Well, after two years of pain and numerous doctor visits (and being told that all my problems are mechnacial), I finally got a second opinion from a different rheumatologist. I have the kind of RA that doesn't show up in the bloodwork. My sonograms showed swelling of course, but thankfully no erosion in my hands; unfortunately there is some in my feet, but it's mild so far.
My doctor would like me to do a little research on three meds he would like to consider: methotrexate, plaquenil, and azulfidine. I know everyone's different, but I thought I would throw the question out to the community and see what experiences other people have had with these drugs.
Also, I was curious as to whether or not anyone has had any luck with a gluten free or mediteranean diet.
I'm sorry for your diagnosis, but also glad you have one so you can now move forward with treatment. I'm SO glad you found a doc who "believes" there's such a thing a sero-negative RA!
Methotrexate, placquenil and azulfidine are three of the oldest, most commonly used, first-line medications for RA treatment. They've all been around a very long time and their effects and side effects are well known and documented.
Everyone is different, so try not to be scared when you read the lists of side effects. Not everyone gets them, and if you do get any unpleasant ones, they tend to get better over time as your body adjusts.
You will probably have to eliminate all alcohol for quite some time to protect your liver while on mtx. After several rounds of blood work, you *might* be able to enjoy a very occasional glass of wine, beer, or cocktail, but with caution.
You'll be given a companion script for folic acid to go along with the mtx. It's to help with side effects like nausea and hair thinning. Drink lots of water to keep it moving through your system. Many patients take it at bedtime to sleep through the fatigue and nausea that sometimes occurs. Folic acid can be increased to deal with side effects; it's water soluble so your body eliminates what it doesn't use.
If the oral form of mtx continues to be problematic, you can switch to a self-injectible form which bypasses the digestive system. This is what I use and the shots are pretty much painless - the needles are tiny and sometimes i barely feel them.
As for diet, I know several people who have found that certain foods make their symptoms worse. I haven't noticed that diet makes much difference. Spring, fall, and stress are my major trigger.
Again, those trigger foods are different for everyone. Some have had good success going gluten free, others haven't noticed any difference, so you won't know until you try. It might be a good idea to work with a nutritionist to help you navigate through an elimination diet or transition to gluten free. Keep a food-symptom journal to see if you notice any patterns.
Best of luck, I hope you find the meds that work for you as quickly as possible!
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