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Rheumatoid Arthritis And Its Treatment

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Posted on Thu, 19 Apr 2012
Question: I have had chronic morning and irregular day time aching joints and muscles. I wake up and feel exhausted and nausiated. i have had 5 high inflamatory tests over the last 3 years so doc thought perhaps rhumatoid arthitus, my RF was fine and the last inflamatory test came back as normal.
I am eating extremely healthy to try and see if this helps, i have been on a diet of very low sugar and high in complex carbs and protein. No refined or white products.

i take 7.5mg of anti inflam meds of a morning (dont know if this would of effected my test).

My feet feel like i am walking on broken bones in the morning and at time i have such little strength in my hands i cant do simple tasks like clean a toilet or brush my teeth. I am really at a loss. My doctor puts it down to the bodys way of dealing with chronic stress, i have had a pretty stressful few years but in saying that it is not all bad i am not depressed and in general life is good.

Do you have any suggestions. i kind of feel like i am bothering my doctor as all his test are coming up with nothing
doctor
Answered by Dr. Chakravarthy Mazumdar (6 hours later)
Hi,

Thanks for your query and description of it.

I am sorry for the difficulty of life even to execute normal tasks.

The chronicity, early morning stiffness, small joint involvement are going in favor of Rheumatoid Arthritis. RF factor is not very sensitive for detecting RA.

What is the medicine that you take?

Can you please type the name and the results of the test?

Are you seeing a specialist Rheumatologist?

Have you done the following tests: ESR, CRP, AntidsDNA, Repeat RF ? Have you got some Xray done?

My answers would be more meaningful if you reply to my questions.

I will be available for your follow up queries.



Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Chakravarthy Mazumdar (40 hours later)
my RF was done a couple of times and said it was negative, I have had a CRP and an x XXXXXXX of my back. The xray showed some damage to my hips from inflammation but nothing that looked like it was RA.

My uncle has haemochromitos does this sound a possibility to you. I do have a very low sex drive, which i thought was "just me" and i am very weak in my hands.

My doctor is quite confident i don't have arthritis from the tests that he has done, i take 7.5 mg of meloxican which is an anti inflammatory each day.

I dont think any of the other tests you mention have been done, i did send a list of the ones that had been done in my original email. I don't have the exact results only to say my GP says they are all with in normal range. BUt my CRP (which i think is inflammatory stuff) had been high for the last 4 tests that had been done)... coincidentally perhaps to the illness i had at the time ie:mis carriage or surgery... so it makes it hard to decide if it was because of my joint pain.

thanks
doctor
Answered by Dr. Chakravarthy Mazumdar (10 hours later)
Hi Deanie,

Xray of the hip does not mean for RA. RA generally affects the small joints in the hand and wrist. I did not find any lab results in your email.

For Hemorchomatosis arthropathy, it is a possibility. It involves symmetrically small joints, with a positive genetic history, the next best thing to rule it out is blood test of Serum ferritin and transferrin saturation.

The fact that CRP high generally denotes an inflammatory process. I hope your GP is not missing any early autoimmune disease. If you have a referral system, get evaluated by Rheumatologist / Immunologist.

Wish you Good Health.





Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Chakravarthy Mazumdar (10 hours later)
My last lab results were all classed as normal ranges... i will write their codes but i dont know if they are the same for you.

Clinical Chemistry-CHOL TRIG NA K CL HC03 C U
GLUC CRP
microbiology-UMCS
Immunology-CCP


My wrists and joints to the knuckles are worse especially on my thumb, my feet bones, hips and across my shoulder blades.

My uncle explained that he had a 1/2 mutant Gene for Haemochromotosus, i pressume he was more than a carrier as he required bleeding. His first symptoms were chronic fatigue and aching... i think it could a long shot but my first symptoms started about 5 years ago approx a year after i had a miraina IUD put in, since then i have had 2 children but only about 4 periods. If it was Haemochromotosis could that be why i am showing symptoms earlier than usual.

I might ask my GP for a referal... DO you think stress can cause these symptoms, he is a very good doctors and knows me well but i feel the symptoms are a little more than that. I have had highly stressful periods but in generagl i not a stressed person.
doctor
Answered by Dr. Chakravarthy Mazumdar (8 hours later)
Hi Deanie,

All the labs are appropriate and normal. Your doctor is good enough to get AntiCCP (early marker for RA) done. Stick to him and I do not think you need a referral at this time.

Generally women are saved from complications of hemochromatosis as they menstruate and have more blood loss than men. Get the Serum Iron and Transferrin saturation done and get them analysed with your primary. As he knows you better than anyone something can be concluded upon.

Stress and mild depression can start with these symptoms. If all of the above are ruled out, Chronic fatigue Syndrome is the last resort.

All the best.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
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Dr. Chakravarthy Mazumdar

General & Family Physician

Practicing since :2004

Answered : 2086 Questions

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Rheumatoid Arthritis And Its Treatment

Hi,

Thanks for your query and description of it.

I am sorry for the difficulty of life even to execute normal tasks.

The chronicity, early morning stiffness, small joint involvement are going in favor of Rheumatoid Arthritis. RF factor is not very sensitive for detecting RA.

What is the medicine that you take?

Can you please type the name and the results of the test?

Are you seeing a specialist Rheumatologist?

Have you done the following tests: ESR, CRP, AntidsDNA, Repeat RF ? Have you got some Xray done?

My answers would be more meaningful if you reply to my questions.

I will be available for your follow up queries.