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Rheumatoid Arthritis: How vitamin D deficiency can make it worse
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Rheumatoid Arthritis: How vitamin D deficiency can make it worse

Vitamin D deficiency is commonly observed among those with rheumatoid arthritis. Experts explain how low levels of the sunshine vitamin can aggravate the symptoms
Rheumatologists generally prescribe vitamin D and calcium supplements on a weekly or a daily basis.
Those with severe arthritis are given vitamin D supplements more frequently and for long periods, say experts.

Inadequate nutrition can aggravate the symptoms of rheumatoid arthritis (RA). One of the most common nutrition deficiencies seen in people with rheumatoid arthritis is vitamin D. The macronutrient plays an important role in the overall management of RA symptoms and a deficiency exacerbates the stiffness and pain in the joints.

“About two-thirds to three-fourths of people with RA are known to be deficient in vitamin D,” says Dr Nagaraj S, consultant rheumatologist, Sagar Hospitals & TRACC, Bengaluru. “Vitamin D, through immunomodulation, modifies the disease course in some individuals. And those with a deficiency have more severe symptoms such as joint pains/stiffness than the ones with normal vitamin D levels.”

Rheumatoid Arthritis and low vitamin D levels

A well-planned diet is essential to manage rheumatoid arthritis. This is important since restricted movement due to pain and stiffness and reduced appetite, which accompany RA, leads to deficiencies, including vitamin D.

“Since vitamin D synthesis is related to exposure to sunlight, a lack of it due to restricted movement, is an important factor for its deficiency,” says Dr Nagraj. “A reduced intake of vitamin-rich diet is another cause.”

Food rich in vitamin D should be made part of the daily diet. It plays an important role in calcium and mineral balance in the body. The immunomodulatory properties are beneficial in those who are affected with autoimmune conditions, and it is advisable for people with rheumatoid arthritis to consult a rheumatologist periodically and ensure that their dietary intake of vitamin D is adequate.

Vitamin D supplements for Rheumatoid Arthritis

A deficiency of vitamin D can be seen in both vegetarians and non-vegetarians. Thus, doctors recommend medicinal supplements at times. Dr Nagaraj states that those who have severe arthritis are given vitamin D supplements more frequently and for long periods. Some individuals, to avoid supplements, try to increase their food intake. This can lead to weight gain and a rise in the uric acid levels in the blood, particularly those who consume non-vegetarian foods.

“Rheumatologists generally prescribe vitamin D and calcium supplements on a weekly or a daily basis. It is strongly recommended to follow the advice of rheumatologists as the prescription pattern is different for each person,” adds Dr Nagaraj. “By following the advice given specifically after evaluation, people do not experience side effects of medicines. But sometimes, people try to copy advice given to others or try to self-medicate and experience side-effects. Some of these side-effects can be serious.”

Intake of vitamin D supplements exceeding the doctor’s recommendation can lead to hypervitaminosis D. This can lead to serious health consequences including difficulty in concentration, drowsiness, headache, reduced appetite, and excessive water intake, among others.

Takeaways

  • Vitamin D and rheumatoid arthritis are directly linked. A fall in the level of the macronutrient leads to worsening of the symptoms including increased stiffness and pain in the joints.
  • Reduced movement due to pain in the joints and reduction in the appetite brought on by RA contributes to low vitamin D levels in the body.
  • Increasing the food intake can lead to unwanted weight gain and can also increase the uric acid levels in the blood, particularly in those who eat non-vegetarian foods.

 

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