Rheumatoid Arthritis Diet

Arthritis deals with your body’s inflammatory response. The joint pain, swelling, and lack of mobility all happen because of inflammation in your body.

While there is no special “diet” an arthritis patient should follow — despite what you may have heard or read online — research shows that eating certain foods, particularly those you’ll find in a Mediterranean diet, can keep inflammation in check. Other diets include going gluten free and following the Autoimmune Protocol. Diets can also be good for heart health and just feeling your best. You can seek council from dietitians, naturopaths, and nutritionists, and always make sure to consult your doctor.

This information is part of CreakyJoints’ comprehensive guide for patients living with rheumatoid arthritis. Learn more or download Raising the Voice of Patients: A Patient’s Guide to Living with Rheumatoid Arthritis.

Best Foods for Rheumatoid Arthritis Patients

Try incorporating more of these foods into your diet to (try to) reduce inflammation and boost your health. Keep track of your symptoms to see if your symptoms improve:

  • Fish: Some fish are rich in omega-3 fatty acids, which reduce inflammatory proteins in your body. These are salmon, tuna, sardines, anchovies, and other cold-water fish. Get at least 3-4 ounces of fish twice a week.
  • Fruits and vegetables: Fruits and vegetables have antioxidants, which support your immune system and may fight inflammation. Eat a colorful variety of fruits and veggies like blueberries, blackberries, cherries, strawberries, spinach, kale, or broccoli. Get at least 1.5-2 cups of fruit and 2-3 cups of vegetables per meal.
  • Nuts: These tasty treats are rich in monounsaturated fat, protein, and fiber, which help make you feel full and fight inflammation. Snack on or add these nuts to your meals: walnuts, pine nuts, pistachios, and almonds. Get 1.5 ounces (about a handful) of nuts per day. More nuts could add too many calories to your diet.
  • Beans: Rich in fiber and protein, beans are full of antioxidant and anti-inflammatory compounds.
  • Olive oil: This heart-healthy fat contains monounsaturated fat, antioxidants, and oleocanthal, an anti-inflammatory compound. Get 2-3 tablespoons per day of extra virgin olive oil in your cooking or salad dressings.
  • Onions: These simple, flavor-rich veggies contain lots of antioxidants and may help reduce inflammation, improve heart health, or help control cholesterol.
  • Fiber: In foods like beans, whole-grain breads and cereals, or fresh veggies and fruits, fiber makes you feel fuller longer and helps you stay regular. It also lowers C-reactive protein, which is found in the blood and is a strong marker of inflammation. Get plenty of fiber in your diet or try fiber supplements.

Foods to Consider Avoiding or Reducing for Rheumatoid Arthritis Patients

  • Processed food: Reduce the amount of processed food (like packaged snack chips, pastries, cookies, and other sweets). Avoid too much refined sugar, salt, and alcohol in your diet to help reduce your levels of inflammation and maintain a healthy weight.
  • Gluten/wheat:  Gluten, a protein found in wheat, rye, spelt, kamut, triticale, and some other grains may irritate the digestive tract, exacerbating autoimmune conditions like RA. An elimination diet may be helpful for four to six weeks to note whether this food is a contributor to pain, digestive, and/or skin problems associated with RA. Consult your physician or nutritionist before embarking on a gluten free trial if you have issues with keeping weight on.
  • Nightshades: Some people believe that nightshade vegetables, such as eggplant, peppers, tomatoes, and potatoes, trigger arthritis flares. There is little evidence to support this, but you can still try an elimination for two weeks or more to see if you feel better. Reintroduce nightshades after the elimination period to see if your pain flares up, and if it does flare up, limit nightshades. If you feel fine after the reintroduction, then do not worry about eating nightshades.
  • Fad diets: Don’t try any diets that list lots of claims about how they’ll get rid of your arthritis symptoms, cure your arthritis, or allow you to stop using all of your arthritis drugs. Talk to your doctor before you try any diet, start eating a certain food in large quantities, or start cutting out whole groups of foods. Also be wary of any diet that requires you to buy anything up front, such as the actual diet plan, foods, supplements, or products. You can eat a healthy, natural diet made of foods that you can find at your local store.

Learn more about about anti-inflammatory diet.

Herbs and Supplements for Rheumatoid Arthritis

Some people with RA also feel better or have symptom relief with herbal and dietary supplements. There are many to choose from, but there’s not much solid, scientific evidence to show they really work. Some herbs and supplements have been studied in smaller scale tests compared to pharmaceuticals, due to several factors. Most notably, high quality research on natural products and dietary supplements are difficult to obtain due to the high cost of doing research and the difficulty for manufacturers to patent natural products. In almost every case, herbs and supplements need to be researched more to say if they will work for RA or not.

However, it’s up to you if you want to give them a try. They may work for some people with RA, but not for others. Or they may make you feel a little bit better, but they won’t replace your arthritis drugs.

Before you take any herbal treatments or dietary supplements, including vitamins or minerals, let your doctor know. Some herbs and supplements can interact with medicines, or even do the same thing — so they can add to the effects of your drugs. So let your doctor know everything you are taking for your arthritis.

In addition, there’s not much testing of herbs or supplements you find in health food stores, online, at alternative healing shops or fairs, or other sources. Some products may not even contain what the bottle or package says it does. Or the actual concentration of the dosage may be very different from what the label states. So use caution and good sense before you buy or try anything. Consult a physician who is knowledgeable about dietary supplements and can guide you on selecting high quality supplement brands to enhance the safety and effectiveness of your treatment regimen. Physicians trained in the specialty of integrative medicine have the highest level of training and comfort level with dietary supplements, nutrition plans, and lifestyle modification to combine with conventional medicine treatments. Collaboration between your rheumatologist and integrative physician may help ensure the safest, most effective treatment plan if you choose to use supplements with your medications to control RA and promote wellness.

ConsumerLab.com is an online source of information for choosing reputable, independently tested supplements.

Click here for an overview of using herbs and supplements for arthritis to let you know some of the pros and cons of dietary supplements and diets.

The following is a descriptive list of some dietary supplements patients have used to support their health. Take note that research on these products and other therapies for RA occur over time to either support or discourage their use.  Check with a physician who is knowledgeable about natural products to get the full assessment of risks, benefits, and potential interactions with your medications.

  • Avocado Soybean Unsaponifiables (ASU): A natural vegetable extract made from ⅓ avocado oil and ⅔ soybean oil. May improve pain or function.
  • Black Currant Oil: An natural supplement made from 15-20% gamma-linolenic acid (GLA). Rich in omega-3 and omega-6 fats. May ease inflammation.
  • Borage Oil: Made from 20-26% GLA. Also called borage seed oil. Rich with essential fatty acids that may help ease inflammation or act to block inflammatory cells.
  • Boswellia: Also called Indian Frankincense. Made from the boswellia serrata plant, it may ease pain and improve joint function.
  • Bromelain: Supplement made from pineapple enzymes. Some people with RA find that it can reduce joint pain.
  • Capsaicin: Made from oil in hot chili peppers. It can be applied as a topical cream, gel, or patch. It depletes the amount of a neurotransmitter called substance P that sends pain messages to the brain, so it can distract you from sensing pain in a joint or muscle. Take care not to touch the eyes or mouth after applying capsaicin to the skin; use gloves.
  • Cat’s Claw: Supplement made from a wild vine found in Central and South America. May have healthy effects on the immune system.
  • Chondroitin Sulfate: Supplement made from the cartilage of cows, pigs, or fish. It’s designed to help replace worn-down cartilage in your joints, to reduce pain and inflammation, and improve joint function. It’s usually used by people with osteoarthritis.
  • Curcumin: Curcumin is derived from the root turmeric. This herbal treatment has potent anti-inflammatory effects, so it could help ease joint pain and swelling.
  • Devil’s Claw: Supplement made from a plant native to southern regions of Africa. Used to relieve joint pain and inflammation, as well as back pain.
  • DHEA: Supplements made from a natural hormone made in your adrenal glands on top of your kidneys. There’s good evidence that DHEA can help improve bone density and improve lupus symptoms, but there’s less proof that it helps people with RA. This hormone can convert to estrogen or testosterone, so patients with breast, ovarian, testicular, or prostate cancer should avoid DHEA.
  • DMSO: Also called dimethyl sulfoxide. By-product of paper manufacturing, DMSO can be found in gel or cream form and rubbed into the skin. It’s meant to ease pain and inflammation, and improve joint mobility. Research on DMSO for RA is scant.
  • Evening Primrose: Herbal oil rich in omega-6 fatty acids. It’s used to lower pain and inflammation, and some evidence shows it could ease morning stiffness.
  • Fish Oil: Supplements of natural liver oil from fatty fish in capsule form, or in fish you consume in your diet. Rich in omega-3 fatty acids. Could reduce joint pain, inflammation, and morning stiffness.
  • Flaxseed Oil: Herbal supplement taken in capsule form. It’s rich in alpha-linoleic acid (ALA), an essential omega-3 fatty acid that builds healthy cells. It’s used to ease joint inflammation, but there’s not much evidence that it works for RA. Eating ground flaxseed will provide more fiber along with ALA compared to flaxseed oil.
  • Ginger: Natural root ground into powder, taken in capsule or oil form, added to foods or eaten in tea, pickled, or candied form. Could reduce chemicals in your body that play a role in inflammation. Could also ease pain in a similar way as aspirin. Effective at easing nausea.
  • GLA: Gamma linoleic acid, found in other herbs like borage oil or evening primrose. Rich in omega-6 fatty acids. Used in supplement or food form to ease joint pain, stiffness, and swelling.
  • Glucosamine Sulfate: Supplement made from the shells of fish like shrimp or crabs (avoid if with shellfish allergy). Glucosamine is used to slow deterioration of joint cartilage, relieve joint pain related to osteoarthritis, and improve joint mobility.
  • Green-lipped Mussel: Shellfish found in the waters off New Zealand. Its hard shells are ground into powder and put in capsules. It’s rich in omega-3 fatty acids that may have anti-inflammatory effects and ease joint pain.
  • Melatonin: Supplement containing a natural hormone that’s found in your brain. The hormone helps control your circadian rhythms, which tell your brain when to sleep and when to wake. Melatonin capsules may help you sleep better if your RA symptoms keep you awake. Nightmares or vivid dreams may occur with this supplement.
  • MSM: Methylsulfonylmethane, an organic sulfur compound found in animals and plants. It’s often taken in capsules or in a cream that you rub into your skin. Meant to reduce pain and inflammation.
  • Pine Bark: Herbal extract from the bark of trees. Also called by a common brand name, Pycnogenol®. It contains procyandin, an antioxidant that may block pro-inflammatory enzymes. Not much evidence supports its efficacy in RA.
  • Rose Hips: Herbal supplement made from the tiny fruits of wild rose bushes. Found in capsule form as well as teas. Rich in polyphenols and anthocyaninins, natural chemicals that may ease joint inflammation. Also rich in vitamin C, an antioxidant.
  • Sam-E: Short for S-adenosyl methionine. Found naturally in the body, it is a precursor to making serotonin, which helps regulate mood. Taken in capsule or pill form, it’s used as a supplement to treat pain, stiffness, and swelling, rebuild cartilage, and improve mobility. Sam-E may also help improve depressed mood.
  • St. John’s Wort: Herbal supplement made from a flowering plant found mostly in Europe. It’s mainly used to ease mild to moderate depression symptoms, but some say it can reduce inflammation and pain in arthritis. Do not take with birth control or HIV medications.
  • Stinging Nettle: Herbal supplement made from a common plant that stings your skin if you brush by it. It can be eaten or cooked into food, or taken as a supplement. It’s used to ease inflammation and pain, and may work best for hayfever. Its use in RA has been studied primarily in vitro (test tubes) and may be helpful in reducing joint pain.
  • Thunder God Vine (Tripterygium wilfordii): Herbal supplement made from a plant that’s used to improve pain, tender joints, and inflammation in RA. One large study compared it to sulfasalazine (Azulfidine®) which is used to treat RA, and found it effective, with a list of mild to moderate side effects.
  • Valerian: Herbal supplement made from a plant root. Can be taken in capsule form or as a tea. Used mainly to treat insomnia, but may also ease pain, and have antispasmodic and sedative effects that could relax tense muscles or joints.
  • Vitamin D:  This is actually a hormone used by every cell of the body, derived from the conversion of inactive vitamin D to its active form by sunlight exposure to the skin. This vitamin helps improve bone density and is deficient in many patients who lack adequate sunlight exposure. Vitamin D supplements can replace deficient levels while avoiding sun damage to the skin. Vitamin D can become toxic if taken in high amounts for a long period of time, so be sure to have your physician check your vitamin D-25 OH levels periodically.

While research is mixed on the effectiveness of most CAM therapies for arthritis symptoms, some show promise. It’s most likely that you will find these therapies helpful as part of your overall RA treatment plan, but they won’t be a magic cure for your symptoms or allow you to stop taking your medications.

The information in these guidelines should never replace the information and advice from your treating physician. It is meant to inform the discussion that you have with healthcare professionals, as well as others who play a role in your care and well being.