Rheumatoid arthritis vitamin and mineral supplements


Research suggests that rheumatoid arthritis sufferers have low levels of antioxidant vitamins and minerals which may contribute to inflammation. Sufferers of the disease appear to have higher levels of free radicals in their blood and joint fluid. "This may be due to increased activity of white blood cells known as macrophages. If these free radicals are not neutralized by antioxidants, they can cause inflammation and damage to tissues.

Rheumatoid arthritis vitamin and mineral supplementsIn a study published in 1997, researchers from the Training Center for Public Health Research in Maryland examined thousands of blood samples donated in 1974. They then specifically tested those from 21 people who were diagnosed with rheumatoid arthritis two to 15 years after donating their blood. The results showed that those with rheumatoid arthritis had 29 per cent lower beta carotene in their blood before they were diagnosed, 5 per cent less vitamin E and 7 per cent less vitamin A. Other studies have found low levels of vitamin C in rheumatoid arthritis sufferers.

It is unclear from this study whether these lower levels of antioxidants are a cause or an effect of the disease. It is possible that the antioxidants in the blood are being used to combat free radical damage caused by the disease, or alternatively, that decreased intake, absorption or transport increases the risk of oxidative damage. Increasing intake of antioxidant nutrients is beneficial in reducing some of the inflammation caused by free radical damage to joint linings in rheumatoid arthritis sufferers.

In a study published in 1997, UK researchers investigated whether there was any additional anti-inflammatory or analgesic effects of vitamin E in rheumatoid arthritis patients who were already receiving anti-rheumatic drugs. The study involved 42 patients who were given 600 mg alpha TE (895 IU) twice a day or placebo for 12 weeks. The results showed that although laboratory measures of disease activity were unchanged, the patients reported less pain.

B vitamins

Folic acid levels are low in arthritis sufferers taking the anti-inflammatory drug, methotrexate, which interferes with the conversion of folic acid to its active form. Methotrexate reduces inflammation but can also have toxic side effects. Studies have shown that folic acid supplements do not interfere with the beneficial action of the drug but may be useful in protecting against the side effects.

Riboflavin levels may be low in rheumatoid arthritis sufferers. In a 1996 study, UK researchers investigated this link in patients and in those without the disease. The results showed that biochemical riboflavin deficiency was more frequent in patients with active disease. Riboflavin is necessary for the action of an enzyme which has anti-inflammatory activity, and deficiency could reduce the activity and beneficial effect of that enzyme. Niacin, vitamin B6 and pantothenic acid have also been used to treat arthritis.

Vitamin D

Vitamin D may be useful in preventing the bone loss that occurs with severe rheumatoid arthritis. Researchers involved in a 1998 study investigated the links between disease activity and blood levels of vitamin D in 96 patients. They found that high disease activity was associated with alterations in vitamin D metabolism and increased bone breakdown. Low levels of vitamin D may also increase the proliferation of white blood cells, and may accelerate the arthritic process in rheumatoid arthritis.


Blood calcium levels are often lower than normal in those with rheumatoid arthritis. Corticosteroids used in the treatment of rheumatoid arthritis can cause bone loss, which may increase the risk of osteoporosis. Supplementation with calcium and vitamin D can help prevent this loss. In a recent two-year study, 96 patients with rheumatoid arthritis, 65 of whom were taking corticosteroid drugs, were given 1000 mg calcium and 500 IU vitamin D per day or placebo. The researchers analyzed the bone mineral density of the lumbar spine and femur once a year. In those patients taking corticosteroid drugs and placebo losses of bone mineral density were seen. In those taking the supplements gains were seeen and in those not taking corticosteroids, the supplements did not appear to affect bone mineral density.

Rheumatoid arthritis vitamin and mineral supplementsCopper and zinc

Copper and zinc metabolism may be altered in rheumatoid arthritis patients. They may have higher than normal urinary copper excretion rates, and serum copper and ceruloplasmin (copper protein complex) levels are also raised in arthritis sufferers while zinc levels are usually lower. Zinc and copper function in the antioxidant enzyme, superoxide dismutase; levels of which may be altered arthritis sufferers. Some studies have shown beneficial effects of zinc and/ copper supplements in arthritis while others have not.


Some experts believe that high iron intake may aggravate joint inflammation in rheumatoid arthritis, possibly by increasing free radical damage. Some studies have found that the iron antidote, deferoxamine is useful in the treatment of rheumatoid arthritis. It may act by lowering iron levels in joint tissue and reducing the inflammation. Iron absorption, however, is decreased in rheumatoid arthritis and anemia is a relatively common complication of the disease.


Manganese supplements have been shown to have beneficial effects in the treatment of rheumatoid arthritis. Manganese is a component of the enzyme superoxide dismutase, which acts as an antioxidant and reduces inflammation. Manganese needs may be increased in rheumatoid arthritis sufferers.


Several studies indicate that selenium levels are low among patients with rheumatoid arthritis. Selenium is part of the enzyme glutathione peroxidase, which acts as an antioxidant and has anti-inflammatory effects. It acts by inhibiting certain hormone-like substances known as prostaglandins and leukotrienes which cause inflammation. Clinical studies have not clearly shown that selenium supplements bring improvements in the condition of rheumatoid arthritis sufferers. Vitamin E and selenium together may have beneficial effects.

In a 1997 German study, 70 patients with rheumatoid arthritis were randomly divided into two groups. One group was given 200 mcg per day of sodium selenite while the other group was given a placebo. Selenium concentrations in red blood cells of patients with rheumatoid arthritis were significantly lower than found in an average German population. At the end of the three-month experimental period, the selenium-supplemented group showed less tender or swollen joints, and morning stiffness. Selenium-supplemented patients needed less cortisone and other anti-inflammatory medications than the placebo group. Analysis also showed a decrease in laboratory indicators of inflammation.

Other nutrients and rheumatoid arthritis

Omega-3 fatty acids

Several research studies suggest that taking omega-3 fatty acids either in food or supplement form reduces the stiffness and pain of rheumatoid arthritis and may also reduce the need for anti-inflammatory medication.This may be due to effects on several parts of the inflammatory process.

Dietary fats are involved in the manufacture of hormone-like compounds known as prostaglandins, which can exert harmful or beneficial effects. Fats in vegetable oils lead to production of harmful inflammatory prostaglandins while fish oils contain fats such as omega-3 fatty acids which lead to the production of anti-inflammatory prostaglandins. Omega-3 fatty acids also seem to affect levels of other chemicals known as cytokines and leukotrienes which are produced by white blood cells and mediate the inflammatory processes involved in rheumatoid arthritis. Omega-3 fatty acids are found in fish oils and plant oils such as flaxseed oil.

In a study done in 1994 in Belgium, 90 patients were enrolled in a 12- month, double-blind, randomized study comparing daily supplementation with either 2.6 g of omega-3 fatty acids, or 1.3 g of omega-3 fatty acids plus 3 g of olive oil, or 6 g of olive oil. The researchers found significant improvement in both the patient's evaluation and in the physician's assessment of pain in those taking 2.6 g per day of omega-3 fatty acids. The number of patients who were able to reduce their anti-rheumatic medications was significantly greater in the group taking 2.6 g of omega-3 fatty acids.

The omega-6 fatty acid, gamma-linoleic acid is found in evening primrose, bin kcurrant, and borage seed oils. These supplements may also be effective in treating rheumatoid arthritis.

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