Rheumatoid Arthritis Weight Loss

Several readers have asked me Rheumatoid Arthritis weight loss questions. Is this confusing? Weight loss is actually a symptom of Rheumatoid Arthritis. There are several reasons. There is the typical appetite loss of RA, the anemia, and the fever that accompany RA. Also, methotrexate and other RA medicines can interfere with food absorption.

 

Rheumatoid Arthritis, weight loss, and confusion

RA patients with severe disease have historically been known to suffer malnutrition. “The increased catabolism raises resting energy expenditure, which leads to weight loss and reduced lean body mass, especially if energy and protein requirements are not met.  This phenomenon is recognized as ‘rheumatoid cachexia’,” Cambridge Journal article. Some studies showed a majority of RA’ers were malnourished.

However, weight gain can still be problem for many living with Rheumatoid Arthritis. Several facts of life with RA can lead to weight gain for many RA’ers. RA patients usually get less exercise, but what else is going on?

Things that necessitate Rheumatoid Arthritis weight loss

  • Prednisone tends to make you gain weight.
  • Muscle mass, which burns more calories, is lost with lowered activity level due to pain.
  • It’s difficult to prepare healthy food when you are disabled. RA’ers may rely on convenience foods.
  • RA’ers usually give up smoking and alcohol, which means weight gain for some.

RA Weight Loss strategies: What can be done?herb tea3

  • If you are well enough at times to do it, exercise. More on RA exercise.
  • Eat frequent small meals to keep your metabolism up. More RA diet tips.
  • Eat plenty of protein to sustain muscle tissue.
  • Tell your doctor you want to include weight considerations in medicine decisions.
  • Get family members to help you get the healthiest options. For example: To bring you a roasted chicken instead of fried chicken when bringing a meal or gourmet tea instead of a latte.
  • Avoid empty calories. Spend them on things that could improve your health. More RA food strategies.
  • Keep close tabs on thyroid levels. Being a middle aged woman & an RA patient are both risk factors for low thyroid, which causes weight gain.

Your turn. Tell us your best tip to maintain a healthy weight with RA!

You might also read:

Kelly Young

Kelly Young is an advocate providing ways for patients to be better informed and have a greater voice in their healthcare. She is the president of the Rheumatoid Patient Foundation. Kelly received national acknowledgement with the 2011 WebMD Health Hero award. Through her writing, speaking, and use of social media, she is building a more accurate awareness of Rheumatoid disease aka Rheumatoid Arthritis (RA) geared toward the public and medical community; creating ways to empower patients to advocate for improved diagnosis and treatment; and bringing recognition and visibility to the Rheumatoid patient journey. In 2009, Kelly created Rheumatoid Arthritis Warrior, a comprehensive website about RA of about 950 pages and writes periodically for other newsletters and websites. Kelly served on the Mayo Clinic Center for Social Media Advisory Board. There are over 42,000 connections of her highly interactive Facebook Fan page. She created the hashtag: #rheum. Kelly is the mother of five, a home-schooler, Bible teacher, NASA enthusiast, and NFL fan. You can also connect with Kelly by on Twitter or YouTube, or LinkedIn. She has lived over nine years with unrelenting Rheumatoid disease. See also http://www.rawarrior.com/kelly-young-press/

48 thoughts on “Rheumatoid Arthritis Weight Loss

  • March 4, 2010 at 8:49 am
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    thank you,,,, weight loss has been a problem for me, i appreaciate this information

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  • March 4, 2010 at 9:26 am
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    When I was first diagnosed I had lost a lot of weight, was anemic, low grade fever and had zero energy. My weight gain after that was due to many of the medications I took to treat the depression, prednisone, and the meds for sleep. I’m now on Wellbutrin (my dr. says this is the only antidepressant that doesn’t cause weight gain) and take Ambien for sleep. Due to the lack of energy I don’t exercise as much and am not as active so my weight remains an issue. I’m not over weight but have to watch what I eat, etc.

    Reply
    • March 4, 2010 at 7:06 pm
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      Doesn’t seem fair. Seems like it goes from one extreme to the other through no fault of our own.

      Reply
  • March 4, 2010 at 11:47 am
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    Kelly,
    Right now, I seem to have issues with my appetit. I believe it is a combo of the RA disease activity and the meds. I still take my Mtx in pill form. I also have hypothyroism. So, trying to keep my med dosages at the “right” levels is also an added difficulty!

    Hope the Orencia is working well for you. When I go back to see my rheumy later this month a med change discussion is on the agenda. Not sure what the next med will be!

    Thanks for being here and working so hard to bring us all of this information and discussions with one another!

    Amy Fowler

    Reply
    • March 4, 2010 at 7:10 pm
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      Thanks for the update, Amy. Let us know how it goes.

      Does it help if you try to eat your old “favorites”? I find I don’t even want to cook -& I love cooking. Of course, the hand, wrist, shoulder, elbow, knee, feet… pain might have something to do with that, too. 😛

      Reply
  • March 4, 2010 at 3:17 pm
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    i hardly eat anything and i keep growing.. my lack of movement is probly the key.. I started Prednisone 40 mgs a day and within days i gained so much weight , wasnt sleeping so i cut back to one 20 mg a day then worked my way down to none.. i couldnt do it.. the weght packed on in three months was astounding.. something in the lines of 30 pounds.. only been off the prednisone for a week so i hope to see it leave me just as fast as it came.. I PRAY!!
    Methotrexate, plaquinel,dilaudid, methodone, migraine meds and shots,nabumetone,metformin,folic acid, stomach meds x2, laxitive pills,muscle relaxers,alergy meds, and more ic ant think of whos got room for food????????

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  • March 4, 2010 at 6:17 pm
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    Yes, I know I need to eat better and exercise…and stay away from sweets – but that Reeses Peanut Butter Cup was AWESOME after my MRI this morning!! LOL!!

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    • March 4, 2010 at 7:12 pm
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      I agree completely. MRI is torture & that is the very least you deserve. :cake:

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  • March 4, 2010 at 9:24 pm
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    I wish RA could make me lose weight! Of course, I wouldn’t want anemia or the other bad things that come with it. My problem has always been weight gain, even when I’ve been in remission. And that’s without prednisone. I’ve never taken it and really, really never want to.

    I’ve lost 50 pounds in the last year, though. I did it by cutting sugar and “white” foods (foods made with white flour, breads, pasta, potatoes and white rice)out of my diet, because they convert to glucose in the blood and mess up insulin levels and cause weight gain. I switched to foods made with whole grain instead. Brown basmati rice, whole grain breads and whole grain pastas fit the bill. I eat a lot more vegetables than I used to, and if I want something sweet, I eat fruit. And I’ve become very careful about portion sizes, though I eat all the vegetables I can hold. :o)

    I was borderline diabetic; now I’m not. Losing weight isn’t easy, that’s for sure, but I’m living proof that it CAN be done. Losing that weight has given me a lot of new confidence in myself; I like how I look now much more than I did 50 pounds ago. I also know that I’m putting a lot less stress on my weight-bearing joints and helping my heart function more efficiently. With RA, that’s important. Eating a healthy diet is well worth the extra trouble.

    That is not to say that I don’t enjoy an occasional slice or cake or Reese’s Peanut Butter Cups. I love those things! But now they’re a real treat, rare enough that I really enjoy them when I eat them.

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    • March 4, 2010 at 10:01 pm
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      Wow, Wren. That is inspirational. You are to be congratulated for that hard work. Hopefully, you will inspire someone else to keep trying to be as healthy as possible. :yes:

      Reply
  • March 8, 2010 at 8:03 pm
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    I worked so hard at losing weight while building muscle mass 2 years ago. I was feeling extremely good about myself, then out of nowhere, Enbrel stopped working for me and I was hurting so bad that I couldn’t work out. Not feeling sorry for myself, it was literally all that I could do to put one foot in front of the other for most of last year. I put on 20 lbs and lost muscle, but have just recently been feeling good enough to start working out, so here we go again.

    Reply
  • March 14, 2010 at 3:25 pm
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    I lost alot of weight (100 pounds after the birth of my daughter) and then when I got pregnant with my son 5 years later and had to use prednisone during the pregnancy, I packed on 85 pounds.

    I am losing it, slowly.

    I find I have to switch it up. Right now, I am just trying to add more exercise, more water and green tea, while watching that I am not eating a lot of junk.

    Reply
  • May 18, 2010 at 10:22 am
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    All my weight gain was due to Steriods. I am now losing weight, but it’s really HARD!

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  • June 16, 2010 at 10:01 am
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    Weight loss tip:

    Use excel to chart what you eat and how many calories. Excel is handy because I only have to figure calories on a food item once, after that I can click on ‘edit’ then on ‘find’ and simply type in the item to see what I’d previously entered.

    By tracking calories I tend to steer clear of things like fried chicken because I see the all those calories right in front of my face.

    A bonus to food and calorie tracking is when I have a really good day….I’ll look at what I ate the day before and the day of, then I’ll search to see when I ate the same things and compare the dates with my RA symptom journal to see if there is any relation. So far nothing yet but I’m still hoping 🙂

    Reply
  • October 8, 2010 at 1:17 am
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    Hi, hope someone can help. My husband is 6ft and weighs 160. His doctor had done a multitude of tests so far and all negative. He has had RA for about 15 yrs and is on mthx. He is 68 years old. He eats a well balanced diet, loves ice cream, and usually has a bowl of cereal before bed. He is so skinny and cannot afford to lose more weight. How can I get some weight on him. Thanks for any help.

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    • October 9, 2010 at 12:20 am
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      Dear Blythe, I hope you will go thru the links on this POST. Does his doctor seem concerned? What is the doctor saying? Maybe you could show him the medical articles & ask him if this is part of the problem. What you are saying sounds very serious.

      Reply
  • November 2, 2010 at 11:07 pm
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    Wow, I can empathize with many here and there are a lot of great ideas. My weight gain came as a precursor to being diagnosed. I am not as organized as Lisa, but writing down what I eat throughout the day has helped. Especially since I discovered that there were more days I was skipping meals because of my meds and nausea. It has made me more aware to make an effort to eat something of worth so that my body has what it needs to fuel the morning hours. Another solution I stumbled on was a small cup of fresh lemon juice, and yes I often make it a lemonade with a little sugar and a touch of salt. On really bad days I water it down so that it is just lemon flavored water, but it has made a difference in my weight and most importantly in my bouts of nausea. Orange juice also helps, so far I have lost 50lbs and kept it off for the past 7 months.

    However, I confess I am with Krista, after sitting through the twisting and draining that comes with the RA tests it feels really good to indulge in the sweet comfort of a Reese’s!

    Reply
  • November 14, 2010 at 11:23 am
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    ever since i was diagonised RA i lost so much weihgt nd it stresses me e lot….wat can ido to regain ma weight nd kip it lky that 4ever?

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  • June 27, 2011 at 3:02 pm
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    I have found that eating small, frequent and usually healthy, meals really helps with my weight loss. Also, when I am at home, I weight myself everyday and if I have lost weight, I really try to eat a little more for a day or two. The muscle loss is a real problem for me. It seems like nobody in the medical profession tells you about the muscle weakness and loss until it happens and then you realize that if you are able, you are going to have to work twice as hard as the average person just to keep walking or doing a minimum of housework or cooking done.

    Reply
  • July 29, 2011 at 12:46 pm
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    First of all I have no Facebook or know what a Tweet is..but I do have a very important question for all of you.
    I have GAINED about 25 lbs since diagnosed with RA in the beginning of this year. I just saw my cardiologist (I have coronary artery disease) and he saw a dramamtic difference in my appearance. He has started testing….but could the metho injections be the cause? Could RA be the cause?
    It seems I am carrying a lot of water all over my body.
    I too also have sores on my hands.
    Has anyone heard of weight GAIN?

    Reply
    • July 30, 2011 at 9:31 am
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      Suzanne, the main reason this happens for RA patients is the use of steriods (it’s a side effect). If you haven’t got steroids to “blame,” some other things to look into –
      Have you been checked by an endocrinologist? There could be a hormone imbalance (such as thyroid or adrenal) which could cause the weight gain.
      Also, there are other meds that have that side effect such as Lyrica or even in recent studies, Remicade.
      Good luck.
      What are the sores on your hands like? Have you shown them to a dr yet? If not, taking a picture is a good idea in case they heal over before you get to the dr.

      Reply
  • October 6, 2011 at 1:54 pm
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    Since the onset of my RA symptoms (my rheumy is still unwilling to diagnose me with RA – calls it “systemic inflammatory polyarthritis”), my appetite has decreased and changed dramatically. I have daily abdominal pain that changes sporadically in its severity and I crave foods that I never craved before. I also don’t want some of the heavier foods that I used to love. I’ve lost about 10 pounds, which is fine with me, but wonder what’s going on. I’ve had every GI test on the planet, including an abdominal CT, endoscopy, colonoscopy, an H-pylori breath test, and extensive blood work. I would really love to know if anyone else thinks abdominal pain accompanies RA.

    Reply
  • October 11, 2011 at 2:13 pm
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    Aline, I also get abdonminal pain, and have gone for every test under the sun! The pain is quite high in the abdomen.
    They are puzzled. I have almost passed out from the pain on a couple occasions. It has lasted intensely for up to 2 hours. I have ended up at the hospital twice. The first time it showed my pancreas was slightly inflammed. But, the very next day it was fine and has been since…

    The last time it happened, I got an xray, and all it showed was that I was —-embarrasingly—constipated, and that was the only thing they could find. Although I “go” everyday, apparently not enough. SORRY TMI!

    I personally don’t believe that is the answer to it, but not sure what else I should do…

    Reply
  • October 16, 2011 at 9:08 am
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    Hello Jill,
    I really appreciate your reply. I’m going to lose my mind if I don’t figure this out pretty soon and it’s reassuring to know that I’m not alone. LIke yours, my pain is mostly up high and center just beneath my solar plexus. It spreads throughout my abdomen though and the severity changes throughout the month. It’s much worse just before and during the first few days of my period. Hormones perhaps? I don’t know. I have another follow-up with my gastroenterologist this week and am hoping he doesn’t just dismiss me as an unsolved mystery.
    Oh, and never worry about the TMI thing with me. I lost almost all modesty years ago when I had children and again with the onset of all these odd symptoms, the newest being intense bladder pain and incontinence last week. How’s that for TMI!? A test at the medical clinic showed blood in my urine but no bacterial proof of a UTI. Antibiotics seems to be working, but it’s yet another unusual and mysterious thing to keep me humble.
    Aline

    Reply
  • January 17, 2012 at 9:57 am
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    I am now down to 129 pounds, just 6 months ago I was somewhere around 159 – been told I am malnourished but it was referred as being due to “nerves”. Thank you for this information, I am going to pass it on to my Dr. on my next visit!

    Reply
    • January 17, 2012 at 10:21 am
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      Your reply comes at a perfect time. I’m pleased to say that, thanks to a wonderful gynecological surgeon, I’ve discovered the source of my abdominal pain -endometriosis. I had no idea that I even had it, but he suspected it and did a laparoscopic exploratory surgery last Friday. He found endo (uterine) tissue that had spread and bled all over my belly, including near my bladder and up high near my diaphragm. I’m 43 years old and always thought endometriosis was a younger woman’s disease, but I guess not.

      Anyway, I’m still recovering and don’t yet have any long term solutions (going to meet with him next week to discuss either complete hysterectomy – mom died from ovarian cancer – or hormone therapy) but for the first time in months, I’m hopeful.

      Side note: per my rheumatologists’s recommendation, I’m on a gluten-free diet. I’ve also been completely off nightshade vegetables. It’s been two weeks today and, for the first time in 6 months, I woke with no pain in my hands. I wanted to jump for joy and shout it from the rooftops. Coincidence? Maybe. But I do feel better eating this way anyway (better and more even energy and moods, less bloated) and don’t see myself going back to wheat as much as I was before. Time will tell…

      Best of luck,

      Aline

      Reply
  • August 8, 2014 at 5:43 pm
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    First of all, RA Warrior is a very informative web page. I have learned so much from it. Over the past several months I’ve had almost continuous nausea. I couldn’t find anything specific about it on this site. I wonder how common it is across the board with RA patients.

    I was diagnosed with RA around 7 years ago. I have noted several instances over the years of nausea and severe indigestion. It has gotten worse this summer-an almost daily occurance. I had an endoscope and MRI this summer. Both were normal. Have you addressed this issue in the past in this newsletter?

    Reply
  • June 24, 2015 at 6:09 pm
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    I have been reading RA Warrior for a couple of years and appreciate you Kelly, and all the contributors. I have lost 24 pounds without trying since last August. I am very grateful because had been “trying” to lose weight for many years. It is probably the RA catabolism and or the Arava that I started last summer. I am also on Enbrel and Plaquenel. Sometimes I feel weak but usually not. My back has been spasming and painful if I stand too long. Have started using a cane for errands and general walking. Will start Physical Therapy tomorrow and want to begin a strengthening program. RA is mildly to moderately controlled and I’m grateful for every day. Blessings to you all. Thanks for posting the excellent article on RA and weight loss.

    Reply
  • March 13, 2016 at 11:33 pm
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    I am one of the few that loss weight caused by ra. I the amount of food and type of food I should be over 3000 pounds. Instead I am losing weight and have been on Prednisone for 11years. I can eat as much or any type of food I want. The weight loss is getting too much starting to worry that something else is going on.

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  • June 20, 2017 at 6:28 pm
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    hi i have been loosing weight since January…I am taking methotrexate ..it worries me i was 160 lbs now 144…just wondering if this meds are causing be to loose weight …I have Rheumatoid Arthritis thank you

    Reply
  • August 9, 2017 at 11:12 pm
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    Kelly, I know your post was from 2010.Did Orencia help you?

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    • August 15, 2017 at 3:07 pm
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      No, unfortunately it did not help my RD. But I know others who feel it makes a big difference.

      Reply
  • September 19, 2017 at 9:21 am
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    Dear All
    my mother got arthritis problem since last 30 days. initially White Blood Cell was in high amount.doctor diagnose some infection inside and start to give antibiotics. which make a problem for my mother stohmic .anyhow my mother facing the following problem .

    Pain in knee, Wrist, (most pain on left side leg joint)
    Loss of Appetite ( She even dont like to see food)
    Fever In Evening time between 99 to 101

    Doctor also advised me to take following reports
    CBC, ESR, CRP , RA Factor, Anti CCP.

    CBC is now fine
    ESR is =68 (High)
    CRP is =8.56 (high)
    RA Factor =19.5 (High)
    Anti CCP =44.1 (high)

    My mother have the Diabetic and Blood pressure issue also. i want to know if these are same symptoms happen to other patient of Rheumatoid Arthritis. i would like to thanks if you guys help me or whatsapp me on +971556964243. so i can discuss .i am too much worried about my mother. please if someone can help me i will be thank full

    Reply
    • October 15, 2017 at 11:21 am
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      Asif, your mother needs to be checked by a rheumatologist since these symptoms and blood levels may indicate RA / RD. Try to find a rheumatologist in your area who is rated high by patients.

      Reply
  • September 20, 2017 at 12:10 pm
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    Thank you good work!

    Reply
  • September 30, 2017 at 11:13 am
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    I am suffering from RA for last 6years and I am taking painkiller tablet Before 3years I put so much of weight to 90kgs my normal weight 78kgs but last 3months my weight become 75kg what shall I do to improve my weight

    Reply
  • March 9, 2018 at 10:11 pm
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    I’ve been diagnosed with RA (RA factor 48), after 2 years of being sent to various doctors performing multiple tests, scans, MRI’s, CT with and without contrasts and the ultimate colonoscopy! On MTX, prednisone, Duexis and Folic Acid. These have brought me down to an RA factor of 30. They are now wanting to add an Humera injections to the mix. Does anyone have any information/comments/ideas as to an alternative? It just seems that there would be some lesser of evils to combat RA to get this to a more manageable RA factor. I hate needles!
    Thanks in advance for your comments.
    Jennifer

    Reply
    • May 18, 2018 at 7:57 pm
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      Rheumatoid factor does not track well with disease activity. The important thing is to improve symptoms and function. And if you have high inflammation, to get that down. Sounds like the steroids and methotrexate may be helping with that. Humira or another biologic would be added because the others didn’t help enough. These meds would definitely be the lesser of evils to what the disease could do to a person if untreated (crippling and earlier death).
      This page—and its comments page—has more on RF http://www.rawarrior.com/rheumatoid-factor-test-should-we-rely-on-rheumatoid-factor-levels/

      Reply
  • April 28, 2018 at 1:49 pm
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    Hello, my mom she has an issue of ra since 3 yrs she loosed her weight about 30 pounds. And she doesnt feel hunger…What is the reason

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    • April 28, 2018 at 3:56 pm
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      Minha, i can’t be sure why in her case, but RA can cause systemic inflammation that could affect her appetite. Also it causes something called cachexia which is a loss of lean body mass (muscle and bone). It could possibly be a side effect of her meds but not a common one. I hope she’ll talk to her doctor about this. Low BMI is a serious sign in a disease like RA / RD.

      Reply
  • May 17, 2018 at 6:34 pm
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    I’ve lost 63 lbs in 3 months. I’ve been eating healthy and seem to be losing despite the prednisone. My question is, can rapid weight loss cause RA flares? The more weight I lose, the more flares I’m having. It’s frustrating, because I thought eating healthy would actually help my flares.

    Reply
    • May 18, 2018 at 7:35 pm
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      Dear Tammy,
      I’m so sorry it’s getting worse for you right now. I assume you are losing weight on purpose – that is a lot. So congratulations on that hard work of eating healthy.
      I do not think weight loss can cause flaring. However, the opposite can be true: more severe disease can cause weight loss.
      Also, I have never found that, as commonly believed, disease activity is worse for heavier people. Lower BMI statistically predicts worse disease activity and even higher risk of death in people with RD.
      Personally, I have always eaten very healthy and it did not prevent me from advancing to severe unrelenting RD that affects all joints and several organs. I’m not sure that diet will ever be proven to be a culprit for RD.

      Reply
  • May 28, 2018 at 1:33 pm
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    Hii, my mom she is diagnoised with RA since 3 years. But since last year she loosed her weight alot. About 30pounds.. I need help to gain her weight once again.

    Reply
  • May 28, 2018 at 1:44 pm
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    She is taking medrol since 3 years..And I searched about medrol pill has side effect of weight loss… she started doing diet of paddison program before 2 months her esr was 70 and last month after doing diet her esr was 38.. but she is thinny before having the issue of RA but after the issue she became more skinny doctor told that it is due to rheumotied arthritis.

    Reply

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