An adequate supply of vitamin D is a critical factor in avoiding symptoms and staying healthy. Here's why the "sunshine vitamin" should be part of your rheumatoid arthritis treatment.

Having rheumatoid arthritis can be maddening, not only because your own immune system is attacking your joints, but also because doctors still don’t know exactly why the disease occurs.

But research into rheumatoid arthritis treatment is beginning to make significant progress toward stopping its progression and relieving joint pain. And in addition to cutting-edge medicine, researchers are discovering that a number of nutrients may help you better manage RA symptoms and limit complications. One that might play a role in easing the severity of RA symptoms such as joint pain is vitamin D, which the body can make from sun exposure.

Vitamin D and RA: Understanding the Relationship

Research on 10,000 people participating in the Nurses’ Health Study showed that those living in the northeastern United States had a significantly higher incidence of rheumatoid arthritis than did people in other parts of the country. Sun exposure is lower in that region, and researchers speculate that lower vitamin D levels may be partly to blame for the higher rates of RA. One line of thinking is that getting more vitamin D may be a useful part of a comprehensive rheumatoid arthritis treatment plan.

“RA patients in general are more prone to lower bone mineral density, as well as muscle loss,” says Lona Sandon, RD, an assistant professor at the University of Texas Southwestern Medical Center and a spokeswoman for the Academy of Nutrition and Dietetics. “It is believed that the constant systemic inflammation plays a role in this, and it is also thought that calcium may not be absorbed as well in the gut of people with RA. Inflammation also affects the ability of muscle to rebuild and repair, and you see a decrease in lean muscle tissue in people with RA. These bone and muscle problems can be further affected by some of the medications RA patients take, namely prednisone.”

Vitamin D plays a key role in both bone health and calcium absorption. So while the vitamin is crucial for everyone, it may be even more so when you have rheumatoid arthritis because of your added risk for osteoporosis, or bone thinning. “Vitamin D plays an important role in helping calcium absorption in the gut and building bone tissue,” says Sandon. “If there is a lack of vitamin D, then bone will not be as strong as it could be, and calcium absorption in the gut will not be as good.”

Vitamin D and RA: Strengthening the Connection

Getting enough vitamin D calls for a creative approach. It’s the one vitamin the body makes on its own from sun exposure, but catching too many rays isn’t safe. Here are your best options to get needed D:

• Be smart about the sun. Robert T. Keenan, MD, MPH, an assistant professor of rheumatology and immunology at Duke University School of Medicine, says you can get adequate vitamin D without a dangerous amount of sun exposure. “Even small doses of sunlight, such as 10 to 15 minutes a few days a week, depending on the season and where you live, can provide adequate amounts of vitamin D,” he says.
• Put more D in your diet. Vitamin D is not plentiful in foods, but there are a few ways to adjust your regular diet to enhance your intake of vitamin D. “Incorporate salmon and low-fat fortified dairy foods — milk and yogurt — or other fortified foods such as soy milk, orange juice, and cereal into your daily eating routine,” suggests Sandon. Read labels to see how much D you get in each serving.
• Ask your health care provider about supplements. Adding a vitamin D supplement to your daily routine might help you meet your vitamin goal. Before you take one on your own, however, talk to your doctor about testing you for a D deficiency, as well as the specific dosage and type of supplement that’s best and whether you should be taking calcium with it for bone health. “Keep vitamin D supplements to less than 2000 IUs [international units] per day unless you’re directed to take more by your rheumatologist,” says Sandon.

With this three-pronged approach, you’ll take in the vitamin D you need and benefit from a rheumatoid arthritis treatment that helps without the side effects that accompany many other medications.