Seronegative rheumatoid arthritis

Hello! I was recently diagnosed with seronegative rheumatoid arthritis. I was prescribed sulfasalazine but have yet to start the medication. I am not one to take medicine and the thought of having to take something with side effects everyday scares me. Is sulfasalazine safe? Are there any holistic approaches I can try first?


  • I’ve been on Sulfasalazine for over 6 months now. No side effects so far!

  • helpline_team
    helpline_team Posts: 3,420
    edited 20. Feb 2023, 11:33


    Thanks for your post to the Helpline. When you are diagnosed with Rheumatoid Arthritis (RA) it shows that your immune system has a problem and is attacking healthy parts of your body - such as joints. The immune system raises inflammatory levels in the bloodstream if not controlled. The inflammation can have other health effects, so when Rheumatology prescribe a medication it's role is to improve your overall health and the balance of risks and benefits need to be weighed against the known risks of inflammation driven by the immune system.

    Not wanting to rush into decisions over taking drug treatments is understandable. A really supportive part of the Online Community is the Living with arthritis forum, where you can hear the experiences of many other people and share support together.

    Sulfasalazine is well known drug and there is monitoring in place to ensure you tolerate it, and discuss report any side effects. This approach relies on a partnership between you and your medical team. If you need further medical advice do speak to the Rheumatology Nurses.

    Research into the management of Rheumatoid Arthritis shows there is evidence to show that following a Mediterranean style of diet (rich in fruit and vegetables, low in red meat) and keeping body weight down (to the levels recommended by the NHS) are both helpful approaches. But these are only in the context of supporting a drug treatment - rather than replacing it.

    Sulfasalazine | Side-effects, uses, time to work (

    Rheumatoid arthritis | Causes, symptoms, treatments (

    All the best

    Guy - Helpline Team

  • jamieA
    jamieA Member Posts: 664

    Hi @hnjames1985

    I've been on the maximum dosage of sulfasalazine since October 2020 when I was diagnosed with psoriatic arthritis. I haven't had any side effects I know of other than orange urine. Unfortunately it didn't work on it's own for me and so methotrexate and then a biologic were added. I'm still on it as the rheumatologists tell me the drugs work together to provide a better outcome.

    Like you prior to being diagnosed with PsA I was always wary of taking medication - and always read the accompanying data sheet. I suppose it's really a balancing act - the effects of inflammatory arthritis may well greatly outweigh the side effect of a drug. In the same way as the data sheet for a drug you can look up a list of untreated inflammatory arthritis side effects and that's probably far more scary.