Vitamin D and Other Nutrients That Help Rheumatoid Arthritis (RA)

Everyone needs vitamin D. It helps your body absorb calcium and allows your bones to grow properly and stay strong.

If you don’t get enough vitamin D, your bones can become soft and brittle. This can raise your risk of bone fractures, deformities, and other problems.

For people with RA, vitamin D can have additional benefits.

RA is an autoimmune disease, and vitamin D plays a role in the immune system. People with RA also have high levels of inflammation, and vitamin D helps decrease that.

Some RA medications can raise your risk of vitamin D deficiencies, which can lead to complications.

According to an older 2011 study, people who take oral glucocorticoids have an increased risk of 25(OH)D deficiency. They’re twice as likely to be short on this form of vitamin D than the average person.

Glucocorticoids, also known as corticosteroids, are sometimes used to help treat RA.

Reduced levels of vitamin D and calcium are also common side effects of prednisone, a glucocorticoid that may be administered orally or via injection. As a result, prednisone use is becoming less common for people with RA.

There are multiple ways to boost your vitamin D intake.

The sun

Ultraviolet (UV) radiation from the sun helps your body produce its own vitamin D. However, too much UV-ray exposure can cause skin cancer. Don’t spend too much time in the sun with your skin exposed.

How much time you’ll need to spend in the sun will depend on factors such as your skin tone and climate. Recommendations will vary.

The Skin Cancer Foundation recommends up to 10 to 15 minutes of sunlight exposure two or three times a week. They recommend that you focus the exposure on the arms, legs, abdomen, and back.

People with darker skin tones will need more sunlight exposure in order to produce adequate amounts of vitamin D.

For instance, Western Australia’s Department of Health recommends 10 to 30 minutes of daily sunlight exposure to the face, arms, and hands for people with light skin. They recommend 20 to 90 minutes of daily sunlight exposure for people with darker skin. Time spent in the sun will vary based on the season.

Studies such as a 2015 Norwegian study and a 2013 Indian study have concluded that midday is the best time to expose your skin to the sun.

Diet

You can also get more vitamin D by adjusting your diet. This important vitamin is found in a select amount of foods, such as:

• certain types of fish, including salmon and mackerel
• egg yolks
• cheese
• beef liver

Few other foods contain vitamin D naturally, but some are fortified with it. For example, vitamin D is added to many brands of milk, cheese, and breakfast cereal.

Vegans in particular may need to look for fortified sources since mushrooms are the only plant-based food that naturally contains vitamin D.

Supplements

It’s important for people with RA to get their vitamin D levels checked. If you can’t get enough vitamin D from sunlight and diet alone, your doctor may suggest taking a vitamin D supplement.

Vitamin D isn’t the only important nutrient when you have RA. Vitamin E deficiency is also relatively common among people with RA.

Vitamin E is a potent antioxidant. According to a literature review, regular supplementation with vitamin E has multiple benefits for people with RA. They include:

• better quality of life
• reduced joint discomfort, swelling, and stiffness
• a healthier gastrointestinal tract

It’s a good idea to include vitamin-E-rich foods in your diet, such as:

• nuts
• seeds
• leafy green vegetables
• certain types of fish and shellfish, including salmon and abalone

In some cases, your doctor may also advise you to take a vitamin E supplement.

Other supplements may also help relieve joint pain and reduce your risk of complications from RA treatments.

Folic acid (vitamin B9)

Methotrexate (Otrexup, Rasuvo) is the most commonly prescribed RA medication. If it’s part of your treatment regimen, you may need to take a folic acid (vitamin B9) supplement.

Methotrexate affects your body’s ability to absorb folate or folic acid. If you don’t get enough of this nutrient, you may develop anemia or other health problems.

Bromelain

Your doctor may also encourage you to take bromelain. This compound is made from a group of enzymes derived from pineapple. A 2020 study suggests that it might have anti-inflammatory and pain-relieving properties.

A healthy diet alone won’t cure your RA symptoms, but eating a nutrient-rich diet can help you stay as healthy as possible. In some cases, it may even decrease common symptoms of this painful condition and lower your risk of complications from RA medications.

Some vitamins, minerals, and other supplements can interact with certain RA medications. Always check with your doctor before adding a new supplement to your routine. They can help you understand the potential benefits and risks of taking it. They can also help you determine how much you should take.