Understanding the Complex Relationship Between RA and Alcohol
For individuals with rheumatoid arthritis (RA), the impact of alcohol is not straightforward. While some studies suggest that moderate intake may correlate with lower disease activity, this is not a recommendation to start drinking. The key takeaway is that for those who already consume alcohol, moderation is paramount, and certain types may be less problematic than others. However, a discussion with your healthcare provider is essential, especially if you are taking specific medications.
The Role of Moderation
The term "moderate" is often misunderstood, and for those with RA, it's particularly important to adhere to clear guidelines. The Centers for Disease Control and Prevention (CDC) defines moderate drinking as up to one drink per day for women and up to two drinks per day for men. A standard drink is defined as:
- 12 ounces of beer (5% alcohol content)
- 5 ounces of wine (12% alcohol content)
- 1.5 ounces of distilled spirits (40% alcohol content)
Drinking more than this amount can promote inflammation, counteract any potential anti-inflammatory benefits, and exacerbate RA symptoms.
Alcohol and RA Medications: A Dangerous Combination
One of the most significant risks associated with drinking alcohol with RA is the potential for dangerous drug interactions. Several common RA medications are processed by the liver, and adding alcohol can place additional, sometimes dangerous, strain on this organ.
- Methotrexate and Leflunomide: These disease-modifying antirheumatic drugs (DMARDs) are known to cause liver toxicity. Combining them with alcohol significantly increases the risk of liver damage and should be avoided or strictly limited as per your doctor's orders.
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen and naproxen can cause stomach upset or internal bleeding. Alcohol can worsen these gastrointestinal side effects.
- Acetaminophen: Often used for pain relief, acetaminophen also places stress on the liver, and its risks are amplified when combined with alcohol.
Potential Choices for Moderate Drinkers
If your doctor has cleared you for moderate consumption, certain types of alcohol may be preferable due to their potential anti-inflammatory properties or lower sugar content.
- Red Wine: Red wine contains a powerful antioxidant called resveratrol, which has demonstrated anti-inflammatory effects in some studies. This is one of the main reasons red wine is often cited in discussions about alcohol and inflammation. However, its benefits are only seen in light to moderate consumption, and the amount of resveratrol is relatively low.
- Clear Spirits: Some individuals may opt for clear spirits like vodka or gin, which contain no sugar or purines, reducing the chance of adding other inflammatory compounds. The key is to mix them with healthy, non-sugary beverages, like sparkling water with a twist of lemon or lime.
- Healthier Mixers: The mixers you choose are just as important as the alcohol. Sugary sodas, juices, and syrupy cocktails are highly inflammatory and should be avoided. Instead, consider:
- Sparkling water with fresh herbs like mint or basil.
- Tea, such as green or ginger tea, which have anti-inflammatory benefits.
- Freshly squeezed citrus juice in small amounts.
- Kombucha for probiotics, but be mindful of sugar content.
Comparison of Alcohol Types for RA
| Alcohol Type | Potential Benefits (Moderate Use) | Risks (Any Use) | Considerations for RA Patients |
|---|---|---|---|
| Red Wine | Contains antioxidant resveratrol with anti-inflammatory effects. | Can interact with medications. Easy to overconsume. | Choose quality red wine and stick to strict moderation. |
| Clear Spirits (Vodka, Gin) | No sugar or purines. Can be mixed with non-inflammatory ingredients. | Potential for liver stress, especially with certain medications. | Avoid sugary mixers. Use sparkling water and fresh fruit instead. |
| Beer | Some studies show a lower risk of RA development with moderate beer consumption in some women. | Can be high in purines, a major risk for gout, which can coexist with RA. High calorie count can contribute to weight gain. | Discuss with a doctor, especially if prone to gout. Not a recommended starting point. |
| Sugary Cocktails | None beyond the alcohol itself. | High sugar content is highly inflammatory and can cause weight gain. | Best to avoid entirely. |
Conclusion
There is no one-size-fits-all answer to what is the best alcohol to drink with RA. The most crucial recommendation is to prioritize moderation and, most importantly, have an open and honest conversation with your healthcare team. While moderate consumption of red wine or clear spirits with healthy mixers may be acceptable for some, the risks of medication interactions and increased inflammation from excessive drinking are significant. For those with RA, the safest approach is to limit alcohol or abstain altogether. Never make changes to your diet or lifestyle based on this information alone without first consulting with a qualified medical professional. For more information on navigating life with RA, visit the National Rheumatoid Arthritis Society (NRAS).
