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Healing Choices for RA, Issue #015 -- Children of RA patients
October 09, 2013

Are my children destined to get rheumatoid arthritis?

No. I often receive questions about the chances that sons or daughters may also get the autoimmune disease, rheumatoid arthritis. My own daughter has asked the same question.

Let’s examine two recent articles on the role of genetics in development of rheumatoid arthritis.

First of all, let’s review the types of genes and their products. All of us have genes for our characteristics from eye color, hair color, to those genes that determine how our immune systems can clear disease-causing bacteria, viruses, and molds. Some characteristics like eye color have just a few varieties or alleles of a single gene, like blue eye color and brown eye color.

Other characteristics like our immune response have many genes and many varieties of each gene that help the human population survive.

Several variants of a main immune response gene, called HLA-DR4 are more common in people with rheumatoid arthritis than healthy people. These variants are nicknamed the HLA-DR4 shared epitope.

Do most people with the HLA-DR4 shared epitope get RA?

NO! Only 3 of 100 people who carry the shared epitope ever come down with RA.

In a more positive angle, 97 of 100 individuals with the HLA-DR shared epitope remain healthy!

What are the chances of getting RA if your mother, father, sibling, or identical twin has it?

It’s less than many of you think. Two recent scientific articles asked whether having a relative with RA would increase your chances of getting RA. The first article by Frisell et al received a lot of media attention (1). His group determined that family members of an RA patient have a 2-3 fold higher risk of getting rheumatoid arthritis than the general population (1). This 2-3 fold higher risk for family members agrees with many previous studies.

Frisell et al study (1) concluded that this higher risk for family members of RA patients was solely due to genetics (contributing 40% of the risk of getting RA.) By the way, his group reduced the role of genetics from 60% by a previous study.

However, Frisell et al (1) mentions that “Family history of a disease may be due to either genes or non-genetic biological, physical or social factors shared by relatives.”

They just didn’t have the information to divide the family influences into genetics and shared family habits.

Families share more than genetics: air, drinks, food, exercise habits, and outlooks.

Most families with children share a home, eat the same types of foods, drink the same types of drinks (water, soda, cider, lemonade, cherry juice), often play similar sports, breathe the same air, share hobbies (TV, gardening, reading), and sometimes can have a similar temperament (although not always).

Environmental factors such as air pollution, coffee consumption, and smoking can be risk factors for developing RA.

The common habits of families likely also contribute to the outcome: staying healthy versus getting RA.

Genetics can play a protective role as well. Spouses have no higher risk of getting the disease than the general public.

Most of the risks for RA are environmental factors

Dr. Svendsen et al recently published an article on 56,707 twins in Sweden (2). His group examined not only the genetics but also common habits in 162 twins with RA.

They concluded that the genetics of an individual in the Swedish population only contributed 12% of the risk for getting rheumatoid arthritis.

Half of the risk is due to “shared environmental risks” and 38% of the risk of getting RA is due to unshared environmental risks.

Thus, 88% of the risk of getting or avoiding RA is based on your choices.

That’s empowering! Choose wisely.

Choices for healthy exercise habits, avoiding smoke, living in areas of low air pollution, adequate sunshine, relaxation techniques, expectations of health, healthy diets (mostly nuts, beans, healthy meats, oily fish, fruit filled desserts, lots of vegetables and fruits, kale chips, collard chips, sufficient nutrients for strong bones and joints), fresh air in homes, and adequate water probably can make a difference!

BTW, I’ve added a new page called rheumatoid arthritis nutrition.

Wishing you and your family a rapid healing journey,



Private consultations are available.

Please note: the information on this website is a sharing of information and knowledge from the research and experience of Dr. Molnar-Kimber and her community. It is not intended to replace your one on one relationship with a qualified health care professional. It also is not intended to be medical advice. However, it is often observed that patients who take a major interest in their disease and learn as much as they can about their disease and potential treatments often improve faster than those who don’t. Dr. Molnar-Kimber encourages you to make your own health care decisions based upon your own research and discussions with your qualified health care professional.


1. Frisell T, Holmqvist M, Kallberg H, Klareskog L, Alfredsson L, Askling J. Familial risks and heritability of RA in relation to RF/ACPA status, number and type of affected relatives, sex, and age. Arthritis Rheum. 2013.

2. Svendsen AJ, Kyvik KO, Houen G et al. On the origin of rheumatoid arthritis: the impact of environment and genes--a population based twin study. PloS one 2013;8(2):e57304.

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