Nearly 60 percent of Americans drink coffee each day, making it more popular than any other beverage including tap water, according to the National Coffee Association. The average daily consumption is almost two cups for every adult in the country. But is caffeine something people living with rheumatoid arthritis should be consuming?

Mixed Research Results on Caffeine and Rheumatoid Arthritis

Some studies have shown that coffee is beneficial for health, but others have not. A review of various observational studies by Danish scientists published on July 28, 2021 in the European Journal of Nutrition found that high coffee consumption was associated with a low risk of mortality, as well as reduced odds of cardiometabolic diseases, some cancers, and gallstones. RELATED: Understanding the Relationship Between Caffeine and Headaches But other research has been less positive. A small study published in August 2016 in Molecular Nutrition and Food Research found that after drinking coffee some people exhibited anti-inflammatory effects in their blood, but others actually had increased inflammation. Some scientists have specifically studied people with RA and found a possible association between heavy coffee consumption and incidence of the condition. A meta-analysis published in Clinical Rheumatology concluded that people living with seropositive RA (although not seronegative RA) were more likely to drink a lot of coffee, although doctors were quick to say that an association doesn’t prove that one causes the other. Drinking a lot of decaf was not linked to higher RA rates. RELATED: 10 Foods to Help Beat Rheumatoid Arthritis Inflammation Meanwhile, Swedish researchers studying tea consumption, which has caffeine but not at the same levels as coffee, found that heavy use of the beverage was correlated with lower rates of RA, as they reported in August 2021 in Arthritis Research & Therapy.

The Takeaway for People With RA Who Crave Caffeine

The bottom line is that coffee may be good in some ways but can be bad in others, such as increasing a person’s heart rate, says Andrew Wang, MD, PhD, a rheumatologist and an assistant professor of medicine and immunobiology at Yale School of Medicine in New Haven, Connecticut. “I tell my patients to drink coffee if they enjoy it, but not to drink it as medicine, and as always, to listen to their body,” Dr. Wang says.

Caffeine and Rheumatoid Arthritis Medication

Caffeine is not contraindicated for the common medications taken for RA. Because one side effect of prednisone is insomnia, however, you might want to ditch the java and other highly caffeinated drinks if you are on the steroid and you’re having sleep issues. RELATED: 11 Benefits of Going Caffeine-Free If you’re taking methotrexate (Rheumatrex, Trexall), however, you may actually want to consider adding a little caffeine to your routine. As described in a February 2017 Clinical Rheumatology article, researchers followed people with RA on this disease-modifying antirheumatic drug (DMARD) for nearly a year. They found that of the people who had trouble tolerating the drug because of its unpleasant symptoms, more than half were fine when they took some caffeine, in the form of coffee or dark chocolate, along with their medicine. Another 13 percent experienced partial relief by adding caffeine.

How Much Caffeine Is Too Much?

Patients with RA often experience fatigue, so they may turn to coffee to give them a boost. Other people simply like the taste or are in the habit of drinking it. RELATED: Should You Add Protein to Your Coffee? Experts say that until more research clarifies caffeine’s role there’s probably no reason to stop drinking what you love. You might want to drink in moderation — something like a cup or glass or two a day — especially if caffeine makes you hyper or keeps you up at night. The U.S. Food and Drug Administration (FDA) does say that up to four or five cups of coffee, some 400 mg a day, is not associated with any dangerous side effect, but it notes that people vary in their sensitivity, and that some medications can impact caffeine metabolism. You’re definitely overconsuming if you experience insomnia, jitters, a fast heart rate, nausea, a headache, or other unwanted effects, the FDA says. If you decide to cut back, do so gradually to avoid unpleasant withdrawal symptoms like headaches or anxiety.

How Much Caffeine Is in Our Diet?

The biggest sources of caffeine are coffee (an 8 ounce cup of drip coffee has about 145 mg; brewed is 95 mg) and energy drinks (some have as much as 200 mg; an 8 ounce can of the popular drink Red Bull has about 80 mg). Be aware of your portion size. Many mugs and coffee-shop drinks can hold as much as 20 ounces. According to Harvard University’s T.H. Chan School of Public Health, other sources of caffeine include a shot of espresso (65 mg), a cup of black tea (47 mg), green tea (28 mg; herbal tea contains no caffeine), 12 ounces of Mountain Dew (55 mg) or cola (40 mg), an ounce of dark chocolate (24 mg; 6 mg for milk chocolate), and decaffeinated coffee (4 mg). Of course, don’t forget to drink water, which not only hydrates the body, but helps counter the potential diuretic effects of caffeine.

Take Your Coffee Sans Sugar

Do keep in mind that soft drinks and elaborate coffee drinks with pumps of syrup or whipped cream have more than just caffeine in them. As the digital arthritis community CreakyJoints notes, fancy coffee-shop brews can have a dozen or more teaspoons of sugar. For example, a Grande White Chocolate Mocha with whipped cream from Starbucks has 430 calories and 53 grams of sugar. Dunkin’s Medium Mocha Swirl Frozen Coffee clocks in at 670 calories and 129 grams of sugar. Excessive sweeteners promote inflammation in the body that over time can damage tissues including joints, CreakyJoints notes. So drink your joe black or with nonfat milk, rather than with flavors or other extras, and consider a dressed-up drink from a coffee shop to be a rare treat.