Rheumatoid Arthritis Disease

A. What is Rheumatoid Arthritis?



There are over 100 types of arthritis, rheumatic diseases and related conditions. The two most common types of arthritis areosteoarthritis and rheumatoid arthritis. It is a chronic disease, in which various joints in the body are inflamed, leading to swelling, pain, stiffness, and the possible loss of function. The joint inflammation begins in the synovium. Continuous inflammation of the synovium slowly destroys the cartilage, narrowing the joint space and eventually damaging bone.

B. The Diagnosis of Rheumatoid Arthritis

1. Morning stiffness, lasting for at least an hour, present daily for at least 6 weeks.
2. Arthritis of 3 or more joints, lasting for at least 6 weeks.
3. Arthritis of the hand joints, lasting for at least 6 weeks.
4. Symmetric arthritis, lasting for at least 6 weeks.
5. Rheumatoid nodules.
6. Positive rheumatoid factor (blood test).
7. Joint changes on x-ray.
   

C. The Treatment of Rheumatoid Arthritis

Treatment of rheumatoid arthritis focuses on relieving pain, reducing inflammation, slowing or stopping joint damage, and improving the person's sense of well-being and ability to function. A combination of treatments is almost always used.

1. Rest and exercise: Both rest and exercise help in important ways. People with rheumatoid arthritis need a good balance between the two, with more rest when the disease is active and more exercise when it is not. A physical therapist is useful in instructing the person with arthritis how to exercise without further damaging the joints.
   
2. Joint protection: Splints, braces and supports can protect the joints and help prevent further damage. A doctor or a physical or occupational therapist can help get a splint and ensure that it fits properly. Other ways to reduce stress on joints include self-help devices, devices to help with getting on and off chairs, toilet seats, and beds; and changes in the ways that a person carries out daily activities.
   
3. Diet: However some people are able to lessen their symptoms by a change in diet. The best diet plan for a person with RA is simply a healthy balanced diet. Eat 1 to 1.2 grams of protein per kilogram of body weight . The most commonly reported triggers of symptoms are dairy protein, corn, wheat, citrus fruits, eggs, red meat, sugar, fats, salt, caffeine, and nightshade plants like potatoes and eggplant. 200 kcal/day fasts consisting of fruit and vegetable juices showed some short-term improvement in symptoms. The vegetarian diet positively influenced measures of inflammation and disease activity.
4. Weight Control
   
5. Effects of Long Chain Fatty Acids. The types and amounts of fatty acids in the diet affect prostaglandin metabolism and a change in prostaglandin concentrations can effect the body's immune responses. A diet high in polyunsaturated fat and low in saturated fat with a daily supplement of eicosapentaenoic acid allowed for decreased morning stiffness and fewer tender joints, with symptoms returning after discontinuation of the diet. Daily supplementation with 18 g of fish oil has also led to an improvement in tender joint score and grip strength when compared to an olive oil supplement (20). As noted by Davis (21) vegetarians can improve their omega-3 intake with the use of flax seed and other plant foods.
6. Medications: NSAIDS (Nonsteroidal anti-inflammatory drugs) are commonly used to treat rheumatoid arthritis. Available over the counter or by prescription, they fight inflammation or swelling and relieve pain. NSAIDS are usually the first drug prescribed to a person newly diagnosed with rheumatoid arthritis. NSAIDS may relieve pain and swelling, but they do not slow the disease process. DMARDS (disease modifying anti-rheumatic drugs) are also known as SAARDS (slow acting anti rheumatic drugs. As their name might suggest these medications take some time to be effective, up to several months. Most of them were originally invented to treat other diseases but were noted to have a positive effect on rheumatoid arthritis. Most of them do not have any common properties other than their ability to slow down the progression of the disease. The most common DMARDS used include methotrexate, hydroxychloroquine, sulfasalazine, gold and leflunomide (Arava). Another new treatment is a device called the Prosorba column. It mechanically removes inflammatory antibodies from the blood. The blood is first removed from the body through a catheter (a process called apheresis) and then passes through a column coated with a substance called protein A, which binds to the antibodies. The blood is then returned to the patient.Oral corticodsteroid, such as prednisolone and prednisone (Deltasone, Orasone) usually work quickly to control inflammation. Corticosteroids can also be injected directly into the joint for relief of inflammation limited to one particular joint. Recent studies have shown the antibiotics in the tetracycline family to have a positive impact on the progression of rheumatoid arthritis. Topical pain-relieving creams,rubs, and sprays can be applied directly to the skin for temporary relief. There are many brands available over the counter.
7. Traditional Therapy. Traditionally, Rheumatoid Arthritis therapy has involved an approach in which doctors prescribed aspirin or similar drugs, rest, and physical therapy first, and prescribed more powerful drugs later only if the disease became much worse.
8. Surgery: Several types of surgery are available to patients with severe joint damage. These procedures can help reduce pain, improve the affected joint's function and appearance, and improve the patient's ability to perform daily activities. Surgical procedures include joint replacement, tendon reconstruction, and synovectomy.

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OSTEOARTHRITIS DISEASE AND DIET

Osteoarthritis is caused by the breakdown of cartilage in one or more joints. Cartilage is a protein substance that serves as a "cushion" between the bones of the joints. Cartilage is composed of 65 to 80 percent water, collagen (fibrous proteins), (proteins and sugars which interweave with collagen), and chondrocytes (cells that produce cartilage).



Healthy cartilage allows bones to glide over one another. In osteoarthritis, the surface layer of cartilage breaks down and wears away. This allows bones under the cartilage to rub together, causing pain, swelling, and loss of motion of the joint. Over time, the joint may lose its normal shape. Also, bone spurs - small growths called osteophytes- may grow on the edges of the joint. Bits of bone or cartilage can break off and float inside the joint space. This causes more pain and damage.

Now you can be a confident expert on osteoarthritis . OK, maybe not an expert. But you should have something to bring to the table next time you join a discussion on osteoarthritis .

Osteoarthritis is also known as degenerative joint disease, wear-and-tear arthritis, and osteoarthrosis. Osteoarthritis most often occurs at the ends of the fingers, thumbs, neck, lower back, knees, hips feet, and spine.
Among the over 100 different types of arthritis conditions.

Osteoarthritis Symptoms
By : Mayo Clinic Staff

Osteoarthritis symptoms often develop slowly and worsen over time. Signs and symptoms of osteoarthritis include:

* Pain. Your joint may hurt during or after movement.
* Tenderness. Your joint may feel tender when you apply light pressure to it.
* Stiffness. Joint stiffness may be most noticeable when you wake up in the morning or after a period of inactivity.
* Loss of flexibility. You may not be able to move your joint through its full range of motion.
* Grating sensation. You may hear or feel a grating sensation when you use the joint.
* Bone spurs. These extra bits of bone, which feel like hard lumps, may form around the affected joint. Specific joints are affected:

• Fingers: Bone enlargements in the fingertips (first joint) are common. These are called Heberden nodes. They are usually not painful. Sometimes they can develop suddenly and are painful, swollen, and red. This is known as nodal osteoarthritis and occurs in women older than 45 years.
• Hip: The hips are major weight-bearing joints. Involvement of the hips may be seen more in men. Farmers, construction workers, and firefighters have been found to have an increased incidence of hip osteoarthritis. Researchers think that a heavy physical workload contributes to OA of the hip and knee.
• Knees: The knees are also major weight-bearing joints. Repetitive squatting and kneeling may promote osteoarthritis.
• Spine: Osteoarthritis of the spine can cause bone spurs or osteophytes, which can pinch or crowd nerves and cause pain and potentially weakness in the arms or legs.
• Pain with no benefit from common pain relievers.
• Confusion regarding the diagnosis (Osteoarthritis can be confused with rheumatoid arthritis.)
• Disability or loss of mobility, especially if sudden
  
  

When to see a doctor

If you have swelling or stiffness in your joints that lasts for more than two weeks, make an appointment with your doctor. If you're already taking medication for osteoarthritis, contact your doctor if you experience side effects such as:

* Nausea
* Abdominal discomfort
* Black or tarry stools
* Constipation
* Drowsiness

What Causes of Osteoarthrotis?
By: emedicine heallth

Osteoarthritis occurs when the cartilage that cushions the ends of bones in your joints deteriorates over time. The smooth surface of the cartilage becomes rough, causing irritation. Eventually, if the cartilage wears down completely, you may be left with bone rubbing on bone — causing the ends of your bones to become damaged and your joints to become painful.

It isn't clear what causes osteoarthritis in most cases. Researchers suspect that it's a combination of factors, including:

* The aging process

* Joint injury or stress

* Heredity

* Muscle weakness

* Endocrine: People with diabetes may be prone to osteoarthritis. Other endocrine problems also may promote development, including acromegaly, hypothyroidism, hyperparathyroidism, and obesity.

* Posttraumatic: Traumatic causes can be further divided into macrotrauma or microtrauma. An example of macrotrauma is an injury to the joint such as a bone break causing the bones to line up improperly (malalignment), lose stability, or damage cartilage. Microtrauma may occur over time (chronically). An example of this would be repetitive movements or the overuse noted in several occupations.

* Inflammatory joint diseases: This category would include infected joints, chronic gouty arthritis, and rheumatoid disease.

* Metabolic: Diseases causing errors of metabolism may cause osteoarthritis. Examples include Paget disease and Wilson disease.

* Congenital or developmental: Abnormal anatomy such as unequal leg length may be a cause of osteoarthritis.

* Genetic: A genetic defect may promote breakdown of the protective architecture of cartilage. Examples include collagen disturbances such as Ehlers-Danlos syndrome.

* Neuropathic: Diseases such as diabetes can cause nerve problems. The loss of sensation may affect how the body knows the position and condition of the joints or limbs. In other words, the body can't tell when it is injured.

* Other: Nutritional problems may cause osteoarthritis. Other diseases such as hemophilia and sickle cell are further examples.


What is Osteoathritis Treatment ?

1. Keep your body weight at Ideal body weight.
2. Avoid food that are high in fat, high in sugar, high protein.
   
3. Drink at least 8 glasses of filtered water a day.
4. NO alcohol, NO tobacco, NO Dairy Products.
5. Spinach, cranberries, plums, buckwheat, nuts, is High In Oxalic Acid Antioxidant.
6. Diet : Vitamins C and E may provide some protection. Vitamin D and Calcium are recommended for strong bones. The recommended daily dose of Calcium is 1000-1200 mg. The current guideline for Vitamin D is 400 per day. Avoid more than 1200 IU of vitamin D per day. Calcium; vitamin D is also used to prevent osteoporosis.
7. Exercise is helpful in osteoarthritis in several ways. Swimming, walking, running , cycling, aerobic, strengthening . Regular exercise may help to strengthen the muscles and potentially stimulate cartilage growth. Avoid high-impact sports.
8. Assistive devices or Orthoses . These assistive devices are used to improve function of moveable parts of the body or to support, align, prevent, or correct deformities. Splints or braces help with joint alignment and weight redistribution. Other examples include walkers, crutches or canes, and orthopedic footwear.
9. Acupuncture.
10. Supplement : evening primrose oil, ginger, niacin, omega-3 fatty acids, fish oil, alpha- acid, glucosamine and chondroitin sulfate. Chondroitin and glucosamine are dietary supplements used together to help ease the symptoms of osteoarthritis.
11. Heat: Hot soaks and warm wax (paraffin) application may relieve pain.

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Thyroid Disease

The following paragraphs summarize the work of thyroid disease diet experts who are completely familiar with all the aspects of thyroid disease diet. Heed their advice to avoid any thyroid disease diet surprises.



If your thyroid disease diet facts are out-of-date, how will that affect your actions and decisions? Make certain you don't let important thyroid disease diet information slip by you.

What is the Thyroid? The thyroid is a small gland, shaped like a butterfly, located in the lower part of your neck. The function of a gland is to secrete hormones. The main hormones released by the thyroid are triiodothyronine, abbreviated as T3, and thyroxine, abbreviated as T4. These thyroid hormones deliver energy to cells of the body.

When word gets around about your command of thyroid disease diet facts, others who need to know about thyroid disease diet will start to actively seek you out.

What Diseases and Conditions Affect the Thyroid?

The most common problems that develop in the thyroid include:

1. Hypothyroidism -- An underactive thyroid.



Hypothyroidism means a reduced level of thyroid hormone (thyroxine). This can cause various symptoms, the most common being: tiredness, weight gain, constipation, aches, dry skin, lifeless hair and feeling cold.

Treatment is usually easy by taking a tablet each day to replace the missing thyroxine. Treatment usually works well and symptoms usually go. Hypothyroidism means a reduced level of thyroid hormone (thyroxine). This can cause various symptoms, the most common being: tiredness, weight gain, constipation, aches, dry skin, lifeless hair and feeling cold. Treatment is usually easy by taking a tablet each day to replace the missing thyroxine. Treatment usually works well and symptoms usually go.

2. Hyperthyroidism -- An overactive thyroid.




Hyperthyroidism means having an overactive thyroid gland. It results in an excess of the thyroid hormones, making the body's functions "speed up" and causing symptoms such as restlessness, anxiety and weight loss. Hyperthyroidism means having an overactive thyroid gland. It results in an excess of the thyroid hormones, making the body's functions "speed up" and causing symptoms such as restlessness, anxiety and weight loss.

Hyperthyroidism, over-production of T3 and T4 can cause the body's metabolism to speed up resulting in characteristic symptoms.

The thyroid hormones are thyroxine (also called T4 because it contains four iodine atoms) and triiodothyronine (also called T3 because it contains three iodine atoms). These are released into the blood stream.

3. Goiter -- An enlarged thyroid.



Smoking may increase your risk of developing an enlarged thyroid gland, known as a goiter, in areas that suffer iodine deficiency.

Cigarette smoke contains thiocyanate, a chemical that can interfere with the thyroid's ability to use iodine. In the research, Danish experts studied adults with some iodine deficiency, and discovered that smokers were almost three times more likely than nonsmokers to have a goiter.

4. Thyroid Nodules -- Lumps in the thyroid gland.



Thyroid nodules are very common. A nodule is a swelling or lump, which can be a solid or liquid filled cyst or mass. Most are benign, but a small percentage can be cancerous. So you should always have a nodule evaluated by your physician as soon as you notice it. Symptoms of a nodule can be varied.

Some people have hyperthyroidism symptoms -- such as palpitations, insomnia, weight loss, anxiety, and tremors -- and others have hypothyroidism symptoms -- weight gain, fatigue, depression. Some will cycle back and forth between hyperthyroid and hypothyroid symptoms. Some people mainly have difficulty swallowing, a feeling of fullness, pain or pressure in the neck, a hoarse voice, or neck tenderness. And finally, many people have nodules wiht no obvious symptoms related to thyroid dysfunction at all.

5. Thyroid Cancer -- Malignant thyroid nodules or tissue.

Although there are several types of thyroid cancer the vast majority are papillary, follicular, or a mixture of these two types of cancer. This cancer is extremely slow growing compared with most other cancers; therefore, it offers a very excellent chance of cure. So good was the "cure rate" that for many years it was not felt necessary to follow patients after their surgery: "The patient with thyroid cancer will generally outlive his surgeon".



Thyroid cancers represent approximately 2% of clinically detected malignancies. The most common tumor types, arising from follicular epithelium (i.e., papillary, follicular, and Hürthle cell cancers), occur three times more often in women and increase in incidence with age. Medullary thyroid cancer arising from parafollicular C cells represents less than 10% of all thyroid cancers but has special importance because of its common familial occurrence.

Thyroid tissue (both normal tissue and cancerous tissue) produces a protein called thyroglobulin which is measured by performing a blood test

A rare type of thyroid cancer (medullary cancer) produces a hormone called calcitonin. Medullary cancer is more malignant than papillary or follicular cancer just described.

A fourth type of thyroid cancer called anaplastic cancer is very malignant, but it is less common than the other types and occurs primarily in elderly people.

6. Thyroiditis -- Inflammation of the thyroid.

Thyroiditis is an inflammation (not an infection) of the thyroid gland. Several types of thyroiditis exist and the treatment is different for each.

The three types of thyroiditis are: Hashimoto's thyroiditis (autoimmune thyroiditis), subacute painful thyroiditis (granulomatous thyroiditis), and subacute painless thyroiditis (silent lymphocytic thyroiditis, postpartum thyroiditis).

- Hashimoto's Thyroiditis: Hashimoto's thyroiditis is the most common type of thyroiditis and the most common cause of hypothyroidism.

Hashimoto’s disease is a member of the family of “auto-immune” diseases such as Rheumatoid arthritis.

- Subacute painful thyroiditis, which is probably caused by a virus, usually begins suddenly. In this disorder, inflammation causes the thyroid gland to release excessive amounts of thyroid hormones, resulting in hyperthyroidism, almost always followed by transient hypothyroidism and finally normal thyroid function.

Subacute painful thyroiditis often follows a viral illness and begins with what many people call a sore throat but actually proves to be neck pain localized to the thyroid. Many people with subacute painful thyroiditis feel extremely tired. The thyroid gland becomes increasingly tender, and the person usually develops a low-grade fever (99 to 101° F). The pain may shift from one side of the neck to the other, spread to the jaw and ears, and hurt more when the head is turned or when the person swallows. Subacute painful thyroiditis is often mistaken at first for a dental problem or a throat or ear infection.

- Subacute painless thyroiditis occurs most often among women, typically just after childbirth, and causes the thyroid to become enlarged without becoming tender. The disorder recurs with each subsequent pregnancy. For several weeks to several months, a person with subacute painless thyroiditis has hyperthyroidism followed by hypothyroidism before eventually recovering normal thyroid function.

Thyroid Diet

The Thyroid Diet will help many previously unsuccessful dieters get diagnosed and treated and proper thyroid treatment may be all that’s needed for you to successfully lose weight.

The Thyroid Diet discusses optimal dietary changes, including how a thyroid sufferer should focus on a low-glycemic, high-fiber, lower-calorie diet, optimal timing of meals for maximum hormonal impact, thyroid-damaging foods to avoid, helpful herbs and supplements, and more.

Getting a good amount of fiber is one of the basic tactics that most thyroid need to follow in order to lose weight. Fiber has so many benefits for hypothyroid people trying to lose weight. With slowed digestion, and sometimes even constipation as a result, fiber can help promote regularity. Fiber also slows the digestive process, and can help prevent dramatic swings in blood sugar. Fiber can help lower cholesterol. And, fiber can help you lose weight, because it fills you up, and may reduce your hunger levels. With 17 grams of fiber in each serving, this is the most fiber-intense drink mix you can find. With 0 calories, but packed with nutrition, it's a really excellent way to go high-fiber as part of your weight-loss effort.

In a study reported on in the American Journal of Clinical Nutrition, it was found that green tea extract resulted in a significant increase in energy expenditure (a measure of metabolism), plus also had a significant effect on fat oxidation. While some of the effects were originally theorized to be due to the caffeine content of green tea, the researchers discovered that the tea actually has properties that go beyond those that would be explained by the caffeine. Moss also feels that green tea may be a good choice for thyroid patients because, unlike caffeine, " green tea has the potential to accelerate metabolism -- which can help weight loss slightly -- without overstimulating your adrenal glands."And even a small effect can go a long way, when you are dealing with a metabolism that may not rebound entirely, despite hypothyroidism treatment.

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