Like all great debates, there are opinions — and evidence — on both sides of the “alcohol and arthritis”  issue.  Some studies show that moderate alcohol intake is actually good for arthritis/inflammation….but many people with the conditions say that drinking worsens their symptoms.

Of course, there are also the medications — many of which state that you should NOT drink while taking them. Many arthritis drugs can cause damage to the liver and drinking would only worsen that problem. Other drugs can make you drowsy or “loopy” and alcohol, being a depressant, would only worsen that effect.

However, my rheumatologist has always said that it’s ok for me to drink “in moderation” and “socially” as long as I do not overdo it or imbibe on a daily basis. My liver tests, personally, have always been OK, and I am very careful to not mix certain meds with alcohol. That being said, it is a personal choice, everyone’s individual experiences are different, everyone’s body is different, and, your doctor may have different advice for you. So, I advise you to take whatever advice your doctor gives.

But, I’ll shed some light on both sides of the debate for those who are interested.

First, we’ll discuss why alcohol may be bad for arthritis. Firstly, it is a big “no-no” for anyone with gout. For whatever reason, alcohol – particularly beer – is known to greatly increase the painful inflammation associated with gout. Additionally, those who drink are even more likely to develop gout as opposed to those who do not. Why is there this relationship between alcohol in gout? For one, gout is the result of excess uric acid in the blood. As alcohol is metabolized, part of it breaks down and contributes to urate which is the salt version of uric acid. Additionally, some wines and stouts contain purines or oxypurines which lead to increased purine load — and purine is a component of foods/etc. that are metabolized into uric acid. Lastly, drinking in excess can lead to obesity. Obesity increases your chance for gout, puts weight on joints, and, increases uric acid output.

People with gout are not the only ones who have to watch it when it comes to drinking, though. One reason is that many autoimmune conditions overlap. If a patient with RA, Lupus, etc. has Celiac Disease as well, they cannot drink many types of beer and alcohol due to them containing gluten. Another reason is that alcohol consumption can make you dehydrated. People with Fibromyalgia and similar muscoskeletal conditions already have muscle soreness and tenderness that would certainly be increased with dehydration. Also, patients with fibro and/or arthritis should avoid drinking alcohol in the evening because it can adversely affect the quality of sleep which could in turn worsen symptoms like fatigue and pain.  It is also worth noting that it is best to avoid drinking later in the day if you take prescribed sleep medications for Fibro or CFS. This is due to the potential of interactions between the alcohol and the drug. Additionally, alcohol causes weight gain — but health professionals often recommend shedding pounds to help improve rheumatoid arthritis, osteoarthritis, and similar conditions. As for Lupus, according to the Lupus Foundation of America, “Moderate use of alcohol is usually not a problem for people with lupus, but alcohol can lower the effectiveness of some of the drugs used to treat lupus, can cause new health problems, and can make certain existing problems worse.”

As far as Rheumatoid Arthritis and drinking goes; the main reason a person with RA shouldn’t drink is simply the meds. As mentioned, many RA drugs can increase liver toxicity anyway, so adding alcohol to that mix could potentially worsen that problem even further.  According to Dr. Lightfoot, a rheumatologist at the University of Kentucky , “If a patient is not taking methotrexate or experiencing liver problems, there is no reason not to drink alcohol in reasonable and responsible quantities,” says Lightfoot. He continues, “But you may want to avoid alcohol in any amounts if you have any stomach irritation or if your liver enzymes increase.” Regarding osteoarthritis and osteoporosis, the main concern is that alcohol can speed up bone loss leading to osteoporosis and the softening of bones.

That being said, some people with RA have reported that alcohol increases their inflammation. If this is the case, then these folks should also be avoiding alcohol consumption.

On the flip side, many studies have shown that moderate intake of alcohol can actually alleviate symptoms, decrease inflammation, and reduce pain.

According to Health.com, “Moderate drinking has been linked to a variety of health benefits, including a reduced risk of heart disease, stroke, and diabetes. According to a new study, drinking alcohol may also ease the pain of — and lower the risk of developing — rheumatoid arthritis, a potentially crippling autoimmune disorder. People who don’t drink alcohol are roughly four times more likely to have rheumatoid arthritis than people who have at least one drink three or more days per week, the study found. The researchers also found that rheumatoid arthritis patients who drink alcohol tend to have less severe symptoms than their nondrinking counterparts. And the more often they drink, the milder their symptoms are.”

This isn’t to say that us RA’ers should all become a bunch of drunks, but, the evidence “for” drinking is actually quite interesting. “Alcohol reduces immune activity, at least to some extent, and [we] suspect that this is the main reason that alcohol consumption is associated with a reduction in severity of rheumatoid arthritis,” says the lead author of the study, James Maxwell, a rheumatologist at Rotherham Hospital, in the U.K. “Alcohol may also have a mild painkilling effect.”

A 2008 study showed that alcohol cuts the risk of developing rheumatoid arthritis by up to 50%, reveals research published ahead of print in the Annals of the Rheumatic Diseases. The Scandinavian researchers based their findings on more than 2750 people taking part in two separate studies, which assessed environmental and genetic risk factors for rheumatoid arthritis. Among those who drank regularly, the quarter with the highest consumption were up to 50% less likely to develop the disease compared with the half who drank the least., with the results being the same in both men and women.

A 2010 study presented at EULAR involved 997 patients with rheumatoid arthritis, reactive arthritis, spondyloarthropathy, or psoriatic arthritis who were enrolled in a Leiden Early Arthritis Cohort. They were compared with 6,874 healthy people.  People in both groups were asked at the start of the study if they drank alcohol and how much they drank.

When compared with teetotalers, drinkers were:

• 73% less likely to develop rheumatoid arthritis
• 69% less likely to develop osteoarthritis
• 66% less likely to develop spondyloarthropathy
• 62% less likely to develop psoriatic arthritis
• 73% less likely to develop reactive arthritis

The researchers did not ask whether the alcohol consumed was beer, wine, or spirits. EULAR president Paul Emery, MD, professor of rheumatology at Leeds University, in England, cautions that the findings should be interpreted with caution.

“Alcohol should be consumed in moderation, with consideration for local public health recommendations. A number of social and medical problems are associated with increased consumption of alcohol; therefore any positive implications of its use must be understood within the wider health context,” he says.

“This actually isn’t a new concept. There have been other articles (stating) that alcohol might be protective,” said Dr. Guy Fiocco, assistant professor of internal medicine at Texas A&M Health Science Center College of Medicine and director of rheumatology at Scott & White in Temple, Texas. “(But) I don’t think we’re going to be advocating alcohol to prevent rheumatoid arthritis.”

None of these researchers advise drinking as a cure for arthritis.

“We would wish to point out that, at the moment, that our findings are preliminary, and would not recommend that patients drink alcohol with the specific purpose of treating their arthritis,” said Dr. James Maxwell. However, he did state that, “Generally speaking, it appears that drinking alcohol in moderation may benefit patients with rheumatoid arthritis.”

So, we’d like to know – what do you think? Does alcohol negatively or positively affect you? Or, are certain types helpful and certain types harmful? Do you think there’s any link between drinking and arthritis? Since there are pros and cons on both sides of the story, I would say that the choice is yours — and your doctor’s — as to whether or not you should drink.

Share your thoughts, and leave a comment!