Rheumatoid arthritis (RA) is an inflammatory autoimmune disorder of the joints resulting in swelling, stiffness, and pain. Like most autoimmune diseases, genetic predisposition and environmental factors are at play in terms of who may be susceptible to developing this inflammatory disease. 

Rheumatoid arthritis usually begins in the small joints of the arms and legs and is usually symmetrical, affecting the same joints on both sides of the body. If the condition is left untreated, larger joints may become involved, and bone destruction and loss of cartilage over time may lead to the development of additional diseases.

Fortunately, there are treatments available to manage symptoms, increase joint mobility, and improve quality of life. Patients with rheumatoid arthritis can be classified as seropositive or seronegative, but this article will focus on diving deep into what seropositive rheumatoid arthritis is and how it’s treated. (Source, Source)

Types of Rheumatoid Arthritis

The majority of people with RA are diagnosed as seropositive. This means that when their blood is tested, it is found to contain antibodies known as rheumatoid factor (RF) and anticitrullinated protein antibodies (ACPA) that are associated with RA. The status of both RF and ACPA is not only important for diagnosis, but also useful in planning treatment and predicting disease outcome. (Source)

Seropositive RA

Anticitrullinated protein antibodies and rheumatoid factor have been found to be present in most people with RA. Middle-aged women are more at risk of developing this disease, and seropositive patients may have a higher risk of uncomfortable RA symptoms that come on rather quickly. Seropositive patients may be treated with disease-modifying anti-rheumatic drugs, although this treatment may not manage symptoms well. (Source, Source)

Seronegative RA

Seronegative patients, who have an absence of antibodies and tend to develop RA later in life, have been found to have more active disease at the time of diagnosis but also respond better to treatment. These patients are not treated as aggressively, even though studies have shown their inflammation to be higher at their time of diagnosis. (Source, Source)

Seropositive Versus Seronegative Rheumatoid Arthritis

Although it seems that those with a seronegative diagnosis have a better prognosis and respond better to treatment, this is not absolute, as inflammatory activity is present in both types of RA. Treatment for both may include disease-modifying anti-rheumatic drugs, although research has shown these drugs to be more effective in managing symptoms of seronegative patients. 

Seropositive patients have been shown to develop the disease earlier in life and go on to experience more extensive joint damage. Some research has shown that seronegative patients respond better to therapy and don’t require as much treatment for their RA. However, the risk of developing cardiovascular disease seems to be about equal between seropositive and seronegative patients. (Source)

Causes of Seropositive Rheumatoid Arthritis

We still don’t know what causes RA, but risk factors that increase the likelihood of developing the disease have been identified. Onset of RA may be triggered by genetic and environmental factors such as:

• age
• sex
• smoking
• diet

You may be genetically predisposed to formation of autoantibodies that increase your risk of developing seropositive RA, and those autoantibodies may start forming years before the onset of active rheumatoid disease. This doesn’t mean you will definitely develop RA due to your gene status alone; environmental factors may influence progression of rheumatoid arthritis as well. (Source)

Symptoms of Seropositive Rheumatoid Arthritis

Early onset of disease generally causes damage to the joints of the fingers and hands as well as the toes and feet. As the disease worsens you may find larger joints being affected, such as the wrists, knees, ankles, elbows, hips, and shoulders. No matter your classification, clinical symptoms of rheumatoid arthritis may vary among patients but can include: 

• joint swelling
• tender, warm joints
• stiff joints that are worse in the morning as well as after activity
• fatigue
• fever
• loss of appetite

In addition to the symptoms above, about 40% of those with rheumatoid arthritis may experience symptoms in other areas of their body including the:

• skin
• eyes
• lungs
• heart
• kidneys
• salivary glands
• nerve tissue
• bone marrow
• blood vessels

Symptoms may not be consistent but rather come and go, with periods of flare-ups in which you may experience severe pain and inflammation. (Source)

How Serious Is Seropositive Rheumatoid Arthritis?

Patients with rheumatoid arthritis, regardless of their classification, are at higher risk of developing co-morbidities such as cardiovascular disease, diabetes, hypertension, and dyslipidemia (unhealthy levels of fat in the blood). This may be partly due to the pain and stiffness of RA making movement more difficult, resulting in a more sedentary lifestyle. The risk of developing these chronic diseases seems to be about the same whether you are seropositive or seronegative. (Source)

Conventional Treatment of Seropositive Rheumatoid Arthritis

Rheumatoid arthritis in general may be treated in several ways, but the goal is to reduce inflammation and pain as well as increase and improve functionality. The following are conventional methods of treatment for RA that may help manage symptoms but do come with side effects as well.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Nonsteroidal anti-inflammatory drugs are a group of fast-acting, over the counter medications that are used to decrease pain and inflammation. NSAIDs include salicylates (such as aspirin), naproxen (Naprosyn), ibuprofen (Advil and Motrin), and etodolac (Lodine).

Although these medications are generally long lasting, they can come with uncomfortable side effects such as:

• nausea
• gastrointestinal upset
• tinnitus
• loss of hearing

(Source)

Corticosteroids

Corticosteroids are stronger than NSAIDs, but also come with potentially severe symptoms. Because of this, they are only intended to be used for a short period of time during flares or when symptoms are more uncomfortable. Side effects of corticosteroids may include:

• bone thinning
• weight gain
• diabetes
• immunosuppression

(Source)

Opioid Analgesics

Opioids — pain relievers derived from opium or based on the chemical structure of opium — can be used in RA patients for short-term pain relief, but come with some major side effects that may outweigh the benefits. In addition, opioids are highly addictive, which can lead to misuse and abuse. Opioids for RA include codeine, dextropropoxyphene, and tramadol. Side effects may include:

• drowsiness
• confusion
• nausea
• constipation
• slowed breathing

(Source, Source)

Disease-Modifying Antirheumatic Drugs

These medications are referred to as second-line drugs and may help slow disease progression, along with destruction and deformity of the joints. It may take anywhere from weeks to months for these drugs to be effective. Disease-modifying antirheumatic drugs include methotrexate, hydroxychloroquine (Plaquenil), sulfasalazine (Azulfidine), and gold salts, a category that includes aurothioglucose (Solganal), auranofin (Ridaura), gold sodium thiomalate (Myochrysine), and D-penicillamine (Depen and Cuprimine). Side effects of these drugs include:

• GI tract problems
• skin issues and rashes

• problems within the central nervous system, especially in the eyes

(Source)

Alternative Methods of Managing Seropositive RA

In addition to conventional means of symptom management, there are also alternative methods that may be used in tandem with conventional treatments. Alternative methods of managing seropositive RA generally do not have many, if any, side effects. The following are some alternative methods to consider managing symptoms of this severe disease.

Anti-Inflammatory Diet

Adopting an anti-inflammatory diet may boost your immune system and nourish a healthy digestive tract full of thriving bacteria, a good start to managing pain and swelling as well as protect joint function. The autoimmune protocol (AIP) diet may be a good place for you to start your journey in regard to eliminating foods that may spark inflammation.

Supplements 

Supplements can be great additions to a healthy diet and lifestyle plan to really amp up your wellness factor, but must be taken correctly so as not to cause further issues or interact with medications you are taking. The following are supplements that have been studied specifically in patients with rheumatoid arthritis:

• omega-3 fatty acids
• probiotics
• thunder god vine (Tripterygium wilfordii)
• cat’s claw (Uncaria tomentosa)
• deer or elk antler velvet
• feverfew (Tanacetum parthenium)
• flaxseed oil
• green-lipped mussel
• rose hip
• willow bark extract

Due to little research and possible side effects, there’s no conclusive evidence that these help manage RA, although future studies may be more promising. (Source)

Stress Management

Managing your stress on a consistent basis is key to improving your overall health, with or without a diagnosis of rheumatoid arthritis. Reducing stress can contribute to a reduction in inflammation, which may result in reduced pain. Consider making time and providing opportunities for activities that may help you manage pain and other accompanying symptoms of RA. These activities may include:

• massage
• breathing exercises
• yoga or meditation
• taking breaks from social media
• getting outdoors each day

(Source)

Movement

Exercise, or daily movement, is an approach to better health that benefits everyone, but if you have a rheumatic disease physical activity can make a huge difference in how your body functions. Consider slow and deliberate movement that does not tax or overburden your body such as:

• walking
• tai chi
• yoga

(Source)

The Bottom Line on Seropositive Rheumatoid Arthritis

Seropositive rheumatoid arthritis can be painful, reducing functionality and quality of life. Fortunately, there are many different treatment methods to consider that may help slow disease progression, manage symptoms, and improve well-being. There will always be flares that come and go with autoimmune diseases such as RA, but following a whole foods diet and holistic lifestyle, paired with your health care provider’s care plan, may help to better manage your chronic pain and allow you to enjoy daily activities on a regular basis. To be confident your plan is suited to fit your unique needs, connect with WellTheory’s Care Team and get a nutrition and lifestyle plan personalized to you.