From healthcentral.com
The research—and people’s individual experiences—are mixed. Here’s what you need to know
When you have psoriatic arthritis (PsA)—an inflammatory condition of the joints linked to the skin disease psoriasis—a healthy lifestyle is a key component for managing your symptoms. That includes regular physical activity, a nutritious diet, and avoiding smoking. Does it also mean you should re-evaluate your alcohol intake? The relationship between alcohol and psoriatic arthritis isn’t completely straightforward, so if you have PsA and you also enjoy unwinding after a busy day with an adult beverage, there are a few things to consider.
Psoriatic Arthritis Symptoms
The symptoms of psoriatic arthritis vary from one person to the next but are mainly felt in the skin and joints. The disease can also affect other areas of the body, like the eyes and gastrointestinal (GI) tract. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), people with psoriatic arthritis may experience:
Eye inflammation that causes pain, redness, and blurry vision
Fatigue
Inflammatory bowel disease, the symptoms of which include abdominal pain, diarrhoea or changes in bowel movements, nausea, and unexplained weight loss
Joint stiffness, pain, and swelling, which can also affect the spine
Nail changes
Sausage-like swelling of a finger or toe
Scaly, inflamed patches of skin on scalp, elbows, and knees
Tenderness in areas where tendons and ligaments attach to bones, such as the back of the heel or sole of the foot
The answer to the question of how alcohol intake impacts your chances of developing psoriatic arthritis isn’t cut and dry—and that’s because much of the research is conflicting, says Elena Schiopu, M.D., a professor of medicine in the division of rheumatology at the Medical College of Georgia at Augusta University.
For example, a British study of more than 90,000 people with psoriasis (about 1,400 of whom had also developed psoriatic arthritis) published in the British Journal of Dermatology found that moderate drinking (but not heavy drinking) was associated with an increased risk of PsA among those with psoriasis.
On the other hand, a study of more than 80,000 women (141 of whom developed psoriatic arthritis) published in the Journal of Rheumatology found that moderate drinkers were at a lower risk of PsA compared to non-drinkers, while those who reported excessive alcohol use (more than two drinks per day) had a four-fold greater risk of psoriatic arthritis compared to non-drinkers. That may be due to the fact that high levels of alcohol contribute to inflammation, possibly triggering the disease in some people. Still, other research has not found alcohol to be a risk factor for psoriatic arthritis.
If you have psoriasis (which often precedes a diagnosis of PsA) or you’re already living with psoriatic arthritis, where does that leave you? To start, researchers do know that increased alcohol intake is associated with more severe psoriasis symptoms and can affect treatment of the disease. Drinking also raises heart disease risk (which psoriasis also increases). The issue is so pressing that one article in the American Journal of Clinical Dermatology called on dermatologists to ask all patients about their alcohol use.
Dr. Schiopu suggests that if you currently have more than two drinks per day, it will probably benefit you to cut back. “Having alcohol socially once or twice a week and limiting yourself to one serving may not cause a big issue,” she says. (Of course, if you don’t drink now, there’s no reason to start.) You’ll also want to keep tabs on how alcohol affects your psoriasis flares, and if you already have psoriatic arthritis, your PsA flares as well.
Alcohol and Psoriatic Arthritis Flare-ups
People who have psoriatic arthritis will notice that they have their own unique individual triggers for flares (times of active disease where you experience symptoms). You may notice that alcohol intake is one of yours. For example, Dr. Schiopu says that some patients report that wine in particular aggravates their condition. Others find that one drink on occasion is okay, but going over a certain amount brings on symptoms. “It requires some personal experimentation,” she says.
There are a few reasons why alcohol may trigger flares. The alcohol itself may be proinflammatory. In addition, the sugar in alcoholic drinks can trigger flare-ups of psoriatic arthritis, says Elizabeth Ortiz, M.D., a rheumatologist and clinical advisor at the virtual care platform WellTheory. (Sugar is also proinflammatory, she says—in research, patients with rheumatoid arthritis or psoriasis report that sugar is a common trigger.) Dr. Ortiz recommends making the lowest-sugar choice you can, which means staying away from mixers like sodas and cocktails (which often contain added sugar in syrups or juices) and instead opting for spirits mixed with no-sugar-added sparkling water, low-sugar canned alcoholic beverages, or zero sugar wines.
Dr. Ortiz points out that alcohol can also decrease your inhibitions, affecting the food choices you make—and you could end up eating foods that trigger symptoms for you. If you are drinking, “be mindful of the amount you drink, as well as how that amount affects other behaviours,” she advises.
Alcohol and Psoriatic Arthritis Medications
If you drink alcohol and are taking a medication to treat psoriatic arthritis, ask your prescriber about any potential interactions or risks associated with imbibing, advises Dr. Schiopu. One to keep in mind is methotrexate, an immunosuppressive medication that is a common treatment for psoriasis and psoriatic arthritis. Because of the potential harm to the liver, people should avoid using alcohol while taking methotrexate. “This medication is known as a liver irritant, as is alcohol. If you have one liver irritant, why add to it and press your luck with another?” says Dr. Ortiz.
Lifestyle Choices to Help Manage Psoriatic Arthritis
Identifying your personal triggers (and then avoiding them as much as possible) can go a long way to helping you manage your condition. “Knowing how someone reacts is based on trial-and-error and seeing how they feel after eating certain foods and making adjustments to their lifestyle. Everyone has their own personal threshold of what they can tolerate,” says Dr. Ortiz.
Keeping a journal can help you pinpoint the foods, drinks, or habits that may be linked to worsening symptoms. In addition, there are several lifestyle measures that are recommended across the board to help manage the disease and keep symptoms at bay. According to NIAMS, these are:
Exercise regularly
Maintain a healthy weight
Quit smoking
Seek out mental health to address the emotional toll of PsA
Research is conflicting on how alcohol intake affects your risk of developing psoriatic arthritis, and its impacts on symptoms can vary from one person to the next. Rheumatologists recommend moderating your alcohol intake if you choose to drink. And even more importantly, pay attention to how alcohol intake affects your symptoms and make adjustments as necessary, such as decreasing the amount or frequency that you drink, or changing the type of drinks you consume.
https://www.healthcentral.com/condition/psoriatic-arthritis/psoriatic-arthritis-and-alcohol
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