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Healing Choices for RA, Issue #016 --Depression and RA
December 01, 2014

Can low levels of essential nutrients contribute to Depression and Rheumatoid Arthritis?

Rheumatoid arthritis (RA) patients with depression may be low in essential nutrients that are needed for healthy brain function, joints and immune system.

When rheumatoid arthritis symptoms flare, it’s easy to become frustrated and discouraged.

In fact, people with highly active (painful) rheumatoid arthritis (RA) show symptoms of depression more often than people with RA in remission.(1) About one in four patients with active RA report feeling very sad, anxious, fatigued, hopeless, helpless, irritable, restless, hazy with poor concentration, and / or achy that doesn’t respond to treatment for extended periods of time. This group of symptoms is associated with depression.

Responses to RA therapy are usually lower in patients who also have depression

Two studies reported that fewer patients with depression and RA saw as much benefit from their therapy for RA as RA patients without depression.(2,3)

Possible reasons: Depression may affect the perception of benefit or the pain may be from depression.

An additional possibility is that some of the same nutrients are needed for healthy moods, balanced immune systems and healthy joints.

When I was so very stiff and painful with RA and very discouraged, I read that maybe I was not getting enough nutrients for my condition. When I added a very high powered nutrient mix, I began to get better.

Maybe people with both depression and rheumatoid arthritis have low levels of some nutrients that can aggravate symptoms of both depression and rheumatoid arthritis.

Healthy moods, balanced immune systems, and flexible joints have common essential nutrients

B vitamins, especially vitamin B3, B6, folate, B12, are needed for healthy moods and brain function, balanced immune system, and flexible joints. While B12 is most abundant in seafood and organ meats, most B vitamins can be readily obtained from organ meats, green and colored vegetables, eggs, nuts, and whole grains. Since folate is destroyed by heat, it’s important to eat at least one serving of a colored vegetable daily, such as in a salad or snack.

Omega-3 oils are essential oils that help turn off inflammation. They are essential for brain health and function and are building blocks of cell membranes. Cleland et al has found that ingestion of 4.5 g of omega-3 oils improved the chances of remission in RA patients taking methotrexate.(4) Omega-3 oils are abundant in freshly ground flaxseed (1-2 tablespoons), an ounce (28g) or small handful of walnuts, a teaspoon of Carlson Cod liver oil, a serving of wild Alaskan salmon or other wild oily fish. Meats from pastured animals, seafood (krill), and some greens also contain omega-3 oils.

Antioxidants found in colorful fruits and vegetables can help your body maintain balanced cellular signals. Once a signal is received, the anti-oxidants can help neutralize the signal so it does not act like an alarm that won’t shut off. The USDA recommends at least 5 servings of colorful fruits and vegetables. Dr. Terry Wahl recommends 9 cups of colorful fruits and vegetables per day because that amount helped her heal from multiple sclerosis and has helped other patients with MS and autoimmune diseases.(5)

Zinc is essential in many enzymes. Physicians may recommend supplements of 10-50 mg daily and they emphasize that the total zinc intake should not exceed 100mg daily.

Vitamin D is a cholesterol based hormone that is converted in the skin by exposure to ultraviolet light. In winter months, some people get seasonal affective disorder, which is a type of depression. Patients with active RA symptoms often had a vitamin D deficiency that was associated with more pain and stiffness.(6) Some physicians recommend supplements of 800IU daily or more as necessary to ensure healthy vitamin D levels.

Other nutrients that may be helpful include a full complement of trace minerals that can be obtained from a serving of seaweed or seafood.

If you have both depression and rheumatoid arthritis, consider adding some of these foods to increase your intake of the essential nutrients for your brain, immune system, and joints.

Wishing you and your family a rapid healing journey,


Kathy Molnar-Kimber, Ph.D.

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.

Selected References

1. Rathbun AM, Harrold LR, Reed GW. A description of patient- and rheumatologist-reported depression symptoms in an American rheumatoid arthritis registry population. Clin. Exp. Rheumatol. 2014;32(4):523-532.

2. Kekow J, Moots R, Khandker R, Melin J, Freundlich B, Singh A. Improvements in patient-reported outcomes, symptoms of depression and anxiety, and their association with clinical remission among patients with moderate-to-severe active early rheumatoid arthritis. Rheumatology (Oxford). 2011;50(2):401-409.

3. Rathbun AM, Reed GW, Harrold LR. The temporal relationship between depression and rheumatoid arthritis disease activity, treatment persistence and response: a systematic review. Rheumatology (Oxford). 2013;52(10):1785-1794.

4. Cleland LG, Caughey GE, James MJ, Proudman SM. Reduction of cardiovascular risk factors with longterm fish oil treatment in early rheumatoid arthritis. J. Rheumatol. 2006;33(10):1973-1979.

5. Wahl T. The Wahl's protocol. (Penguin Group, 2014).

6. Haque UJ, Bartlett SJ. Relationships among vitamin D, disease activity, pain and disability in rheumatoid arthritis. Clin. Exp. Rheumatol. 2010;28(5):745-747.

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