Change of med

Morag_36

Hi all, diagnosed with RA since 2017 and have mostly been in remission since with the help of methotrexate however, they now think that it may be affecting my liver so took me off it a couple months ago while liver investigation underway. Major flare up now affecting just about all joints and steroid injection didnt work. I've to start on sulfazaline next week and wondering if you think this will work as well as the methotrexate did ? Looking for some hope that there is a solution to the pain 🙄

PeterJ

Hello @Morag_36 and welcome to the community.

I understand that you have RA and been taking methotrexate but have been taken off it for other reasons and about to start on sulfasalazine.

Our website has a lot of useful information and I would suggest having a look around it. I've put a link below which might help

https://www.versusarthritis.org/about-arthritis/treatments/drugs/sulfasalazine/

Please do keep posting and I am sure that others will connect with you to share their experiences as well.

With very best wishes

Peter

Arthuritis

@Morag_36 I am so sorry to hear about your pain. The meds often produce individualised responses, I guess its down to our individual genetic make up. Biologics are the next step if sulfasalazine does not work for you, however like MTX, they have their own serious risks.

Unfortunately modern medicine is rarely about investigating underlying causes, and mainly about treating the symptoms/deficitncies.

Years ago ulcers were treated as a chronic stress induced disease with antacids and inhibitors, nobody investigated the underlying cause, until an Aussie doctor Barry Marshall thought the ulcer was the body’s response to a pathogen (stomach producing more acid in a futile attempt to try and kill the pathogen). Nobody believed him, and wondered why he was wasting time investigating the cause instead of treating the symptoms & moving to the next patient, however he proved he was right by infecting himself with what he suspected was the cause, helicobacter bacterium, developed an ulcer, and then curing himself with antibiotics. The med community finally accepted his research paper and now its taken as a given that its a pathogen to be eliminated.

Long story, but what you might want to read up on is possible environmental & diet contributors for your RA that if reduced, might alleviate your flares.

Current thinking is that genetic predisposition is often present, but does not predetermine it, additional triggers are often present that cause the immune sys to mount an inflammatory response.

While there are a few external triggers, an easy one you can do something about is avoiding anything that irritates your gut. I did do some reading around damaged gut lining causing inflammation elsewhere by letting in irritants that your immune sys reacts badly to.

In my own experience I found fasting for a day followed by adding fresh veg was a great help. Found it cleared up my inflamed sinuses for which I was taking nasal steroid spray several times a day to help with breathing - gone. Cause - gluten

I also found I was flaring a lot when I was eating a lot of fruit. Bizarre, but later found fruit contains a lot of sugar, and that was triggering it.

In short a healthy diet can only help, but a bad one def won’t.

You also need to avoid chronic stress, and get a good nights sleep or as best as you can.

I also use cold gel wraps around inflamed joints for instant relief when I have a flare.

I also found staying well hydrated helps.

Finally, losing weight helped reduce pressure on my poor joints.

A lot of different things I did to get myself to a state where I don’t wake up in agony as I did at the beginning.

Again a lot of this is being discovered by doctors who have themselves become patients, giving them a whole new perspective!

There is no single silver bullet, but I would recommend listening to youtube lectures by Prof Tim Spector of Kings College London (and ZOE fame), on just how major the impact is of the gut & diet on the immune system. He is both a doctor and genetics prof, and very good at explaining stuff.

I do hope you get relief from your pain soon.

frogmorton

Hi @Morag_36

Bless you you must be so disappointed about having to stop your MTX I have a friend in the same position at the moment. Unfortunately this can happen to some people and you need your liver.

Sulfa is another Disease modifying anti-rheumatic drug like MTX. It may suit you it may not I very much hope it does.

there are lots of DMARDs

https://www.versusarthritis.org/about-arthritis/treatments/drugs/disease-modifying-anti-rheumatic-drugs-dmards/

They will keep going for you until they find a drug which helps I have my fingers crossed that it's sulfasalazine 🤞

take care

Woofy

https://community.versusarthritis.org/discussion/55919/change-of-med

Hi. I have just been started on Sulphasalazine. But only one week in. I was on Hydroxychloraquine but that didn’t suit me.

keep me updated how you get on, I’ll do the same😊