15 Things Doctors Don’t Always Tell You About Rheumatoid Arthritis (But You Really Should Know)

9. The bread basket may be doing you more harm than you think

“In my experience treating patients with RA, coming off gluten, dairy, and processed sugar helps at least 60 to 70 percent of people,” Dr. Levitan says. Some research, he says, indicates that gluten may be pro-inflammatory whether you are sensitive to it or not. This means that in addition to ditching junk food like cookies and cupcakes, cutting back on foods like bread and pasta, even if they’re whole grain, may help.

It’s a good idea to talk to your doctor before making any dramatic changes in your diet. They may be able to give you pointers on how to follow an elimination diet temporarily to see if there are any trigger foods that affect you personally.

10. 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.

11. 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.

12. Exercise doesn’t have to hurt to help

When it comes to all kinds of arthritis, exercise can feel like a catch-22. You need to stay active to help minimize stiffness and swelling, but thanks to RA’s effects on your joints, the very exercises that can help you manage it can sometimes feel hard or even impossible to do.

But that doesn’t mean you should give up on fitness. The trick, Dr. Levitan says, is to find a way to move your body that is manageable and, importantly, that makes you happy. No need to go hardcore (in fact, high intensity exercise can make joint inflammation worse) but it is important to move every day.

With your doctor’s OK, you could start with 10-, 15- or 20-minute daily walks. Swimming or using an elliptical machine or recumbent bike at the gym are also easier on your joints. Gentle exercises like yoga can keep your joints limber and your muscles strong, he adds.

13. Treatment may make you more susceptible to other illnesses

“Many medications [used to treat RA] work by lowering the body’s immune system,” says Orrin Troum, MD, a clinical professor of medicine at the University of Southern California and rheumatologist at Providence Saint John’s 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 it’s 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.

It’s 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, it’s a good idea to ask about infection risk (as well as other potential side effects) and any precautions you can take to minimize them.

14. Consider learning more about medical marijuana

If you grew up in the “just say no” era, you might be hesitant to try this remedy, but it may help RA patients, says Jordan Tishler, MD, a Harvard-trained emergency medicine physician and founder of InhaleMD. There are certain types of cannabis specifically grown for medicinal purposes that might help treat the pain of RA pain, he says.

“I have seen improvements for patients in pain control, stiffness, and increased mobility with cannabis,” he says. “Most importantly, I have seen significant improvement in reported quality of life.” Marijuana is legal for medical use in 31 U.S. states, and according to a new Medscape poll, 80 percent of health care providers say it should legalized nationally.

If you are interested in trying cannabis and it’s legal in your state, talk to your doctor or another provider who’s experienced in this area. There are many different strains of the plant, and cannabis products contain varying ratios of the active ingredients CBD to THC (so they’ll impact your body differently). It’s important to remember that cannabis can interact with other medications you may take or affect other health conditions you have, so make sure to talk to your doctor before you explore this option.

15. Pregnancy may give you a reprieve

RA is primarily diagnosed in women during their childbearing years, so it’s natural to have many questions and concerns about how the disease will affect your fertility, pregnancy, and postpartum (ex: breastfeeding) health.

The good news is that for many patients with inflammatory arthritis, pregnancy temporarily suppresses the immune system. This causes an overall decrease in inflammation throughout the body, giving many patients a nine-month window of some relief. On the other hand, some women may still experience flares during pregnancy, so it’s important to work together with both your ob-gyn and rheumatologist closely to manage all your arthritis and pregnancy symptoms.

15 Things Doctors Don’t Always Tell You About Rheumatoid Arthritis (But You Really Should Know)

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