Rheumatoid arthritis is one of the oldest ailments in human existence and for anyone suffering from this condition, the symptoms can be unbearable. At the microscopic level, the lining of the joints becomes inflamed and as a result, aches. Unfortunately, there is no cure as the culprit behind the trouble is not a microbe but the immune system. Somewhere along the way, the immune cells begin to recognize these areas of the body as foes and start a sustained attack. Not surprisingly, trying to figure out how to manage arthritis has been the goal of many researchers.
One of the strangest options came out in 1939: vitamin D. It was discovered in 1921 and gained notoriety as a miracle drug in the public. The medical community, however, was not about to be convinced without more research.
Unfortunately, little useful information was gained until 1974 when a more defined association was established. According to a small study on women, vitamin D deficiency led to significant issues in bone health and also an increased chance for arthritis. Although this finding wasn't considered revolutionary, it did open the door to more advanced research to figure out what mechanism, if any, was involved.
The results were less than encouraging though. During the 1980s, research looking at the role of vitamin D in affected joints showed no association with the condition. In some cases, higher levels could actually worsen disease progression. The conflicting information essentially threw out the 1939 suggestions and put the 1974 data into question.
But while the two sides could not meet, another possibility came into light in 2001 when vitamin D was recognized as an immunological suppressor. A host of studies over previous years in the lab and in mice revealed the vitamin was important in helping to slow down autoimmunity processes. With regular doses, a person might be able to control autoimmune processes and possibly could reduce if not completely alleviate symptoms. By 2008, there was enough knowledge to offer guidelines regarding treatment.
While there appeared to be little to stop the growing trend, there was still some skepticism. Even as the concerns from the 1980s were put to rest some believed there was still a lack of proper information to fully conclude vitamin D could help manage arthritis. Without a proper analysis of all the data to date, there was no real way to know whether supplementation could indeed help and possibly prevent disease.
That undertaking has now been performed. Last week, a team from China and the United States released a review of studies regarding vitamin D and rheumatoid arthritis. Based on the analysis, there is good reason to believe supplementation could help anyone at risk.
The study examined 24 reports between 1998 and 2015 encompassing 3,489 patients, 2148 with arthritis and 1,991 healthy controls. Each study focused on the relationship between vitamin D levels in the blood and the onset of rheumatoid arthritis. The studies were analyzed separately and then as a group in the hopes of finding a definitive answer.
When all the work was completed, the results were fairly conclusive and proved the work from 1974. Essentially lower vitamin D levels correlated with rheumatoid arthritis. This at least confirmed there was some relationship between the two and anyone who may be at risk may want to consider daily supplementation.
As to whether supplementation could treat or even cure the disease, the results revealed the answer is far more complex. Although supplementation may offer help, other factors including diet, hygiene, and other medications also play a role in how bad the disease gets. Another problem is exposure to pollution, which no amount of supplementation can solve. For those living in areas where environmental contamination is high, the effects are far worse regardless of vitamin D status.
For those of us in Canada, the situation is not quite as dire. Vitamin D is readily available in numerous food products and we can also get it in the form of pills and drops. Maintaining a daily ritual of taking an appropriate dose may help to maintain a healthy and immunologically balanced body.
As for the other factors involved in the onset of the condition, paying regular attention to one's lifestyle can also offer some perspective on the risk. Although escaping the rigours of stress may not be entirely easy, for the sake of the joints, it may be the best way to prevent longer lasting aches.
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If you're going to choose a fish dish, go with salmon. An oily fish high in vitamin D, salmon also has omega 3 fats, protein, vitamin B12 and selenium. "If you eat the soft bones in half a can of salmon (105 grams) you will be consuming almost as much calcium as in a glass of milk," says registered dietitian dietitian Shauna Lindzon.
Another oily fish high in vitamin D and omega 3 fats, mackerel is also rich in vitamins A, B6, B12, C, E and K. Lindzon adds pregnant women, however, should limit mackerel consumption because of its high mercury content.
Sardines are loaded with vitamin B12, selenium, omega 3 fats, protein and vitamin D. "Sardines are very perishable, so eat them when they are fresh," Lindzon says. And since they are smaller fish, they contain lower levels of mercury. Watch out for canned sardines, which may be filled with extra sodium.
Beef liver is a high protein, high cholesterol food choice, Lindzon says. It's high in vitamin B6, B12, and also contains a large amount of dietary iron.
Milk is often called "nature's perfect food", because it's a rich source of many different vitamins and minerals, including calcium, vitamin D and B.
The nutrients in egg yolks differ greatly from egg whites. Egg yolks are high in cholesterol, fat and fat-soluble vitamins including vitamins A, D, E and K.
There are a variety of non-cow milks on the market that are also fortified with vitamin D — perfect for those of you who are vegan or have a lactose intolerance. "Certain brands of soy, rice, almond, and hemp milks have similar vitamins to cow's milk because of the fortification process," Lindzon says.
Mushrooms (all of their edible varieties) have many cancer fighting properties and are a great source of vitamin D.
"When reading labels of breakfast cereals, it is important to choose ones with a high fibre content (more than 4 to 5 grams) and low sugar content (less than 8 grams)," Lindzon says. Adding milk or a milk substitute to a breakfast cereal boosts the calcium, vitamin A, D, and protein content.
There are some orange juices on the market that have calcium and vitamin D added to them. "This fortified orange juice provides people with an option to increase their vitamin intake if they don't consume milk," Lindzon says. However, it is important to note that orange juice lacks the fibre that is in the original orange, and some boxed varieties may have an excessive amount of sugar.
"It is important to check the nutrition labels of yogurts to see if they have vitamin D added," Lindzon says. When choosing yogurts, choose ones that are low in added sugar and high in vitamins.
Cheese is derived from milk, and therefore has the same beneficial vitamins and minerals, including calcium and vitamin D.
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