Rheumatoid arthritis is an autoimmune disease and, like all autoimmune diseases, the exact cause is not known.  We do know that autoimmune disease affects approximately 8% of the population worldwide, with rheumatoid arthritis affecting approximately 1%.  Alarmingly, the rate of rheumatoid arthritis has been rising at a rate of 8% per year.

While the exact causes of rheumatoid arthritis are not known, it is apparent that there is a combination of factors which may or may not be present for different people.  These can be classed into three broad categories: 

• Genetics

• Environment 

• Food and Lifestyle

I’ll explain each of these in more detail below.

Genetics

Autoimmune disease does seem to run in families. If a parent had rheumatoid arthritis then it’s not uncommon to see sons or daughters also develop the disease. 

Your genes may predispose you to autoimmune disease, however, genetic susceptibility doesn’t guarantee that a person will develop an autoimmune disease.   

The Human Genome Project determined that less than 2% of our DNA is responsible for genetic coding of factors which can’t be changed, like how tall you are, for example.  The other 98-99% of our DNA is not for permanent coding.  

Research is exploding in this new field, called epigenetics.  While research is still ongoing, it is clear that genes can “turn off” or “turn on” (called gene expression) in response to the environment. So, while you can’t change your genes, you can change whether or not genes are expressed. 

Isn’t that interesting?  We are not a victim of our genes!  

Environment

Environmental factors which may be causes of rheumatoid arthritis are widespread!  Included in this category are infections, exposure to toxins, and hormones.  

While it is not known for sure if infections are the actual cause of autoimmune disease, there is a strong link between autoimmune disease and infections, both past and current.

Past infections which are linked to rheumatoid arthritis are: 

• Borrelia: transmitted by lice and ticks and also responsible for Lyme disease

• Epstein-Barr virus: associated with mononucleosis

• Parovirus B19: causes fifth disease or “slapped cheek syndrome”

• Bartonella: related to “cat scratch” disease

Being infected by these microorganisms at some point in your life may contribute to the development of rheumatoid arthritis later in life.  Other autoimmune diseases are also linked to these infections and/or different infections.  

Autoimmune disease in general is also linked with persistent infections including:

• Helicobactor pylori (H. pylori)

• Toxoplasmosis gondii (T. gondii)

• Cell wall-deficient bacteria

Exposure to toxins, environmental pollutants, chemicals and drugs have all been linked to autoimmune disease. Exposure to heavy metals such as mercury, cadmium, lead, aluminum and gold, is strongly associated with autoimmune disease.  

Cigarette smoking is linked to rheumatoid arthritis specifically, as well as other autoimmune diseases. There is also correlation between multiple chemical sensitivity (MCS) and autoimmune disease, although it is not clear if the MCS is an early symptom of the disease or a secondary condition.

Hormones like estrogen, progesterone and testosterone play a role in immune system function, especially estrogen. Women’s hormones fluctuate throughout the menstrual cycle and go through major shifts during puberty, pregnancy and menopause which may in turn affect the immune system. 

It’s no wonder women are three times more likely than men to develop autoimmune disease!  Interestingly though, with rheumatoid arthritis the division is more evenly balanced between men and women.

Women are also more likely to manipulate their hormones with birth control, fertility treatments and hormone replacement therapy.  Environmental estrogens are everywhere in our environment from food, to plastics to household cleaning products and cosmetics. 

Food and Lifestyle

Much of what we call food now is heavily processed and contains additives which are not good for our bodies.  High-fructose corn syrup, so prevalent in many foods and drinks, is associated with many illnesses.  Many foods are made from genetically-modified crops and are sprayed with pesticides.  Produce is grown in nutrient-poor soil so the final product does not contain proper nutrients our bodies need to function.   

Factory farmed animals are fed food they were never meant to eat, raised in poor living conditions and injected with antibiotics and hormones to make up for it.  

We are exposed to light, particularly blue light from screens, more than our predecessors. We are also exposed to electro-magnetic fields (EMFs) from electronics, cell phones, electrical meters on our homes and more.  The long term effects of these exposures on our bodies are not known. 

Our cultural lifestyle also seems to contribute to autoimmune disease since the prevalence of autoimmune disease in underdeveloped countries is much less than in the developed world.  

One theory backing this trend is the Hygiene Hypothesis which infers that infectious agents which have co-evolved with humans are needed to protect against immune-related disorders.  Our culture has become so clean that many of these possibly beneficial organisms are not present in our bodies. It’s not really clear though if other factors, such as social and economic also play a role.

Stress seems to be strongly associated with autoimmune disease.  My own observations in rheumatoid arthritis support groups seems to be that a major stress event was a trigger for the onset of symptoms.  

The Good News

This article was all about the causes of rheumatoid arthritis, but I have to end on a positive note!

The good news is that aside from genetics and prior exposure to bacteria and viruses, the causes of rheumatoid arthritis and most autoimmune diseases are largely within our control. 

This means that the solution is also within our control. To a large degree WE are in control of our environment. We are most definitely in control of the food we eat and our lifestyle choices.  Even our genes are not the masters of our destiny since genes can be turned on or off by the environment … which we can control (mostly). 

This is good news indeed!  There is so much hope in this because by making better food and lifestyle choices, we don’t have to be victims of our illness.  We can be the CEOs of our health and become empowered in our healing!  That is what Jane Hogan Health is all about!

Let’s move from being IN PAIN to being EMPOWERED! 

In upcoming blogs, I will be talking more about how to make better lifestyle choices.  In the meantime, you could try implementing some of the habits in my list of 25 Easy and Free Ways to Transform Your Health.  Click on the image below to have it delivered to your inbox.

References used in this blog:

1. British Society for Immunology (2018), Report reveals the rising rate of autoimmune disease, https://www.immunology.org/news/report-reveals-the-rising-rates-autoimmune-conditions

2. Harvard University Graduate School of Arts and Science (2012) The 99%… of the Human Genome, Blog post

3. Ballantyne, S, (2013) The Paleo Approach: Reverse Autoimmune Disease and Heal Your Body Victory Belt Publishing

4. Peake, T, (2012) Bartonella Infection Associated with Rheumatoid Illnesses in Humans, https://news.ncsu.edu/2012/04/bartonella-rheumatoid/ 

5. D., Rose, NR. (2004) Women and autoimmune diseases. Emerging Infectious Diseases  http://dx.doi.org/10.3201/eid1011.040367 

6. Okada, H., Kuhn, C., Feilte, H., & Bach, J.F. (2010). The hygiene hypotheses for autoimmune and allergic diseases: an update. Clinical and experimental immunology