Drinking alcohol in moderation is typically safe for people with rheumatoid arthritis (RA).

According to the Arthritis Foundation, drinking alcohol in moderation is usually safe, and may even reduce certain types of inflammation. Some research says that small amounts of alcohol could reduce the risk of developing RA in the first place. However, heavier drinking can cause problems. Also, alcohol can interfere with some RA medications, with serious health implications. Before drinking alcohol, people can speak to a doctor about the risks and benefits.

This article looks at the research behind how drinking alcohol can affect RA, as well as the interactions between RA drugs and alcohol, and other safety considerations.

Alcohol and 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 closely link 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 megnetic resonance imaging (MRI) scan results. They suggested the anti-inflammatory effects of alcohol could be systemic and not involve the joints specifically.

However, the US Centers for Disease Control and Prevention (CDC) says 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.

Alcohol and RA medications

When a person drinks alcohol, their liver processes and breaks down the ethanol. Overloading the liver with excessive alcohol consumption can damage the liver. The liver also filters many medications that people use to treat RA. Taking alcohol with these drugs can increase a person's risk of liver damage. The following medications do not interact well with alcohol:

• Nonsteroidal anti-inflammatories (NSAIDs), such as naproxen and ibuprofen
• Acetaminophen
• Methotrexate
• Leflunomide

Taking NSAIDs increases the risk of stomach bleeding, and ulcers and excessive alcohol use may intensify these effects. Read more about mixing ibuprofen and alcohol and acetaminophen and alcohol.

How much alcohol is too much?

Current research does not point to a specific amount of alcohol that makes RA symptoms worse. In moderation, alcohol should not negatively affect people with RA. The CDC defines moderate drinking as:

• Up to 1 drink per day for women
• Up to 2 drinks per day for men

Binge drinking can lead to an increase in body-wide inflammation, and chronic alcohol use can lead to inflammatory liver disease over time. Binge drinking refers to 4 or more drinks on one occasion for women or 5 for men.

The long term risks of excessive alcohol use include:

• Liver health problems
• Alcohol use disorder
• Mental health conditions, such as depression
• High blood pressure
• Certain cancers, including breast, colon, and esophageal

Summary

The effects of alcohol on the body are complex. Research consistently links excessive drinking to a host of health problems, as well as accidents and injuries. Yet alcohol is not universally harmful, particularly in moderation.

Alcohol may affect people in different ways. People with RA can monitor how alcohol affects their symptoms and their bodies. If a person suspects that alcohol is making their RA symptoms worse, it may be best to stop drinking alcohol.

People with RA can safely drink alcohol in moderation, though they should speak to a doctor about any possible drug interactions, contraindications due to prescribed medication, and other medical conditions that could cause complications.