Drinking alcohol in moderation is typically safe for people with rheumatoid arthritis (RA).

According to the Arthritis Foundation, drinking alcohol in moderation is usually safe and may even reduce certain types of inflammation. Some research says that small amounts of alcohol could reduce the risk of developing RA in the first place.

However, heavier alcohol use can cause problems. Alcohol can also interfere with some RA medications, with serious health implications. Before drinking alcohol, people can speak with a doctor about the risks and benefits.

This article examines the research behind how drinking alcohol can affect RA and the interactions between RA drugs and alcohol, and other safety considerations.

Learn more about RA, including symptoms, treatments, and causes.

Until recently, little research has directly assessed the effects of drinking on RA.

Current research is mixed, and the link between alcohol and RA appears to differ depending on how much a person drinks and their medications.

The following sections of this article discuss what the research says about alcohol and how it affects RA.

Does alcohol affect inflammation?

Inflammation causes the symptoms of RA, including joint pain, stiffness, and fatigue. Heavy alcohol use can increase inflammation in the body, while moderate drinking may actually reduce inflammation.

A 2015 review states that moderate drinking can reduce certain inflammation markers, including c-reactive protein, interleukin-6, and tumor necrosis factor (TNF)-alpha receptor 2. On the other hand, excessive drinking can increase inflammation.

When a person drinks too much, the alcohol can damage the gut and liver, leading to body-wide inflammation. Scientists closely link alcohol-related medical conditions with chronic inflammation.

However, alcohol should not negatively affect people with RA when taken in moderation.

Can alcohol reduce RA symptoms?

Some small research studies suggest that drinking moderate alcohol could reduce RA symptoms, possibly because alcohol reduces certain types of inflammation. However, more research is needed to uncover the true effects of alcohol on RA symptoms.

A 2020 study showed that moderate alcohol consumption may reduce the severity of nonalcoholic fatty liver disease (NAFLD).

However, a 2018 study of 188 people with early RA found no difference in the severity of joint inflammation when the researchers examined their MRI scan results. They suggested the anti-inflammatory effects of alcohol could be systemic and not involve the joints specifically.

However, the Centers for Disease Control and Prevention (CDC) say that nobody should start drinking alcohol for any potential health benefits. Alcohol can cause short- and long-term health problems, even if it does not exacerbate symptoms of RA.

Can alcohol reduce the risk of RA?

Another strand of evidence suggests that drinking a moderate amount of alcohol could actually reduce the risk of developing RA in people who do not have the condition.

In a 2020 study, researchers found a significant association between alcohol consumption and RA risk in women but not men. Among women, every 10 grams (g) increase in alcohol consumption significantly increased the risk of developing the condition.

Researchers need to conduct further studies to explain, understand, and confirm the link between drinking alcohol and the risks of developing RA — and why this may impact females more than males.

When a person drinks alcohol, their liver processes and breaks down the ethanol. Overloading the liver with excessive alcohol consumption can damage the liver.

The liver also filters many medications that people use to treat RA. Taking alcohol with these drugs can increase a person’s risk of liver damage.

The following medications do not interact well with alcohol:

Taking NSAIDs increases the risk of stomach bleeding and ulcers, and excessive alcohol use may intensify these effects.

In addition, Janus kinase inhibitors (JAK) are a newer class of oral medications that a doctor can prescribe to treat RA. An example of a JAK inhibitor is tofacitinib (Xeljanz).

Although these medications post a lesser risk in terms of liver toxicity than methotrexate, a person may still want to do some blood tests to check their liver function about 4–8 weeks after starting the medication and then every 3 months.

A person should also avoid consuming high amounts of alcohol to avoid increasing the risk of liver problems.

Read more about mixing ibuprofen and alcohol or acetaminophen and alcohol.

Current research does not point to a specific amount of alcohol that makes RA symptoms worse. In moderation, alcohol should not negatively affect people with RA.

The CDC defines moderate drinking as:

  • up to 1 drink per day for women
  • up to 2 drinks per day for men

Binge drinking can increase body-wide inflammation, and chronic alcohol use can lead to inflammatory liver disease over time. Binge drinking refers to four or more drinks on one occasion for women or five for men.

The long-term risks of excessive alcohol use include:

The effects of alcohol on the body are complex. Research consistently links excessive drinking to a host of health problems, as well as accidents and injuries. Yet alcohol is not universally harmful, particularly in moderation.

Alcohol may affect people in different ways. People with RA can monitor how alcohol affects their symptoms and their bodies. If a person suspects that alcohol is worsening their RA symptoms, it may be beneficial to stop drinking alcohol.

People with RA can safely drink alcohol in moderation. However, they should speak with a doctor about any possible drug interactions, contraindications due to prescribed medication, and other medical conditions that could cause complications.