RF and ANA+

Bones, joints and muscles
1

I have tested + for low levels of RF and ANA but negitive for C-reactive protiene  These are my symptoms.  I don't have a rheumitologist or other specialist.  Just wondering what I should be trying for test wise and referrals next with my GP.

pitted nails

chronic diarrhoea 

joint pain, most joints, hips, wrists, elbow, knees, shoulders, fingers, worse in the AM

weight gain

sweaty feet and hands

either too hot or too cold

dry skin

brain fog

extra weight in mid section and double chin

anxiety

pms

menorangia

heart palps

tinitis 

headaches

difficulty swallowing over a “lump” in throat

indigestion

easy bruising

Dizzy when I bend over

Wake up in the night in cold sweats

large ganglion cyst removed from wrist

ovarian cysts 

currently on cytomel 25mg, and 30mg of synthroid, but last set of labs came back wonky, TSH    A0.09   range0.32-5.04mU/L

                                      T4 Free A7.3    range10.6-19.7pmol/L

                                      T3 Free 4.16     range 3.00-5.90pmol/L

Prolactin low A    3.1    range 4.2-28.2    ug/L

AM cortisol high side of normal- 498    range 125-536    nmol/  doctor isn’t willing to test cortisol further at this time.

ANA is 1:80 speckled pattern 

RF is 12  range <12 is a flag

C Reactive Protein (High Sensitivity) 1.6

-ultrasound of thyroid showed small lump, less than 1cm, repeat after a year shows no change.

2

Your symptoms  indicate low thyroid, your test results show autoimmunity, so keep current with your doctors, may want to have x-rays of hands and wrists to see if you have erosions seen in RA.  Chin up, it's all treatable after proper diagnosis

3

But do they? The weight gain does, but the GI stuff, the hotness, and the anxiety are more like hyperthyroid. 

It's all so confusing.

What does the RF indicate? Is it too low to mean anything?  My GP said that the ANA was too low to be an issue. 

4

You could be in the early stages of "whatever" it is.  The chemistry may change in a month or so, but why wait?  Get those x-rays, because erosions can't be explained away.  There are 7 early signs of RA without even using blood work that a good doctor will see.  Google it.  Do you have a close relative with RA, early morning stiffness, swelling and stiffness in any fingers or toes, etc.  RF is Less than 1:80 (1 to 80) titer for normal, although some people who do have these conditions still have a "normal" or low RF.

Normal value ranges may vary slightly among different laboratories.

5

You need to see a rheumatologist who knows about psoriatic arthritis. CRP is often normal in people with psoriatic arthritis, even though they appear to have most of the symptoms of rheumatoid arthritis. It's every bit as bad and damaging as RA, but too few doctors know about it. Pitted nails is a big sign. Weight gain is common. Do you have relatives with psoriasis? 

6

OK, thanks. I will ask my GP for xrays. And will google the signs and see if they match up with me.

7

Interesting! OK, I will google it and ask my doctor.  What are the tests for it? 

8

No family that I know of with psoriiasis though.

 

9

I don't know for certain, but I think my grandma may have.  her toes on both feet were completely garbled, and she had a hump back.  She died when I was 7 though.  Also, my aunt had a hip replacement and always complained about stiff bones.

10

I found a check list of 9, and all but 2 seem to fit...

11

Everyone is different and if it is RA, it can be low level for many years.  In other words you can go it alone for awhile but the damage continues.  It's a good idea to be on a medication that can hinder that progression, but of course you need to be diagnosed.

12

There aren't specific blood tests so they look out for nail changes, changes in the joints closest to the ends of the fingers, eye problems, family and personal history. Unlike RA, it tends to affect the back. Treatment is more or less the same as for RA though.

13

Hi Rose

  The telltale sign for me was the hand xrays which showed erosions and the MRi confirmed it.  Basically blood tests all normal.  Main problem that I had for well over  a year was unbelievable fatigue.  I was ready to go to bed at 630pm, most  unlike me   Only had swelling in 1 finger and the doc didn't even notice the swelling/  I had to tell him that my finger never looks like that normally.   So I think the xrays are the key.  I still don't have a tremendous amt of pain (thankfully)  We are all so different.  I am in the process of getting ready to start a biologic.  

  keep reading up on the disease/  ask questions of the docs/ get those xrays and go from there.   Some  have a definite diagnosis  confirmed with blood tests but others it is not so clear

   I THINK my Aunt had RA but I am not sure/  she had terrible pain in her joints/  I don't know if it was osteoarth or RA..  I also have vitilgo and Crohn's which are both autoimmune and no one in my extended family has had those

Good luck!

 

14

Where did you have xrays?  I have pain in my hands, wrists, elbows, sholders, hips and knees. Will they xray it all?

 

15

i doubt they would xray all those joints.  My pain was in my hands and 1 finger swollen so he started with that and erosions were noted.  I have stiffness in neck/ back/ arms/ ankles at the time but I can't say it was a lot of pain--still and achy at times

 

16

OK, thanks  

 

17

Hi Rose

FYI both cytomel and synthroid are in mcg not mg...hugh difference.

You have thyroid symptoms and rheumatoid symptoms.

Perhaps you can see both an endocrinologist and a rheumatologist. You might also consider dividing your symptoms into theae two heading with a third heading for the miscellaneous symptoms, things like diarrhea, indigestion tinnitus, easy bruising.

Consider your blood pressure.. it may be dropping suddenly.

A lot if these symptoms are thyroid.

kind regards

judith