Rheumatoid arthritis (RA) - diagnosis and treatment

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In some ways the body is not very clever. The immune system can only react in one way, that is with inflammation. Nearly always this inflammation is helpful. But sometimes it is unhelpful; indeed, positively destructive. This is the case with Rheumatoid Arthritis (RA). RA is a "useless" inflammation of joints - see Inflammation

Possible causes

  1. Rheumatoid arthritis could be a classic example of a lectin disease - see Lectins - Natural Toxins found in some grains and some vegetables Lectins are natural toxins within plants to try to make them poisonous - this prevents animals from eating them. Because humans have got such a good digestive and detox system they can eat a wide range of plants. However if this fails then lectins can become a clinical problem. They are found in the highest amounts in wheat, potato, tomato and pulses.
  2. Another possibility is that RA is an example of molecular mimicry (see Ankylosing spondylitis for the 'classic' molecular mimicry example). With RA there is a cross-reaction between proteus mirabilis (a common cause of urinary infections) and the joints. This explains why RA is more common in women because urinary infections are more common in women. This would be a good reason to try high dose probiotics (see Probiotics - we should all be taking these all the time and double the dose following antibiotics and gastroenteritis ) to try to change the gut flora since proteus mirabilis is not a normal part of the gut flora. See also Worldwide Links between Proteus mirabilis and Rheumatoid Arthritis and Rheumatoid arthritis is caused by a Proteus urinary tract infection

ASIDE - Molecular Mimicry - The idea here is that the immune system reacts to an antigen, such as a food or microbe, in the gut. Through pure chance this antigen is the same shape as a cell type in the body. Autoimmunity is switched on because the body ‘sees’ the cell type as an antigen.

Clinical picture

  • The joints show signs of inflammation: heat, pain, swelling, redness and loss of function.
  • Hands and wrists commonly affected, then feet, knees and ankles, but can be any joint.
  • It is the proximal metacarpal joints and the metacarpo-phalangeal joints (DIPs and MCPs) often affected - the former result in fusiform swellling, the latter in lateral dislocation of the joints.
  • Both sides often equally affected - this is a symmetrical arthritis.
  • Often there is joint and muscle stiffness which is worse in the morning and improves as the day progresses. Patients will tell me they have to "warm up" in the mornings, sometimes need a hot bath to get going but by the end of the day are moving better.
  • Often patients do not feel well.
  • Blood tests usually show signs of inflammation (ESR, plasma viscosity, C reactive protein) are raised.
  • Blood tests are positive for rheumatoid factors.
  • Associated with a tissue type HLA D4 and HLA DR4 - see Association of MHC and rheumatoid arthritis: Association of RA with HLA-DR4 - the role of repertoire selection and HLA-Disease Associations in Rheumatoid Arthritis
  • Later on there are characteristic X ray changes.
  • Later on there are characteristic joint changes.


So my treatment for rheumatoid arthritis would be to start with Arthritis - Nutritional treatments and The general approach to maintaining and restoring good health.

I would also use bolt on extras as per the Inflammation.

All my RA patients must do a The Paleo Ketogenic Diet - this is a diet which we all should follow
Please see also

But I have a low threshold for starting enzyme potentiated desensitisation (EPD) because of delayed reactions, multiple reactions and the possibility of bacterial allergy being a problem. See Enzyme Potentiated Desensitisation (EPD)

Physiotherapy is very important to keep joints mobile and keep muscles as strong as possible. Muscle wasting is a real problem in RA. Because exercise is painful many sufferers do no exercise, but 12 minutes a week is possible for all and highly beneficial See Exercise.


These are largely preventable with good nutrition:

RA patients can get complications involving the heart, lungs, arteries, eyes etc., which is why specialist treatment should always be sought.

Useful websites

This website which looks at treating inflammatory arthritis with antibiotics. This makes sense if the cause is molecular mimicry. See ROAD BACK FOUNDATION.

This website looks at all forms of arthritis, some available treatments, advice for self-help etc. Have a look at THE ARTHRITIS AND GLUCOSAMINE INFORMATION CENTRE.

Related Articles

External Links


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