6 Things You Might Not Know About Rheumatoid Arthritis

If you or someone you care about has rheumatoid arthritis (RA), you probably already know a lot about the disease, such as that it's a chronic disease that causes joint inflammation and discomfort, and that it affects three to four times more women than men. But because RA is still a mystery—the specific etiology is unknown, as is why it affects women more (though hypotheses point to hormonal and immune system abnormalities), experts are constantly revealing new findings. The following are ten startling facts and potential theories concerning RA that you should be aware of.

1. Rheumatoid arthritis is not just a joint disease 

This is arguably the most significant distinction between how rheumatologists and others understand RA. Most people think of RA as an arthritic illness that also causes heart and lung difficulties, among other things. However, RA causes the immune system to target practically every area of the body, including the heart, lungs, eyes, skin, liver, kidneys, and other organs, and that it manifests differently in different people. It's possible that our genetics play a role in how the disease manifests itself, but it's still a topic that is still under investigation.

2. RA blood tests are not 100% reliable 

Higher levels of specific antibodies, such as rheumatoid factor (RF) and anti-cyclic citrullinated peptides (anti-CCP), are one symptom of RA, indicating that the immune system is working overtime. However, because RF and anti-CCP blood tests aren't very sensitive, they don't identify antibodies when levels are low. Anti-CCP has a sensitivity of only 60%, which indicates that 40% of RA patients will receive a negative result. Rheumatoid factor is even less reliable: it's positive in only 40% of patients with early rheumatoid arthritis. People with negative tests, called seronegative RA, still have RA and need the same treatment as those with a positive test. Seronegative RA is less aggressive than seropositive RA, although it can nonetheless cause the same complications.

3. There is a connection between RA and gum disease 

When experts identified a link between rheumatoid arthritis and gum disease, they suspected it was due to oral bacteria. The link was recently validated by Johns Hopkins University researchers, who identified that one oral bacteria in particular—Aggregatibacter actinomycetemcomitans—triggered an overproduction of antibodies that produce inflammation and target joints in RA patients. However, because this can lead to gum disease, it's also plausible that RA is to blame for the gum disease. Although there is a link between gum disease and overall health, our understanding of human bacteria and its relationship to diseases is still in its infancy.

4. RA is also linked to urinary tract infections 

There's a decent probability that experiencing more than your fair number of UTIs in the years preceding up to your RA diagnosis wasn't a coincidence. In the six years leading up to their diagnosis, RA patients had considerably more urinary tract, vaginal, and general viral and bacterial infections, according to a study published in Rheumatic & Musculoskeletal Diseases. Though additional research is needed, researchers believe that repeated infections may act as a warning indicator of the onset of RA.

5. Pregnancy RA remission led to a breakthrough 

Many women's RA symptoms improve during pregnancy, as you've probably heard. In fact, according to a study published in Open Access Rheumatology, up to 40% of pregnant women may achieve remission. But did you know that this pattern led to the development of a new RA treatment? When a rheumatologist at Mayo Clinic noticed that pregnant women with RA were getting better, he assumed it must be something they generated and identified it as cortisol. During pregnancy, women's levels of cortisol, a steroid hormone, rise dramatically. Prednisone became a treatment for RA as a result of this.

6. Giving birth can provoke RA onset 

While pregnancy may provide some protection for those who already have RA, it can sadly also trigger the disease in others. Within the first year of pregnancy, there is a 20-fold increase in the risk of getting rheumatoid arthritis, according to a study. Female hormonal influences are a leading possibility, but scientific evidence is inconclusive. According to the argument, these women were predisposed to rheumatoid arthritis and would have developed it regardless, but the effects of pregnancy accelerated the onset.