Rheumatoid arthritis (RA), an autoimmune inflammatory condition that causes pain, stiffness, and swelling, is most noted for its effects on the body’s joints. But rheumatoid arthritis is also a systemic disease, meaning it can affect the whole body, damage major organs, and even lead to a shortened life span.

The earlier you begin medication, the better your chances of halting joint damage, protecting your organs, and living a longer life without pain and disability, says Jonathan Greer, MD, a rheumatologist in Boynton Beach, Florida.

Here's everything you need to know to protect various parts of your body if you have RA.

How Rheumatoid Arthritis Can Affect Your Eyes

Because of inflammation around the eyes, some people with rheumatoid arthritis may get either dry eye syndrome or episcleritis, a redness in the white part of the eye. These can generally be managed with over-the-counter or prescription drops, according to Johns Hopkins Medicine.

A more serious eye condition is scleritis, in which a deeper part of the white area, the sclera, is affected. Untreated, scleritis can lead to vision loss.

Uveitis can develop when the eye’s middle layer, the uvea, is inflamed. This brings on floaters (cobwebs or black spots in the field of vision), blurred vision, and pain, says Ana-Maria Orbai, MD, a rheumatologist and an assistant professor of medicine at the Johns Hopkins University School of Medicine in Baltimore.

Untreated uveitis can put a person at risk of glaucoma, a disease that causes pressure to build up in the eye that can ultimately damage the optic nerve and cause blindness. (This can also happen to people who take steroid medications for RA over a long period of time.) Treatment for both scleritis and uveitis involves corticosteroid eye drops, though this may not be enough to treat uveitis beyond the front of the eye, in which case oral and injected corticosteroids may be needed, according to the Mayo Clinic.

It’s also important to note that up to 30 percent of people with RA develop another autoimmune disease, Sjögren’s syndrome. This disease affects tear glands (as well as salivary glands), causing very dry eyes along with other symptoms.

Because of the risk of these eye diseases, regular eye exams by an ophthalmologist are critical to diagnosing these conditions early, which is why everyone living with RA should see this specialist every year.

How Rheumatoid Arthritis May Affect Your Mouth

Research shows that people who have rheumatoid arthritis may be more likely to develop periodontal disease, which usually starts with a gum infection.

They are also more likely to have dry mouth, which can predispose them to tooth decay. (This is especially true for people with coexisting Sjögren’s syndrome.)

The flip side of this may be true too: Poor oral health may lead to the onset or worsening of RA. Evidence suggests that bacteria in the mouth create autoantibodies that can attack the lining of the joints; according to the Arthritis Foundation, damaged gum tissue allows these bacteria to travel from the mouth into the bloodstream and affect other parts of the body.

Researchers have been working to better understand the mechanism behind this, but the takeaway is that treating gum disease and preventing unnecessary gum infections is good for your RA, as well. Schedule frequent dental checkups to catch minor issues before they become major problems. Some rheumatologists recommend a visit every three months, instead of the usual six, if you can afford it or your insurance covers it.

Rheumatoid Arthritis and Your Hands and Feet

Since RA is a condition of the joints, it’s obvious that it affects a person’s hands and feet. But beyond joint pain, RA can cause other distortions and deformities if it is not treated as early as possible with disease-modifying antirheumatic drugs (DMARDs).

Some of the most common symptoms affecting the hands include locking joints, ulnar deviation (also called ulnar drift — a weakening of tendons and ligaments that cause fingers to curve toward the pinkie), swan-neck deformities (distortions of the joints causing unusual bending and straightening), and even ruptured tendons, according to research published in the European Journal of Orthopaedic Surgery and Traumatology in 2020. All these effects can make basic life tasks such as writing, holding objects, and unscrewing lids difficult.

The hands can also be affected by muscle cramping, which can be relieved by gentle movements and warm compresses. More concerning, the inflammation of RA can affect the median nerve (which runs from the wrist to the fingers), causing numbness or carpal tunnel syndrome, notes CreakyJoints. See your doctor if you experience any of these.

In the feet, uncontrolled inflammation may lead to painful conditions like hammertoes (abnormal bending of the toes), bunion (a bony nodule on the outside edge of the big toe), a collapsed arch, and flatfoot deformity, notes the American Academy of Orthopaedic Surgeons.

In addition to seeing your rheumatologist and, if necessary, a podiatrist, you may also consult an occupational or physical therapist. These experts help you learn ways of moving that are less painful and that strengthen muscles, says Rebecca Manno, MD, a rheumatologist and adjunct assistant professor of medicine at the Johns Hopkins University School of Medicine in Baltimore.

Rashes, Ulcers, and Bumps: How RA Affects Your Skin

A skin rash or ulcers on the arms and legs sometimes occur in people with rheumatoid arthritis, especially if the disease has gone untreated for a long time, Dr. Greer says.

Up to 25 percent of people with RA develop rheumatoid nodules — knots of inflammatory tissue just under the skin near a joint. Most often appearing on the elbows, hands, and feet, they can be treated with a steroid injection if they become bothersome.

The conditions that affect the skin tend to resolve once RA is controlled with DMARD medications.

Rheumatoid Arthritis and Your Heart and Circulatory System

Higher levels of inflammation in people with rheumatoid arthritis increase the risk of heart disease, especially heart attacks and strokes, Greer says. Inflammation increases the buildup of plaque in the arteries, which narrows blood vessels and slows blood flow, notes the Arthritis Foundation, upping the chances of stroke and heart attack.

These heart conditions are also more deadly in those with RA. In people with systemic inflammatory diseases, heart attacks in those under 50 were found to be twice as likely to be fatal compared with heart attacks in people without an inflammatory condition, according to a study published in the European Journal of Preventive Cardiology in March 2021.

To lower your risk, you’ll want to get your RA under control and also reduce heart risk factors, such as high blood pressure and high cholesterol. A healthy diet like the Mediterranean diet can lower your risk of heart disease.

Another way to assist your heart and improve your RA: Don’t smoke; and if you do smoke, quit as soon as possible; in addition, avoid exposure to secondhand smoke.

Finally, know that certain RA medications themselves – including NSAIDs and steroids, per the Arthritis Foundation – have been linked to heart problems; JAK inhibitors may raise cholesterol levels, notes CreakyJoints. But these side effects are are not a reason to skip drug treatment. “The negative effects of not treating RA with medication are much, much worse than the side effects of RA drugs,” cautions Greer.

RA Can Trigger Anemia and Fatigue

A large percentage of people living with RA experience anemia, a shortage of red blood cells or the iron-rich hemoglobin in the red blood cells. Red blood cells carry oxygen from your lungs to all the cells in the body and organs, so when your organs aren’t getting enough O₂, you can experience weakness, fatigue, headaches, shortness of breath, dizziness, and more.

There are different types of anemia, and a common type in RA patients is called anemia of chronic disease. RA’s inflammatory molecules may interfere with the body’s ability to use iron, which in turn leads to anemia. Iron supplementation can help, but the best treatment is to keep the inflammation of RA under control with DMARD medication.

Another cause of fatigue: Autoimmune disorders like RA can trigger the release of inflammatory cytokines (proteins) in the blood, and the body undergoes stress as it tries to manage this, which leads to fatigue, notes the Arthritis Foundation. In addition, the depression and pain that may come along with RA continually sap energy.

Fever: A Full-Body Effect of Rheumatoid Arthritis

According to the American College of Rheumatology, low-grade fever is one of many common rheumatoid arthritis experiences. The Centers for Disease Control and Prevention (CDC) considers an adult to have a fever when their temperature is at least 100.4 degrees F (37.8 degrees C), with symptoms of feverishness or chills.

Fever can occur as a result of your body’s autoimmune response. Once you start treating your RA, systemic symptoms like fever should improve, notes CreakyJoints, but some people may still develop low-grade fevers on occasion, depending on their disease activity.

How Rheumatoid Arthritis Impacts Organs

In addition to heart problems, RA can increase your risk of damage to other organs, such as the lungs and kidneys.

Rheumatoid Arthritis and Your Lungs

The most common RA-related lung complication is interstitial lung disease (ILD), a condition that causes inflammation and scarring of the lung tissue. This illness can be hard to detect but occurs when lung tissue becomes inflamed and eventually scarred.

It’s unclear exactly how many people with RA develop it, but French researchers presenting an abstract at the American College of Rheumatology (ACR) annual conference in 2020 found that the prevalence of subclinical (symptomless) ILD was 18 percent in people who had RA for a dozen years. Other research has detected ILD in up to 60 percent of patients with RA, with 10 percent of cases being clinically significant. People with RA are nine times more likely to develop ILD than the general population, according to a review published in May 2022 in Frontiers in Medicine.

This scarring makes it harder for oxygen in the lungs to enter the bloodstream and travel to other organs. The condition can cause breathlessness and coughing, but it can also be asymptomatic. If untreated, it can progress to pulmonary fibrosis, in which tissues are permanently scarred.

Research also shows that RA sufferers are at double the risk of chronic obstructive pulmonary disease, or COPD (which includes emphysema and chronic bronchitis), in which the air sacs can’t expand as easily and become clogged with mucus. There is no cure for COPD, although inhalers and steroids can help open airways.

Pleural effusion is another condition with increased risk. Here, the pleura — the tissue surrounding the lungs — becomes inflamed, which can lead to fluid buildup between the lung and the chest wall, according to the Arthritis Foundation.

People with RA may also develop nodules in the lungs, though they may not be bothered by them. (Nodules can also form on the throat and vocal cords, causing difficulty speaking.)

Being proactive and diligent about your RA treatment can address inflammation and minimize the risk for lung problems. And of course, if you smoke, quit.

Rheumatoid Arthritis and Kidney Function

People with RA have a greater risk of developing chronic kidney disease, though as RA treatment has improved — including the use of biologic medications and a decrease in chronic NSAID use — kidney problems have been reduced, according to an article published in Rheumatic Diseases Clinics of North America in November 2018.

Amyloidosis, a condition caused by the abnormal buildup of certain proteins that can impair kidney function, may occur in association with RA — usually in the later stages or if someone’s disease isn’t well-controlled with medication. The symptoms can be vague, such as weakness or swelling, and can include an enlarged spleen and gastrointestinal issues.

To screen for amyloidosis, rheumatologists will periodically check your kidney function.

To maintain healthy kidneys, you should also take care not to overuse nonsteroidal anti-inflammatory painkillers (NSAIDs), like ibuprofen and naproxen, as they can damage the kidneys, too.

Mental Health: Rheumatoid Arthritis and Depression

The fear that comes with living with any chronic illness, as well as dealing with daily pain and limited mobility, can take a toll on emotional wellness. But when it comes to RA, depression can be more than just an emotional response to the disease. “There is a clear link between RA and depression,” says Daniel Solomon, MD, MPH, the chief of the clinical sciences section in the division of rheumatology at Brigham and Women’s Hospital in Boston. “We don’t yet understand how much of the depression is from a reaction to the disease and how much is the inflammation of the disease, but they both contribute somehow.”

What experts do know is that treatment for RA’s inflammation quells the inflammation associated with depression. The opposite may also be true: Treatment for depression (with talk therapy or medication, for example) may lessen the pain of the disease. As the Arthritis Foundation notes, while pain can incite depression, depression can also worsen pain. According to research presented at the 2021 annual congress of the European Alliance of Associations for Rheumatology (EULAR), catastrophizing about pain makes it worse, and it can actually impede RA remission.

Rheumatoid Arthritis Can Threaten Bone Health

RA can increase your risk of osteoporosis, a disease in which bones become less dense and more fragile, increasing the likelihood they will break.

According to a study in the August 2021 issue of Cureus, there are several reasons for this association: chronic joint inflammation, genetics, the role of estrogen, and the fact that certain RA medications, such as corticosteroids, can speed bone loss. Bone loss is most prevalent in areas that immediately surround joints affected by rheumatoid arthritis, notes the National Institutes of Health (NIH). Fractures most commonly occur at the spine, wrist, and hip, per the American College of Rheumatology (ACR), which notes that spine and hip fractures may lead to chronic pain, disability, and even death.

The best way to protect bones when you have rheumatoid arthritis? Eat calcium-rich and vitamin D–rich foods like eggs and fish, as well as D-fortified foods; do weight-bearing exercises (walking, stair-stepping) that your doctor approves; if you smoke, quit; and get a bone mineral density test so your doctor can consider whether you need medication.

How Rheumatoid Arthritis Can Affect All Parts of Your Body