joints showed less damage.
The researchers also credited the protection provided by alcohol on its ability to suppress the immune system as well as on its mild analgesic and anti-inflammatory properties.
Alcohol affects the risks and progression of different forms of arthritis differently. For example, while it reduces the risks of other forms of arthritis, it actually causes and worsens gout arthritis.
Alcohol increases the painful joint inflammation experienced by patients suffering from gout.
This is caused by the increased deposition of uric acid because uric acid salts are formed in the body from the metabolism of alcohol. Alcoholic drinks can also increase the amount of purines present in the body. Since purine is one of the precursors of uric acid, these drinks worsen gout symptoms.
This effect is most evident with alcoholic beers but it is also seen with other forms of alcohol including wine.
Even though alcohol reduces the risk and symptoms of rheumatoid arthritis, other ingredients of alcoholic drinks may worsen these symptoms.
For example, the gluten found in certain beers can trigger hypersensitivity reactions in rheumatoid arthritis patients who also have celiac disease. Since autoimmune diseases often present in the company of each other, this kind of reaction is more common than most people realize. It may actually bring out the second autoimmune condition.
Overall, even though alcohol consumption improves the symptoms and lowers the risks of most forms of arthritis, alcohol is not a cure for arthritis and it should not be used for that purpose.
Therefore, non-drinkers should not necessarily take up drinking as a form of treatment for their arthritis pains.
However, drinkers should know that alcohol consumption may or may not contribute to the risks of developing arthritis later in life.
There are many factors to consider before a clear-cut recommendation about alcohol consumption can be made for arthritis patients or those at risk of developing the condition. In addition, most of the studies for and against alcohol in arthritis management are neither conclusive nor definitive.
We do not know how alcohol consumption reduces the risk of arthritis but we know it does. On the other hand, only a few studies have demonstrated that drinking worsens or increases the risk of arthritis yet we know the effects of alcohol in the body should lead to those conclusions.
The general consensus then is that moderate drinking is permissible, does not significantly worsen arthritis symptoms and may even protect against some forms of arthritis.
There are different definitions for moderate drinking. It may mean drinking alcohol about 10 days every month, only drinking socially or taking no more than a drink every day.
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