Rheumatoid Arthritis And Hormone Balance
Women are aware of the problems of osteoporosis and osteoarthritis, but not many know of the link between hormone balance and rheumatoid arthritis.
Rheumatoid arthritis is a painful condition and not the same as ordinary arthritis. If you believe you have it, then your doctor can give you a blood test which will normally indicate if you have it or not.
What is rheumatoid arthritis?
It is an autoimmune disease that causes inflammation in your joints. The main symptoms are joint pain and swelling. It’s the second most common form of arthritis in the UK.
The ends of your bones are covered with cartilage, which has a very smooth, slippery surface. The cartilage allows the ends of your bones to move against each other almost without friction. The joint is surrounded by the synovium, which produces a small amount of synovial fluid that nourishes the cartilage and lubricates the joint.
The synovium has a tough outer layer called the capsule that, together with the ligaments, holds your joint in place and stops the bones moving too much. Strong fibrous bands called tendons anchor the muscles to the bones.
Rheumatoid arthritis causes inflammation in the synovium and the result is very similar to inflammation that you may have seen if you’ve had an infected cut or wound – it goes red, swells, produces extra fluid and hurts.
The redness is caused by the flow of blood increasing. As a result, the inflamed joint may feel warmer than usual and the inflammation is caused by a build-up of fluid and cells in the synovium.
Such joints are often painful as your nerve endings are irritated by the chemicals produced by the inflammation and the capsule, the outer layer of the synovium, is stretched by the swelling in your joint.
When the inflammation goes down, the capsule remains stretched and can’t hold your joint in its proper position which can make your joint unstable, and it can move into unusual or deformed positions.
Some damage is done to the joints every time they’re inflamed, and the joint can be worn away after repeated flare-ups.
How is it related to hormone balance?
Rheumatoid arthritis is an autoimmune disease and the hormone progesterone acts as an anti-inflammatory whereas oestrogen tend to be pro-inflammatory, so if you are oestrogen dominant that can make a difference to your symptoms.
Studies have documented low progesterone levels in women with autoimmune diseases and showing that an imbalance in favor of higher oestrogen levels may contribute to immune reactivity in women according to Shabanova in 2008.
Further studies by Karlson and Cutolo in 2009 concluded that ensuring adequate levels of progesterone to balance excess oestrogen in women (and sufficient levels of testosterone in men) may help with some underlying features of the disease..
Interestingly, Weitoft in 2008 also indicated that medications used to treat RA symptoms have been shown to suppress sex hormone production as well, potentially compounding an existing hormone insufficiency or imbalance
What can help
Clearly having good levels of progesterone to offset any oestrogen dominance is an excellent place to start with self help measures.
There’s some scientific evidence that certain diets may help the symptoms in some people, but it can be trial and error. You need to look for an anti-inflammatory diet and Andrew Weil, MD has a specific diet on his website as well as excellent books by nutritionist Patrick Holford.
The diets most likely to help are:
– low in saturated fats
– high in unsaturated fats, especially omega-3 fatty acids, which are found in oily fish
– a good supply of vitamin C
– Omega-3 from supplements or oily fish
There’s some evidence that a very strict vegetarian diet can help, and that people who eat a lot of red meat may have a slightly increased risk of rheumatoid arthritis.
Generally it is an unfortunate fact that at Menopause many women do put on additional weight around the middle and this is often related to excess oestrogen, oestrogen dominance.
In order to help rebalance this you would need to supplement with bioidentical progesterone and a diet that will support that.