Treating Early Rheumatoid Arthritis

Rheumatoid arthritis (RA) is the most common inflammatory form of arthritis affecting approximately two million Americans. It is a systemic, autoimmune disease for which there is no known cure.

Several pieces of data have shown that joint damage in RA can occur as early as 4 months after the start of symptoms. And further evidence has demonstrated that early intervention with the disease using disease-modifying anti-rheumatic drugs (DMARD) therapy improves signs and symptoms of the disease but also slows the rate of x-ray progression, a primary determinant of future disability. In addition, since it is a systemic disease, damage inflicted on the joints can also be accompanied by significant damage to other organ systems such as the lungs, eyes, bone marrow, skin, and nerves.

Guidelines from the American College of Rheumatology have suggested the prompt initiation of DMARD therapy within the first three months of diagnosis. Sometimes adding low dose prednisone - an oral corticosteroid- can help buy time by serving as a "bridge" until the DMARD begins to kick in. Combining methotrexate, the "workhorse" DMARD, with low dose prednisone can reduce disease activity, slow the rate of progression of disease, and prevent further physical disability.

One word of warning is that delay of treatment beyond three months from the time of diagnosis has grave consequences since there is a higher probability of joint damage and less likelihood of achieving remission in the future. Furthermore, joint damage, once it occurs, cannot be reversed. So, prevention is the key.

So a common sense paradigm has emerged for the management of early rheumatoid arthritis. This is a model which most rheumatologists increasingly are adhering to.

The first is early diagnosis. This, of course depends on early referral to a rheumatologist.

The second important point is to institute DMARD treatment, preferably with methotrexate, along with low dose prednisone immediately.

And the final approach is to use the "treat to target" model that has become in vogue recently. Treating to target implies the need for very tight control of the disease. This approach allows a patient to have a custom-tailored treatment program with the aim of establishing either low disease activity or complete remission. The achievement of the treatment target can be objectively made using various measurement tools, including joint counts, blood tests of inflammation, and various imaging techniques.

Such a treatment approach is not dissimilar to the treatment approaches for other serious chronic conditions such as hypertension and diabetes.

Rheumatoid Arthritis Diet - Delayed Food Sensitivities

Is there a rheumatoid arthritis diet that can lessen the symptoms or even cure rheumatoid arthritis? For many people the answer is yes.

One study published in the medical journal "Lancet" found that 37% of their study participants (who all had rheumatoid arthritis) had food sensitivities that were one of the causes of their arthritis. The list of problem foods was different for each person. But when these individually determined foods were eliminated from their diets, they all felt much better.

For about a third of people with RA, this type of individually tailored rheumatoid arthritis diet can make the difference between suffering with a challenging illness and enjoying good health.

This is because delayed food sensitivities are one of the underlying causes of rheumatoid arthritis. They are not the same as classical food allergies, which usually cause symptoms immediately or within a few hours. Instead, delayed food sensitivities usually take between 24-36 hours for symptoms to occur. This delay can make it hard to track the connection between eating a problem food and worsening of arthritis symptoms, especially if a problem food is a regular part of your diet.

To make the problem worse, normal allergy tests are not a reliable way to test for these sensitivities either.

Luckily, however, there are ways to test for delayed food hypersensitivities.

One way is a blood test called the ALCAT test.

Another way is eliminating all your suspected problem foods for a week and then selectively reintroducing them into your diet, no more than one each 24 hours. When the foods causing delayed sensitivities are removed from the diet, the body goes through a withdrawal period, similar to a drug withdrawal period. It becomes hypersensitive to those foods. If you reintroduce any of these problem foods into your diet during this time, the reaction tends to be quicker and more noticeable than any other time. This is a great aid in getting accurate test results.

It takes about 7 days to eliminate all traces of a given food from your body after you stop eating it. That is why the elimination phase lasts a week. The hypersensitivity period begins at this point, so that is why the testing by reintroduction begins then. This hypersensitivity period can last for week to months, so don't worry about missing it if you have a long list of foods you have eliminated that need to be tested.

If you do react to something you test, go back to your safe foods for a few days until your symptoms have calmed down again. The fewer symptoms you are having when you test, the easier it is get clear results when you test a new food. You need these clear results to create you're the exact rheumatoid arthritis diet you need to heal.

If delayed food sensitivities are a problem for you, then identifying your problem foods and eliminated all of them from your diet, will make a huge difference in how you feel.

There is no one rheumatoid arthritis diet out there that works for everyone, but this type of individually tailored rheumatoid arthritis diet can work miracles if you do happen to have delayed food sensitivities.

Foods May Contribute to Rheumatoid Arthritis Through a Leaky Gut - The Gut-Joint Axis

Foods frequently blamed for food allergies and sensitivity reactions are also believed to cause or contribute to inflammatory and autoimmune conditions. These common foods are likely doing so through a process of gut inflammation resulting in leaky gut. This injury, especially occurring in genetically predisposed people, and in the setting of altered gut bacteria (dysbiosis), and immune stress likely predisposes to further inflammation and leaky gut. This vicious cycle is thought to allow toxic food protein-bacteria complexes to enter the body resulting in a variety of inflammatory and/or autoimmune conditions such as rheumatoid arthritis. A new study sheds some additional light on link of food intolerance to rheumatoid arthritis is reviewed in this context.

Researchers from Norway in 2006 published in the British journal Gut additional new evidence of the link between foods and rheumatoid arthritis. Professor Bradtzaeg and his colleagues at the Institute of Pathology in Oslo measured IgG, IgA, and IgM antibodies to foods. The measured these antibodies in blood and intestinal fluid in people with rheumatoid arthritis compared with healthy people.

The researchers performed blood and intestinal fluid antibody tests to the following food antigens: gliadin, oats, cow's milk proteins (casein, lactalbumin, lactoglobulin), soy, pork, cod fish, and egg (ovalbumin). These foods are in the top 10 of common food allergens as well as food protein intolerances.

What they found was a "particularly striking (incidence) of cross reactive food antibodies in proximal gut secretions" as well as increased IgM antibodies to some of these foods in the blood. The findings in the blood were less striking than in the intestinal secretions. This is consistent with difficulties finding elevated blood antibodies to foods in people with rheumatoid arthritis and other autoimmune/inflammatory conditions despite a lot of anecdotal and elimination diet experience supporting the role of foods in these conditions. Interestingly, Dr. Ken Fine's stool antibodies tests may be on to something.

The results, in their opinion, indicate that measuring blood antibodies to foods in rheumatoid arthritis provides little information about the role of foods in rheumatoid arthritis. However, intestinal antibodies not only show a "striking" pattern of elevation consistent with adverse food immune reactions but also that there appears to be a potential cumulative effect of multiple foods. That is, not only may some foods trigger an abnormal immune response resulting in joint inflammation but the combination of multiple problem foods may be a key component to this link. Their results support the connection of mucosal (gut) immune activation from cross reaction of foods to rheumatoid arthritis in at least some people.

What might this mean? This data supports the concept and the experience of many people that elimination of certain problem food combinations may be beneficial in preventing or reducing joint inflammation. This is both exciting and intriguing.

Multiple commonly eaten foods frequently linked to food allergies and sensitivities may be contributing to inflammatory and/or autoimmune conditions. These common problem foods or their lectins are likely contributing to the process of gut inflammation. This is likely causing gut injury resulting in leaky gut. This injury and leaky gut, especially in genetically predisposed people, may, in the setting of altered gut bacteria (dysbiosis), predispose to further injury. This then allows the entry of toxic food protein (lectin)-bacteria complexes into the body, especially the blood stream. The result is inflammatory and/or autoimmune conditions like rheumatoid arthritis.

This gut-joint axis is likely the same mechanism as the gut-brain axis and gut-skin axis that produce the myriad of symptoms and diseases we are now seeing. The associated food protein (lectin)-bacteria immune reactions in the gut are increasingly being blamed for the development of a myriad of diseases.

Much more needs to learned, but it is interesting that certain foods keep showing up as the usual suspects. These problem foods or lectins include the grains (especially wheat, barley, rye, oats, corn), dairy (casein), nightshades (potato, tomato, peppers) and peanuts, soy and other legumes. Diets eliminating or restricting these foods have been reported as being beneficial for many symptoms and diseases. However, definitive links are difficult to establish because of limitations of scientific research.

The foods implicated are usually limited in some manner in a variety of elimination diets such as the gluten-free/casein free diet, naked diet, paleolithic/hunter-gatherer or caveman diets, arthritis diet, low carbohydrate diet, anti-inflammatory diet, and six food elimination diet.

The Paleolithic or Hunter-Gatherer diet specifically recommends restricting grains, dairy and legumes. Various anti-inflammatory or arthritis diets usually recommend eliminating either wheat or gluten, dairy and the nightshades. The dietary approach to autism commonly advocated is a casein-free, gluten-free diet.

Despite lay public reports of great successes with such elimination diets, mainstream medicine continues to be slow to study the dietary treatment of disease. However, especially in the past two to three years more studies are appearing showing links supporting a significant role of food and bacteria in the gut and various autoimmune diseases.

Rheumatoid Arthritis Symptoms That You Should Not Ignore

Everyone feels a little worn out every now and again, especially when overextending or being under an undue amount of stress. Some people, however, become prey to an overwhelming fatigue that comes on with no extenuating circumstances. This excessive weariness may be accompanied by a low-grade fever and stiffness. These could be indicators of early rheumatoid arthritis symptoms that should checked by a doctor.

While some people also experience unexplained weight loss and numbness in their hands, these are not the prominent symptoms. The biggest telltale sign of rheumatoid arthritis is joint pain. The joints are usually very painful, swollen and stiff. The pain usually affects the joints on the same side of the body in the hands, wrists, ankles, knees and elbows. There is also typical a pattern of the disease which causes more than three sets of joints to be affected at once.

People who suffer with rheumatoid arthritis symptoms struggle with debilitating pain that makes it difficult to accomplish simple, everyday tasks. Normal activities, such as buttoning a blouse or unscrewing a bottle top can be extremely difficult or nearly impossible, depending on the severity of the condition. It is very hard for rheumatoid arthritis patients to carry out their everyday activities without some kind of medical or lifestyle intervention.

Rheumatoid arthritis is more than just a condition that causes chronic pain, joint and muscle stiffness. It is an autoimmune disease that causes the body to attack itself and can cause systemic symptoms. A number of patients report having rheumatoid nodules or bumps over such areas as their knuckles, elbows or spine. These bumps can range in size, from the size of a pea to an average size plum.

If these symptoms are not detected and treated, the disease can progress aggressively and destroy joint tissue as well as ligaments, tendons and other parts of the body. The disease can be very serious, as it can cause organ damage in very advanced cases and rare instances. People who experience excruciating, symmetrical joint pain should definitely seek medical attention to find out the cause.

Some autoimmune diseases, including lupus, have some symptoms that are similar to rheumatoid arthritis, so it is important to get a clear diagnosis through imaging and blood tests. Most common symptoms are marked by symmetrical joint pain on both sides of the body and can have a crippling affect on one's quality of life. People who experience these symptoms should give the doctors a complete symptom history and get properly tested for a clear diagnosis.

Rheumatoid Arthritis: Management Of This Disease

Management of the rheumatoid arthritis is generally medical, but therapeutic approaches and measures as well as surgical interventions can minimize and slow the effects of the disease. The evaluation and treatments rendered in an ongoing manner. It is best for the disease to be managed from a multidisciplinary perspective approach, this means including the principal rheumatologist, orthopedic surgeon, nurses, physiotherapists, occupational therapists, orthotists and the social worker, for a more holistic approach.

The management during the acute stage is primarily a medical perspective, characterised by frequent visits and even in-staying in the hospitals for increased rests, pain management and education. In the sub-acute phase, there will be more visits and treatments by the physiotherapists and occupational therapists, depending on the level of systemic and local effects of rheumatoid arthritis.

During this stage, there is also a chance of the hand occupational therapist attending to the patient with the disease for splinting and mobilization of the affected finger and hand joints, if the patient is able tolerate. The benefits of physiotherapy and occupational therapy is positive, and often increases the general mobility and pain management of the joints, equating to a better quality of life.

The drugs/pharmaceuticals that is often prescribed at this point in time include anti-inflammatories, painkillers, and hydrocortisone injections into the joint(s). There need to be careful management and monitoring of the effects of the abovementioned drugs when ministering to the patients, as some may have unpleasant side effects, but with safe administration, they are very effective.

Arthritis Relief and Your Diet

Arthritis affects more than 40 million Americans and is referred to as the

most common chronic disease in people over 40.
Doctors believe there are over 100 different forms of arthritis, all sharing

one main characteristic: they all cause joint inflammation.
What can you do to relieve the symptoms of arthritis? A lot.
There is a great deal of debate in the medical world about the effects of overall

diet on arthritis and using diet toward alleviating the condition.
Doctors have known for a long time that diet affects gout, a specific type

of arthritic condition, however the jury remained out for a long time on other

common types of arthritis such as rheumatoid and osteoarthritis.
What is known however, is that overall dietary health is important and does

come into play. Weight and nutrition are two factors that play a role in arthritic

pain.
Being overweight can affect certain arthritic conditions, forcing some joints

to carry more of a load. This added weight stresses the joints, causing overuse

or more wear to components, and pain, especially in the knees.
If you suffer from arthritis make sure you eat good foods and get help from

healthcare providers to create and follow a well-balanced dietary plan.
To begin with, here are some vitamins, minerals, foods, supplements and herbal

applications to consider.
Vitamins that have shown to reduce tissue swelling or provide relief include

Vitamins B5, B6, B12, the antioxidant vitamins C and E, and vitamin K, which

improves bone health.
Several independent studies have found that rheumatoid arthritis patients given

increased doses of zinc showed marginal improvement.
Other minerals to consider include Boron, Calcium, Magnesium, Manganese (not

to be taken with calcium), Copper, Germanium and Sulfur.
The National Institutes of Health is studying the food supplements, glucosamine

and chondroitin, for use in relieving symptoms of pain and stiffness for some

persons with osteoarthritis.
Patients with osteoarthritis taking blood-thinners should be careful taking

chondroitin as it can increase the blood-thinning and cause excessive bleeding.

Fish oil supplements have been shown to have anti-inflammatory properties.

Increasing dietary fish intake or fish oil capsules (omega 3 capsules) can relieve

inflammatory conditions like arthritis.
For more information, see Omega

3 Fats
Glutathione is an antioxidant with anti-inflammatory properties and can be

safely boosted by consuming its precursors available in the supplements, N-Acetyl-Cysteine

(NAC) or undenatured whey protein.
For more information, see Glutathione.
Quercetin is also known to help reduce inflammation, while Type II Collagen

plays a role in growth and repair of joints, articular cartilage and connective

tissue.
Because of the risk in overdosing, one should be discouraged from taking doses

of vitamins that are higher than recommended without a physician's direction.

Some vitamins and minerals can actually worsen certain conditions, and the

concentration that can be attained through vitamins can be dangerous. It is

always better to increase in vitamin or mineral intake through your normal diet.

Foods To Avoid
There are many factors to consider with regards to arthritic diets and nutritional

healing, and each factor may not apply to each individual.
For example, certain people are allergic to specific foods, and these allergies

can indeed worsen arthritic conditions. The best way to approach the situation

is to examine each arthritic condition and tailor one's approach based upon

the specifics.
Ingesting foods that contain sodium nitrate or tartrazine can inflame rheumatoid

arthritis, while ingesting foods containing a substance called hydrazine can

contribute to an arthritic condition connected to lupus.
Black walnuts can cause flare-ups in people a rare type of arthritis called

Behcet's Disease.
With osteoarthritis, deterioration of cartilage is a concern. Since there is

some evidence that Vitamin A, contributes to cartilage deterioration, those

with osteoarthritis should avoid large doses of it.
Although clinical proof is not available, anecdotal evidence suggests that

in the case of fibromyalgia, eliminating wheat, dairy, citrus, sugar, aspartame

(Nutrasweet), alcohol, caffeine, and tobacco can provide relief.
Many nutritionists and naturopaths suggest that those suffering with rheumatoid

arthritis avoid dairy products all together, as they seem to exacerbate rheumatoid

arthritis flare-ups.
The report "I

Cured My Arthritis You Can Too" suggests that white flour aggravates

arthritis symptoms.
Disclaimer: The information here is not provided by medical professionals and

is not intended as a substitute for medical advice. Please consult your physician

before beginning any course of treatment.

Rheumatoid Arthritis Symptoms: Listen To Your Body

What happens if you don't pay attention to the rheumatoid arthritis symptoms that you feel? It doesn't matter how old you are or what you have going on in your life. Paying attention to the problem at hand, which has to do with your health, is incredibly important. If you don't take care of your arthritis pain, you could find yourself unable to do the things that you are worrying so much about right now. Do you know what the symptoms of arthritis are? If so, you should also know why its important to listen to your body so that the worst of the complications from the rheumatoid arthritis symptoms you face can be avoided.

What Are The Symptoms?

The symptoms of rheumatoid arthritis are in fact fairly simple. For starters, you are likely to feel pain. The pain is likely to be in joints throughout your body. The most common places for this pain to be in is the smaller joints in your body including your fingers and feet, but it can be felt anywhere. You are also likely to feel aching in those joints from movement. For some, moving your joint after it has been sitting for a few minutes will cause soreness and pain.

In addition to those symptoms, you are likely to experience swelling in the joints which is caused by the inflammation there. The amount of swelling and pain that you have is an indication of just how severe your condition is. Those that have extreme levels of pain are often facing rheumatoid arthritis symptoms that are advanced. That can lead to a very urgent need to seek out help. When the symptoms progress, you may have loss of range of motion in that joint that may lead to deformity. You may notice this in knuckles that are no longer aligned or in swollen knees.

The Complications That You Face

As your rheumatoid arthritis symptoms progress, you are likely to see increased amounts of pain and discomfort. The stiffness that you feel can also lead to fatigue in the muscles of that area of your body, which can ultimately limit the use that you can use them for. In addition, some patients end up facing depression from the loss of quality of life that they are used to. But, they don't stop there. Many patients with rheumatoid arthritis can also develop osteoporosis and some may develop a heart condition that some believe is caused by the arthritis itself. They believe that the inflammation of your joints can cause your arteries and the tissue of your heart to become affected.

Probably the last part of the process of rheumatoid arthritis symptoms is that you will find yourself unable to use that joint any longer because the pain and deformity has removed that from you. For some, that means being in a wheelchair and for others that means a treatment like joint replacement. In either case, there are risks that can be important to consider. But, if you listen to your body and get the help you need for the arthritis that you feel, you can severely slow the progression of the condition and even restore some of the motion you need.