Why Is It Important For Those With Autoimmune Diseases To Get Vaccinated Including The Covid
Dr. V. Michael Holers: Its important for everyone to get vaccinated. I think the specific issue regarding patients with autoimmune diseases is not whether they should get vaccinated, but how to get vaccinated relative to their medications. We work hard to give usual vaccines at time points when the vaccine can be most effective. That may involve holding off for a week or two on a drug that a patient is taking for an autoimmune condition often we can do that without risking an adverse event or a disease flare or vaccinating right before the next dose of the therapeutic so the immunosuppressive aspect of the therapeutic is minimal. For some drugs, we dont do anything in particular for others, we time the vaccine so the therapeutics are not interfering with the bodys ability to respond to the vaccine.
What About Rheumatoid Arthritis And Pregnancy
In general, rheumatoid arthritis often improves during pregnancy. It is commonplace for the rheumatoid joint inflammation to decrease and be minimized during pregnancy. Unfortunately, this reduction of joint inflammation during pregnancy is not usually sustained after delivery.
- Do not use non-steroidal anti-inflammatory drugs, including ibuprofen , naproxen and others, during pregnancy. Women should not use methotrexate or cyclosporine during pregnancy. They must discontinue their use well in advance of conception due to potential risks to the fetus. Biologic medicines are avoided during pregnancy when possible.
- When rheumatoid arthritis is active during pregnancy, steroid medications such as prednisone and prednisolone are often used to quiet the joint inflammation. These medicines do not adversely affect the fetus.
What Are Common Symptoms Of Autoimmune Disease
Between taking care of yourself and family members and trying to manage a social life and career, its common for women to feel tired and achy. But are these symptoms of a stressful life, or could they be tied to an underlying condition like autoimmune disease?
Ana-Maria Orbai, M.D., M.H.S., is a rheumatologist at the Johns Hopkins Arthritis Center. Rheumatologists specialize in diagnosing and treating musculoskeletal diseases and autoimmune conditions . Orbai talks about how to recognize common autoimmune disease symptoms and when you should see a doctor.
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How Is Juvenile Idiopathic Arthritis Treated
Systemic JIA is treated by a care team that includes:
- a rheumatologist
- a primary care doctor
Kids with uveitis also get care from an ophthalmologist . Treatment goals are to ease pain and inflammation, improve strength and flexibility, and prevent joint damage. Treatment usually includes medicines to ease inflammation and physical therapy.
Sometimes surgery is needed for damaged joints.
Rheumatoid Arthritis Diet Exercise Therapy Home Remedies And Alternative Medicine
Foods to avoid with RA
There is no special RA diet or diet“cure” for rheumatoid arthritis. One hundred years ago, it was touted that “night-shade” foods, such as tomatoes, would aggravate rheumatoid arthritis. This is no longer accepted as true. There are no specific foods or food groups that should be universally avoided by individuals with rheumatoid arthritis.
There is no evidence that gluten bothers rheumatoid arthritis. Nevertheless, for those who are definitely sensitive to gluten , the gluten-free diet can prevent poor intestinal absorption of important nutrients. Bowel inflammation can be detrimental for those with RA if they become deficient in nutrients, such as vitamin D and folate.
Foods that fight RA inflammation
Nevertheless, some home remedies may be helpful, although these are not considered as potent or effective as disease-modifying drugs. Fish oils, such as in salmon, and omega-3 fatty acidssupplements have been shown to be beneficial in some short-term studies in rheumatoid arthritis. This suggests that there may be benefits by adding more fish to the diet, such as in the popular Mediterranean diet. The anti-inflammatory effects of curcumin in dietary turmeric, an ingredient in curry, may be beneficial in reducing symptoms of rheumatoid arthritis.
Supplements for RA
Exercises and home remedies for RA
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Give Your Gut Some Love
Gut health is a crucial component when it comes to healing, and preventing, the development of autoimmune diseases.
A 2017 study in the Frontiers of Immunology found that leaky gut when the intestinal epithelial lining loses integrity and allows the passage of bacteria and toxins into the blood can trigger the initiation and development of autoimmune disease.
Gut health is a crucial component when it comes to healing, and preventing, the development of autoimmune diseases
Another report in 2012 in the journal Nature found that when the digestive system encounters saturated fat, it breaks down the healthy bacteria in the gut.
This causes inflammation, an increased immune response, and tissue damage.
Saturated fat is primarily found in butter, cheese, red meat, and other animal-based foods.
So whats the best way to take care of your gut? Healthy probiotics can be helpful. Good sources may include fermented foods, such as kimchi and sauerkraut, unsweetened yogurts, coconut kefir, and probiotic supplements.
But its equally important to feed the good guys abundant healthy prebiotic foods that help them to increase.
The number one food that probiotics love is fiber. The particular kinds of fiber that are most beneficial are found in chicory root, Jerusalem artichoke, dandelion greens, garlic, leek, onion, asparagus, jicama, apple, flaxseed, and burdock root.
Treatments For Inflammatory Arthritis
Although presently there is no cure for Inflammatory Arthritis, doctors and other healthcare providers can make lifestyle recommendations and prescribe medication that aim to control the inflammatory process and hence reduce its symptoms and signs. In patients in whom the process is well controlled, the progress – and potential damage resulting from the disease – can be slowed and often halted. Treatment is most effective when it begins early in the course of the disease. Over the past two decades, research in this field has resulted in dramatic improvements in care. Recent developments in treatment strategies have also significantly improved the long term outcomes of inflammatory arthritis.
Medications for Inflammatory Arthritis fall into one of the following categories:
Because the medications used to treat inflammatory arthritis affect the immune system and can have side effects, rheumatologists monitor their patients carefully throughout treatment. This can involve regular doctors visits and blood tests.
In addition to treatment with medication, people with inflammatory arthritis benefit from eating a healthy, balanced diet and maintaining an optimal weight to minimize stress on the joints.
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How Can Parents Help
JIA is a lifelong disease, but treatments can help ease pain, keep kids active, and prevent long-term joint damage. To help your child:
- Make sure your child takes all medicines exactly as directed.
- Work with your childs physical therapist to develop a regular exercise program. This will help keep your childs muscles strong and flexible.
- Learn about JIA with your child. Your care team is a great resource. You can also find information and support online at:
Osteoarthritis Of The Spine
Osteoarthritis is the most common form of spinal arthritis. It usually affects the lower back and develops through wear and tear. As the cartilage between the joints slowly breaks down, it leads to inflammation and pain. Because the pain is from mechanical damage, it is typically more noticeable when you bend or twist your back. Past back injuries may also contribute to the development of degenerative arthritis of the spine.
Osteoarthritis of the spine usually affects the facet joints between the vertebrae. It is also known as facet joint arthritis, facet joint syndrome and facet disease. In some cases, degeneration of the spinal discs may contribute to facet joint arthritis. As discs between the vertebrae become thinner, more pressure is transferred to the facet joints. This leads to more friction and more damage to the cartilage.
When these degenerative changes occur in the neck, this condition is called cervical spondylosis. Arthritis in the neck doesnât always cause pain, and many people have no noticeable symptoms.
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Whats An Autoimmune Disease
When you have an autoimmune disease, your immune system misidentifies healthy tissues and organs as being foreign. This causes the body to produce antibodies that attack your bodys own tissues.
Your symptoms might come on quickly or gradually. You may feel overwhelming fatigue, crippling pain, and debilitating weakness. Or you may feel dizzy and have brain fog.
You may feel miserable like youre on a roller coaster of good days and bad days with no end in sight. These diseases can be frustrating and isolating, but each experience is unique.
All autoimmune diseases share one common theme: an out-of-sync immune system that has turned inward, attacking parts of the body as if they were foreign invaders.
In fact, autoimmune diseases can show up in at least 80 different ways in all areas of the body.
But all autoimmune diseases share one common theme: an out-of-sync immune system that has turned inward, attacking parts of the body as if they were foreign invaders.
Your immune system is crucially important, serving the purpose of protecting your body from infections and bacteria. But when its functions are out of balance, your immune system can become dangerous.
How Is Juvenile Idiopathic Arthritis Diagnosed
To diagnose the different types of JIA, doctors:
- ask about symptoms
- ask whether other family members have had similar problems
- do X-rays or other imaging study to look inside the joints
- order blood tests to check for:
- anemia or other blood problems
- inflammation in the body
Sometimes, an orthopedic surgeon take samples of joint fluid or synovium . The sample is sent to the lab for testing.
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Autoimmune Disease And Stress: Is There A Link
- By Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing
A new study has raised the possibility that stress may cause autoimmune disease, such as lupus or rheumatoid arthritis, because it found a higher incidence of autoimmune diseases among people who were previously diagnosed with stress-related disorders.
I have patients who heard about this research and are saying, “I knew it!”
But before we accept a potential link between stress and autoimmune disease, lets look at some details of the study and consider how we define the terms “autoimmune disease,” “stress,” and “stress-related disorder.”
E How Do We Document And Evaluate Immune Deficiency Disorders Excluding Hiv Infection
1. General.
a. Immune deficiency disorders can be classified as:
Primary for example, X-linked agammaglobulinemia, thymic hypoplasia , severe combined immunodeficiency , chronic granulomatous disease , C1 esterase inhibitor deficiency.
Acquired for example, medication-related.
b. Primary immune deficiency disorders are seen mainly in children. However, recent advances in the treatment of these disorders have allowed many affected children to survive well into adulthood. Occasionally, these disorders are first diagnosed in adolescence or adulthood.
2. Documentation of immune deficiency disorders. The medical evidence must include documentation of the specific type of immune deficiency. Documentation may be by laboratory evidence or by other generally acceptable methods consistent with the prevailing state of medical knowledge and clinical practice.
3. Immune deficiency disorders treated by stem cell transplantation.
a. Evaluation in the first 12 months. If you undergo stem cell transplantation for your immune deficiency disorder, we will consider you disabled until at least 12 months from the date of the transplant.
b. Evaluation after the 12-month period has elapsed. After the 12-month period has elapsed, we will consider any residuals of your immune deficiency disorder as well as any residual impairment resulting from the treatment, such as complications arising from:
Graft-versus-host disease.
Immunosuppressant therapy, such as frequent infections.
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How Do Autoimmune Diseases Affect You If You’re Trying To Get Pregnant
Some autoimmune diseases can affect your ability to get pregnant and some have adverse effects on pregnancy. You may need fertility treatments to get pregnant. You might also want to wait until your disease is in the remission stage to try to conceive.
There is a higher risk for stillbirth or preterm birth if you have lupus. If you have myasthenia gravis, you may experience trouble breathing.
Spinal Arthritis Causes And Risk Factors
The causes of arthritis in the back or neck vary depending on the type of arthritis you have. Besides normal wear and tear and autoimmune triggers, in many cases the exact cause remains unknown. Genetic components have been identified in connection with some forms of spinal arthritis, meaning that it may be hereditary.
Other spinal arthritis risk factors include:
-
Excess weight/obesity
-
Presence of certain conditions such as diabetes, gout, psoriasis, tuberculosis, irritable bowel syndrome and Lyme disease
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What Are The Different Types Of Inflammatory Arthritis
The major types of inflammatory arthritis include:
When detected and treated in its early stages, the effects of inflammatory arthritis can be greatly diminished, or the condition may even disappear completely. The importance of proper diagnosis, particularly in the early stages of the disease, may prevent serious, lifelong arthritic complications.
The Early Arthritis Initiative of the connects patients quickly and efficiently with a rheumatologist who can evaluate their joint pain and get each patient started on an appropriate course of treatment. HSS also offers specialized patient for conditions such as and .
The Usual Caveats About Observational Studies
Its important to emphasize that a study of this type cannot conclude that stress-related disorders actually cause autoimmune disease. There could be other explanations for the findings. For example, it is often impossible to identify a precise date that an autoimmune disease or a stress-related disorder began. So, despite the researchers requirement that the autoimmune disease be diagnosed well after the stress-related disorder, its possible that the autoimmune condition was already present before the stress-related disorder was diagnosed. If that was the case, the stress-related disorder could not have caused the autoimmune disease.
In addition, its possible that something other than the stress-related disorder was to blame for the higher rate of autoimmune disease. For example, people who have been through severely stressful circumstances may be more likely to smoke, and smoking has been linked to an increased risk of certain autoimmune diseases, including rheumatoid arthritis and multiple sclerosis.
One more point: this study appears to have included type 2 diabetes among the 41 autoimmune diseases it considered. Although this is the most common type of diabetes , it is not considered an autoimmune disease. Different results might have been noted if stricter definitions of autoimmune disease had been applied.
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What Are The Risk Factors For Ra
Researchers have studied a number of genetic and environmental factors to determine if they change persons risk of developing RA.
Characteristics that increase risk
- Age. RA can begin at any age, but the likelihood increases with age. The onset of RA is highest among adults in their sixties.
- Sex. New cases of RA are typically two-to-three times higher in women than men.
- Genetics/inherited traits. People born with specific genes are more likely to develop RA. These genes, called HLA class II genotypes, can also make your arthritis worse. The risk of RA may be highest when people with these genes are exposed to environmental factors like smoking or when a person is obese.
- Smoking. Multiple studies show that cigarette smoking increases a persons risk of developing RA and can make the disease worse.
- History of live births. Women who have never given birth may be at greater risk of developing RA.
- Early Life Exposures. Some early life exposures may increase risk of developing RA in adulthood. For example, one study found that children whose mothers smoked had double the risk of developing RA as adults. Children of lower income parents are at increased risk of developing RA as adults.
- Obesity. Being obese can increase the risk of developing RA. Studies examining the role of obesity also found that the more overweight a person was, the higher his or her risk of developing RA became.
Characteristics that can decrease risk
What Is Rheumatoid Arthritis
Rheumatoid arthritis, or RA, is an autoimmune and inflammatory disease, which means that your immune system attacks healthy cells in your body by mistake, causing inflammation in the affected parts of the body.
RA mainly attacks the joints, usually many joints at once. RA commonly affects joints in the hands, wrists, and knees. In a joint with RA, the lining of the joint becomes inflamed, causing damage to joint tissue. This tissue damage can cause long-lasting or chronic pain, unsteadiness , and deformity .
RA can also affect other tissues throughout the body and cause problems in organs such as the lungs, heart, and eyes.
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F How Do We Document And Evaluate Hiv Infection
Any individual with HIV infection, including one with a diagnosis of acquired immune deficiency syndrome , may be found disabled under 14.11 if his or her impairment meets the criteria in that listing or is medically equivalent to the criteria in that listing.
1. Documentation of HIV infection.
a. Definitive documentation of HIV infection. We may document a diagnosis of HIV infection by positive findings on one or more of the following definitive laboratory tests:
HIV antibody screening test , confirmed by a supplemental HIV antibody test such as the Western blot , an immunofluorescence assay, or an HIV-1/HIV-2 antibody differentiation immunoassay.
HIV nucleic acid detection test .
HIV p24 antigen test.
Isolation of HIV in viral culture.
Other tests that are highly specific for detection of HIV and that are consistent with the prevailing state of medical knowledge.
b. We will make every reasonable effort to obtain the results of your laboratory testing. Pursuant to §§ 404.1519f and 416.919f, we will purchase examinations or tests necessary to make a determination in your claim if no other acceptable documentation exists.
c. Other acceptable documentation of HIV infection. We may also document HIV infection without definitive laboratory evidence.
2. Documentation of the manifestations of HIV infection.
c. Other acceptable documentation of manifestations of HIV infection. We may also document manifestations of HIV infection without definitive laboratory evidence.