From healthcentral.com
Most people with RA can still enjoy their morning coffee—in moderation
You love your morning cup of coffee but if you have rheumatoid arthritis (RA), you may sometimes wonder if you should be cutting back—or skipping it completely. While coffee consumption has been linked with acid reflux, sleep troubles, and increased anxiety (depending on how much you drink), there’s no data showing it’s harmful for people with RA. In fact, it might even be helpful. Let’s take a deeper look at some of java’s pros and cons.
Is Coffee Bad for RA?
The short answer is no. But that’s not always the same answer for everyone: Coffee affects people differently, so it’s possible it could bother some people with RA. “If there are certain triggers that people find to be personal, I’m not one to tell them that it’s not true,” says Lena Eder, M.D., a rheumatologist and internal medicine doctor at Duke Health in Raleigh-Durham, NC. “Everyone’s autoimmune and symptom profile is personal. I wouldn’t be surprised if we find out that for some people coffee can be a trigger.”
When you have a cup of coffee, you’re really ingesting a drink with potentially two powerful aspects. First, coffee beans contain healthy plant-based compounds. “The hydrocinnamic acids and polyphenols in coffee have quite powerful antioxidant properties,” says Lena Bakovic, a registered dietitian nutritionist with Top Nutrition Coaching in Palm Beach Gardens, FL.
Second, coffee naturally contains caffeine, a stimulant. (Decaffeinated coffee also contains very small amounts of caffeine.) According to the Food and Drug Administration (FDA), consuming up to 400 milligrams (mg) a day of caffeine is safe (that’s about four to five cups of coffee, depending on the brew type and how big your mug is). The more you drink, the more noticeable its stimulant effects may be (regardless of whether or not you have rheumatoid arthritis). “However, some people may experience negative side effects—jitteriness, anxiety, or difficulty sleeping—with even lower amounts of caffeine,” cautions Bakovic.
Of course, anything you add to your coffee, whether that’s creamers, sweeteners, syrups with additives and/or preservatives, can potentially impact your RA symptoms and negate some of the beverage’s potential health benefits.
Benefits of Coffee
Overall, coffee has a winning reputation, at least in studies. Research has linked coffee consumption with a lower risk of type 2 diabetes, dementia, certain cancers, depression, and Parkinson’s disease, according to experts at Harvard T.H. Chan School of Public Health. “The antioxidants contained within coffee may have an anti-inflammatory effect, which may be helpful with RA symptoms,” says Bakovic. Antioxidants help fight cell damage, which is part of many chronic health conditions, as well as the aging process. “Coffee consumption been linked with improved longevity as well,” says Dr. Eder.
Coffee also may be heart-protective: A review published in 2023 in Ochsner Journal found that regular coffee consumption is linked with a lower risk of developing high blood pressure, heart failure, atrial fibrillation, and all-cause and cardiovascular-related early death. This is important for people with RA, who have double the risk of developing cardiovascular disease (CVD) due to elevated levels of inflammation in the body, according to a study published in The Lancet Rheumatology.
Just note: There is some research showing drinking unfiltered coffee can increase levels of “bad” cholesterol, which can contribute to CVD risk, and caffeine may temporarily elevate blood pressure, according to the American Medical Association. Try to drink your coffee filtered, and if you have any blood pressure issues, check with your doctor about your caffeine habit and whether it’s still serving you.
Coffee and RA Medications
Many people with RA take disease-modifying anti-rheumatic drugs, a.k.a. DMARDs, such as methotrexate, adalimumab, or Janus kinase (JAK) inhibitors. “Coffee shouldn’t interfere with these medications,” says Kevin Byram, M.D., an associate professor of medicine in the division of rheumatology and immunology at Vanderbilt University Medical Centre in Nashville, TN. It may even help you tolerate some of the side effects of these drugs. “Some patients have what’s called the ‘methotrexate flu’ the day or so after they take the drug,” says Dr. Byram. Symptoms can include headaches, fatigue, and malaise. “One of the things that may help is to drink an extra cup of coffee on those days,” he says, since the caffeine can give you an energy boost and potentially help resolve head pain.
Coffee and RA Symptoms
When used moderately (not exceeding the 400-mg-a-day recommendation), coffee shouldn’t exacerbate any RA symptoms, whether they’re coming from the disease process itself or side effects from medications. But since everyone’s symptoms, medication side effects, and severity can differ, it’s always possible coffee could be having a negative impact.
Some of the most common symptoms of rheumatoid arthritis include joint pain, stiffness, and swelling. People with RA may also complain of fatigue, depression, fever, heart and lung problems, dryness in the eyes and mouth, and more, according to Johns Hopkins Arthritis Center. While caffeine can be a diuretic (making you pee more and contribute to feelings of dryness or fatigue), coffee is mostly water, so it shouldn’t cause dehydration, according to experts at the Mayo Clinic.
It's not uncommon for people with RA to have gastrointestinal (GI) problems, according to the Arthritis Foundation, which can include diarrhoea, constipation, reflux, or nausea. Some of these symptoms could also be due to medications, which tend to have a long list of possible side effects. Drinking coffee could contribute to GI distress, including reflux, nausea, or diarrhoea.
Coffee and RA Management
Coffee shouldn’t interfere with your ability to manage your condition, but diet and supplements can impact your RA—in good and bad ways—says Dr. Eder, so be sure to talk with your doctor about what you’re eating and taking. “It’s okay to drink coffee, but keep in mind the recommendation ‘everything in moderation.’ And try to stick to a Mediterranean-style diet, which has the most research for being beneficial for RA.”
Coffee Alternatives for RA
If you find coffee exacerbates any of your RA symptoms (or causes discomfort in general), cut back on your consumption, try decaffeinated coffee, or switch to another drink. Tea contains lower levels of caffeine but is also packed with healthy plant-based compounds, especially green tea. Herbal teas, called tisanes—such as peppermint, ginger, turmeric or chamomile—can also be beneficial for various RA symptoms. “Yerba mate, matcha, and chai are some alternatives to tea and coffee,” says Bakovic. “They each have their own nutritional benefits.”
You might be surprised to discover you don’t need coffee for energy. In fact, healthy lifestyle habits may be able to make up for the energy you’re missing if you skip coffee (and they’ll help your RA as well, says Dr. Eder). Good sleep, exercise, a healthy diet, and staying on top of your RA treatments can help you feel your best.
Talking With Your Doctor
If you drink coffee, ask your doctor if they expect it to have any effect on your current RA picture (your stage, whether you’re in remission, your medications, and other health issues). It may prompt a discussion about other aspects of your diet. If you’re not sure how your diet rates for fighting inflammation, ask for a referral to a dietitian who can make sure everything you eat and drink is helping to address inflammation and lower your risk of flares as well as other chronic diseases.
Bottom Line
If you’re enjoying coffee in moderation, there’s probably no need to give it up. If you think it’s exacerbating your symptoms or interfering with your medications, try cutting it out of your diet and see how you feel. That’s the easiest way to know if it’s causing problems: Just do it gradually to avoid the dreaded caffeine-withdrawal headache.
https://www.healthcentral.com/condition/rheumatoid-arthritis/rheumatoid-arthritis-and-coffee
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