Help swollen hands

[Coco]

Hi: I have RA and recently my hands are swollen especially my left. I’m on 100mg of minocycline 3 times a week twice a day. Could this be caused by diet?

[Maz]

Hi Coco,

Are you working with an experienced AP doctor? How long have you been on AP? Were you in sustained remission before this flare? Changed generic brands recently? Recent RA labs? Any co-morbities- e.g., thyroid imbalance or other hormone shifts? I find my hands get boggy when my thyroid levels are out.

[Coco]

Hi Maz: i am on the same brand of minocycline. I see my AP every 6 months and have done so since 2005. I do take a thyroid drug for hypothyroidism. My hands were ok in May and the swelling started in June. My RA labs were all ok when I saw my Rheumy at the end of May. I have acupuncture regularly as well. I use heat and cold and massage. It’s such a puzzler and painful.

[Maz]

Any recent thyroid and RA labs? Do you take NDT for thyroid replacement, generic or brand-name levothyroxine/T3? Being hypo- or hyperthyroid can creep up and inflammation can block T4 to T3 conversion so these labs need a close eye during these times.

If not thyroid and everything is in good order with those labs, have you had any other routine labs run for RA recently? ANA, RF, anti-CCP, sed rate, CRP, complete metabolic panel, CBC?

If you’ve been on mino for over 5 years, have you talked with your AP doc about adjusting your protocol? Some people find that temporarily changing their dose, switching to a diff tetracycline snd/or adding a secondary abx can make a huge difference. Back in Dr. Brown’s day, he treated flares with IV clindamycin.

[Coco]

I take 30 mg of desiccated thyroid daily.
My recent complete labs results were normal. I’ve been on mino since 2005.
I tried doxycycline but it caused me further damage to my hand joint thus I have stayed with minocycline.
Perhaps a change in diet may work not sure what else to do.

[Maz]

Any chance you had Covid or any other infection of late? I’ve had dental cleanings in the past that can set off a flare. Ugh

I also take NDT (NP Thyroid) and find I need my Free T4 to be mid-range and Free T3 to be in upper quartile of range. TSH is usually very suppressed unless I get early morning labs drawn before I take morning dose. The T3 in NDT can falsely elevate thyroid labs to look normal otherwise.

Some folk find adding a macrolide to doxy does the trick or rethinking mino dose.

Yes, diet can really affect RA flaring as evidenced by recent emerging research. Without attempting an exclusion diet, it might be hard to unravel which food offenders may be a root cause.

[Coco]

Thanks for your help Maz.
I haven’t had any illnesses for a long time. I’m going to detox and introduce foods gradually and see if that helps.

Coco

[Maz]

Hope it helps, Coco! Pls come back and let us know how you’re doing!

[Coco]

Hi Maz:
I went to my Rhumy in July and he said my X-ray and ultrasound showed arthritis in my middle finger. He gave me an injection of cortisone as my fingers were badly swollen.
It is now August 13th and the swelling has not reduced.
I took care of a bad tooth which had a problem under a bridge but that did not alleviate the swelling.
I’m so frustrated that my fingers are not better. I use ice and salonpas pads on my hand. I also use a red green blue light (Celluma) which is supposed to help with inflammation. I have tried Voltaren and Croyderm spray.
I feel I am doing as much as I can.
It’s puzzling to say the least.
Oh well.

[Maz]

Very sorry to hear the cortisone injection didn’t seem to help, Coco. Most of the time they help to reduce swelling and pain, though usually only a brief respite.

Dr. Brown would sometimes use short courses of 5-10mg oral prednisone, as described in the book, to help quell a flare. The key being “short course” as it is tricky, as you likely already know, to taper off prednisone without inducing some systemic pain rebound.

Dental work always has a similar effect on my RA, too. I suspect disturbed oral microbes, tucked comfortably in biofilm, are released and are swallowed into gut to have a bit of a field day.

You said you were going to work on diet – has that helped any? Are you doing anything for leaky gut and detox?

[Coco]

I take 2 capsules of Metagenics Ultra Flora Balance. Each capsule has 7.5 billion bifidobacterium and 7.5 billion lactobacillus therefore a daily total of 30 billion twice a day.
I also eat sugar free lactose free Oikos greek yogurt and sauerkraut with dinner occasionally.
I take good quality vitamins etc.
Can you recommend anything else I should be taking. I am truly at a loss. Thank you

[Maz]

These are things I do to help detox free radicals causing inflammation:

Drink half my body weight in water as well as the lemon-olive oil detox drink.

Preventing constipation

FIR infrared saunas

Supplements I have used to help move out free-radicals at different times and found helpful:

Liposomal vitamin C (2000mg twice a day)
Liposomal milk thistle (600mg twice a day)
Liposomal glutathione
Alpha lipoid acid
N-acetylcysteine
Grape seed extract
Alka-seltzer Gold
Bromelain
Systemic enzymes (Neprinol or Serrakor-NK)
Non-denatured whey protein
Transfer Factor L-Plus
Activated charcoal (this supp can be tricky to use timing-wise with everything else and can also affect nutrient absorption)

Aside from good quality probiotics to help prevent gut overgrowths-dysbiosis, my integrative rheumatologist suggested I take “Leaky Gut Revive” which he said helps to restore the protective barrier of gut.

I’ve found that maintaining optimal Vit D levels (60-80) by taking Vit D3 gelcaps is important in terms of reducing pain levels as well as optimizing thyroid replacement therapy. Too much or too little can increase pain levels.

This is a lot to absorb (and cost) and my integrative doc would add one or two things at a time to see what helped most. I have always had great relief from IV Vitamins (Myer’s Cocktail) and Glutathione IV push. The effects are temporary, but over time, I found cumulative value in having regular IVs.

[Author]

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