24 ways to help rheumatoid arthritis patients neutralize toxic substances, decrease exposure and reduce your flares.

Many rheumatoid arthritis patients, maybe you, are less able to get rid of toxic substances which are in many of today’s common items.

For example, some toxic substances, like silicone, increase the risk for RA.

Other toxic substances like pesticides or the toxic metal mercury impair the immune system, cause abnormal cell responses and may aggravate your sign and symptom of your rheumatoid arthritis.

Why many rheumatoid arthritis patients are less able to subdue toxic substances.

Your body has several ways to subdue toxic substances it encounters.

Your intact skin, gums and gut resist the absorption of many toxic substances.

Unfortunately, rheumatoid arthritis patients often have an inflammed gut (Cordain et al., 2000), and increased intestinal permeability or “leaky gut syndrome”.

Leaky gut syndrome often allows some incompletely digested foods or other eaten substances like pesticides to be easily absorbed into the bloodstream.

Rheumatoid arthritis patients with long-term active disease, maybe you, have more periodontal disease including loss of teeth compared with healthy controls. Reduced flexibility in the arms and shoulders increases the risk of periodontal disease. (Gleissner et al., 1998)

Rheumatoid arthritis patients, maybe you, may want aids to adequately perform dental care. I use “brush picks” rather than dental floss because it’s easy to clean between all my teeth, even with just one hand.

You may also breathe in toxic substances as formaldehyde from glues (furniture and synthetic rugs), xylene from permanent marking pens and more.

No matter how you originally got the toxic substances, your body needs to neutralize them.

Your glutathione defense system alters most toxic substances into non toxic (or less toxic) substances.

Rheumatoid arthritis patients have significantly lower levels of the glutathione defense system (Hassan et al., 2001; Jaswal et al., 2003; Kamanli et al., 2004).

Your liver makes glutathione which plays a key role in neutralizing toxic substances.

In addition, I have been treated with a glutathione and 15 g vitamin C therapy intraveneously. The first treatment stopped my bursting-grenade-style rheumatoid arthritis pain for 6 hours. Afterwards, I had only a dull ache. Subsequent treatments provided further relief from the rheumatoid arthritis pain. I think glutathione and 15 g vitamin C therapy warrants further study for treatment of rheumatoid arthritis.

If you’re interested, some physicians trained in environmental medicine or natural healing may be able to administer this therapy.

In the meantime, here are 11 delicious foods that boost your glutathione levels. Several supplements provide essential building blocks for glutathione. I take N-acetyl cysteine by NOW. Vitamin C complex and selenium help your body use glutathione most efficiently.

Boosting your levels of glutathione will likely help tame any toxins stored in your body. I had many deposits in my joints that have begun to dissolve during my detox programs.

Many toxic substances cause cell damage by making oxygen free radicals. Your body can block cell damage by oxygen free radicals with anti-oxidants.

However, most rheumatoid arthritis patients, probably you, have significantly lower serum levels of the anti-oxidant vitamins A, C, E and the mineral selenium than healthy controls. (Karatas et al., 2003).

Adding antioxidant rich foods and antioxidant supplements to your diet would likely decrease sign and symptom of your rheumatoid arthritis, as indicated by a small clinical trial. (Helmy et al., 2001; Jaswal et al., 2003).

Beans, dark colored berries (blueberries, raspberries, blackberries, strawberries), apples, prunes, and pecans contain the high levels of antioxidants, according to a 2004 USDA study.

However, if you do not neutralize all the toxic substances you absorb, then they may damage your DNA.

Your body repairs any damage to your DNA due to toxic substances.

Most people repair any damage to their DNA using the DNA mismatch repair system and other enzymes.

Unfortunately, there is a higher level of DNA damage in lymphocytes of rheumatoid arthritis patients and in the cells lining the joints than controls. (Bashir et al., 1993) (Bhusate et al., 1992)


Rheumatoid arthritis patients express too little of some enzymes such as poly(ADP-ribose) polymerase (PARP)-1 in joint cells. Low PARP levels lead to poor DNA repair, changes in the DNA, survival of altered cells and modulation of gene transcription. In fact, one allele of the PARP-1 promoter increases the chances of getting rheumatoid arthritis.

Other enzymes that repair DNA, called DNA Mismatch repair enzymes, are expressed in the synovial intimal lining layer 2-3 x more than in normal tissue.

DNA damage still accumulates in rheumatoid arthritis patients because 3-10 fold higher levels of DNA repair enzymes are needed (Simelyte et al., 2004).

DNA damage in lymphocytes often impairs lymphocyte function and increases cell growth in the joints of rheumatoid arthritis patients. (Bhusate et al., 1992)

In other words, DNA damage in lymphocytes likely aggravates your rheumatoid arthritis.

Hopefully, your body gets rid of toxic and neutralized toxic substances before they damage your DNA.

Getting rid of toxic substances or neutralized toxic substances

Some toxic substances, like heavy metals, most pesticides and solvents dissolve better in fats than water. Your glutathione defense system binds a glutathione to a fat-soluble toxic substance. This glutathione bound toxic substance becomes neutralized and water soluble.

Other toxic substances or neutralized toxic substances are soluble in water (or blood). Kidneys filter these neutralized toxic substances from your blood to urine and send them to your bladder. You can then get rid of them.

However, most rheumatoid arthritis patients (50-60%) display both glomerular and tubular damage in their kidneys. Renal disease in rheumatoid arthritis is usually asymptomatic and is detected only on laboratory investigations.

The kidney damage may be due to rheumatoid arthritis disease itself or due to drugs used to treat RA or both. (Pathan and Joshi, 2004)

Kidney disease is an important clinical problem because it directly affects the outcomes of RA. (Lewandowski et al., 2004).

Personally, I prefer to boost my glutathione defense system as well as reduce my exposure to toxic substances daily so my kidneys and liver have less stress. You’ll probably benefit also.

19 ways to reduce your exposure to toxic substances

1) Pure Water is essential for life.

It’s feasible that one cause of rheumatoid arthritis pain and swelling may be chronic dehydration in your joints, suggests Dr. F. Batmanghelidj.

Drinking enough water helps you wash out the toxic and neutralized toxic substances from your cells, and send it to the kidneys. There, the kidneys can remove it from the blood and put it into your urine.

You’ll also more easily attain optimal weight (weight loss), improve your digestion, help your joints move smoothly, boost your energy and more.

However, water today often includes some contaminants.

For example, many communities or wells contain fluoride up to levels of 4 parts per million, deemed safe by the EPA. However, a 2001 study showed that hip fractures increased in people drinking water with fluoride levels of 2.6-3.4 ppm. J Bone Miner Res 2001 May;16(5):932-9.

Chlorine and its byproducts found in tap water can also affect your health, Chlorine harms your “good bacteria” in your gut, dries your hair and gives you a small dose of carcinogens.

Water bottled in plastic often contains phthalates, which act as triggers for female hormones in your body.

So you may want to choose to remove these contaminants, improve your health and likely your rheumatoid arthritis.

2) Some foods are grown, processed and sold with residues of 4-25 pesticides and fungicides. (You may decide to choose to buy organic produce instead of the most contaminated foods—like me-- and reduce your buildup of toxic substances.)

Raisons and peanut butter have high levels of pesticides.

Many foods, like onions, thrive on their own, repelling insects.

Some studies show that organically raised vegetables have higher antioxidant levels and phytonutrients, which will likely benefit your rheumatoid arthritis.

3) Microwaves, although convenient, give off electromagnetic frequency that can harm life, like you. Cooking in a microwave also reduces the life-giving value of many foods by 60- 90%, some up to 97%.

Worse, microwaving foods actually alters some of its nutrients in food to be carcinogenic.

Instead, savor the aromas and taste of roasting, herbed meat and vegetables. Benefit from their full set of nutrients by cooking in your toaster oven, regular oven, a crock pot or on the stove.

Or, check out this convection oven, the Aroma Convection oven that can easily fit on your countertop. It cooks quickly and the flavor is delicious.

4) About a decade ago, many authorities proclaimed that vegetable fats were the healthiest. Well, vegetable oils like corn oil, safflower oil, canola oil and sunflower oil do contain essential fatty acids called omega 6 oils. However, these oils also increase inflammation, probably in your joints of rheumatoid arthritis.

Your body needs to eat 3 types of fats or essential fatty acids (omega 3, omega 6 and omega 9) in the right ratios every day. Most American diets contain 5-20 times too much of omega 6 fatty acids, which increase inflammation.

You may want to choose to replace corn oil, safflower oil, canola oil and sunflower oil with extra virgin olive oil and get your essential omega 9 fatty acids.

Flaxseed oil also adds a nice flavor to your salad dressings while giving you a nice helping of essential fatty acids called omega 3.

Clinical studies have shown that most rheumatoid arthritis patients improve with 1.2 g – 4 g of Omega-3 fatty acids in their everyday diet.

(Fish oil is also a great source of omega 3 oil. Note: It’s important to choose a molecularly distilled fish oil or you could end up getting a dose of heavy metals with your fish oil).

5) Several decades ago, many authorities proclaimed that margarine was healthier than butter. Well, it’s not. Let butter replace any margarine in your home and savor the taste as well as enjoy better health.

Margarine is approx. 25-35% trans fats. Most solid shortenings are also made of trans fats.

The FDA has stated that “there is no safe amount of trans fats” to eat for anyone, including rheumatoid arthritis patients.

Unfortunately, if you’re buying processed foods, they often contain hydrogenated oils which are trans fats.

Instead, rheumatoid arthritis patients may want to choose prepared foods that contain organic butter, coconut oil or palm oil.

Organic butter, coconut or palm oil improves the flavor and texture of your baked cookies, cakes, muffins, pies, and more …as well as your health.

6) Diet sodas with their artificial sweeteners, provide fewer calories than sugar but may lead to weight gain.

Sharon P. Fowler, MPH, and colleagues at the University of Texas Health Science Center, San Antonio studied the effect of drinking 1 or 2 cans of soda (or diet soda) on the weight of 622 people over a 7-8 year period. They found that the risk of becoming overweight or obese for regular soft-drink drinkers was:

• 26% for up to 1/2 can each day

• 30.4% for 1/2 to one can each day

• 32.8% for 1 to 2 cans each day

• 47.2% for more than 2 cans each day.

For diet soft-drink drinkers, the risk of becoming overweight or obese was:

• 36.5% for up to 1/2 can each day

• 37.5% for 1/2 to one can each day

• 54.5% for 1 to 2 cans each day

• 57.1% for more than 2 cans each day.

For each can of diet soft drink consumed each day, a person's risk of obesity went up 41%.


Fowler suggests, "If you offer your body something that tastes like a lot of calories, but it isn't there, your body is alerted to the possibility that there is something there and it will search for the calories promised but not delivered,".

"People think they can just fool the body. But maybe the body isn't fooled," she says. "If you are not giving your body those calories you promised it, maybe your body will retaliate by wanting more calories. Some soft drink studies do suggest that diet drinks stimulate appetite."

It’s feasible that artificial sweeteners tell the brain that something sweet and lots of calories are coming. The brain may then tell the pancreas, there’s a load of sugar coming so clear the blood of glucose. When no sugar arrives, then the brain tells the body to eat because the blood sugar is low.

Is it only limited to diet sodas? It’s probably associated with the use of artificial sweetners.

Instead, stevia and raw honey provide delicious sweetness and satisfies your sweet tooth and brain.

Even eating white sugar or brown sugar is better than the artificial sweeteners because sugar at least tells your brain that you’ve eaten.

Some artificial sweeteners like aspartame also contain at least one excitotoxin. For example, Aspartame is digested into 2 excitotoxins, glutamate and aspartate.

7) Some compounds, like MSG or monosodium glutamate, can increase the perceived flavor but play havoc in your nervous system. These compounds have been called excitotoxins.

MSG and aspartame lead to rapid absorption and high blood concentrations of glutamate and aspartate. The concentrations of these amino acids are normally low and tightly regulated.

These amino acids are used in signaling in your brain and nervous system. They bind to their receptors on nerve cells. If your body ate MSG, it’s rapidly absorbed. The very high glutamate concentration keeps the receptors full and the signal to the nerve cell continues too long. The over excited neurons often make abundant oxygen free radicals, lipid peroxidation, calcium influx, etc., and if they aren’t neutralized, the cells will likely die.

Although the FDA has ignored the toxicity data on high levels of excitotoxins, some scientists and physicians are observing an association of eating excitotoxins with various neurological disorders, including ALS, parkinson’s, alzheimer’s disease and seizures.

More information on MSG and excitotoxins are available. There have been no studies to date on the ability of excitotoxins to trigger flares of rheumatoid arthritis. However, the excitotoxins, (MSG, aspartame, etc), cause my rheumatoid arthritis to flare. Does it cause your rheumatoid arthritis pain to flare?

Since many rheumatoid arthritis patients, maybe you, have higher oxygen free radicals, lipid peroxidation, reduced glutathione defense system, excitotoxins may also flare other rheumatoid arthritis patients like you.

You may choose to avoid excitotoxins and see if it also makes a difference in your pain and number of rheumatoid arthritis flares.

Unfortunately, MSG is being added to more and more foods, including my previous favorites, Triscuits, Wheat Thins and some Tostito Tortilla Chips.

Instead, I now savor delicious Rye Crisp.

Other additives that include excitotoxins are hydrolyzed vegetable protein, monoglycerides, vegetable protein, textured protein, hydrolyzed plant protein, soy protein extract, caseinate, yeast extract, and natural flavoring.

Excitotoxins usually strongly nudge the brain to eat more.

Since most processed food contains additives with excitotoxins, you may want to choose to purchase organic foods.

Alternatively, delicious meals can be made quickly from real foods. You’ll savor the taste.

8) Most commercial tooth pastes contain some unappetizing ingredients.

At least one common toothpaste contains aluminum oxide, says one trucker who delivered the load.

Most contain the strong detergent, sodium dodecyl sulfate so that it bubbles. It also forms cancer causing nitrates.

Alternatively, Dr. Sears recommends putting a little baking soda on your toothbrush and a splash of food grade hydrogen peroxide from the grocery store.

Although periodontal disease is associated with rheumatoid arthritis, there are no studies reporting the best toothpastes or dental hygiene.

9) Dental fillings.

About 78% of Americans have at least one silver amalgam filling in their mouth.

Silver amalgam fillings also contain 42-55% of the toxic element mercury as well as copper, tin and zinc. Each filling contains approx. 800 mg of the toxic element mercury.

Although originally controversial, NIH agrees that the amalgam fillings give off mercury vapors. However, the extent of harm done by these mercury vapors on your health, regardless of whether you have rheumatoid arthritis, is controversial.

Gum chewing, brushing and drinking of hot liquids releases more toxic metal mercury vapors.

Having gold inlays in addition to silver amalgam fillings sets up a micro-electric environment in your mouth and also significantly increases the mercury vapors.

Silver amalgam fillings increased the risk of Alzheimers disease, autoimmunity, food allergies, kidney dysfunction, altered brain function, seizures, multiple sclerosis, and impaired immune responses.

Sweden, Denmark, and Germany have restricted the use of silver amalgam fillings. Japan no longer teaches about silver amalgam fillings in their dental schools.

If you need a filling or a filling replacement, composite fillings would be a potentially less toxic choice.

If your silver amalgam fillings need to be replaced because they are beginning to degrade, it would be wise to choose a dentist that protects you from the mercury vapor and particles released during drilling. You can locate information on finding one at http://www.holisticmed.com/dental/dental.res or ask for a referral at your local health food store.

My 3 yr remission of rheumatoid arthritis ended at the time I had a silver amalgam removed without precautions. Coincidence? Maybe.

My rheumatoid arthritis worsened with the next removal. Coincidence? I doubt it. After that I had the dentist use precautions. With precautions is much, much better!

Selenium is an essential trace element that can help protect you from the toxic element, mercury. Selenium is used in many enzymes. If there’s too little selenium, mercury will be used as a substitute for selenium. Most nutritionally trained doctors recommend selenium at 200 micrograms / day.

Just munch on 1 or 2 brazil nuts each day for your selenium.

Vapors from the toxic element mercury of dental fillings are usually only a very minor concern of indoor air pollution.

10) Indoor air can be more seriously polluted than the outdoor air of even the largest and most industrialized cities.

Many people spend approximately 90 percent of their time indoors. Thus the risks to health may be greater due to exposure to air pollution indoors than outdoors.

In addition, people who may be exposed to indoor air pollutants for the longest periods of time are often those most susceptible to the effects of indoor air pollution. Such groups include the young, the elderly, and the chronically ill, especially those suffering from respiratory or cardiovascular disease. Smoking itself increases the risk of getting rheumatoid arthritis so if you, your family or friends smoke, it’ll be healthier for everyone to puff them outside.

Inadequate ventilation can increase indoor pollutant levels. You need to bring in enough outdoor air to dilute emissions from indoor sources and to carry indoor air pollutants out of the home.

High temperature and humidity levels can also increase concentrations of some pollutants.

In Europe, people routinely open their windows for 10 min per day to air out their homes, bringing in fresh air.

If you feel better when you walk outside, it’d be wise to consider airing out your home 10 min. per day or getting an air purifier.

Indoor pollution sources that release gases or particles into the air are the primary cause of indoor air quality problems in homes.

Here’s a very thorough discussion on sources of indoor air pollution and EPA recommended improvements. I’ve summarized some common sources of indoor air pollution below.

11) These cleaning solutions add sparkle to your counter, floors, woodwork without dyes, fragrances and other unnecessary chemicals.

Some people, including rheumatoid arthritis patients, are allergic or sensitive to some dyes, fragrances and other chemicals. They may get a runny nose, stuffed up chest, or joint pains and stiffness (like me).

These natural cleaning solutions are free of dyes, fragrances, and other unnecessary chemicals. They really work, too!

You may also decide to choose one of the many laundry detergents that are free from dyes and fragrances. They’re sold in your local supermarkets.

12) Furniture made with pressed wood products such as particle board, plywood, medium density plywood give off formaldehyde. High indoor temperatures or humidity can cause increased release of formaldehyde from these products.

The rate of out gassing of formaldehyde and other chemicals usually declines as the furniture or wood product ages.

In contrast, furniture made with solid wood gives off few chemicals.

If you’d like to minimize the chemicals given off by your furniture, then you may want to consider buying solid wood furniture instead of furniture made from pressed wood products.

13) Carpets and rugs can be made of many different ingredients ranging from wool, jute, to many synthetic fibers from petrochemicals.

If you are purchasing a new rug, you may want to consider whether you’d prefer to spend extra money on wool carpet with a jute underlayment.

These natural fibers usually do not cause any outgasing of chemicals.

Alternatively, keep in mind the EPA’s recommendations on carpets, especially when considering the installation of synthetic carpets.

14) Molds, bacteria, dust mites, animal dander or feathers, pollen, cat saliva and other biological contaminants may cause sensitivity in some people, including rheumatoid arthritis patients.

The growth of some sources of biologicals can be minimized by maintaining a relative humidity of 30-50 percent in homes. Standing water, water-damaged materials, or wet surfaces also serve as a breeding ground for molds, mildews, bacteria, and insects.

Whirlpool bathtubs may harbor many bacteria in the hoses. It’s recommended to disinfect the bath water and run the jets. Alternatively, copper pipes will also inhibit the growth of bacteria.

House dust mites, the source of one of the most powerful biological allergens, grow in damp, warm environments. Here are some tips that decrease the buildup of biological contaminants in your indoor air.

15) Mattresses may improve the sleep patterns of some arthritis patients. (Price et al., 2003) but some people may be sensitive to the out gassing of petrochemicals and glues.

Most new mattresses and mattress pads today are made of a variety of foams, plastics and flame retardants which include petrochemicals. Some chemicals, like formaldehyde often used in glues, are mutagenic and carcinogenic. Formaldehyde and others evaporate during the aging process of the mattress, pads and pillows.

An individual sleeping on a new bed or pillow, like you, lies in extremely close proximity to the chemical source (inches compared to feet). Thus, the individual breathes many times higher concentrations of out gassing chemicals than they would if the source was further away and the air diluted the out gassing chemicals. Numerous people purchasing regular mattresses reported health problems so severe that they had to dispose of the mattress. You can read about their experiences with new mattresses.

Some rheumatoid arthritis patients, especially those that have multiple chemical sensitivities may want to consider a mattress that is made of natural materials such as solid wood, cotton and wool.

16) Many clothes and bed linens may include formaldehyde, pesticides and petrochemicals.

Clothes and bed linens are often treated for perma press. Well, that includes formaldehyde. Polyester and acrylic are made from petrochemicals. Cotton is often grown with many pesticides.

Formaldehyde, a colorless, pungent-smelling gas, can cause watery eyes, burning sensations in the eyes and throat, nausea, and difficulty in breathing in some humans exposed at elevated levels (above 0.1 parts per million).

High concentrations of formaldehyde may trigger attacks in people with asthma.

Some people, including rheumatoid arthritis patients, develop sensitivity to formaldehyde. Formaldehyde also causes cancer in some animals and may cause cancer in humans.

If you decide to reduce your exposure to formaldehyde, it may be worthwhile to choose organic bed linens, since you’ll be in close proximity to them during your 8 or so hours of sleep.

17) Pesticides are usually designed as neurotoxins for insects or other animals and can cause serious health issues.

In a recent study, about 75% U.S. households used at least one pesticide product indoors during the past year.

Pesticides used in and around the home include products to control insects (insecticides), termites (termiticides), rodents (rodenticides), fungi (fungicides), and microbes (disinfectants). They are sold as sprays, liquids, sticks, powders, crystals, balls, and foggers. Products used most often are insecticides and disinfectants.

Another study suggests that 80 percent of most people's exposure to pesticides occurs indoors. Measurable levels of up to a dozen pesticides have been found in the air inside homes.

The amount of pesticides found in homes appears to be greater than can be explained by recent pesticide use in those households.

Other possible sources include contaminated soil or dust that floats or is tracked in from outside, stored pesticide containers, and household surfaces that collect and then release the pesticides. Pets or people can easily bring residues inside their home on their feet or shoes.

Two ways to decrease your risks from pesticides is to plant native plants and use organic soaps and pesticides first.

While pesticide exposure is not associated with an increase risk of getting rheumatoid arthritis, studies did not address whether pesticide exposure caused flares of rheumatoid arthritis, increased pain or reduced flexibility.

It is feasible that some food sensitivities of rheumatoid arthritis patients (like mine for tomatoes, maybe yours, too) may be caused by sensitivities to pesticides.

18) Many vitamins on the market today contain only some of the essential ingredients for the health benefits and may contain chemicals that are similar but confuse your body. Food-derived vitamins yield best health benefits.

Rheumatoid arthritis patients have benefited by eating more antioxidant vitamins.

However, some clinical trials appear to disagree. These disagreements can usually be traced to differences in the design of the clinical trials, such as dose, source of vitamin or antioxidant, length of time, and single versus multiple vitamins.

For example, vitamin E is a family of 2 groups of 4 related molecules. The four tocopherols and four tocotrienols are called the alpha, beta, gamma and delta forms.

Vitamin E supplements from food include D-alpha tocophenol. They may also include some of the 7 other tocopherols and tocotrienols parts of the vitamin E complex.

In contrast, synthetic vitamin E includes 2 types: the D-alpha-tocopherol is the same as 1 component of vitamin E in foods but the second, L-alpha-tocopherol, is foreign to your body and can not be used. It’d be like giving your body one normal elbow and one elbow that bends backwards when it really needs 2 elbows that bend towards the front.

Because of this, rheumatoid patients may want to mainly choose vitamins that are derived from food, preferably organic foods. Your health and probably your rheumatoid arthritis will benefit.

19) Much of the make up, facial creams, deodorants, hair dyes contain dyes, potentially trans fats and other less healthy ingredients.

You may decide to choose to buy organic make up and organic face creams to avoid exposure to some of the less healthy ingredients.

Alternatively, you may choose to use a little organic coconut oil on your dry skin—it’s a great moisturizer.

Your face and skin will likely begin to radiate your healthy blush, especially with a little sunshine and fresh air everyday.

These 19 ways decrease your exposure to toxins and some will likely slow the fueling of your inflammation and rheumatoid arthritis.

All of these ways have reduced the surprised flares in my rheumatoid arthritis.

In addition, my pain declined and the flexibility of my joints really began to return once I started detoxifying my body.

For those toxins that are already in your body, you may want to consider one or more methods for detoxification for rheumatoid arthritis.

Please note that 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.

Here are the references that were cited in this article.

BASHIR, S., HARRIS, G., DENMAN, M. A., BLAKE, D. R. and WINYARD, P. G. (1993). Oxidative DNA damage and cellular sensitivity to oxidative stress in human autoimmune diseases. Ann Rheum Dis 52, 659-666.

BHUSATE, L. L., HERBERT, K. E., SCOTT, D. L. and PERRETT, D. (1992). Increased DNA strand breaks in mononuclear cells from patients with rheumatoid arthritis. Ann Rheum Dis 51, 8-12.

CORDAIN, L., TOOHEY, L., SMITH, M. J. and HICKEY, M. S. (2000). Modulation of immune function by dietary lectins in rheumatoid arthritis. Br J Nutr 83, 207-217.

GLEISSNER, C., WILLERSHAUSEN, B., KAESSER, U. and BOLTEN, W. W. (1998). The role of risk factors for periodontal disease in patients with rheumatoid arthritis. Eur J Med Res 3, 387-392.

HASSAN, M. Q., HADI, R. A., AL-RAWI, Z. S., PADRON, V. A. and STOHS, S. J. (2001). The glutathione defense system in the pathogenesis of rheumatoid arthritis. J Appl Toxicol 21, 69-73.

HELMY, M., SHOHAYEB, M., HELMY, M. H. and EL-BASSIOUNI, E. A. (2001). Antioxidants as adjuvant therapy in rheumatoid disease. A preliminary study. Arzneimittelforschung 51, 293-298.

JASWAL, S., MEHTA, H. C., SOOD, A. K. and KAUR, J. (2003). Antioxidant status in rheumatoid arthritis and role of antioxidant therapy. Clin Chim Acta 338, 123-129.

KAMANLI, A., NAZIROGLU, M., AYDILEK, N. and HACIEVLIYAGIL, C. (2004). Plasma lipid peroxidation and antioxidant levels in patients with rheumatoid arthritis. Cell Biochem Funct 22, 53-57.

KARATAS, F., OZATES, I., CANATAN, H., HALIFEOGLU, I., KARATEPE, M. and COLAKT, R. (2003). Antioxidant status & lipid peroxidation in patients with rheumatoid arthritis. Indian J Med Res 118, 178-181.

LEWANDOWSKI, B., KLIMIUK, P. A., KITA, K. and SIERAKOWSKI, S. (2004). [Kidneys in rheumatoid arthritis]. Pol Merkuriusz Lek 16, 73-77.

PATHAN, E. and JOSHI, V. R. (2004). Rheumatoid arthritis and the kidney. J Assoc Physicians India 52, 488-494.

PRICE, P., REES-MATHEWS, S., TEBBLE, N. and CAMILLERI, J. (2003). The use of a new overlay mattress in patients with chronic pain: impact on sleep and self-reported pain. Clin Rehabil 17, 488-492.

SIMELYTE, E., BOYLE, D. L. and FIRESTEIN, G. S. (2004). DNA mismatch repair enzyme expression in synovial tissue. Ann Rheum Dis 63, 1695-1699.

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Smoking as a risk factor for RA and RA flares

Smoking causes local air pollution. Several groups report that smoking more than doubles the risk for RA.

Smoking also slows healing of bone fractures, increases bone loss, increases risk for osteoporosis, and promotes disc degeneration (back problems).

I recently published a scientific paper on Smoking's effects on bones in RA.

Remicade is active in fewer smokers with RA than non-smokers with RA.

This paper also reviews the effect of smoking on responses to immunotherapies.

Surprisingly, one of three 3 commonly prescribed anti-TNF agents was not as effective in smokers as nonsmokers. Fortunately, the other two anti-TNF agents appeared equally effective in smokers and non-smokers.

For those who take anti-TNF inhibitors, infliximab (Remicade) was active in fewer smokers than non-smokers.

Other sources of smoke

Besides cigarette smoke, the wood-burning stove may leak some smoke while you load it with wood.

Heavy air pollution also increases the risk of arthritis in children (juvenile inflammatory arthritis).

Note that some medications work less often in smokers with RA than in non-smokers with RA.

Removing smoke and other air pollutants

While removing smoke from the air won't heal your RA necessarily, clean air supports better health.

Removing smoke also may improve the aroma in your home.