Doctor insights on:
Early Ra. AntiCCP + 17. Other blood negative.
Doc1: MTX 7.5mg, Plaquenil 400mg, Celebrex (celecoxib).
Doc2: Plaquenil 200mg, Pred 5mg, Celebrex (celecoxib) .
Reasonable: You have the opportunity to do very well. Early RA responds better to any of the treatments compared to late RA (disease > 2 years). If you still have pain, stiffness, fatigue on this regimen, talk to your Rheumatologist about adding a biologic medication such as Enbrel, Humira or Remicade (infliximab). There are several others, but I usually start with one of these. Would help get rid of the prednisone. ...Read moreSee 1 more doctor answer
I have been diagnosis w/rheum and psoriatic arthritis, as well as fibromyalgia. I'm 37 will i always need meds never been in remission since diagnosis 4 yrs ago?
Severe RA. dr. prescribed Actemra (tocilizumab) inj. plaqunil. methotrexate.Sulfasalazine. norco.folic acid.What 2 watch out for? Any concerns from theses drugs?
ANA+ (1:160 homologous), all other titers NEG (Lupus, RA, vasculitis, etc) Rheum thinks seroneg RA. Morning stiffness, joint/spine/SI pain. Possible?
+ana1:640terrible flares >4yrs of fatigue, arthr/myalgia, pleuritic pain, photosen rashes, sicca.Exten rheum work up all neg even during flares.Rheum tried methotrexate which stoped sx! diagnosis w/neg work up?
Hashimotos. Ana + anti-ssa/ro. Stiff, painful, swollen joints + raynauds. Doc says it's "lupoid arthritis". Is this lupus? He gave me plaquenil (hydroxychloroquine) 200mg
Sounds consistent: The joint complaints and positive lab markers are consistent with lupus. The fact that raynaud's is present and you have an autoimmune thyroid condition help cinch the diagnosis of an autoimmune arthritis. In addition to standard treatments like Plaquenil (hydroxychloroquine) there are other interventions like diet and supplements to help decrease the dose of rx meds. A practitioner of integrative medicine can help. ...Read moreSee 2 more doctor answers
Tried numerous meds for fibro like lyrica, cymbalta, gabapentin, savella (milnacipran). None work, not fibromyalgia?
Psa have tried mtx w /remicade& w/ humara no help methotrexate caused blood issues but worked better. Now embrel/leflunomide.No relief frustrated help?
MTX sc ?: Mtx causes less liver issues given sc versus oral. Also mtx has more potent metabolites that take 10 weeks to develop. You did not specify what tests where abnormal. But you suggest that mtx was given alone. Was it? Mtx and Humira (adalimumab) are a good combo for psoriatic arthritis. ...Read more
My lupus rheumMD has me working w/endocrineMD 2help w/prednisone taper below 5mg even tho adrenal fxn is normal.Foggy,achy,stiff. Endo or rheum issue?
Lupus? osteoporosis?: Steroids can cause severe calcium demineralization of the bones hence if you are able to tolerate the steroid taper it is good. You should be taking calcium with Vit D supplements I assume, prescribed by ur PCP/Rheumatologist. Achiness and stiffness though could be from Lupus, pl. see whether calcium supplemets if you are not on so far, are helping you in the future. Get your Vit D level checked . ...Read more
RA + psoriasis. MTX allergy. Enbrel (etanercept) non effective. Humira semi-effective but Vectra score 30 with extreme fatigue. MD wants to try Xeljanz?
RA + psoriasis: There are a number of newer medications that could help you. Xeljanz works by disrupting cytokine and growth factor signaling pathways. A trial of the medication is useful to see whether it helps you. Other medications that might help include Remicade (infliximab) and Apremilast ...Read more
Work with your psych:
Talk to your doctor. Tell him or her what you are experiencing, and what you expect from the medication. Sometimes medication takes time to work, sometimes what we are looking for requires more than just medicine. Sometimes several approaches must be tried before the right one is found.
An alliance with the doctor increases the chance that you will get the results you need. ...Read more
Ana 1:640x10yrs, other labs neg. Flares of rashes, fatigue, arthralgia, myalgia, dizziness.Crp & sed normal during flares!tx: plaquenil (hydroxychloroquine) & low doses pred prn. Dx?
Severely fatigued for 10 years-fall asleep in meetings, ect. Seen endo, psych, rheum, allergist, sleep specialist, blood work ok, what else can it be?
Dysfunctional REM: Are you dreaming? If not, you may have dysfunctional rem sleep. Meds can cause this. Are you on an antidepressant? Do you drink alcohol? If so, your deep sleep may be interrupted or dysfunctional. Medication such as Doxepin or Remeron (mirtazapine) can be used to "reboot" your rem sleep pattern. I would see another sleep specialist and ask specifically about disordered rem. ...Read more
Ana + spec pattern titer 1:640. All labs ok. Lupus panel neg. Elevated sed rate. 2 rheum drs dismissed it. Anything else I should do? Cancer?
Autoimmune symptoms (fatigue, joint/muscle pain, headaches, gastro issues, etc.)Tested for lupus. RNP was 2.5. No lupus. Rheum said restest. Thoughts?
Up back pain , thinning hair , cold hands. Ana+ spec patrn. 1;640. Cbc ok. Metabolic ok. Serum protein ok. Lupus panel negative. Rheum drs dismissed it.
ANA: Get a 2nd opinion. Maybe the doctor wasn't listening to your problem list. ...Read more
Spouse has IBS & UC. Doc ordered Prometheus panel. Expensive. Worth it?Lialda & Canasa current Meds
Yes: Another cause of similar symptoms to to irritable bowel and ulcerative colitis can be celiac disease or gluten sensitivity. The test is very accurate to rule gluten sensitivity in or out. It would be nice to know that since gluten intolerance is very treatable by dietary avoidance of gluten. ...Read more
Been ill ever since double root canal surgery developing lupus-like symptoms but saw rheum & bloodwork all completely normal+tests neg. Toxicity?
+ana1:640, intermit low wbc.Exten rheum work up all neg even during flares.Bad flares >4yrs of fatigue, arthr/myalgia, pleuritic pain, photosen rashes, sicca.Rheum tried methotrexate which stopped sx.Ctd?
Hi, i'm MTF trans and have been on HRT for 6 months, i developed tension on my shoulders and it won't go away even after massage, side effect of meds?
I am on MTX & feel like all I am doing is complaining to my Rheum about the side effects. My cheek is twitching. Is that serious enough to tell her?
Neuropathy: from Methotrexate can cause focal muscle twitching and numbness. Have your Rheumatologist check you for neuropathy or better yet have her send you to a neurologist who can perform a nerve conduction test. I recently had a patient develop polyneuropathy on MTX for Psoriatic arthritis. He was switched to Embrel (Enanercept) and the neuropathy resolved (as did his skin lesions and arthritic pain) ...Read more
My muscles have become weaker & sore over last several weeks arms & legs are tingly. Positive ana, sjog. Ssa.Rheum. Appt 3 mos away. Too long to wait?
agreed: It is important to find a rheumatologist who will see you in a timely manner. 3 months is too long to wait for this problem. ...Read more
20yr old F with thrush for the 3d time this yr. I'm been on HCQ for SLE w/o organ damage for yrs. Do I need to discuss w/ rheum stronger meds ?
Have lupus.Get on/off bad muscle pain/stiffness(legs, hips, back,arms) x1 month.My rheum said c3, c4 normal.OTC meds dont help.Do I have to live w/it?
Get second opinion: Although the normal blood tests suggest that your lupus is not active, one needs to consider other causes for your pain and thus I would suggest that you seek a 2nd opinion- perhaps an orthopedist. Having one disease does not preclude another condition. ...Read more
Who treats Fibromyalgia? Neuro? Pain Manag., Rheum? Is thier a well known "Fibro" Dr. out there somewhere? I would travel anywhere for the best!
Any of the above: Rheumatologists, neurologists, pain docs and internists all diagnose and manage fibromyalgia. We have well-established criteria for diagnosis and management of FM, but some care providers are more proficient. Call around to find out which care providers (MD/DO, PA, NP) in your area are good with managing FM, and research online who has a good reputation treating FM. Good luck! ...Read moreSee 1 more doctor answer
If you have seen a rheum dr and are ANA + 1:640 and negative for everything else. What is left to look for? Sed is elevated as well
Infex/Inflam/ca: With anas in the concentration >1:640 (high), follow up testing of dsdna, sm, rnp, ro, la and scl70 may be helpful. If no autoimmune (ai) disorder can be identified, it is important to be seen at minimally 6mo intervals, as an ai may develop (ana may be + before development of disorder). Rarely, cancer may be associated with high ana. Infections causing +ana: viruses, tb, parasites. Drugs may also. ...Read more
Had + ANA bloodtests every time, several times a year for past 7 yrs (1:160). Went to new rheum & bloodtest showed ANA negative. How? Whats this mean?
+ANA: The ANA level may fluctuate based on a number of different things. The question is why are the still testing it? Unless you have severe hair lose, a facial rash, renal or CNS disease, or joint complaints, I would not keep testing you. I would be happy to do a consult if needed. ...Read moreSee 1 more doctor answer
I heard a factiod that eye crusts (rheum) contains a small amount of urine. I am trying to verify.
Not true: I don't think this one is on snopes.Com however. ...Read more
Can fibromyalgia feel like flu? I dont have pain, just the gross flu feeling all over, i get it often. Rheum. doc thinks fibromyalgia after exams
Then it likely is...: Absolutely! Your symptoms are VERY common amongst my FBS suffers. It is a complex syndrome that likely has multiple causes with similar presentation. There are MULTIPLE treatments but you will likely only find some of them to be helpful for you. I HIGHLY recommend that you seek out a Fellowship-trained Board-Certified Pain Medicine specialist who treats a LOT of FBS suffers. Do NOT go for opioids ...Read moreSee 1 more doctor answer
Have severe muscle weakness. Rheum lab show vit d was low (16, normal is 30+) read m.S. Can be assoc. Have related symptoms. How? Which causes which?
Immunocompromised w 3.5 CM nontender lymph node upper breast & axillary node since 6/10/14. Benign mammogram. No change w/ Bactrim. US pending. CellCept (mycophenolate mofetil) withheld by rheum. Do you ever biopsy for C&S?
NO: The diagnosis of lupus or other autoimmune disorders depend on satisfying a number of criteria. Many people will have mild elevation of ANA but not meet other criteria to make a diagnosis or not have enough symptoms to warrant immunosuppressive treatment which can also be dangerous or laden with side effects. The positive ANA is not a sign of cancer. Sed rate reflects an inflammatory condition. ...Read moreSee 2 more doctor answers