10 Things Even RA Vets May Not Know

Patient Expert
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For most of its history, not much was known about rheumatoid arthritis (RA) except the damage and deformities it could create in your joints. Recently, research has revealed more about the complexities of the condition and that it’s not just affecting treatment, but also how people with RA are living their daily lives. Knowing more about your RA can help you live a better life.


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RA is systemic

RA’s most visible effect is on the joints. Inflammation can cause damage to joints, as well as deformities. But the condition affects much more than the joints — it’s systemic, which means it affects systems in the whole body. This includes organs, such as the heart and kidneys, the vascular system and more. Just as joints can become damaged by inflammation, so can organs. Treating RA with medication protects your whole body.


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Heart disease and RA

RA can affect your heart. Historically, this led to people with RA having a life expectancy 10 years shorter than the general population. Advances in treatment, particularly biologics, have led to a significant improvement in this aspect of having RA. For instance, the longer your RA is suppressed by medication, the more your life expectancy returns to the norm. Because of this risk, you may wish to add a cardiologist to your medical team.


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Inflammation marker blood tests

There are two blood tests that are often used to measure inflammation. They are erythrocyte sedimentation rate, also called sed rate or ESR, and C-reactive protein (CRP). They are actually not an accurate indicator of RA inflammation because they measure the body’s general level of inflammation. If you are, for instance, brewing a sinus infection, these markers will increase because of the systemic level of inflammation.


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The Vectra test

The Vectra DA blood test is a recent addition to the rheumatology arsenal and a better indication of how your RA is doing. It measures 12 different biomarkers related to RA, rather than just one as in the ESR and CRP tests. The results are then averaged to a number that indicates your disease activity and can be used to indicate your response to treatment. At present, the Vectra test is only available in the United States and it’s quite expensive. Check with your insurance provider before getting the test.


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RA in your throat

Do you get laryngitis without having a cold or feel like you have a lump in your throat? Then your cricoarytenoid joint may be affected by your RA. This is a tiny joint in your larynx (voicebox). Up to 50 percent of people with RA have RA involvement here. Rarely, inflammation in this joint can cause difficulty breathing. If you do find that you have any of these symptoms, speak to your rheumatologist about a referral to an ear, nose, and throat specialist, who can help keep an eye on the health of your larynx.


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You have rights

When you have RA, you are protected under the Americans with Disabilities Act. That means you’re entitled to accommodations at work, changing how you work to be easier on your body. Talk to human resources or at the Job Accommodation Network to find out more. If accommodations aren’t enough to help you work, you may be able to apply for Social Security Disability (SSD). Involving a lawyer or advocate in the application process will reduce the risk of being rejected.


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Dental health

Your oral health can be involved in RA from several perspectives. First, the bacteria that causes chronic gum inflammation is theorized to be part of the process that starts a chain of events leading to the development of RA. As well, people who live with RA are more likely to have periodontal disease. Researchers believe that this may be connected to the systemic inflammation of RA. When you have RA, you may also develop Sjogren’s syndrome, characterized by dry eyes and mouth.


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The root of RA may be in your stomach

Great strides have been made toward identifying the cause of RA. Recent research has demonstrated a link between RA and the bacteria in the microbiome — a collection of different species of bacteria in your gut. Studies have shown that when someone has RA, there is an increase in certain bacteria that may be involved in the inflammatory response. Also, certain bacteria in your gastrointestinal system can affect how effectively a drug is treating your RA and it may indicate the presence of side effects.


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RA increases the risk of osteoporosis

When you have RA, you are at a 20- to 30-percent higher risk for osteoporosis. This is further compounded by additional risk factors, such as pain and fatigue making you more sedentary and doing less weight-bearing activity, as well as potentially taking steroid medications to control your RA. Making sure you get plenty of calcium and vitamin D can reduce that risk, as can finding a way to do weight-bearing exercises. As well, there is some evidence that biologics may help reduce the risk of osteoporosis.


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New treatments, big changes

The potential for effective treatment of is a fairly new factor in the history of RA. With the advent of biologics, the landscape has changed and that includes treatment approach. The goal is now to treat to target, that is, frequent adjustments of medication to achieve remission or, at the very least, low disease activity. If your RA is not under control, talk to your doctor about options in treatment approach and medication that may help you live better with your condition.