Rheumatoid arthritis is the second most common type of arthritis and affects over two million Americans. This chronic inflammatory disease injures the lining of the joints, deforming them in many cases and eventually leading to bone erosion. The disorder generally affects the joints in the hands and feet most severely.
The most common symptoms associated with the condition include stiffness, swelling and pain. In addition, joints affected by RA may look red and be warmer to the touch than unaffected joints. Below are 20 things you should know about this disease:
1. Rheumatoid Arthritis Isn’t Osteoarthritis
Rheumatoid arthritis – commonly known as RA – is different from another form of the disorder called osteoarthritis. Nevertheless, like most people, you have probably heard others refer to both types of the disease as simply “arthritis.”
However, they are quite different, as RA is the result of an abnormal immune reaction, while osteoarthritis stems from erosion of the cartilage and bone and is primarily the result of aging, obesity, or overuse of various joints. For this reason, it is important to ask specific questions if you have been diagnosed with arthritis, as treatments for each type can be vastly different.
2. Muscle Atrophy and Loss of Appetite Are Common Symptoms
You may have known people in the past with rheumatoid arthritis who were extremely thin. This is because for multiple decades, those in the medical community were of the opinion that exercise would further damage the joints in RA patients and for this reason recommended a sedentary lifestyle. This caused individuals to suffer from muscle atrophy. In addition, a study completed by David Pisetsky, MD, a professor at Durham, North Carolina’s Duke University Medical Center, found that the chronic inflammation RA patients experience can cause extreme loss of appetite.
These two factors combined gave the disorder the nickname “wasting disease” in the 1960s. As you may have suspected, current opinions among immunologists and orthopedic specialists have changed over the years, and exercise is actually now part of the common treatment protocol for RA patients. Although during an extreme flareup exercise is not recommended, when a patient is enjoying a period of remission, doctors now state there is no evidence to suggest exercise would cause a flareup.
Medicines are now available to curb the inflammation as well, making it easier to maintain a healthy active lifestyle. Additionally, nutritional supplements and special diets are often recommended to ensure that despite a lack of appetite, those suffering from RA still consume adequate nutrition.
3. Shared Epitope May Be the Cause
A genetic variant known as shared epitope is believed to be the cause of the disorder in certain individuals. There is also longstanding evidence that certain genotypes in the HLA class are linked to a higher risk of developing RA.
Researchers are working to determine if there is a way to isolate and alter such genes in predisposed patients before the disease manifests. If you or anyone you know suffers from rheumatoid arthritis, this research may eventually lead to some light at the end of the tunnel.
4. Smoking May Trigger RA
Other risk factors for RA include smoking. In fact, almost 33 percent of the most severe cases of the disorder are seen in smokers. Additionally, those who smoke and also have the genetic variant “shared epitope,” which increases the risk for developing rheumatoid arthritis, are ten times more likely to develop RA.
Cigarette smoking increases your risk of a wide variety of diseases and conditions, and now scientists have proven that rheumatoid arthritis is on that list. This is simply more motivation to quit smoking or encourage those you know to do so.
5. Pregnancy May Decrease the Most Common Symptoms of RA
Certain autoimmune diseases, including rheumatoid arthritis, often go into remission during pregnancy. Certain statistics show that up to 75 percent of women suffering from RA will experience a remission by approximately the second month of the pregnancy and continue until the baby is born.
If you are suffering from RA and are experiencing this remission during your pregnancy, beware that a serious flareup may take place shortly after you deliver your baby. For this reason, planning to have extra support immediately following the birth may be wise. Doctors are unsure why being pregnant dampens the otherwise overactive immune systems of RA patients, but some researchers believe it may be due to an increase in protective hormones.
6. RA Increases Your Risk of Heart Attack
Another important fact you should know is that rheumatoid arthritis can significantly increase your risk of a heart attack. Even if you are not a diabetic and your blood pressure and cholesterol levels are normal, if you have active RA, your risk of a heart attack is approximately two to three times higher than those who do not have rheumatoid arthritis. Most doctors agree that the systematic inflammation that characterizes the disorder is probably the culprit.
7. RA Also Increases the Risk of Diabetes
The inflammation associated with rheumatoid arthritis may increase a person’s risk of developing adult onset diabetes, otherwise known as type II diabetes. Many doctors believe this is simply due to the corticosteroids that are sometimes used to treat RA. For example, drugs such as prednisone may increase your blood sugar levels, even if you are not predisposed to diabetes.
On a more positive note, other RA medications, such as Kineret and the antimalarial medication hydroxychloroquine, may lower your risk for diabetes. If you have a family history of high blood sugar and have been diagnosed with rheumatoid arthritis, you may wish to speak to your doctor about options other than corticosteroids.
8. Rheumatoid Arthritis Is Linked to Fibromyalgia
In 2010, studies were completed that showed approximately 20-30 percent of RA sufferers also suffer from a disorder called fibromyalgia. The latter is marked by widespread pain at various soft tissue points. Extreme fatigue, cognitive issues and depression are also among the most common symptoms of the disorder. It is not clear why individuals with rheumatoid arthritis are at a greater risk for fibromyalgia, but additional studies are being conducted to determine the link.
9. Risk Factors for RA Include Location
If you are like most people, you are probably completely unaware that the risk of developing RA is higher among individuals who live farthest from the equator. Additionally, living at a high altitude increases a person’s general risk for the disorder by 25 to 35 percent. Additionally, living at high altitudes before age 30 may increase the risk even more, although further research is necessary to make a definitive decision about this risk.
Interestingly, however, scientists are not sure whether cold temperatures are the primary culprit of this increased risk or if it has something to do with the lack of sunlight that is typically associated with colder regions of the world.
that perhaps vitamin D–which is produced naturally in the body in response to direct sunlight–plays a bigger role than initially thought concerning the development of rheumatoid arthritis.
Another interesting fact is that other autoimmune disorders are linked to vitamin D deficiency, such as multiple sclerosis, for which a definitive link has now been found between the development of the disease and the lack of vitamin D. Again, this disorder is also far more prevalent in cold, damp geographical locations than in areas where sunshine is abundant.
Vitamin D deficiencies are much more common among women than men, although regardless of your gender, you should speak to your doctor about supplements or lifestyle changes if you suspect you are not consuming an adequate amount of this vitamin.
13. More Live Births = Less RA
A little-known fact about rheumatoid arthritis is that women who have never experienced a live birth have an increased risk of developing the disorder. Researchers have not made much progress in discovering why this is the case. Some studies are focused on determining if perhaps it is the other way around, and giving birth to a child decreases a woman’s overall risk for rheumatoid arthritis, rather than something specifically to do with not having children that increases the risk.
Various scientists have different schools of thought regarding this matter, but some suggest that women who have never had children be screened for rheumatoid arthritis approximately every five years after they reach age 45. This is something you may wish to speak to your doctor about if you have never given birth.
14. Depression and RA Are Companions
For reasons unknown to medical science, if you have rheumatoid arthritis, you are much more likely to suffer from clinical depression than those who do not suffer from the disease. This was once believed to be simply depression from the fact that one is in constant pain, but new studies have determined there may be more to this phenomenon. For example, high levels of an inflammatory protein factor called TNF-a in a person’s bloodstream may be linked to clinical depression.
Additionally, some of the drugs used to treat RA can lead to mental depression when taken at high doses. These include steroids, NSAIDs that work on a hormonal level and disease-modifying antirheumatic drugs (DMARDS).
15. Traffic Pollution Plays a Role in RA Development
Pollution through microscopic particles that humans inhale is linked to all types of inflammation. You may not realize you are inhaling these particles, but if you live in an area where you are exposed to at least some traffic or factory exhaust, you are breathing in these pollutants.
Harvard scientists completed a 2009 study of almost 100,000 individuals living in the United States to take a closer look at the relationship between traffic pollution and rheumatoid arthritis. They found that those living within a third of a mile of a major highway had the highest risk of developing the disorder when compared with other groups participating in the study who live farther away. If you live close to a highway or even a factory, speak to your doctor about lifestyle changes or other things you can do to offset this exposure to pollutants.
16. Steroids Are a Common RA Medication
Some patients are surprised to learn that steroids are often one of the best medications for rheumatoid arthritis. This is because the disorder is a result of the immune system attacking your own body, and therefore medications such as prednisone, a drug classed as a corticosteroid, can be very helpful in alleviating acute symptoms.
However, because such drugs have severe side effects and also suppress the immune system (subsequently leading to recurring colds or other illnesses), doctors are usually hesitant to recommend them on a long-term basis. For this reason, it is wise to speak to the prescribing doctor if he or she has suggested long-term use of prednisone or other steroids for you or someone you love.
17. RA Is On the Rise Among Women
RA is on the rise among U.S. women for the first time in 40 years, and some interesting statistics have emerged since 2010, when the Mayo Clinic released a report that RA is twice as common in women than men. Furthermore, risk rates among men dropped between 1995 and 2007.
Researchers are not clear why, but speculate it may be connected to cigarettes, as statistics show that females are not quitting this habit as quickly as males, and scientists speculate that perhaps the combination of smoking and the aforementioned higher vitamin D deficiency in women than men may be a combination that considerably increases the risk.
18. Rheumatoid Arthritis Is Affected Both Positively and Negatively By Alcohol Consumption
Drinking alcohol is not recommended for those with rheumatoid arthritis, as similar to certain drugs, it could be harmful to the liver. Nevertheless, research suggests that individuals who drink a glass of red wine a day are at a lower risk of developing rheumatoid arthritis than those who do not include wine as part of their diet. This may be because light to moderate intake of wine has an anti-inflammatory effect.
However, it is important to remember that you should not drink alcohol if you have already been diagnosed with rheumatoid arthritis. Additionally, if you are a non-drinker, it is not recommended that you begin drinking wine or any other alcoholic beverage solely for the purpose of attempting to lower your risk of RA.
19. Rheumatoid Arthritis Is a Modern Disease (Relatively Speaking)
You may find it quite interesting that no evidence of rheumatoid arthritis was found prior to the 1400s. In fact, none of the mummies uncovered during archaeological excavations showed any signs of rheumatoid arthritis, which can show in the bones of corpses for thousands of years.
Martin J Bergman, a renowned rheumatologist at Ridley Park’s Taylor Hospital in Pennsylvania, is convinced that this is because rheumatoid arthritis and the malfunctioning of your immune system that causes it is based solely on environmental factors. His theory is certainly worth considering when you think of the fact that most people in ancient civilizations had far more sun exposure than modern cultures, and cigarettes were not invented until the 20th century. These are two major risk factors that were not present centuries ago.
20. Juvenile Rheumatoid Arthritis Exists
Many people are under the erroneous impression that arthritis–regardless of the type–is an “old person’s disease.” However, if you have ever known a child with juvenile rheumatoid arthritis, you know that this is not the case. In fact, among children who develop arthritis, rheumatoid is the more common form of the disorder.
This condition can manifest as early as five years old, and many parents overlook it because they believe the child has simply fallen or sustained some injury while playing. For example, children with rheumatoid arthritis who play baseball may think the swollen joints are simply from catching the ball. Therefore, if you have children, it is important to know that this disorder is a possibility and always follow up with a medical doctor if your child has swollen joints or stiffness that you cannot account for in any other way.
Ultimately, if you have a history of RA in your family or you are experiencing the most common symptoms of the disorder or otherwise suspect it is present, you should contact a medical professional as soon as possible. This will ensure that proper treatment is offered as soon as the diagnosis is made.