Whether it’s served up in the form of hot coffee, iced coffee, energy drinks, soda, or even dark chocolate, Americans love their caffeine. We get about 300 milligrams (mg) a day on average, mostly from coffee and other beverages.
Nearly 60 percent of Americans drink coffee each day, making it more popular than any other beverage, including tap water, according to the National Coffee Association. The average daily consumption is almost 2 cups for every adult in the country.
But is caffeine bad for people living with rheumatoid arthritis (RA)?
Mixed Research Results on Caffeine and Rheumatoid Arthritis
Some studies have shown that coffee is beneficial for health, but others have not.
A review of research found that high coffee consumption was associated with a low risk of mortality, as well as reduced odds of cardiometabolic diseases, some cancers, and gallstones.
RELATED: Understanding the Relationship Between Caffeine and Headaches
But other research has been less positive. One study found that after drinking coffee, some people exhibited anti-inflammatory effects in their blood, but others actually had increased inflammation.
Some scientists have specifically studied people with RA and found a possible association between heavy coffee drinking and incidence of the condition. A meta-analysis concluded that people living with seropositive RA (although not seronegative RA) were more likely to drink a lot of coffee, although doctors were quick to say that an association doesn’t prove that one causes the other. Drinking a lot of decaf was not linked to higher RA rates.
RELATED: 10 Foods to Help Beat Rheumatoid Arthritis Inflammation
Meanwhile, researchers found that drinking tea, which has caffeine but not at the same levels as coffee, was correlated with lower rates of RA.
The Takeaway for People With RA Who Crave Caffeine
The bottom line is that coffee may be good in some ways but can be bad in others for RA, such as increasing a person’s heart rate, says Andrew Wang, MD, PhD, a rheumatologist and an associate professor of internal medicine (rheumatology) at Yale School of Medicine in New Haven, Connecticut.
“I tell my patients to drink coffee if they enjoy it, but not to drink it as medicine, and as always, to listen to their body,” Dr. Wang says.
Caffeine and Rheumatoid Arthritis Medication
Drinking caffeine will not cause harmful effects for the common medications taken for RA. Because one side effect of prednisone (Deltasone) is insomnia, however, you might want to ditch the java and other highly caffeinated drinks if you are on the steroid to manage RA symptoms and you’re having sleep issues.
RELATED: 11 Benefits of Going Caffeine-Free
If you’re taking methotrexate (Trexall), however, you may actually want to consider adding a little caffeine to your routine. As described in one research article, researchers followed people with RA on this disease-modifying antirheumatic drug (DMARD) for nearly a year. They found that of the people who had trouble tolerating the drug because of its unpleasant symptoms, more than half were fine when they took some caffeine, in the form of coffee or dark chocolate, along with their medicine. Another 13 percent experienced partial relief by adding caffeine.
How Much Caffeine Is Too Much?
Patients with RA often experience fatigue, so they may turn to coffee to give them a boost. Other people simply like the taste or are in the habit of drinking it.
RELATED: Should You Add Protein to Your Coffee?
Experts say that until more research clarifies caffeine’s role, there’s probably no reason to stop drinking what you love. You might want to drink in moderation — something like a cup or glass or two a day — especially if caffeine makes you hyper or keeps you up at night.
The U.S. Food and Drug Administration (FDA) does say that up to 4 or 5 cups of coffee, some 400 mg a day, is not associated with any dangerous side effects, but it notes that people vary in their sensitivity and that some medications can impact caffeine metabolism.
You’re definitely overdoing it if you experience insomnia, jitters, a fast heart rate, nausea, a headache, or other unwanted effects, the FDA says. If you decide to cut back, do so gradually to avoid unpleasant withdrawal symptoms like headaches or anxiety.
How Much Caffeine Is in Our Diet?
The biggest sources of caffeine are coffee (an 8-ounce [oz] cup of drip coffee has about 145 mg; brewed is 95 mg) and energy drinks (some have as much as 200 mg; an 8-oz can of the popular drink Red Bull has about 80 mg). Be aware of your portion size. Many mugs and coffee shop drinks can hold as much as 20 oz.
According to the Harvard University T.H. Chan School of Public Health, other sources of caffeine include a shot of espresso (65 mg), a cup of black tea (47 mg), green tea (28 mg; herbal tea contains no caffeine), 12 oz of Mountain Dew (55 mg) or cola (40 mg), 1 oz of dark chocolate (24 mg; 6 mg for milk chocolate), and decaffeinated coffee (4 mg).
Of course, don’t forget to drink water, which not only hydrates the body but helps counter the potential diuretic effects of caffeine.
Take Your Coffee Sans Sugar
Do keep in mind that soft drinks and elaborate coffee drinks with pumps of syrup or whipped cream have more than just caffeine in them.
As the digital arthritis community CreakyJoints notes, fancy coffee shop brews can have a dozen or more teaspoons of sugar. For example, a Grande White Chocolate Mocha with whipped cream from Starbucks has 430 calories and 53 grams (g) of sugar. Dunkin’s Medium Mocha Swirl Frozen Coffee clocks in at 670 calories and 129 g sugar. Excessive sweeteners promote inflammation in the body that over time can damage tissues, including joints, CreakyJoints notes.
So drink your joe black or with nonfat milk, rather than with flavors or other extras, and consider a dressed-up drink from a coffee shop to be a rare treat.