Alcohol and inflammation
August 6, 2018 7:49 AM   Subscribe

I have fibromyalgia and significant arthritis. I recently discovered that alcohol is functioning as a much better anti-inflammatory than ibuprofen, ice, rest, and yoga. I’ve always believed that alcohol is unhealthy and should be used only occasionally and in moderation. So what do I do with this information?

I would like to know:

(1) If alcohol’s particular effectiveness suggests that other treatments might be particularly helpful for symptom management, for example if they act along similar pathways
(2) A general guideline of how much is reasonable to drink per 24-hour period, factoring in the tradeoff between truly helpful medical use and long-term ill effects
(3) If any of you have experience using alcohol in this way

Assume that my doctors will not be helpful in suggesting alternative treatments or assisting in my risk assessment (they have not been in the past), but I do see them regularly and will not lie about my substance use.

I am fairly confident that alcohol is working as an anti-inflammatory and not merely dulling the pain because pain and mobility are improved for up to 12 hours after consumption.

I have never had addiction issues in the past, though I have also never relied on any substances for pain before.

Strict elimination diets have not been helpful.
posted by metasarah to Health & Fitness (9 answers total) 5 users marked this as a favorite
Alcohol is mildly carcinogenic, implicated in breast cancer. It is bad for your liver. Moderate use of alcohol is mildly good for your heart and seems to help avoid stroke and diabetes. If moderate use of alcohol makes you feel significantly better, then my risk:benefit analysis would say drink moderately. Addiction creeps up, and you sound aware of the need to monitor your use of alcohol.

I have some variety of autoimmune disorder that causes significant inflammatory arthritis, exhaustion, and would probably have a diagnosis of fibromyalgia. I became lactose-intolerant and found that quitting dairy has been good for my joint pain, long term. When I have occasionally splurged and had cheese, pizza, milkshakes, etc., I have had flare-ups. I have 1 or 2 drinks a day, occasionally none, and in this hot weather occasionally a 3rd beer. Coffee is good for your liver, and I drink 2 cups a day. It also helps a lot with being able to move in the morning and brain fog.
posted by theora55 at 8:05 AM on August 6, 2018 [3 favorites]

Other people have noticed the interaction of alcohol and inflammation. Here is a very basic summary of the pros and cons, written for a non-scientific audience. They do at least cite the relevant researchers and studies, if you wish to learn more.
posted by seasparrow at 8:23 AM on August 6, 2018 [6 favorites]

The biggest thing I would be concerned about if I were contemplating using alcohol for a medical purpose is dependency. A drink or even two each day is not going to be disastrous for your health (although two a day is definitely more than the guidelines say is healthy) but with regular alcohol use you will develop a tolerance. If you then start increasing the dosage to compensate, you'll find yourself heading in a bad direction—toward increased drinking and increased dependency. Alcohol addiction is a really bad scene, and you can become physically as well as psychologically dependent—you will need to drink to avoid getting sick. If I had a chronic pain condition on top of that, I'd be pretty concerned about it coming back in full force if I stopped drinking.

So I'd be pretty cautious about using alcohol in this way, if I were you.
posted by Anticipation Of A New Lover's Arrival, The at 10:09 AM on August 6, 2018 [1 favorite]

I don't have an easy answer for this. I think it's a terrible idea, because if you're drinking regularly enough to help with inflammation you WILL be drinking enough to harm yourself eventually. It helps my medical conditions also, but I don't drink regularly because that's also a problem.

But, the dirty little giant elephant in the room that no one wants to talk about because they're more excited about moral judgment is the other medications I take are just as if not more harmful: immune suppressants, and you also develop a tolerance to those, and have to switch to another and another and another.

In the end, I don't drink because it's bad for my brain, in a way that I can actually see, and my urinary tract.

If you think it's worth the risk and you're willing to monitor, have no family history of dependency, and are willing to switch to something else when the cost benefit ratio no longer works and probably go through unpleasant physical withdrawal and deal with the upturned noses and the suspicion from your doctors, then go for it. You are your best advocate and source of information on how things work for you.

Best of luck. I wish there were better answers for everyone who deals with chronic health problems.
posted by liminal_shadows at 11:01 AM on August 6, 2018 [2 favorites]

Alcohol is a metabolic depressant - one of the things this means in practice is that it will tend to make you gain weight/be unable to lose it, and this is bad for arthritis. I avoid it for that reason, and also because it interacts badly with the other drugs I take to manage my inflammatory arthritis.
posted by restless_nomad at 11:30 AM on August 6, 2018

Arthritis runs in our family, and I remember my grandmother's pain-specialist (I don't know the English word for such a doctor, but he was an international capacity on pain-management for chronically ill patients) saying that he strongly preferred that chronic patients had one serving of wine or a cocktail a day than any ibuprofen at all. He advised to combine with a lower than normally prescribed dose of paracetamol, where many of his colleagues combined a daily low dose of ibuprofen with a full dose of paracetamol. This is obviously only an option if there was no risk of addiction, but his reasoning was that regular use of ibuprofen is much more damaging than a single serving of alcohol a day, and that the alcohol had the additional benefit of aiding rest and sleep. IANAD, and IANYD. But this was a very well known specialist and my gran was well-cared for by him and his team. She never developed any form of addiction and lived to 93 with pain, but not unbearable pain. My mother and aunt struggle with arthritis as well, and I don't find their problems are nearly as well managed.

I probably have to repeat that this was only advice for chronic pain patients, because the doctor saw that long-term use of ibuprofen was damaging.

That all said, have you tried strength training? I've heard in the radio that current research is showing great results, even that some people are going entirely off medication.
posted by mumimor at 11:30 AM on August 6, 2018 [2 favorites]

I temporarily drank about a half a bottle of red wine a night to get to sleep when I was first diagnosed with osteoarthritis in my knees. It came on very quickly, and was very painful, bone on bone, unable to move, even using crutches. Even with the wine I had to sleep with my torso bent onto the seat of the sofa, knees on the ground to avoid most of the pain throughout the night.

Luckily for me, that situation was temporary because I started getting viscosupplementation (injections of hyarulanic acid in the knee).

I had tried everything, and I mean everything, and nothing would relieve the pain enough for me to sleep. Just red wine. Not white wine, not whiskey or vodka or wine only . I got up to almost a bottle a night over the several weeks I had to wait before the knees injections were scheduled, but it worked, and I got some sleep.

I am lucky to not have any issues with addiction even though alcoholism runs in my family (I am a bar owner so I have pretty much unlimited access to booze ). It just doesn't interest me enough to keep drinking and I can accidentally go weeks without having any alcohol. Once I got the injections and was relatively pain free and could sleep on my own again I just stopped drinking the wine.

That was several years ago. Since I haven't had knee replacements yet and the insurance companies decided to stop reimbursing for viscosupplementation, my knees have deteriorated and until very recently I've had to take up to 4 advil a night to sleep.

I'm sure the advil has done more damage than the wine (the wine trick also didn't work more recently as my knees got worse).

But very recently I made a change that seems to be working and I no longer have to take advil to sleep (full disclosure: in the past three weeks I've only taken it twice, and only two pills, not the four I was up to)

Due to lack of insurance and increasing pain and lack of mobility I decided to give supplements a try again. I'd tried supplements (glucosamine/chondroitin, HLA, etc) in the past and they made virtually no difference but I had a moment of inspiration while feeding my dog...

I tend to adopt big old dogs and with big old dogs frequently comes hip issues. There's a dog food I found three dogs ago in the early 2000's that has had a near miraculous result with all the pups I've switched to it, and within a week or two most signs of their lameness are gone and they are running more youthfully (It's called Avoderm Joint Relief Formula, it's great stuff). Looking at the ingredients I saw that the main difference between this food and other dry foods was that chicken cartilage is the second ingredient.

I ordered and started taking two different types of chicken cartilage; capsules that I take four of a night, and powdered collagen that I mix into my coffee in the morning. This eliminated maybe 75-80% of my daytime pain within a week or two. I don't know if it's one or the other that's working or maybe both in conjunction with each other because I'm kind of afraid to switch it up to see.

I still had night time knee pain though and still needed the ibuprofen to sleep. Since I really wanted to stop poisoning myself with advil, I started googling and found some youtube tutorials on how to relax the muscles around the knees for pain relief. There are a lot of very simple quick exercises and massages there that I tried with varying results.

What works best for me is about a minute or two of deep thigh massage on each leg when I first get into bed and the pain starts rising up. The knee pain goes away, just like that. It's kind of amazing to me that something so simple seems to be working, but it does seem to be working.

I really wish I had googled this years ago and possibly avoided the kidney damage I'm sure is in my future due to the ibuprofen.

I don't know if any of these things I'm doing will last long term or if they'll work for anyone else or on other types of arthritis, but they're working great for me right now, and if you haven't already you might want to look into them and, fingers crossed, maybe they'll help.

Good luck and I hope you find some relief.
posted by newpotato at 2:37 PM on August 6, 2018 [14 favorites]

I would try it for a few months and see how things go. There are many pharmaceuticals which have much larger problems with side-effects, damage, and tolerance/addiction issues. See how a few months of having a couple of drinks a day works for you. This certainly falls within parameters of how alcohol is commonly used, especially in countries where it's an accepted as long-term cultural tradition. A few months seeing how it works for your specific situation and your specific body chemistry seems like a very low risk experiment and could potentially increase your quality of life significantly.

There's a long history of people using elderberry wines and liquors to relieve arthritis pain. Hippocrates even wrote about it. You could experiment with different forms of alcohol to see which work best for you.
posted by quince at 2:37 PM on August 6, 2018 [1 favorite]

Alcohol has many different effects. It's possible that the benefits you are seeing come not from its anti-inflammatory effects, but instead from its muscle relaxant effects. Your doctor may be able to prescribe a muscle relaxant that will not provide as high a risk of serious damage as alcohol does.

Not all muscle relaxants are alike. You may need to try several before you hit on the one that works best for you. Taking a muscle relaxant at bedtime might allow better sleep, since it's hard to sleep when your muscles are knotted up. Better sleep, whatever you need to do to get it, is widely acknowledged as key in improving the symptoms of fibromyalgia.

If you experiment with this, keep in mind that it's not safe to take a muscle relaxant until after any alcohol you have consumed has had a chance to wear off, allowing at least an hour to metabolize an ounce of alcohol, plus additional time for a margin of safety. The same is true for a number of medications, some of which can be deadly when taken at the same time as alcohol.
posted by chromium at 9:18 AM on August 7, 2018

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