Ask the Doctors March 2003 Issue

Ask Dr. Marks: 03/03

I’ve heard it’s important for people with arthritis to take plenty of vitamin C and/or vitamin E. Is this true?

Research has been published on both sides of the issue. A recent major study from Australia showed no effect on cartilage wear and joint symptoms between Vitamin E and placebo-treated groups. Neither did dietary levels of antioxidants (Vitamin C and beta carotene) have any effect on cartilage loss. On the other hand, some studies, employing a retrospective analysis of existing data, have hinted at a reduced risk of OA progression in patients with high Vitamin C and E intake. It is safe to say that there is no convincing proof as yet that large doses of Vitamin C, Vitamin E or other antioxidants alter the clinical course of OA.

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I understand that rheumatoid arthritis can be quite variable in its course. Can you give me some idea of what to expect from the disease? Does RA ever just go away?

Rheumatoid arthritis is a progressive disease that rarely goes away even with treatment. It can become quiescent for a number of years but eventually it will reestablish itself. Early treatment with the expanding array of new drugs is the key to slowing down the progression of the disease. It is important to start treatment before articular cartilage destruction or bone erosion develops. With better medical control of RA there is a decreased need for surgery. Drugs such as methotrexate, Embrel and Remicade have made a dramatic impact on the mobility and quality of life of rheumatoid arthritis sufferers.

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I’ve heard that a vegetarian diet can help people with arthritis. Does it?

Although many diets have been suggested to control the symptoms of osteoarthritis, almost none have been proven effective. There is no evidence that a vegetarian diet will change the course of the disease. A well balanced diet that contains dark-meat fish, such as salmon, may be as effective as any diet in controlling arthritis symptoms. The oil from these fish contains elevated amounts of omega 3, which is believed to be a naturally occurring anti-inflammatant. Omega 3 fish oil capsules can also be used to supplement any type of diet and may be marginally useful in reducing the severity of arthritic symptoms.

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Is there any connection between depression–or stress-–and arthritis?

It is known that depression affects a person's sleep patterns, appetite and the perception of pain. Sleep-deprived people, in particular, frequently perceive pain more intensely than others. It is important that you bring to your doctor's attention symptoms of depression so that treatment may be undertaken. Such treatment can enable you to better cope with arthritis pain and should be part of a comprehensive medical program to reduce the impact of arthritis on your mobility and quality of life. Stress is another factor that affects arthritis, especially rheumatoid arthritis. It can weaken the immune system, which in turn may affect the severity or onset of rheumatoid arthritis.