Do You Need To Modify Rheumatoid Arthritis Medications Before Or After Getting The Vaccine
Temporarily stopping certain immunosuppressant medications after receiving the vaccine, or timing when you get the vaccine in the course of your treatment, might help increase the effectiveness of the COVID-19 vaccine if you have RA.
But whether this is right for you depends on a number of factors, including which medications you take and your overall health. For example, if your RA is not well-controlled and skipping medications is likely to cause you to flare, your doctor may suggest that you keep taking them. You and your doctor should decide together about making any medication changes. You should not stop taking any of your rheumatoid arthritis medications on your own.
Most disease-modifying antirheumatic drugs, including biologics, should not be stopped for those with rheumatoid arthritis. Here are the RA drugs for which the ACR guidance suggests changes may be recommended:
- Methotrexate: Skip for 1 week after each vaccine dose
- JAK inhibitors : Skip for 1 week after each vaccine dose
- Abatacept , injectable form: Skip one week before and after the first vaccine dose only
- Abatacept , IV form: Get COVID-19 vaccine 4 weeks after your last infusion, then skip a week and get next infusion
- Rituximab : Get COVID-19 vaccine approximately 4 weeks before next infusion, then delay next infusion by 2-4 weeks after second vaccine dose if possible
- Cyclophosphamide infusion: Time administration so its one week after each COVID-19 vaccine dose
Forget What Youve Read On The Internet: There Is No Secret Cure
More than 1 million Americans have rheumatoid arthritis, and unfortunately there is no cure, Dr. Ware says. Despite what you may have read or heard, there are no special diets, oils, secret protocols, or trial medications that can permanently banish the disease.
But while doctors may not yet be able to cure RA, the right treatment plan can help many patients achieve low disease activity or even degrees of remission. Years ago, before the sophisticated disease-modifying drugs of today were widely used, RA and other forms of inflammatory arthritis could cause severe, permanent joint damage. This is usually no longer the case for people who take these medications and see a rheumatologist for ongoing testing and monitoring. More and more biologic therapies are in development, so people who dont respond well or stop responding well to a certain medication will have more ways to target their immune system and reduce symptoms and long-term damage.
What You Eat Can Help Manage Your Symptoms
An anti-inflammatory diet consisting of lots of fruits and vegetables, omega-3 fatty acids from such sources as grass-fed meat and wild salmon, and limited sugar and carbohydrates is a secret weapon for helping to manage RA for some patients, Dr. Levitan says. Reducing inflammation can help limit flare-ups and pain, he says.
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Your Herbal Supplements Are Probably Garbage
Theres a lot of buzz about natural remedies for RA. While some may be helpful as an add-on to a treatment plan prescribed by a rheumatologist many are snake oil designed to remove your money rather than your pain, says Don R. Martin, MD, of Sentara RMH Rheumatology in Harrisonburg, Virginia.
Patients need to remember that natural does not necessarily mean its healthy. Remember both arsenic and asbestos are naturally occurring substances, he explains. Supplements are not regulated by the FDA the same way prescription and over-the-counter drugs are, so the purity of agents and the quality of scientific studies regarding their effectiveness varies widely, he adds.
Two kinds he says can be effective as part of an overall treatment plan? Capsaicin and turmeric. But make sure your doctor knows about any supplements you take, since some could have an effect on other medications you take.
Consider Learning More About Medical Marijuana
If you grew up in the just say no era, you might be hesitant to try this remedy, but it may help RA patients, says Jordan Tishler, MD, a Harvard-trained emergency medicine physician and founder of InhaleMD. There are certain types of cannabis specifically grown for medicinal purposes that might help treat the pain of RA pain, he says.
I have seen improvements for patients in pain control, stiffness, and increased mobility with cannabis, he says. Most importantly, I have seen significant improvement in reported quality of life., and according to a new Medscape poll, 80 percent of health care providers say it should legalized nationally.
If you are interested in trying cannabis and its legal in your state, talk to your doctor or another provider whos experienced in this area. There are many different strains of the plant, and cannabis products contain varying ratios of the active ingredients CBD to THC . Its important to remember that cannabis can interact with other medications you may take or affect other health conditions you have, so make sure to talk to your doctor before you explore this option.
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Use Of Certain Medications For Arthritis
Certain medications used in the treatment of RA and PsA may make you ineligible to donate blood for a period of time.
Medications that may disqualify you from giving blood include:
- Arava : You should wait two years after taking this immunosuppressive drug before donating blood.
- Aspirin: There is no waiting period for donating whole blood when taking aspirin, but you must wait two full days before donating platelets by apheresis .
- Feldene : There is no waiting period for donating whole blood, but you must wait two days before donating platelets by apheresis.
- Rinvoq : You should wait one month after taking this biologic disease-modifying antirheumatic drug .
- Soriatane : You should wait three years after taking this vitamin A derivative that treats psoriasis.
- Tegison : If you have ever taken this second-generation retinoid that is used to treat severe psoriasis, you are ineligible to donate blood.
What To Expect During The Tests
You usually do not need to do anything before a blood test for RA, fasting is not required. Tell your healthcare provider if you are taking any prescription or over-the-counter medications that may affect your tests.
Wear a garment that allows access to your elbow area for the blood draw. Bring your identification. The healthcare professional drawing the blood will ensure your identification and label the blood draw sample tubes.
A tourniquet will be placed on your arm, the vein area sanitized, and a needle will be used to collect the blood into one or more vials.
After drawing the blood, the site will be bandaged. You should not have any side effects and usually do not need to take any precautions after the test.
These tests are sent to the lab rather than being done in the clinic as a rapid test. Your results will not be available immediately but will be reported to your healthcare provider in hours to a day or more.
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You might wonder why we ask a lot of questions when it comes to donating blood. It’s about safety: for you and the person receiving your donation.
Are There Any Specific Vaccine Side Effects To Be Aware Of With Rheumatoid Arthritis
Some COVID-19 vaccine side effects could mirror those of a disease flare. Its important to carefully track your symptoms and talk to your doctor if you have any concerns. Typically, vaccine side effects only last a few days .
The CDC lists the following common side effects from the COVID-19 vaccine:
- Pain on the arm where you got the shot
- Redness on the arm where you got the shot
- Swelling on the arm where you got the shot
- Tiredness
- Fever
- Nausea
Some vaccine side effects that can overlap with rheumatoid arthritis disease activity may include muscle aches, joint pain, temporary fever, and fatigue, says clinical rheumatologist Magdalena Cadet, MD, Associate Attending Physician at NYU Langone Health in New York City.
Nausea may be present in some individuals after the vaccine, but rheumatoid arthritis patients may also experience that symptom with medications used to treat rheumatoid arthritis, like methotrexate or sulfasalazine, she adds.
Another common symptom of the vaccine is swollen lymph nodes under the arms on the side of the body where you received the vaccine, per the Cleveland Clinic. The swollen lymph nodes typically appear a few days after the vaccine and tend to subside within a few days to a few weeks. Although uncommon, swollen lymph nodes can also appear with rheumatoid arthritis.
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Most Rheumatologists And Public Health Experts Want People Living With Rheumatic Diseases Like Rheumatoid Arthritis To Get The Vaccine At The Soonest Opportunity
Learn more about our FREE COVID-19 Patient Support Program for chronic illness patients and their loved ones.
If you live with rheumatoid arthritis, an inflammatory and autoimmune form of arthritis, you may understandably have many questions and concerns about getting the COVID-19 vaccine.
Heres the bottom line: Especially if you have rheumatoid arthritis, most rheumatologists and public health experts recommend you get the COVID-19 vaccine. In fact, guidance from the American College of Rheumatology states that autoimmune and inflammatory rheumatic disease patients should receive the vaccine when theyre eligible.
While getting the vaccine would ideally occur in the setting of well-controlled disease, you should get the COVID-19 vaccine as soon as possible regardless of disease activity and severity, with the exception of extreme cases say, in the intensive care unit.
Heres everything you need to know about getting the COVID-19 vaccine if you have rheumatoid arthritis.
Who Gets Rheumatoid Arthritis And Why
About one out of every 100 adults has rheumatoid arthritis. For most people, it begins between 30 and 50 years of age. Women are more likely to get rheumatoid arthritis than men. Smokers are more likely to get rheumatoid arthritis than nonsmokers. No one knows what causes rheumatoid arthritis. Some infections may cause it, and it may run in families.
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Take Care Of Your Teeth And Gums
People who have rheumatoid arthritis tend to get gum disease. Some experts think that infection that enters the body through the mouth may make rheumatoid arthritis worse, although this has not been proved. You can help prevent gum disease through good basic dental care. For more information on taking care of your teeth and gums, see:
Treatment Of Rheumatoid Arthritis
Treatment of rheumatoid arthritis continues to improve, which can give many people relief from symptoms, improving their quality of life. Doctors may use the following options to treat RA:
- Medications.
- Routine monitoring and ongoing care.
- Complementary therapies.
Your doctor may recommend a combination of treatments, which may change over time based on your symptoms and the severity of your disease. No matter which treatment plan your doctor recommends, the goals are to help:
- Relieve pain.
- Prevent, slow, or stop joint and organ damage.
- Improve your ability to participate in daily activities.
Rheumatoid arthritis may start causing joint damage during the first year or two that a person has the disease, so early diagnosis and treatment are very important.
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Erythrocyte Sedimentation Rate Test
An erythrocyte sedimentation rate test evaluates how much inflammation is present in your body. The test measures how quickly your red blood cells, called erythrocytes, separate from your other blood cells in a lab when they are treated with a substance that prevents clotting.
Red blood cells clump together when theres inflammation in your body, making them separate from your other blood cells much faster. Low ESR levels indicate low levels of inflammation while high ESR results indicate high levels of inflammation.
Doctors use this test to diagnose rheumatoid arthritis because this condition causes inflammation throughout your body. An ESR test on its own, however, is not enough to diagnose rheumatoid arthritis.
Inflammation and a rise in ESR levels can be caused by other chronic conditions, and by infections or injuries. However, your ESR rate can help point doctors in the right direction. For example, very elevated ESR levels would likely indicate an infection and not rheumatoid arthritis.
I Feel Like Ive Gained A Lot Of My Life Back
We spoke to Léa, who was diagnosed with RA in February 2020. Léa gives us first hand experience of her initial RA journey, the different medicines she has been prescribed to treat her RA and advice on the condition itself. Want more RA stories, Facebook Lives and informative videos? Subscribe to our YouTube channel.
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What Is Rheumatoid Arthritis
Similar to other autoimmune conditions, rheumatoid arthritis causes your immune system to attack the healthy tissues and cells in your body. Although RA usually damages the joints, it can affect other parts of the body, such as the eyes, heart, or lungs. RA can cause inflammation in joints located in the wrists, hands, knees, and ankles.
Symptoms can vary from person to person, but some early signs of RA include pain and tenderness in the joints. Over time, symptoms may get worse and progress to redness, stiffness, and swelling in the joints. Some people also have a low-grade fever and fatigue.
The exact cause of RA is not known, but several factors increase the risk of having this disease. It occurs more often in older adults and women. Smoking and being overweight also raise the risk of having RA. Certain genes have been linked to a higher chance of developing RA.
Illustration by Verywell
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Inflammatory Foods For Rheumatoid Arthritis
In addition to medication treatment plans that include non-steroidal anti-inflammatory medications and disease-modifying antirheumatic drugs , limiting or eliminating altogether certain foods from your diet can help you to feel better as well.
Inflammatory foods are foods that can produce or trigger inflammatory symptoms in joints and in the digestive system. These are foods that are generally processed, cooked at high temperatures, or contain lots of chemical preservatives and unnatural ingredients. Be sure to check all foods labels carefully for any of the below ingredients.
Tips For Eliminating Inflammatory Foods For Rheumatoid Arthritis
Maintaining a healthy diet can be done by simply eliminating or reducing inflammatory foods for rheumatoid arthritis. Here are some tips to help you to better avoid these kinds of foods:
- Always read ingredient labels and look for indicated levels of saturated and trans fats
- Compare different product brands to see which ones have lower levels of unhealthy fats and sugars
- Switch to natural cooking oils like olive or avocado oil
- Avoid deep fried foods or ones that have been cooked at high temperatures
- Choose more low fat and trans-fat-free options when buying packaged foods
- Add more omega-3 fatty acids and reduce omega-6 fatty acids
- Eat as close to nature as possible by consuming less prepackaged and processed foods
If youre concerned about how inflammatory foods for rheumatoid arthritis are affecting your symptoms, talk to your doctor about dietary solutions. Remember to stick to as many fruits, vegetables and whole grains as possible to help lower your inflammation levels.
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Rheumatoid Arthritis And Heart Disease
Learn why RA puts you at a greater risk for heart disease, and what you can do to protect yourself.
Swollen and painful joints arent the only things you need to worry about when you have rheumatoid arthritis . People with RA are almost twice as likely to develop heart disease as those without the condition. Having RA makes you more likely to experience a serious cardiovascular event like a heart attack or stroke.
Youre not destined to have heart troubles just because your joints are inflamed. With the right screening and preventive measures, you can keep your heart and blood vessels healthy.
RA and Heart Disease: Whats Behind the Connection?
Two factors come together to increase your risk: chronic inflammation and shared risk factors.Inflammatory substances called cytokines fuel joint destruction in RA and blood vessel damage in CVD. Inflammation causes plaque build-up in the arteries, which slowly narrows blood vessels and blocks blood flow, and is the main cause of heart attack and stroke.
The other reason people with RA are more likely to develop heart disease is shared risk factors like these:
High blood pressure – A number of factors increase blood pressure in people with RA, including a lack of exercise and drugs used to treat the disease . People with RA also have less-elastic arteries that can narrow, which lets less blood through and increases blood pressure.
Reduce Your Risks
Monitor Your Heart Health
Diagnosis Of Rheumatoid Arthritis
- Ordering laboratory tests.
- Ordering imaging studies, such as x-rays or ultrasound.
It can be difficult to diagnose rheumatoid arthritis when it is in the early stages because:
- The disease develops over time, and only a few symptoms may be present in the early stages.
- There is no single test for the disease.
- Symptoms differ from person to person.
- Symptoms can be similar to those of other types of arthritis and joint conditions.
As a result, doctors use a variety of tools to diagnose the disease and to rule out other conditions.
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