How to Stay Hydrated With Rheumatoid Arthritis
For people with RA, dehydration can lead to more severe joint pain and other uncomfortable symptoms.
You’ve no doubt heard that staying hydrated is important for overall health. But if you have rheumatoid arthritis (RA), consuming enough fluids is especially critical for maintaining joints and keeping symptoms at bay.
RA is a disease that occurs when the body’s immune system mistakenly attacks joints and other tissues, leading to symptoms such as joint pain, fatigue, inflammation, and stiffness.
Lack of Adequate Water May Intensify Joint Pain and Other RA Symptoms
“My rheumatoid arthritis symptoms definitely increase when I don’t drink enough water, or if I’m in extreme heat,” says Eileen Davidson, a rheumatoid arthritis patient, advocate, and author of the Chronic Eileen blog. “I tend to feel more stiffness in my joints and muscles. I have a spike in fatigue, sluggishness, and definite increase in cognitive dysfunction.”
Water plays a vital role in helping different parts of the body function at their best. A lack of liquids can increase inflammation and lessen the amount of fluid that cushions joints. The good news: Simple measures can help you avoid the negative effects of dehydration.
Here’s what you need to know about how dehydration affects someone with RA.
How Does Dehydration Affect Someone with RA?
Dehydration results when your body doesn’t have enough fluids to perform normal functions because you use or lose more liquids than you consume, according to the Mayo Clinic.
Studies have suggested more than 500,000 people in the United States are hospitalized for dehydration every year.
Although research on the exact relationship between dehydration and RA is limited, scientists do know water consumption can affect the processes that keep joints working.
“To my knowledge, there are no studies showing the effects of dehydration with people with RA, but there is evidence that hydration might help maintain joint health,” says Betty Hsiao, MD, a rheumatologist at Yale School of Medicine in New Haven, Connecticut.
According to the Arthritis Foundation, staying hydrated is important for flushing toxins from your body, which may lessen inflammation.
Cartilage Needs Hydration to Stay Healthy and Functional
Hydration is also crucial for healthy cartilage, tissue that covers the ends of your bones and allows them to glide over each other without rubbing together. An article published in the British Medical Bulletin found between 65 and 80 percent of the cartilage in your body is made of water. When you are sufficiently hydrated, friction between bones is reduced, so you can move more easily.
A good visual might be to compare cartilage to a sponge. When a sponge is hydrated, it’s wet, soft, and easy to manipulate. But when it dries out, it’s stiff and difficult to use.
Additionally, if you’re dehydrated, your body may not produce enough synovial fluid — the thick liquid located between joints that acts as a cushion and helps prevent friction when you move. “Water is a major component of synovial fluid, so maintaining adequate hydration may help keep joints healthy,” explains Dr. Hsiao.
Some research suggests that consuming hydrogen water (water with hydrogen gas added to it) may reduce symptoms of RA. The idea is adding hydrogen to the water increases its anti-inflammatory and antioxidant effects. But more studies are needed to confirm these findings.
Signs and Symptoms of Dehydration in People With Rheumatoid Arthritis
According to the Mayo Clinic, some signs and symptoms of dehydration to watch out for include:
- Fainting or dizziness
- Dark-colored urine
- Urinating less frequently
- Dry skin or mouth
“Not only does my mouth feel dry, but so do my joints and muscles,” says Davidson. “I also tend to crave sugary foods, which are known to increase inflammation. If I don’t drink enough water while I take my daily NSAIDs or SSRI, I can notice an increase in heartburn and stomachache.”
How Much Water Should You Drink?
The amount of water you should consume depends on your gender, age, and how active you are. Additionally, certain medicines may require ample fluid consumption.
“For the treatment of RA, we frequently use methotrexate, which is eliminated by the kidney, so it’s very important to stay hydrated when taking methotrexate to help prevent kidney toxicity,” says Hsiao.
While there are no hydration guidelines specifically for people with RA, the National Academies of Sciences, Engineering, and Medicine suggests the following:
- Adult men should consume 3.7 liters (L), or about 16 cups, of water a day
- Adult women should consume 2.7 L (about 11 cups) of water a day
The total daily water consumption in these recommendations can come from both beverages and foods.
The guidelines are a good rule of thumb, but some people may need to consume more or fewer liquids depending on the weather, their activity level, or other factors.
RELATED: Hydration Calculator: How Much Water Do You Need to Drink a Day?
Tips to Stay Hydrated When You’re Living With Rheumatoid Arthritis
Drinking enough fluids might require a conscious effort on your part.
"It is important to stay hydrated, especially during warmer weather, so it may help to carry a reusable water bottle to help rehydrate during the day,” Hsiao says. “Remember to stay hydrated before, during, and after exercise. Hydration will also help reduce muscle cramps.”
Davidson has some hydration tricks of her own. “Water can be a bit boring to drink all day, so I always keep on hand sparkling water and some lemons or limes for flavor and added vitamin C,” she explains. “This not only helps me stay hydrated but can help with malaise from both RA and side effects of medications.”
Here are some other ways to stay hydrated:
- Set a routine. Some people find it helpful to drink a glass of water after every bathroom visit or before each meal.
- Track your consumption. High-tech water bottles communicate with smartphones to help you document how much you drink.
- Set reminders. Daily alarms on your phone or computer can alert you when it’s time to drink a glass of water.
- Try an app. Apps like Daily Water Free or Daily Water help keep you on track.
- Avoid dehydrating beverages. Drinks that contain alcohol or caffeine can pull water from the body and dehydrate you.
- Eat foods that aid in hydration. Foods like fruit, veggies, and soups contain a high water content.
RELATED: 13 Hydration Hacks to Help You Drink More Water
The Bottom Line on the Importance of Hydration
While drinking more water won’t cure RA, adequate hydration may help improve joint health and keep joints lubricated.
When you’re hydrated, your entire body functions better, and you’re likely to have more energy and improved mood.
But don’t overdo it. Drinking too much water can cause hyponatremia — a condition that’s characterized by low sodium levels in the blood.
Talk to your doctor if you’re concerned that you’re not consuming enough liquids.