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How Antibiotic Use May Raise the Risk of Rheumatoid Arthritis

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  • Researchers say antibiotic use may increase a person’s risk for rheumatoid arthritis (RA).
  • They add that higher antibiotic use seems to correlate with a higher risk of RA.
  • They add that the type of infection the antibiotics treated seems to make a difference.

A new study has found that antibiotic use can increase the risk of RA by 60 percent.

While it isn’t clear that antibiotics are definitively triggering or causing the condition, there’s an apparent link between the two.

In addition, researchers report this risk increases with the amount of antibiotic treatments a person receives.

They say more antibiotic usage seemed to correlate with a higher chance of developing RA.

The type of antibiotic treatment also didn’t seem to matter. However, the type of infection the drugs were used to treat did seem to have some impact.

Researchers said when antibiotics were used to treat an upper respiratory infection, it was more common that a person would eventually develop RA or have worse symptoms.

There’s no known cause for RA — yet. There are many risk factors, however, including obesity, smoking, family history, PTSD, depression, physical or emotional trauma, and the use of certain medications.

In addition, people with one autoimmune condition often develop other issues, so having an autoimmune disease can also be a risk factor for RA.

What the study revealed

The latest research was what’s called a nested case-control study.

It was conducted by looking at data from a database of records known as the primary care Clinical Practice Research Datalink (CPRD).

Researchers reviewed people who had a diagnosis of RA between 1995 and 2017.

Researchers identified 22,677 cases of RA matched to 90,013 controls. There was a median follow-up of 10 years before RA diagnosis.

The researchers reported that “the odds of developing RA were 60 percent higher in those exposed to antibiotics than in those not exposed.”

“A dose- or frequency-dependent association was observed between the number of previous antibiotic prescriptions and RA,” the researchers wrote. “All classes of antibiotics were associated with higher odds of RA.”

They noted the individuals with antibiotic-treated upper respiratory tract infections were more likely to also be people who develop RA.

“This exciting work offers another glimpse into the complexity of understanding rheumatoid arthritis, opening the door for future work in this area,” Christian Mallen, PhD, a professor at Keele University in England and a researcher on the study, said in a press release.

The researchers also reported that antifungal drugs increase RA risk.

The researchers said the association between antibiotics and RA “may be due to disturbances in the body’s microbiota — the organisms that affect the immune system — or to the underlying infections.”

Reaction to the research

Kristine Blanche, PhD, the CEO of the Integrative Healing Center, agrees with the study’s findings.

“Yes, I believe that antibiotic use increases the risk for developing all autoimmune diseases by throwing off the balance of the microbiome in the gut,” Blanche told Healthline.

“This disruption of healthy bacteria in the gut causes intestinal permeability, kicking off the immune cascade. This could leave any patient vulnerable to increased risk of autoimmune disease,” she said.

Her theory extends from RA and type 1 diabetes to celiac disease and other conditions.

“For those with a genetic weakness — for example possessing the celiac gene HLA-DQ2 and HLA-DQ8 — this could increase risk for the development of celiac disease or even type 1 diabetes. Patients should try to avoid antibiotics when possible,” Blanche said.

“However, if necessary, taking a good quality probiotic and fish oil and being sure to stick to an anti-inflammatory diet (avoiding gluten, dairy, and sugar) can be helpful in protecting the gut and minimizing the risk of triggering an autoimmune disease,” she added.

In 2016, Healthline published an article on a potential link between juvenile forms of arthritis and early antibiotic use.

On the other hand, a blog on the Arthritis Foundation website notes antibiotics such as minocycline have treated some cases of RA, but the benefits haven’t been proven yet.

Christa S. from Salem, Massachusetts, a health coach with RA, says careful antibiotic use can be helpful.

“I think that with medical treatments and diet, moderation and balance is key. Same goes for antibiotic use,” she told Healthline. “RA patients like myself need to strive to live well and just do the best for their health at any given time.”

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