Who Has A Higher Risk Of Complications
Stomach ulcers or bleeding are more likely to occur in people who
- are over 65 years old,
- have other serious diseases, especially gastrointestinal conditions like or ulcerative colitis,
- have already had gastritis , a stomach ulcer or stomach bleeding,
- have an infection with Helicobacter pylori ,
- drink a lot of alcohol,
- take blood-thinning heart medicines, for example anticoagulants like warfarin or acetylsalicylic acid,
- take a selective serotonin reuptake inhibitor antidepressant,
- take corticosteroids , or
- take several anti-inflammatory painkillers at the same time.
NSAIDs can sometimes be a problem for people who have kidney disease too.
What Is Treat To Target
T2T is a term that experts use to describe treating a disease while keeping very specific goals in mind. In other words, its a methodical way to make decisions regarding treatment. It involves several steps:
Choosing a target, or goal, for treatment
Making a change to treatment if the target is not met
T2T starts with shared decision-making, meaning you and your rheumatologist will work together to come up with a plan. For example, if you were recently diagnosed with RA, and its time to start treatment, you and your healthcare provider would have a discussion based on the points above. This would include your goal for treatment, what medication to start, and how and when to decide if its working.
What Are The Best Rheumatoid Arthritis Medications For Pain
Most of the medications used for rheumatoid arthritis provide relief from pain. However, depending on current disease activity, some may be more effective than others.
- For acuteflare-ups, for example, short-term treatment with a corticosteroid, such as prednisone, may be highly beneficial.
- If there is excessive inflammation, a non-steroidal anti-inflammatory can address that symptom and also relieve pain.
- Over-the-counter analgesics, such as acetaminophen, may be used for minor pain.
- But for chronic, moderate-to-severe pain, an opioid analgesic would be more effective.
- Pain and inflammation are both addressed by biological drugs which have the added benefit of altering disease activity.
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What Is The Treatment For Rheumatoid Arthritis
While theres no cure for rheumatoid arthritis, there are many strategies to help manage the condition and its symptoms so you can continue to lead a healthy and active life. Its helpful to understand the nature of your condition and build good relationships with your doctor, rheumatologist and healthcare professionals.
Does Hydroxychloroquine Have Side Effects
Like all medications, there is the risk of side effects. Fortunately, the problems seen by people taking this medication are usually very mild. Serious side effects are rare. Overall, most people who have any noticeable side effects from hydroxychloroquine experience diarrhea or nausea. These usually get better after the person adjusts to the medication, and taking the drug with food can help, as well. Additionally, some people experience anemia and vision changes or even vision loss, but this is quite rare. Its more commonly seen with high doses for long periods, in older people, and in those who have kidney problems.
How Will My Doctor Choose Drugs That Are Right For Me
Your doctor will work with you to develop a treatment program. The drugs your doctor prescribes will match the seriousness of your condition.
Your doctor will combine the results of your medical history, physical exam, X-rays and blood tests to create your treatment program. The doctor will also consider your age, sex, physical activity, other medications you are taking and any other medical conditions you may have.
It is important to meet with your doctor regularly so that he or she can closely monitor you for any side effects and change your treatment, if necessary. Your doctor may periodically order blood tests or other tests to determine the effectiveness of your treatment and any side effects.
Where To Buy Lab Grade Products
There are a lot of extremely inferior products on the market. Still worse, many of the cheap herbal supplements found in Amazon.com and on the shelves of local drugstores are not inspected by third party regulators with FDA oversight. The majority are selling weakly concentrated ingredients, and there is growing concern that many products are testing in the danger zone for toxic chemicals and fillers.
Below are two companies that weve tested and found to produce lab grade turmeric and boswellia serrata. Their cost is higher due to the quality of ingredients and their strict self-imposed testing standards. Still, the cost is small compared to prices of pharmaceuticals.
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Make Healthy Lifestyle Choices
Maintaining a healthy lifestyle will help your physical and mental well being. Doing gentle, regular exercises can help keep your joints flexible, strengthen your bones, help you maintain a healthy weight, relieve emotional stress and create a feeling of general well being. Eat a well-balanced diet with a high intake of whole grains, vegetables, fruits, legumes, nuts, fish and olive oil. There is no specific diet for people with RA and no specific foods to avoid.
How Can I Determine If A Treatment Method Is Working
When its time to follow up with your rheumatologist, youll determine whether youve met your goal. This might involve a physical examination to count how many joints are painful or swollen. It might also involve bloodwork to look at markers of inflammation, and imaging tests of your joints. If youve met your goal, you may decide to stay the course. If not, it could be time to try a new medication. Know that its best to give a new medication at least 3 months to do its job before you decide whether its working or not.
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Tumor Necrosis Factor Inhibitors
Tumor necrosis factor alpha is a pro-inflammatory cytokine produced by macrophages and lymphocytes. It is found in large quantities in the rheumatoid joint and is produced locally in the joint by synovial macrophages and lymphocytes infiltrating the joint synovium. TNF is one of the critical cytokines that mediate joint damage and destruction due to its activities on many cells in the joint as well as effects on other organs and body systems. TNF antagonists were the first of the biological DMARDS to be approved for the treatment of RA. These drugs began to enter the market for rheumatoid arthritis in 1999 and are now considered a part the ACR recommendations for treatment of RA. There are currently five TNF inhibitors FDA approved for the treatment of RA etanercept , infliximab , adalimumab , certolizumab pegol , and golimumab . Etanercept is a soluble TNF receptor-Fc immunoglobulin fusion construct infliximab, adalimumab, and golimumab are monoclonal antibodies and certolizumab pegol is an anti-TNF antigen binding domain-polyethylene glycol construct. While differing in structure, the efficacy and safety of the drugs is similar across the class in reducing the signs and symptoms of RA, as well as in slowing or halting radiographic damage, when used either as monotherapy or in combination with methotrexate.
The Alternative Treatment So Effective Its Becoming Mainstream
Once youve determined whether or not allergies or sensitivities play a role in your arthritis, you can move on to other natural therapies, starting with glucosamine. By now, even mainstream medical doctors have heard of glucosamine. Research shows that it works by helping to stimulate the growth of new joint cartilage. This is probably why theres usually a three to four week delay after starting treatment for pain relief to begin. I recommend 500 milligrams of glucosamine sulfate three times a day.
There have been some warnings in mainstream medical publications that glucosamine might affect blood sugar control. If you have significant osteoarthritis and dont have diabetes, this theoretical possibility shouldnt be a problem. If you do have diabetes, checking your blood sugar will tell you whether the glucosamine has enough of an effect to warrant not taking it. In most cases, the improvement youll likely feel will far outweigh the possibility of any slight effect on blood sugar.
Glucosamine is often combined with chondroitin in natural arthritis formulas. But theres enough question about chondroitin and risk of prostate cancer for me to advise all men to avoid chondroitin at this time. Besides, Ive observed that glucosamine usually works just as well by itself. So just use plain glucosamine until this question is settled for good.
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How Fast Does This Medication Work
RheumatoidArthritis.net indicates that you can expect to see some results after a month or two of taking hydroxychloroquine, but in order to get the full benefits you will need to take the medication for at least six months. That can help you realize how much benefit youre going to actually get from the drug. Some people see a nearly complete remission of symptoms. Other people see only a slight improvement thats virtually nothing at all. For most people, there will be a difference in their symptoms that will be somewhere in the middle of these two extremes. Taking the medication for the full six months can help you make a decision about continuing it.
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.
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What Are The Symptoms
RA sufferers are familiar with the severity of the pain associated with stiff and sore joints. Some describe it as having sprained all the joints in their bodies at once. Now imagine that with simultaneous fatigue, appetite loss, and feeling feverish, and you can easily envision how they are apt to feel downright lousy. Then to add insult to injury, some suffer through those episodes it for years and years. The most common signs and symptoms are:
* Swollen joints* Pain and stiffness in the joints, especially after periods of inactivity * Extreme fatigue
Even though RA is not life threatening, you will feel pretty miserable. And thats no way to live your life. Youll be searching for relief and relief that works.
How Does Rheumatoid Arthritis Progress Over Time
Regardless of whether symptoms appear gradually over several months or rapidly over weeks, the disease follows the same progression:
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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.
Ra And Hydroxychloroquine: How Effective Is It For Rheumatoid Arthritis
Joint damage worries and aching hands are no fun, and if youre experiencing those kinds of problems because of rheumatoid arthritis you may have options that can help you feel better. Theres no cure for arthritis, which is unfortunate, but feeling better is definitely possible. The progression of RA may be diminished in severity and duration by the combination of medicines and therapy that work best as determined by you and your physician. You can also put off joint damage, and in some cases, you can do more than just slow it down. Being able to stop joint damage can lessen pain and mean a better quality of life. Hydroxychloroquine is one of the medications that can be a valuable part of your treatment plan.
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A Common Culprit Contributes To Rheumatoid Arthritis
Over the years, multiple studies have reported a high incidence of stomach malfunction in individuals with rheumatoid arthritis. These reports also revealed that just replacing the missing hydrochloric acid and pepsin without making any other changes-can significantly improve many cases of rheumatoid arthritis.
So with this in mind, I always ask individuals suffering from rheumatoid arthritis to have a gastric analysis done. In the majority of instances, the test discloses low stomach function .
If this is the case for you, consider supplementing with either betaine hydrochloride-pepsin or glutamic-acid hydrochloride-pepsin before meals.
I usually recommend starting out by taking one capsule . After two or three days, if there are no problems, use two capsules in the early part of the meal then, several days later, increase the amount to three capsules. The dose is gradually increased in this step-like fashion until it equals 40 to 70 grains per meal.
Youll probably need to work with a doctor on this aspect of rheumatoid arthritis, too. On rare occasion treatment with hydrochloric acid can be dangerous, so it should only be used when testing indicates a need. Though problems occur rarely, they can be bad ones.
Prescription Medications For Ra Include:
- Corticosteroid drugs, also called oral steroids, are a common part of rheumatoid arthritis treatment regimen because they’re highly effective at reducing inflammation. The downside is that over time, the drug becomes less effective because your body adjusts to the anti-inflammatory effect. Decadron and methylprednisone are examples of oral steroids.Corticosteroids also come with the risk of bone thinning, bruising, weight gain, and high blood pressure.
- COX-2 inhibitors, such as Celebrex, are a newer class of NSAIDs that reduce pain and inflammation but without the risk of stomach complications. These drugs are used mainly by people with moderate to severe rheumatoid arthritis.
- Disease-modifying anti-rheumatic drugs work differently than corticosteroid drugs. Instead of acting quickly but without a lasting effect, DMARDs slowly modify the disease. So slowly, in fact, that it may take several months for you to feel their effects. That’s why doctors often prescribe DMARDs within three months of your diagnosisso you’ll get the benefits as quickly as possible. DMARDs are also usually taken with an NSAIDthe NSAID treats the painful symptoms while the DMARD works to prevent joint damage. Methotrexate is among the most prescribed DMARDs.Many DMARDs come with serious side effects, usually involving blood-producing cells, the kidneys, and the liver. Regular tests are necessary when using a DMARD so your doctor can monitor any possible adverse effects.
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How Is Ra Diagnosed
If you have painful or swollen joints, see your doctor. Early diagnosis is important as treatment does help and reduces long-term damage to your joints. There is no single test that can make a certain diagnosis of early rheumatoid arthritis. Doctors have to make a clinical diagnosis, where they put together all the information from listening to you and examining you, alongside with laboratory tests and sometimes x-rays. Your doctor may suggest any of the following tests and investigations.
|Type of test
|C-reactive protein levels may be high in RA, but not always.
|Levels of rheumatoid factor and other antibodies may be checked. About 80% of people have a positive RF.
|X-rays and other imaging techniques
|X-rays can reveal damage caused to the joints by RA. Magnetic resonance imaging and ultrasound scanning may also be used. They are more sensitive in picking up changes and are being studied to see how useful they are for diagnosing early disease and for monitoring its progress.