Alcohol May Intensify Symptoms
Alcohol consumption does have a pro-inflammatory effect, says Delamo Bekele, MBBS, a rheumatologist and an assistant professor of medicine at the Mayo Clinic in Rochester, Minnesota. While research on the link between alcohol and psoriatic arthritis flares has so far been inconclusive, a study published in March 2020 in the British Journal of Dermatology found that moderate drinking did increase the risk of psoriatic arthritis in people with psoriasis.
Drinking may also have an impact on the effectiveness of methotrexate, a medication that doctors commonly prescribe to people with psoriatic arthritis. Alcohol can affect the liver and so can methotrexate, which is another reason for people with PsA to limit what theyre drinking, says Dr. Bekele.
But even people on that drug may find that they can imbibe occasionally: A study published in Annals of the Rheumatic Diseases in August 2017 found that people with rheumatoid arthritis taking methotrexate experienced no ill effects as long as they drank fewer than 2 drinks a day or 14 drinks a week.
How to avoid this trigger Given that the data on alcohol and psoriatic arthritis isnt consistent, we usually advise people to limit alcohol use or cut it out completely if they can, says Bekele.
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Has Taking Colchicine Cured My Intolerance To Nuts
Q) As a long-term gout sufferer, I’ve been prescribed allopurinol at a hospital but it has tended to promote bouts of gout. The quick-fire cure I’ve found is colchicine, as the side-effects are not too dire. From being very young to the age of 30 I couldn’t tolerate eating peanuts or ground nuts as they caused violent stomach ache. I’ve had gout since the age of 30 and from then to my present age, 64, I’ve enjoyed eating nuts again with no traumas to my digestion. I’ve had no bouts of gout for nearly two years and wondered if this was anything to do with being able to successfully ingest nuts? Food for thought?
Bob, West Totton – 2008
A) A fascinating observation. There are two important points to come out of your letter. Firstly, when people who have gout first start allopurinol there’s a tendency for them to get acute attacks of gout. This happens during the first three months of treatment. Therefore, rheumatologists recommend taking something to help prevent these attacks . Usually that something is an anti-inflammatory drug such as ibuprofen but it could equally be colchicine or even steroids if the other two drugs couldn’t be tolerated. Not giving this prophylaxis is the single most important reason why people don’t persist with allopurinol treatment. And allopurinol is currently the best way of preventing gout attacks.
This answer was provided by Dr Philip Helliwell in 2008, and was correct at the time of publication.
What You Eat Might Have An Impact
When it comes to diet and symptoms of psoriatic arthritis, Ogdie-Beatty says, its really an individual thing. Some people say tomatoes, some say gluten, or sugar can cause symptoms to worsen.
Adds Bekele, Diet is interesting, because we know that in some ways, it affects inflammation in the body globally, but though many people are doing research, we dont yet have a clear idea of what foods are best or worst for people with PsA.
For instance, given that psoriatic arthritis is linked to gut health, there have been many claims that probiotics supplements for gut health might help reduce symptoms of psoriatic arthritis.
Yet a study published in May 2020 in ACR Open Rheumatology found that there were no differences in health outcomes between people with PsA who took probiotics and those who didnt.
On the positive side, there is evidence that certain foods seem to fight inflammation in the body, including turmeric, flaxseed, olive oil, and kale, though again, We really dont know how much impact eating these foods has on inflammation and PsA, Bekele says.
But its not a bad thing to include these foods in your diet. Usually, we tell patients to try a Mediterranean diet, and tailor it depending on how they feel, whether that means reducing sugar or gluten, Bekele says.
How to avoid this trigger Bekele recommends keeping a food journal and seeing if certain foods correlate with symptom flares: Then you can try a process of elimination to see if that helps.
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How To Reduce Inflammation & Swelling From Alcohol
The surest way to reduce inflammation from alcohol is to reduce how much you drink, or even quit.
If you continue to drink, one thing you can do is hydrate. Alcohol dehydrates you, and dehydration worsens inflammation. Drink plenty of water and electrolytes before, during, and after drinking to combat the inflammatory effects of alcohol. Similarly, its a good idea to avoid sugary alcoholic beverages, as sugar8 is also known to cause inflammation.
You can also eat anti-inflammatory foods like tomatoes, olive oil, nuts, fatty fish, leafy green vegetables, and fruits such as oranges, strawberries, blueberries, and cherries. Other ways to fight inflammation include exercising for 20 minutes daily, maintaining a healthy weight, getting enough sleep, and limiting stress through relaxation and mindfulness techniques.
Although not all of the effects of inflammation from alcohol can be reversed, your body has tricks up its sleeveincluding a class of regenerative molecules called pro-resolving mediators9, This helps repair the damage inflammation causes. This means that the sooner you make healthy lifestyle changes, the sooner your body will begin working to restore and rejuvenate itself.
Alcohol And Arthritis Symptoms
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.
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Alcohol Abuse Can Weaken The Immune System
Alcohol can impair the immune system. This can make it more difficult for the body to heal itself.
For a person with a condition that causes joint pain, this could make it harder for the body to combat the conditions that trigger pain. For acute injuries, such as sprains or falls, that cause joint pain, this could potentially slow down the healing process, causing the pain to last longer.
Rules For Drinking Alcohol Safely With Arthritis
If youre not on a medication thats potentially toxic to the liver and your doctor sees no other signs that alcohol is interfering with your health, theres no reason you cant sometimes enjoy the relaxation, sociability, and potential health benefits of a little alcohol, says Dr. Bolster. If you want a drink, thats fine, but always in moderation.
Follow these guidelines to avoid experiencing negative side effects of drinking alcohol on your arthritis.
1. If you dont already drink, dont start just because of a possible heart-health benefit.
2. Have an honest conversation with your rheumatologist. Since dosage is so important in assessing possible risks, your rheumatologist needs the truth about what youre drinking and exactly how much. If you want to have a glass of wine, Id rather talk about it and you can have that wine and really enjoy it instead of having misconceptions about the risk, says Dr. Manno.
3. Be vigilant about liver tests. If you take methotrexate or another medication metabolized by the liver, regular checks of liver enzymes are recommended. This is doubly important if you drink alcohol. Keeping an eye on your blood work is a great way to find out early if youre having a liver issue. If there is a change, the first thing Ill ask about is alcohol and you may need to cut back or stop, says Manno.
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How To Safely Stop Drinking Alcohol
Although it may sound simple to limit or altogether quit drinking alcohol, it can be difficult for those whove developed a physical dependence on alcohol or those struggling with alcoholism. When a person can one can no longer control their drinking, compulsively abuses alcohol despite its negative ramifications, and/or experiences emotional distress when they are not drinking, they may have an alcohol use disorder .8
Acute alcohol withdrawal can occur when a consistently heavy drinker suddenly stops after a period of time.9 Left unmanaged, users may experience uncomfortable and potentially severe symptoms when attempting to quit.9 Some symptoms may develop as soon as 8 hours after the last time alcohol is consumed.9
Additional withdrawal symptoms, depending on the magnitude of physical dependence, may continue to arise beyond 24 hours, with some potentially severe effects emerging in the range of 2 to 4 days after abstinence.9
Symptoms may include:9,10
- Seizures.
- Delirium tremens.
Severe withdrawal symptoms may include cardiac rhythm disturbances, markedly altered mental status, psychomotor agitation, and continuous grand mal seizures.9 A professionally supervised medical detox can help minimize the risk of severe complications and discomfort associated with acute alcohol withdrawal.9
Benefits Of Not Drinking Alcohol
Even though it was upsetting to make the connection that alcohol makes me flare, my friends tried to remind me of all the positives. Naturally, I’d never have to worry about hangovers and I’d always be a safe driver. Not drinking would also help save a ton of money. Plus, there was no possibility of getting a beer belly or wine-stained teeth. And I’d be able to take NSAIDs like ibuprofen without worrying about liver damage. While it doesn’t seem like much, those points did help me feel better.
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Whats Best For You May Not Be Whats Best For Another Psa Patient
As you can see, the evidence isnt exactly crystal clear on precisely how alcohol contributes to or affects PsA. Complete avoidance of alcohol is not necessarily needed, but it does depend on each individuals circumstance, Dr. Smith says.Weighing the benefits and risks may help if youre trying to make a decision. For instance, if alcohol is clearly making your symptoms worse, you already have heart or liver disease, or youre taking certain medications, it might be reasonable to teetotal. Cutting back can also help if you’re trying to lose weight.
Alcohol Abuse Can Aggravate A Preexisting Condition Or Disease That Causes Joint Pain
A variety of illnesses and diseases can cause joint pain that ranges from mild to severe. This pain may be accompanied by inflammation, swelling and tenderness. With certain illnesses and diseases, alcohol abuse may cause a persons condition to become more severe.
Joint pain caused by the following conditions may be exacerbated by alcohol abuse:
- celiac disease
- other types of arthritis
- rheumatoid arthritis
Individuals with these conditions may want to consider speaking to their doctor prior to consuming alcohol, this could be especially true if they take any pain relievers or other medications to manage their symptoms.
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Skin Injuries Can Worsen Psoriatic Arthritis Symptoms
Whether it’s a scrape, sunburn, or something more serious, skin damage can trigger flares for people with psoriatic arthritis. A review published in May 2019 in Archives of Medical Science found that surgical incisions can cause psoriatic arthritis or make symptoms worse.
The link between skin injury and psoriatic arthritis flares probably goes back to the immune systems abnormal inflammatory response, says Ogdie-Beatty.
How to avoid this trigger Exercise caution in the sun so you dont get burned and think twice before you get a tattoo. A Finnish survey, published in June 2017 in Acta Dermatovenerologica Alpina, Pannonica et Adriatica, of 90 psoriasis patients with one or more tattoos found that 27 percent experienced an increase in plaques on the tattoo, a reaction known as the Koebner phenomenon among those, 30 percent reported having a psoriasis flare in the weeks after tattooing.
Alcohol Inflammation And Your Ra
Rheumatoid arthritis is an autoimmune disease in which the bodys immune system mistakenly attacks the joints, causing inflammation. Immune cells called cytokines are involved in the inflammatory process, and excess alcohol consumption may promote higher levels.
The current research on alcohol consumption in people with RA does suggest that alcohol may not be as harmful as researchers used to think. Still, many of these studies conflict with one another and raise concern over related inflammation.
For example, a 2018 study in the Scandinavian Journal of Rheumatology looked at alcohol’s effect on joint erosion or joint space narrowing in the hands, wrists, and feet of people with RA. Researchers used periodic X-rays to track radiological progression over time.
They found that even moderate alcohol consumption could lead to an increase in radiological progression in women with RA. Interestingly, the opposite was true for men with RA.
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Does The Type Of Alcohol Matter
Research mainly focuses on the amount of alcohol and not the specific type. Any type of alcoholic beverage can be consumed in excess. Therefore, the type doesnt matter when it comes to the relationship between alcohol and psoriasis.
The type also doesnt matter when drinking alcohol with some psoriasis medications and treatment. Some medications warn to not drink any alcohol of any kind while taking.
Other Ways Alcohol Affects Arthritis
There are some other things to know about the effects of alcohol on arthritis:
- Drinking can be problematic because alcohol is a diuretic. This means your body loses water as you drink, and this can lead to problems with ligaments and tissue. Your joints require fluids to move smoothly, so if you are dehydrated you may feel the results in your joints, and it can make the symptoms of arthritis more noticeable or worse.
- In terms of rheumatoid arthritis, there is research showing that people who have at least one drink three times or more a week are four times less likely to have RA than nondrinkers, but with more than that, you may be putting yourself at risk for other conditions and diseases.
- Its important to consider the medications you may be taking to treat the inflammation and joint pain. If someone takes disease-modifying anti-rheumatic drugs , theyre advised not to drink alcohol because of the increased risk of liver toxicity.
- Its not just prescription drugs that may cause problems. If you take over-the-counter NSAIDs like Aleve or Motrin and you drink alcohol, you may be at a higher risk of ulcers and bleeding. Combining alcohol with acetaminophen, which can be used to treat the pain of arthritis, increases the risk of liver disease.
- Sources
Maxwell, James Gowers, Isobel Moore, David Wilson, Anthony. Alcohol consumption is inversely associated with risk and severity of rheumatoid arthritis. Rheumatology, July 22, 2010. Accessed June 4, 2020.
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Bone Tissue Death And Alcohol Abuse
Excessive, daily alcohol abuse, over the course of several years, is a risk factor for avascular necrosis or osteonecrosis, or death of the bone tissue.
This condition occurs when a lack of blood supply causes the bone tissue to die off. This can lead to minuscule cracks, and may even cause the bone to collapse. The foot, hand, hip, knee, and shoulder can be afflicted by this painful condition.
Drinking May Worsen Your Quality Of Life
Alcohol is a potential trigger for flare-ups because it increases inflammation, particularly in your joints. “Alcohol can also make patients more tired, have more pain, and become less functional, says Shaiba Ansari-Ali, M.D., a rheumatologist at Northwestern Medicine Central DuPage Hospital in Winfield, IL. Plus, the extra calories can increase your weight over time, potentially escalating inflammation, Dr. Smith adds. If you notice that your PsA symptoms get worse after drinking, try tracking your alcohol intake and symptoms to see for sure. Simply cutting back may make a difference.
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How Will Alcohol Mix With Your Medications
Before you make having a drink part of your daily routine, think about the medications you take. Alcohol doesnât mix well with many drugs.
If you regularly take pain relievers such as ibuprofen, acetaminophen, or naproxen, drinking alcohol while those medicines are in your system is not a good idea. If you take methotrexate for your RA, make sure to ask your doctor if itâs OK for you to drink. You should talk to your doctor about the risks of mixing alcohol with any drugs you take.
When To See A Doctor
You should tell your doctor if you have psoriasis and also drink alcohol. Your doctor can best advise you on whether there is a safe amount that you can drink or not depending on your treatment.
If youre depressed because of your psoriasis or for any other reason, you should contact your doctor immediately. You should also talk to your doctor if you think you might be drinking excessive amounts of alcohol due to depression or other reasons. Your doctor can help find treatment plans that can help both your depression as well as any excessive use of alcohol.
There are three primary ways to treat psoriasis flares:
- Topical treatments include corticosteroid lotions, vitamin D creams, and solutions.
- Light therapy also known as photo therapy uses ultraviolet light, which may be artificial or natural.
- Medications include injections and ones taken orally. Some of the most common are:
- retinoids
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