Can Ra Be Prevented Before Synovitis Becomes Clinically Evident
One of the major impediments to the development of definitive treatment for RA is the inability to detect, and in turn study, the earliest events that predictably lead to the development of persistent, destructive synovitis. There are virtually no data, epidemiologic or otherwise, regarding the premorbid status of individuals destined to develop RA. It can reasonably be asked: can anyone develop RA given the right circumstances? The available data indicate that a typical high-risk individual would be a perimenopausal woman with a family history of RA or a related autoimmune disease, who is a smoker, who is positive for rheumatoid factor, and who carries at least one HLA-DR4 allele. The risk of such an individual developing clinically detectable disease, say, within 5 years, has not been established. A conservative estimate would be at least 5% and the actual risk could be substantially higher. Assembling and longitudinally studying a cohort of such individuals would afford the best opportunity to understand how RA starts and, ultimately, how it can be prevented.
What Are The Early Signs Of Rheumatoid Arthritis
Early signs of rheumatoid arthritis include tenderness or pain in small joints like those in your fingers or toes. Or you might notice pain in a larger joint like your knee or shoulder. These early signs of RA are like an alarm clock set to vibrate. It might not always been enough to get your attention. But the early signs are important because the sooner youre diagnosed with RA, the sooner your treatment can begin. And prompt treatment may mean you are less likely to have permanent, painful joint damage.
An Overview Of Rheumatoid Arthritis
The goal of treatment is to achieve remission in order to halt the progression of joint damage, maintain mobility, minimize pain, and increase your overall quality of life.
Rheumatoid Arthritis Healthcare Provider Discussion Guide
Get our printable guide for your next healthcare providers appointment to help you ask the right questions.
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Are There Any Natural Remedies For Rheumatoid Arthritis
Most natural remedies dont have enough data to support definitive claims about their benefits. But some evidence suggests these two may be helpful:
Fish oil: Possibly the most thoroughly studied dietary therapy for RA, fish oil is a direct source of omega-3 fatty acids. Moderate-quality research shows that fish oil supplements may reduce RA-related pain. Omega-3s may interfere with the formation of inflammatory molecules called prostaglandins, which in excess may contribute to RA. Still, fish oil can irritate your gut and may interfere with blood clotting and increase stroke risk when taken with aspirin or other NSAIDs. Be sure to talk to your doctor before taking it.
Turmeric: The RA community is increasingly interested in the potential anti-inflammatory effects of this golden spice. Several small studies show that turmeric and its major ingredient may help treat arthritis symptoms just as effectively as pain medicines like ibuprofen. Try it in smoothies, soups, and curriesits health benefits may need more research, but its deliciousness is well documented.
Meditation Is A Seriously Powerful And Underused Treatment
Most autoimmune disorders react negatively to stress so learning how to manage your day-to-day stress is huge, Dr. Levitan says. In fact, one of the first prescriptions he gives his patients is to download a meditation app and start using it regularly. Personal time and positive self-talk are also important stress reducers, he adds.
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Ra Treatment: What Is The Safest Treatment For Rheumatoid Arthritis
Rheumatoid arthritis has no cure, but doctors recommend that patients adhere to suggested treatments early in diagnosis to decrease the severity of symptoms. There are a variety of treatment methods used to control symptoms and stop joint damage, including medications, surgery, and daily routine and lifestyle changes. Communication with a doctor or rheumatologist is necessary for choosing the most effective treatments. Your physician will ensure that treatments are safe and the medications are prescribed correctly based on each unique situation.
Treating RA will not cure the disease, but certain treatments can significantly reduce the pain and prevent permanent damage to the body. Depending on the severity of your symptoms, the goals of treatment will be to gain tight control of RA, meaning the diseases activity is kept steadily at a low level. Keeping RA in tight control can prevent long-term joint damage.
These goals primarily focus on:
- Reducing inflammation
- Preventing further or permanent damage
- Improving the quality of life
- Reducing daily and long-term side effects
Following a strict treatment regimen could bring RA into remission. Remission means that the level of disease activity has decreased in the body. It is never an indication that symptoms will not return, but following remission, many patients can go for long periods of time without experiencing symptoms.
Maintaining A Healthy Weight Matters
When it comes to weight and RA, the connection is clear: Excess pounds not only put extra pressure on your already over-taxed joints, but being overweight or obese can also contribute to inflammation throughout your body, which can further worsen your symptoms, Dr. Levitan says.
A 2017 study from the Hospital for Special Surgery of nearly 1,000 people with RA found that overweight patients were 25 percent less likely and obese patients were 47 percent less likely to experience a sustained remission compared to healthy weight patients, even though all received similar treatments. Losing weight may reduce RA symptoms and help drugs that treat RA work better.
Other research indicates that weight can be a factor in the onset of RA. A Mayo Clinic study from 2012 found that obese people were 25 percent more likely to develop rheumatoid arthritis than those at a healthy weight. The connection may have to do with the inflammatory activity of fat cells.
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Signs And Symptoms Of Rheumatoid Arthritis
Treatment May Make You More Susceptible To Other Illnesses
Many medications work by lowering the bodys immune system, says Orrin Troum, MD, a clinical professor of medicine at the University of Southern California and rheumatologist at Providence Saint Johns Health Center in Santa Monica. This helps the body to stop attacking the joints, but at the same time can make you more susceptible to outside infections, like pneumonia, he says.
This does NOT mean you should stop taking your meds, but its important to know so you can take extra steps to protect yourself from germs and get treatment as soon as possible when symptoms of infections occur, he adds.
Its not just the newer biologic drugs that affect infection risk. Conventional DMARDs like methotrexate and corticosteroids to manage flares can raise your risk of infections as well. Any time your doctor prescribes you medication, its a good idea to ask about infection risk and any precautions you can take to minimize them.
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Methotrexate And Other Traditional Dmards
Disease-modifying antirheumatic drugs are used used to slow or stop rheumatoid arthritis by suppressing the immune system. The generic names for commonly used DMARDs include:
Biologic drugs target and prevent a specific reaction from happening, stopping the inflammatory process.
This class of medications, called biologic response modifiers, is technically a subset of DMARDs. They may be used with traditional DMARDs or as an alternative to them. Biologics:
- Disrupt certain parts of the cascade of events that lead to RA inflammation and have the potential to stop the disease process.
- Increase a persons risk of infection and tend to be expensive. Because of these potential downsides, biologics are used when methotrexate or other DMARDs prove insufficient or cause unacceptable side-effects.
- May become less effective and/or cause worsening side effects over time. The doctor and patient can work together to monitor changes and decide if and when switching medication is advisable.
Testing for TuberculosisBefore taking any type of biologic medication, a person must be tested for tuberculosis. People who have latent tuberculosis carry the Mycobacterium tuberculosis bacterium without having tuberculosis symptoms. If a person with latent tuberculosis takes immune-suppressing biologic medications the bacterium can multiply and cause symptomatic tuberculosis.
See Risks and Side Effects of Biologics
Articles On How To Treat Ra Pain
The main treatment goals with rheumatoid arthritis are to control inflammation, ease pain, and reduce disability linked to RA.
Treatment usually includes medications, occupational or physical therapy, and exercise. Some people need surgery to correct joint damage. Early treatment is key to good results. And with today’s treatments, joint damage can often be slowed or stopped.
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Nutrition And Dietary Supplements
For anyone with a chronic illness, eating a healthy diet high in antioxidant-rich foods, fruits and vegetables, is essential. Eating a poor diet may increase inflammation in the body.
Also, people with RA are at higher risk of developing heart disease and diabetes. A healthy diet and regular exercise can lower that risk.
Although diet cannot cure RA, studies show that people with RA report less pain, stiffness, and fatigue when they switched from a typical Western diet to a Mediterranean diet that is high in fruits, vegetables, beans, nuts, seeds, fish, and olive oil, and low in red meat. Other studies link a vegan diet, with lots of uncooked berries, fruits, vegetables, nuts, roots, seeds, and sprouts with reduced RA symptoms. Vegan diets contain no animal products and get protein from vegetable sources.
Some people think food allergies play a part in the inflammation common in RA, and say their symptoms get worse after they eat certain foods. Although researchers are not sure if food allergies are to blame, you may want to try an elimination diet, which removes certain foods from your diet and then adds them back, one by one. You will need to keep track of your symptoms in a food diary. Usually it’s best to try an elimination diet under the supervision of your doctor or a registered dietitian.
These general nutritional tips can help you eat a healthy diet:
These supplements may help relieve inflammation and pain:
Other Immunomodulatory And Cytotoxic Agents
Some additional immunomodulatory drugs are used in RA including azathioprine , and cyclosporin A . Rarely cyclophosphamide and d-Penicillamine are used. Because the potential of high toxicity, these agents are typically utilized for life-threatening extra-articular manifestations of RA such as systemic vasculitis or with severe articular disease that is refractory to other therapy.
Azathioprine has some activity in rheumatoid arthritis but may take 8-12 weeks to see an effect. It is a purine analog that can cause bone marrow suppression and lowering of blood cell counts particularly in patients with renal insufficiency or when used concomitantly with allopurinol or ACE inhibitors. Increased risk of secondary malignancy due to azathioprine is controversial. Screening for levels of the enzyme thiopurine methyltransferase is recommended before initiating therapy with azathioprine. Certain individuals have deficiencies in this enzyme that metabolizes azathioprine with a concomitantly increased risk of toxicitiy for the medication. Side effects include nausea, and alopecia. Blood tests to monitor blood counts and liver function tests are necessary for patients on azathioprine.
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Routine Monitoring And Ongoing Care
Regular medical care is important because your doctor can:
- Monitor how the disease is progressing.
- Determine how well the medications are working.
- Talk to you about any side the effects from the medications.
- Adjust your treatment as needed.
Monitoring typically includes regular visits to the doctor. It also may include blood and urine tests, and xrays. Having rheumatoid arthritis increases your risk of developing osteoporosis, particularly if you take corticosteroids. Osteoporosis is a bone disease that causes the bones to weaken and easily break. Talk to your doctor about your risk for the disease and the potential benefits of calcium and vitamin D supplements or other osteoporosis treatments.
The Treatment Of Early Ra
The time frames within which the effects of therapy have been studied in most trials of early intervention in RA have been somewhat arbitrarily defined and have been based on the principle of the earlier the better .
Most trials of early therapy have chosen a maximum symptom duration of 2 years. Therapeutic approaches studied to date have included intra-articular and systemic steroid, DMARD monotherapy, DMARD combination therapy and anti-TNF- therapy these approaches in each case were compared with less aggressive approaches to treatment.
Those studies that have shown benefit from early combination therapy have used steroids, albeit in different regimens.,, Steroids certainly allow a more rapid control of synovitis than conventional DMARDs, explaining their incorporation in step-down regimes. The use of steroid in the medium to long-term, however, remains controversial. Several studies suggest that oral steroids reduce the risk of development of erosions in patients with early RA, and there is a clear biological rationale for this. However, data from the WOSERACT study does not support this clinical benefit.
Therefore, even with potent regimens it appears unlikely that permanent drug-free remission can be induced in patients with established RA once symptoms have been present for more than 3 months.
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The Hidden Cause Of Acne
A few months later, a friend of mine, Melissa Gardner emailed me a copy of her brand new book, The Hidden Cause of Acne, asking me if Id consider reading it.
I had known Melissa for nearly a decade. I met her in my earliest days of blogging. She had a blog called The Cellulite Investigation. On that blog, she was investigating cellulite and possible dietary and/or environmental causes. I always loved her blog and respected her as an investigative journalist.
The Hidden Cause of Acne was a revelation! It was the answer that I had been seeking for Jennifer.
This was the missing piece for so many people who were not recovering. The answer: fluoride.
In The Hidden Cause of Acne, , Melissa Gardner explains how she discovered it was fluoride that was causing her chronic acne and cellulite.
You can watch my video interview with Melissa here:
I also wrote a review of the book, The Hidden Cause of Acne.
The Importance Of Early Intervention
Still, the treat-to-target strategy works best the sooner you catch RAideally within three to six months of the first signs of disease. Diagnose and treat early, according to the research, and youre more likely to have a better long-term outcome. RA thats left untreated, however, can lead to permanent joint damage within as little as two years. And because RAs a systemic disease that can affect anywhere in the body, it can also lead to serious health complications like a weakened immune system, lung problems, and heart disease.
Luckily, doctors have grown better at spotting and treating RA. If you havent been diagnosed with RA but youre concerned , : pain, swelling, or stiffness in the morning in the small joints of the hands and feet that lasts longer than 30 minutes. Bottom line: If you suspect something, dont put off calling your doctor.
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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.
Lifestyle Is The Key To Beating Your Rheumatoid Arthritis
I know this is a easier said than done. Most of us know what we have to do but have a hard time committing to things over the long run. The key to overcoming your RA is to adopt healthy habits that eventually become part of your lifestyle. Chances are that youll fall off the wagon a few times but who cares get back up and keep on going. Be okay with small failures knowing that their a part of the process. Before you know it these habits will be ingrained in your routine. A few healthy habits can completely change your life.
My life changed when I took personal responsibility for my health. I cant change my genes or better put my genetic susceptibility. But I can affect how my genes are expressed by controlling what goes into my body . I can do more of the things that promote wellness and less things that promote sickness. fortunately for me this approach worked awesomely and Ive enjoyed great health for over a decade.
I believe passionately that you can overcome your Rheumatoid Arthritis. You might be in a rough place right now but this is only temporary. Ive watched many others reclaim their lives from autoimmune conditions, so can you! Your body knows how to heal, its built in. Your body is a marvelous self healing and self regulating machine. Remove the toxins, give it nutrients, and let the body do its thing.
You got this!
Also, if you try Carnivore or Keto and it makes a difference please let me know about your experience. Feel free to reach out anytime.
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