Tips For Avoiding/Managing Rheumatoid Arthritis
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Avoiding/Managing Rheumatoid Arthritis
Arthritis is the umbrella term for a cluster of joint diseases involving inflammation of the joints, hence “arthr-” (joint) “-itis” (suffix used to denote inflammation). These are mostly, but not all, autoimmune diseases, in which the body’s immune system mistakenly attacks our own joints.
Inflammatory vs Non-Inflammatory Arthritis
Arthritis is broadly divided into inflammatory arthritis and non-inflammatory arthritis.
You may be wondering: how does one get non-inflammatory inflammation of the joints?
The answer is, in “non-inflammatory” arthritis, such as osteoarthritis, the damage comes first (by general wear-and-tear) and inflammation generally follows as part of the symptoms, rather than the cause. So the name can be a little confusing. In the case of osteo- and other “non-inflammatory” forms of arthritis, you definitely still want to keep your inflammation at bay as best you can, but it’s not as absolutely critical a deal as it is for “inflammatory” forms of arthritis.
We’ll tackle the beast that is osteoarthritis another day, however.
Today we’re going to focus on…
Rheumatoid Arthritis
This is the most common of the autoimmune forms of arthritis. Some quick facts:
- It affects a little under 1% of the global population, but the older we get, the more likely it becomes
- Early onset of rheumatoid arthritis is most likely to show up around the age of 50 (but it can show up at any age)
- However, incidence (not onset) of rheumatoid arthritis peaks in the 70s age bracket
- It is 2–4 times more common in women than in men
- Approximately one third of people stop work within two years of its onset, and this increases thereafter.
Well, that sounds gloomy.
Indeed it’s not fun. There’s a lot of stiffness and aching of joints (often with swelling too), loss of joint function can be common, and then there are knock-on effects like fatigue, weakness, and loss of appetite.
Beyond that it’s an autoimmune disorder, its cause is not known, and there is no known cure.
Is there any good news?
If you don’t have rheumatoid arthritis at the present time, you can reduce your risk factors in several ways:
- Having an anti-inflammatory diet. Get plenty of fiber, greens, and berries. Fatty fish is great too, as are oily nuts. On the other side of things, high consumption of salt, sugar, alcohol, and red meat are associated with a greater risk of developing rheumatoid arthritis.
- Not smoking. Smoking is bad for pretty much everything, including your chances of developing rheumatoid arthritis.
- Not being obese. This one may be more a matter of correlation than causation, because of the dietary factors (if one eats an anti-inflammatory diet, obesity is less likely), but the association is there.
There are other risk factors that are harder to control, such as genetics, age, sex, and having a mother who smoked.
See: Genetic and environmental risk factors for rheumatoid arthritis
What if I already have rheumatoid arthritis?
If you already have rheumatoid arthritis, it becomes a matter of symptom management.
First, reduce inflammation any (reasonable) way you can. We did a main feature on this before, so we’ll just drop that again here:
Next, consider the available medications. Your doctor may or may not have discussed all of the options with you, so be aware that there are more things available than just pain relief. To talk about them all would require a whole main feature, so instead, here’s a really well-compiled list, along with explanations about each of them, up to date as of this year:
Rheumatoid Arthritis Medication List (And What They Do, And How)
Finally, consider other lifestyle adjustments to manage your symptoms. These include:
- Exercise—gently, though! You do not want to provoke a flare-up, but you do want to maintain your mobility as best you can. There’s a use-it-or-lose-it factor here. Swimming and yoga are great options, as is tai chi. You may want to avoid exercises that involve repetitive impacts to your joints, like running.
- Rest—while keeping mobility going. Get good sleep at night (this is important), but don’t make your bed your new home, or your mobility will quickly deteriorate.
- Hot & cold—both can help, and alternating them can reduce inflammation and stiffness by improving your body’s ability to respond appropriately to these stimuli rather than getting stuck in an inappropriate-response state of inflammation.
- Mobility aids—if it helps, it helps. Maybe you only need something during a flare-up, but when that’s the case, you want to be as gentle on your body as possible while keeping moving, so if crutches, handrails etc help, then by all means get them and use them.
- Go easy on the use of braces, splints, etc—these can offer short-term relief, but at a long term cost of loss of mobility. Only you can decide where to draw the line when it comes to that trade-off.
You can also check out our previous article:
Managing Chronic Pain (Realistically!)
Take good care of yourself!
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Delicious Quinoa Avocado Bread
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They’re gluten-free, full of protein and healthy fats, generous with the fiber, easy to make, and tasty too! What’s not to love? Keep this recipe (and its ingredients) handy for next time you want healthy burger buns or similar:
You will need
- 2½ cups quinoa flour
- 2 cups almond flour (if allergic, just substitute more quinoa flour)
- 1 avocado, peeled, pitted, and mashed
- zest and juice of 1 lime
- 2 tbsp ground flaxseed
- 1 tsp baking powder
- ½ tsp MSG or 1 tsp low-sodium salt
- Optional: seeds, oats, or similar for topping the buns
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 350℉/175℃.
2) Mix the flaxseed with ⅓ cup warm water and set aside.
3) Mix, in a large bowl, the quinoa flour and almond flour with the baking powder and the MSG or salt.
4) Mix, in a separate smaller bowl, the avocado and lime.
5) Add the wet ingredients to the dry, slowly, adding an extra ½ cup water as you do, and knead into a dough.
6) Divide the dough into 4 equal portions, each shaped into a ball and then slightly flattened, to create a burger bun shape. If you’re going to add any seeds or similar as a topping, add those now.
7) Bake them in the oven (on a baking sheet lined with baking paper) for 20–25 minutes. You can check whether they’re done the same way you would a cake, by piercing them to the center with a toothpick and seeing whether it comes out clean.
8) Serve when sufficiently cooled.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Gluten: What’s The Truth?
- Why You Should Diversify Your Nuts!
- Monosodium Glutamate: Sinless Flavor-Enhancer Or Terrible Health Risk?
Take care!
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Just One Heart – by Dr. Jonathan Fisher
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First, what this is not: a book to say eat fiber, go easy on the salt, get some exercise, and so forth.
What this rather is: a book about the connection between the heart and mind; often written poetically, the simple biological reality is that our emotional state does have a genuine impact on our heart health, and as such, any effort to look after our heart (healthwise) would be incomplete without an effort to look after our heart (emotionally).
Dr. Fisher talks about the impact of stress and uncertainty, as well as peace and security, on heart health—and then, having sorted emotional states into “heart breakers” and “heart wakers”, he goes about laying out a plan for what is, emotionally and thus also physiologically, good for our heart.
Chapter by chapter, he walks us through the 7 principles to live by:
- Steadiness: how to steady your heart amid chaos
- Wisdom: how to develop a wise heart in uncertain times
- Openness: how to safely open your heart in a threatening world
- Wholeness: how to show up with your whole heart without going to pieces
- Courage: how to lead with a courageous heart when fear surrounds you
- Lightness: how to live with a light heart in a heavy world
- Warmth: how to love with a warm heart when life feels cold
The style is anything but clinical; it’s well-written, certainly, and definitely informed in part by his medical understanding of the heart, but it’s entirely the raw human element that shines throughout, and that makes the ideas a lot more tangible.
Bottom line: if you’d like your heart to be healthy (cardiac health) and your heart to be healthy (emotional health), this book is a very worthwhile read.
Click here to check out Just One Heart, and take care of yours!
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Oral retinoids can harm unborn babies. But many women taking them for acne may not be using contraception
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Oral retinoids are a type of medicine used to treat severe acne. They’re sold under the brand name Roaccutane, among others.
While oral retinoids are very effective, they can have harmful effects if taken during pregnancy. These medicines can cause miscarriages and major congenital abnormalities (harm to unborn babies) including in the brain, heart and face. At least 30% of children exposed to oral retinoids in pregnancy have severe congenital abnormalities.
Neurodevelopmental problems (in learning, reading, social skills, memory and attention) are also common.
Because of these risks, the Australasian College of Dermatologists advises oral retinoids should not be prescribed a month before or during pregnancy under any circumstances. Dermatologists are instructed to make sure a woman isn’t pregnant before starting this treatment, and discuss the risks with women of childbearing age.
But despite this, and warnings on the medicines’ packaging, pregnancies exposed to oral retinoids continue to be reported in Australia and around the world.
In a study published this month, we wanted to find out what proportion of Australian women of reproductive age were taking oral retinoids, and how many of these women were using contraception.
Our results suggest a high proportion of women are not using effective contraception while on these drugs, indicating Australia needs a strategy to reduce the risk oral retinoids pose to unborn babies.
Contraception options
Using birth control to avoid pregnancy during oral retinoid treatment is essential for women who are sexually active. Some contraception methods, however, are more reliable than others.
Long-acting-reversible contraceptives include intrauterine devices (IUDs) inserted into the womb (such as Mirena, Kyleena, or copper devices) and implants under the skin (such as Implanon). These “set and forget” methods are more than 99% effective.
Oral retinoids taken during pregnancy can cause complications in babies. Gorodenkoff/Shutterstock The effectiveness of oral contraceptive pills among “perfect” users (following the directions, with no missed or late pills) is similarly more than 99%. But in typical users, this can fall as low as 91%.
Condoms, when used as the sole method of contraception, have higher failure rates. Their effectiveness can be as low as 82% in typical users.
Oral retinoid use over time
For our study, we analysed medicine dispensing data among women aged 15–44 from Australia’s Pharmaceutical Benefit Scheme (PBS) between 2013 and 2021.
We found the dispensing rate for oral retinoids doubled from one in every 71 women in 2013, to one in every 36 in 2021. The increase occurred across all ages but was most notable in young women.
Most women were not dispensed contraception at the same time they were using the oral retinoids. To be sure we weren’t missing any contraception that was supplied before the oral retinoids, we looked back in the data. For example, for an IUD that lasts five years, we looked back five years before the oral retinoid prescription.
Our analysis showed only one in four women provided oral retinoids were dispensed contraception simultaneously. This was even lower for 15- to 19-year-olds, where only about one in eight women who filled a prescription for oral retinoids were dispensed contraception.
A recent study found 43% of Australian year 10 and 69% of year 12 students are sexually active, so we can’t assume this younger age group largely had no need for contraception.
One limitation of our study is that it may underestimate contraception coverage, because not all contraceptive options are listed on the PBS. Those options not listed include male and female sterilisation, contraceptive rings, condoms, copper IUDs, and certain oral contraceptive pills.
But even if we presume some of the women in our study were using forms of contraception not listed on the PBS, we’re still left with a significant portion without evidence of contraception.
What are the solutions?
Other countries such as the United States and countries in Europe have pregnancy prevention programs for women taking oral retinoids. These programs include contraception requirements, risk acknowledgement forms and regular pregnancy tests. Despite these programs, unintended pregnancies among women using oral retinoids still occur in these countries.
But Australia has no official strategy for preventing pregnancies exposed to oral retinoids. Currently oral retinoids are prescribed by dermatologists, and most contraception is prescribed by GPs. Women therefore need to see two different doctors, which adds costs and burden.
Preventing pregnancy during oral retinoid treatment is essential. Krakenimages.com/Shutterstock Rather than a single fix, there are likely to be multiple solutions to this problem. Some dermatologists may not feel confident discussing sex or contraception with patients, so educating dermatologists about contraception is important. Education for women is equally important.
A clinical pathway is needed for reproductive-aged women to obtain both oral retinoids and effective contraception. Options may include GPs prescribing both medications, or dermatologists only prescribing oral retinoids when there’s a contraception plan already in place.
Some women may initially not be sexually active, but change their sexual behaviour while taking oral retinoids, so constant reminders and education are likely to be required.
Further, contraception access needs to be improved in Australia. Teenagers and young women in particular face barriers to accessing contraception, including costs, stigma and lack of knowledge.
Many doctors and women are doing the right thing. But every woman should have an effective contraception plan in place well before starting oral retinoids. Only if this happens can we reduce unintended pregnancies among women taking these medicines, and thereby reduce the risk of harm to unborn babies.
Dr Laura Gerhardy from NSW Health contributed to this article.
Antonia Shand, Research Fellow, Obstetrician, University of Sydney and Natasha Nassar, Professor of Paediatric and Perinatal Epidemiology and Chair in Translational Childhood Medicine, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How To Build a Body That Lasts – by Adam Richardson
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This book is written on a premise, and that premise is: “your age doesn’t define your mobility; your mobility defines your age”.
To this end, we are treated to 328 pages of why and how to improve our mobility (mostly how; just enough on the “why” to keep the motivation flowing).
Importantly, Richardson doesn’t expect that every reader is a regular gym-bunny or about to become one, doesn’t expect you to have several times your bodyweight in iron to life at home, and doesn’t expect that you’ll be doing the vertical splits against a wall any time soon.
Rather, he expects that we’d like to not dislocate a shoulder while putting the groceries away, would like to not slip a disk while being greeted by the neighbor’s dog, and would like to not need a 7-step plan for putting our socks on.
What follows is a guide to “on the good end of normal” mobility that is sustainable for life. The idea is that you might not be winning Olympic gymnastics gold medals in your 90s, but you will be able to get in and out of a car door as comfortably as you did when you were 20, for example.
Bottom line: if you want to be a superathlete, then you might need something more than this book; if you want to be on the healthy end of average when it comes to mobility, and maintain that for the rest of your life, then this is the book for you.
Click here to check out How To Build A Body That Lasts, and build a body that lasts!
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The Science and Technology of Growing Young – by Sergey Young
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There are a lot of very optimistic works out there that promise the scientific breakthroughs that will occur very soon. Even amongst the hyperoptimistic transhumanism community, there is the joke of “where’s my flying car?” Sometimes prefaced with “Hey Ray, quick question…” as a nod to (or sometimes, direct address to) Ray Kurzweil, the Google computer scientist and futurist.
So, how does this one measure up?
Our author, Sergey Young, is not a scientist, but an investor with fingers in many pies. Specifically, pies relating to preventative medicine and longevity. Does that make him an unreliable narrator? Not necessarily, but it means we need to at least bear that context in mind.
But, also, he’s investing in those fields because he believes in them, and wants to benefit from them himself. In essense, he’s putting his money where his mouth is. But, enough about the author. What of the book?
It’s a whirlwind tour of the main areas of reseach and development, in the recent past, the present, and the near future. He talks about problems, and compelling solutions to problems.
If the book has a weak point, it’s that it doesn’t really talk about the problems to those solutions—that is, what can still go wrong. He’s excited about what we can do, and it’s somebody else’s job to worry about pitfalls along the way.
As to the “and what you can do now?” We’ll summarize:
- Mediterranean diet, mostly plant-based
- Get moderate exercise daily
- Get good sleep
- Don’t drink or smoke
- Get your personal health genomics data
- Get regular medical check-ups
- Look after your mental health too
Bottom line: this is a great primer on the various avenues of current anti-aging research and development, with discussion ranging from the the technological to the sociological. It has some health tips too, but the real meat of the work is the insight into the workings of the longevity industry.
Don’t Forget…
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How To Avoid Age-Related Macular Degeneration
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Avoiding Age-Related Macular Degeneration
Eye problems can strike at any age, but as we get older, it becomes a lot more likely. In particular, age-related macular degeneration is, as the name suggests, an age-bound disease.
Is there no escaping it, then?
The risk factors for age-related macular degeneration are as follows:
- Being over the age of 55 (can’t do much about this one)
- Being over the age of 65 (risk climbs sharply now)
- Having a genetic predisposition (can’t do much about this one)
- Having high cholesterol (this one we can tackle)
- Having cardiovascular disease (this one we can tackle)
- Smoking (so, just don’t)
Genes predispose; they don’t predetermine. Or to put it another way: genes load the gun, but lifestyle pulls the trigger.
Preventative interventions against age-related macular degeneration
Prevention is better than a cure in general, and this especially goes for things like age-related macular degeneration, because the most common form of it has no known cure.
So first, look after your heart (because your heart feeds your eyes).
See also: The Mediterranean Diet
Next, eat to feed your eyes specifically. There’s a lot of research to show that lutein helps avoid age-related diseases in the eyes and the rest of the brain, too:
See also: Brain Food? The Eyes Have It
Do supplements help?
They can! There was a multiple-part landmark study by the National Eye Institute, a formula was developed that reduced the 5-year risk of intermediate disease progressing to late disease by 25–30%. It also reduced the risk of vision loss by 19%.
You can read about both parts of the study here:
Age-Related Eye Disease Studies (AREDS/AREDS2): major findings
As you can see, an improvement was made between the initial study and the second one, by replacing beta-carotene with lutein and zeaxanthin.
The AREDS2 formula contains:
- 500 mg vitamin C
- 180 mg vitamin E
- 80 mg zinc
- 10 mg lutein
- 2 mg copper
You can learn more about these supplements, and where to get them, here on the NEI’s corner of the official NIH website:
AREDS 2 Supplements for Age-Related Macular Degeneration
Take care of yourself!
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