I was addicted to coffee. I HAD to have a cup every morning. Black. No cream or sugar. And, I would die if I didn't have it. Ok, I may be exaggerating, but I loved, and relied on, my morning cup of joe.

When I started this journey, coffee was the first thing to go. I thought if I could go a day without coffee, then I could eliminate any other food. So, I cut it out cold turkey. The first 2 days were awful! I supplemented with coconut water and green tea, but that did not help the headache, groggy, tired feeling. Once I detoxed from this habit, I felt amazing. It's been 7 months, and I have not caved. In many ways, it's been freeing to not heavily rely on my morning cup for energy. Somedays, I have a cup of green tea at work, purely to hold a warm mug, but there are many days I go without it.

So, has eliminating coffee affected my rheumatoid arthritis? I can't say I noticed a difference in my joint pain after eliminating it. However, I did not make the decision lightly, rather I dug into the research behind coffee and RA.

Coffee & RA Statistics

  • Consuming 4 or more cups of coffee a day increases risk of RA compared to those drinking less
  • Even drinking decaffeinated coffee, which still contains about 7mg of caffeine per 8 oz, substantially increasing risk of developing seropositive RA
  • Tea intake is associated with decreased risk of RF-positive RA1

Coffee Affects on Immune System

Caffeine has both anti-inflammatory and pro-inflammatory actions, and it's a wonderful source of anti-oxidants, which protects our cells from damage1,2.

Caffeine is processed by the liver into theophylline, which has immunosuppressive and anti-inflammatory properties. It suppresses cytokine production, cell proliferation, and chemotaxis, which inhibits our immune function. Because of these properties, it has been used to therapeutically treat asthma, which is an immune reaction2.

This is the main reason I've chosen not to drink coffee. I flare from alcohol and my nails have ridges, which may be signs my liver is not operating as efficiently as it should. So, I try to reduce things for my liver to process, like coffee and caffeine.

Contrary to anti-inflammatory benefits, caffeine has some pro-inflammatory aspects, especially when combined with pharmaceuticals or consumed in large quantities. Caffeine blocks anti-inflammatory actions of methotrexate (MTX), which may cause the need for higher MTX dosing to counteract. Some studies have seen significant increases in MTX treatment failure in those who regularly drink coffee, while others site no change1,3.

Caffeine chronically elevates cortisol, which is part of our fight or flight response. More than 300 mg of caffeine per day (about 3 cups) has shown to chronically elevate cortisol levels for 6 hours. Cortisol can be anti-inflammatory in short term use, however when chronically elevated it compromises the immune system. When chronically elevated, our bodies accumulate stress hormones and increase inflammatory cytokines, both of which negatively alters our immune function4.

Lastly, new research is emerging around coffee and our gut. We are finding that it alters our gut micro-biome5. This is still a new field being studied, and one to keep a close eye on.

Should I Continue Drinking Coffee with RA?

As we can see, the amount of coffee we drink plays a crucial role in immune function. Coffee drinkers should drink 3 or less cups of coffee a day to keep cortisol levels in check.

If you're looking to see the effects of coffee on your RA, try eliminating it for 2 weeks and see how you feel. On a pain scale from 0-10, does your joint pain increase or decrease? Does your GI seem to process foods better?

If you're on MTX, consider decreasing caffeine consumption and tracking your symptoms. If you see improvements in pain consider decreasing MTX dosing.

Lastly, the kind of coffee matters. Most coffee is processed with chemicals that have been connected to diseases, including RA1. Try buying organic coffee. You may not see immediate relief, but your body will thank you later.

References:

  1. Mikuls, T. R. et al. (2002). Coffee, tea, and caffeine consumption and risk of rheumatoid arthritis. Arthritis & Rheumatism, 46(1):83-91.
  2. Horrigan, L., Kelly, J., Connor, T. (2006). Immunomodulatory effects of caffeine: Friend or foe? Pharmacology & Therapeutics, 111(3): 877-892.
  3. Silke, C., Murphy, M., Busteed, S., Murphy T., Phelan, M., Molloy, M. (2001). Does heavy caffeine ingestion affect the efficacy of methotrexate. Annals of the Rheumatic Diseases. 60(1).
  4. Lovallo, W. R., et al. (2008). Caffeine Stimulation of Cortisol Secretion Across the Waking Hours in Relation to Caffeine Intake Levels. Psychosomatic Medicine, 67(5): 734-739.
  5. Cowan, T., et al. (2014). Chronic coffee consumption in the diet-induced obese rat: impact on gut microbiota and serum metabolomics. The Journal of Nutritional Biochemistry, 25(4), 489-495.