Semi-related to previous post

[JHvanN]

I have FLD and rheumatoid arthritis and lately headaches which I suspect is the RA, but regardless…

Which painkillers can you use?

[Richard-Allen]

Hello JHvanN.

I have a question to ask if you wouldn't mind. Do you by chance suffer from depression?

I ask this because it has been found that conditions like rheumatoid arthritis can bring about a response by the immune system. Proteins called cytokines and macrophages go in search of any invading, harmful bacteria. The cytokines identify it as being dangerous, and the macrophages devour and destroy it.

It has been discovered, that these cytokines can crossover the blood-brain barrier and alter a person's mental state. Some treatments for rheumatoid arthritis can be toxic to the liver over time. Also by adding anti-depressants to the mix, you could end up with a rather toxic cocktail that the liver is having to process.

So, rather than treating depression with anti-depressants, anti-inflammatory medication may be more beneficial for some people. I’d also recommend that your GP carries out a medication review to see if there could be any interaction with the liver. Many of the medications we all take are perfectly safe as a single dose, but we tend to take multiple medications all at the same time. These can become toxic when they are all broken down and missed together.

Also it should be noted that some anti-inflammatory medication such as ibuprofen should be avoided if a person has liver damage.

This pain management question should really be answered by a hepatologist or gastroenterologist consultant.

I hope this is of some help.

Merry Christmas

Richard

[JHvanN in reply to Richard-Allen]

Hi Richard,

Nope, no depression to speak of just off days sometimes, because of all the issues mentioned in previous posts not being diagnosed fully yet and of course a helping of joint and “ ghost” pains from the RA. Hoping for answers tomorrow after all results have hopefully come in.

I especially wanted to ask about painkillers for now because what I usually take is not good for my liver and would like some hints as to what might be good to be taking now until I’m in contact with my Physician. (Hopefully soon)

But thank you for the link and the answer 😊

Merry Xmas to you too!

[Kristian]

Hi JHvH

Looking at this post and your previous one, you seem to have a few issues going on to contend with. It would therefore be inappropriate for us here to answer this question. What advice has been given to us in our circumstances may be totaly inappopriate for you, so we always have to be wary of that.

Unfortunately, therefore, the only recommendation I can give would be to discuss this with your own medical team. I appreciate that may look like a bit of a sledgehammer to crack a nut situation, but in your case I'd suggest this is really the only advice that would be appropriate and they won't mind you asking. Your situation is quite particular.

Sorry I couldn't be any more specific. Good luck.

[JHvanN]

Hi there! Yep I figured it would boil down to ask my doctor was just hoping there would be something to recommend in the meantime. But ah well I will hopefully be hearing from her soon. 🤞

[Fibro2021]

Hello JHvanN,I want to continue Richard's reply, but somewhat from an alternative side. Part of the problem with chronic liver disease is that at some point in the disease, hepatic encephalopathy appears. Symptoms of hepatic encephalopathy are very diverse and non-specific. It can be chronic fatigue, liver laziness, drowsiness during the day and insomnia at night, chronic headache, irritability, brain fog, etc. Who hasn't experienced something similar in life? Perhaps the only laboratory marker of HE is an elevated ammonia level. Treatment to lower ammonia levels can reduce these symptoms at least. As for RA, it can be one of the arrows flying at the target of the liver and damaging it. At least secondary liver damage has been described for many systemic diseases. Perhaps this approach can be somewhat hepatocentric. But we're all a little hepatocentric here. 🙂

[JHvanN in reply to Fibro2021]

Thank you so much for the kind reply 😊 Yes there are so many factors and symptoms going on that I really can’t wait to hear what my results are for all the many (and super expensive and extensive) tests and scans I’ve had.

Hoping for some sort of conclusions tomorrow! 🤞