Is Rheumatoid Arthritis Genetic? — All Your Questions Answered
A healthy immune response protects the body’s health by recognizing foreign organisms such as bacteria and viruses and attacking them. With RA, the body mistakenly attacks healthy tissue surrounding the joints.
In RA, the cartilage that surrounds joints, allows the body to absorb shock, and allows the body to move smoothly becomes inflamed, causing swelling and pain. This can later lead to erosion of the joints and a loss of mobility.
Read on to learn more about the causes, risk factors, and prevention for RA.
The relationship between RA and inheritance is not clear, as clinicians believe the condition relates to many factors, including both genetic and environmental factors.
Research has suggested that people with particular genetic markers and variations may be more susceptible to developing the condition.
For example, the human leukocyte antigen (HLA) known as HLA-DRB1 may link to the condition. This gene produces proteins that can help the immune system differentiate the body’s own proteins from proteins of foreign invaders, such as bacteria and viruses.
Many other genetic factors may also have a small impact on the risk of developing RA.
Additionally, having a relative with RA may increase a person’s risk of developing the condition. If a first-degree relative, such as a parent or sibling, has RA, you are four times more likely to develop RA than the general population.
However, as the Rheumatoid Arthritis Support Network states, this risk still does not conclusively confirm that RA is hereditary. Many individuals with the condition have no close family members with the condition, and not all those with the HLA gene will develop RA.
As a result, genetic factors may increase the likelihood of developing RA, but they do not directly cause the condition.
It is probable that RA results from a combination of both genetic and environmental factors. Some of these factors are still unknown.
Anyone can get RA, including children. However, certain factors, including genetics, may mean you have an increased risk of developing the disease.
For example, females are not only three times more likely than males to get RA but they may also develop symptoms at a younger age.
Environmental factors may relate to an increased risk of developing RA.
One 2018 analysis of genetic and environmental factors for RA suggests that environmental factors may include air pollution and occupational exposure to triggers such as dust, smoke, and other air pollutants.
People born with the HLA class 2 gene are at greater risk of developing RA, as well as having a more severe case of RA.
The risk of developing RA may be the highest in individuals who both have the HLA class 2 gene and have factors like smoking or obesity that increase risk.
Smoking may increase the risk of getting RA and can also worsen the severity of the disease.
This includes both first-hand smoking and second-hand environmental exposure to smoke. Multiple studies suggest that exposure to smoke accounts for approximately 20–30% of environmental risk for developing RA.
People with obesity may have a higher risk of developing RA.
According to the Centers for Disease Control and Prevention (CDC), the more overweight a person is, the higher their risk of developing RA.
Diet and nutrition
Environmental factors that may increase the risk of developing RA include dietary and nutritional factors.
One 2017 analysis of genetic and environmental risk factors suggests that a diet with high sodium, red meat, and iron consumption could increase risk.
Additionally, a low vitamin D intake or low vitamin D levels in the body may be a risk factor for RA.
Hormonal changes and sex
Since females experience RA at a more significant proportion than males, theories suggest that hormones are a trigger for RA.
Individuals can experience major hormone shifts during pregnancy and menopause.
The 2017 analysis suggests that female hormonal factors can contribute to the development of the condition. Researchers found that the onset of RA was related to:
- the post-menopausal period
- early age at experiencing menopause
- the postpartum period
- the use of anti-estrogen agents
However, more research is necessary to understand the precise role of sex and hormonal factors on RA.
Perinatal and birth history
The CDC suggests that females who have never been pregnant are at greater risk of developing RA. This may relate to hormonal and sex risk factors for RA.
Additionally, breastfeeding may be a protective factor against the risk of developing RA.
However, the 2017 analysis found conflicting results, suggesting that having more than one pregnancy increased the risk of a certain type of RA, particularly if the first pregnancy was before the age of 23.
Researchers also suggested that the postpartum period resulted in an increased risk of RA in the year after birth compared to subsequent years. This may be due to hormonal changes and increased levels of prolactin.
Early life exposures
According to the CDC, certain exposures during early life may increase the risk of developing RA later on.
Children whose parents smoked had double the risk of developing RA in adulthood. Children of lower income parents may also have an increased risk of developing RA as adults.
While you may not be able to completely prevent RA, especially if you have risk factors due to genetics and the environment, avoiding or reducing further risk factors may help.
The best methods of care for RA are lifestyle management and maintaining good overall health.
Factors associated with a decreased risk of developing RA include:
- consumption of fish or omega-3 fatty acids
- moderate to low alcohol consumption
- maintaining a healthy, balanced diet
- maintaining a moderate weight
- avoiding smoke and smoking
Learn more about diets and arthritis here.
Generally, people develop RA between the ages of 30 and 60 years old. However, the average age of developing symptoms is 60.
Initial symptoms of RA include:
- joint pain and stiffness
- joint swelling or redness
- symptoms affecting multiple joints
- symmetrical symptoms that affect both the left and right sides of the body
- body stiffness in the morning that lasts longer than 30 minutes
Doctors may also investigate additional symptoms that can be the result of inflammation, including:
- chronic fatigue
- low-grade fever
- unintentional weight loss
- loss of appetite
- illness and general malaise
Diagnosis of RA may require the services of a specialized doctor or rheumatologist.
- physical examination
- investigation of present and historical symptoms
- investigation of personal and family medical history
- blood tests for rheumatoid factors, anti-CCP antibodies, and inflammation levels
- imaging tests to detect bone erosion and joint inflammation
Current treatments focus on medications, lifestyle changes, and treatments, including surgery, to target the symptoms of RA and make daily life more manageable.
Because RA is a progressive disease, ranging from minor to severe, your RA treatment may depend on your particular condition.
All RA treatments aim to reduce swelling, inflammation, and pain, and to prevent further joint damage caused by RA.
Clinical treatment options for RA can include:
- surgery, including joint replacement surgery and joint aspiration
- nonsteroidal anti-inflammatory drugs, such as ibuprofen
- disease-modifying antirheumatic drugs
- biological response modifiers
- steroid injections
- physical therapy
- occupational therapy
Management strategies for RA
There are also methods of self-management that can reduce pain and improve quality of life. These can include:
- protecting your joints — for example, by avoiding sports-related or occupational injuries where possible
- joining a self-management education class or support group for people with arthritis
- maintaining a moderate weight
- performing moderate exercises for at least 150 minutes per week
- following your treatment plan and contacting your doctor as soon as possible with any symptoms or flare-ups
- stopping smoking
RA is an inflammatory disease affecting the joints. If left untreated, it will lead to degeneration of joints.
The exact cause of RA is unknown, but it seems to be related to both genetic and environmental factors. Developing RA can be more likely according to certain genetic factors, such as having a specific HLA class 2 gene or a family history of RA. However, RA is not directly or exclusively caused by genetics.
Treatment and self-management strategies can alleviate symptoms of RA and improve quality of life.
Contact your doctor promptly for any symptoms of RA.