If you have rheumatoid arthritis (RA), you may need to pay more attention to your diet for these three reasons:
- Some RA medications block nutrients your body needs. For instance, methotrexate can block folic acid, and corticosteroids block calcium.
- RA causes chronic inflammation in your body, which may mean you need more calories and protein than someone who doesn't have RA.
- If your RA makes cooking difficult, you might start choosing foods that you don't have to cook. That's fine as long as they're nutritious, but they often have more empty calories, fat, and salt.
Folic acid is a B vitamin that promotes health and supports your body’s metabolism. Folic acid also plays a crucial role in pregnancy, where it helps prevent some birth defects. In its natural form, folic acid is called folate.
Some common RA drugs such as methotrexate (Rheumatrex, Trexall) and sulfasalazine (Azulfidine) interfere with how the body uses folic acid. Eating more foods with folic acid, such as spinach, collards, broccoli, garbanzo beans, lentils, peas, and oranges, can help. Some foods, such as orange juice, are fortified with folic acid. Some people may need to take folic acid supplements.
Ask your doctor or dietitian how much folic acid you need to help prevent medication side effects during methotrexate treatment. There's some evidence that taking nonsteroidal anti-inflammatory drugs (NSAIDs) may also cause low levels of folic acid, so ask your doctor if you take NSAIDs often or take high doses.
Corticosteroids can make it harder for your body to use calcium. That can lead to weak bones and the bone disease osteoporosis. RA can also put you at risk for weak bones in other ways. Your immune system, which RA makes overactive, may attack your bones directly.
Being active is important in keeping up bone strength, but RA can make it feel more difficult. Exercise can help keep your bones strong, in addition to helping relieve the symptoms of RA.
Food sources of calcium include dairy products, canned sardines and salmon, almonds, broccoli, kale, and fortified orange juice and cereal.
How much calcium do you need? The recommendations are 1,000 milligrams a day for adults under age 50 and 1,200 milligrams for people 51 and older. Your doctor might recommend a higher amount or suggest that you take calcium supplements.