Seronegative v seropositive RA: Sorry its Jax again... - NRAS

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Seronegative v seropositive RA

Jaxine
Jaxine
51 Replies

Sorry its Jax again!! But What s the difference between seronegative and seropositive? All i know is my bloods came back positive for inflammatory artheritis. Same debilitating symptoms so what s the difference? Sorry I'm always on hear posting questions but you guys seem so knowledgeable! I don't know know my RA factor.

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Mmrr

Seropositive means your bloods show inflammitory markers Rheumatoid factor and anti - CCP. They may show that you have rheumatoid arthritis, but the rheumatologist considers the state of your joints too to make a diagnosis.

Seronegative means your bloods do not show the inflammitory markers, but you can still have rheumatoid arthritis. Some people might initially not show the markers then develop them. Some people never show them.

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Jaxine
Jaxine
in reply to Mmrr

Got it! Cheers Mmrr

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Hidden
Hidden

Hey Jaxine, I’m seropositive as well. My understanding is that elevated CRP/ESR and RF/CCP levels above the “normal” range are seropositive and symptoms of RA with unremarkable inflammatory markers is seronegative. Also if you type some search terms into the search box up there, you’ll get previous questions on this topic :) Hope this helps, cheers Deb

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helixhelix
helixhelix
in reply to Hidden

ESR and CRP are inflammatory markers which is a bit different. RF/anti-CCP are antibody markers, and so you are positive or negative for those specific antibodies.

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Jaxine
Jaxine
in reply to Hidden

It helps, thanks YanniBaci

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AngelMar

Hi jax, all I can tell you is my blood test came back seropositive, it refers to the presence in the blood of an antibody called rheumatoid factor. I think on the whole it can just be the same as seronegative only the negative one can have a better outlook, hope that helps! X

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Mmrr
Mmrr
in reply to AngelMar

Seronegative is just as damaging to joints as seropositive. Treatment can also be more difficult to obtain and can be delayed as bloods are negative.

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Jaxine
Jaxine
in reply to Mmrr

Thank you

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Simba1992
Simba1992
in reply to Mmrr

Serronegative is in fact seen as less destructive, symptoms often aggressive though. There are those who in fact believe it is an other illness alltogether. SN doesn't react as well to meds as SP and mtx is often not tolerated. Lots of research still needs to be done to really understand SN.xSimba

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Mmrr
Mmrr
in reply to Simba1992

Absolutely, more recent thinking suggests SN and SP are quite different diseases, often lumped together as the disease processes are not understood and have similiar presentation signs and symptoms. Often, but not always SN people will become SP as the disease progresses. It is not understood why, yet the disease can be very advanced before this happens.

It is often written that SP is more destructive than SN, but recent thoughts are changing. SN can be just as destructive. Add the difficulty with getting taken seriously by some rheumatologists , and the joints are often seriously damaged before treatment is started. I'm going through this process myself at the moment.

There are around 100 types of arthritis , many with similar signs and symptoms, many are co morbid. It is not an easy task to separate them out.

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Simba1992
Simba1992
in reply to Mmrr

So it is. So much we still do not know and this is why we should also be very cautious with thinking that the meds offered would automaticly help even though the the diagnosis is not clear. There is a possibility that they may also make the situation worse. The effects of the toxic meds on diesease procesess long term is still not clear.Not easy no. Simba

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Mmrr
Mmrr
in reply to Simba1992

Simba, I'm going through a bad phase at the moment. Mutterings now that maybe I don't have inflammatory arthritis, well ok , but what is wrong with me ? (See my response to fruitandnutcase)

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Simba1992
Simba1992
in reply to Mmrr

I'm so sorry Mmrr:( It must be so utterly frustrating. I can imagine you have tried everything but it feels that you don't really have enough support from the medical professionals in figuring it out(?) Have you tried the functional medical doctors? Sorry if I already asked you this. All the best. Simba

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Mmrr
Mmrr
in reply to Simba1992

I'm waiting on results from MRIs I had last week, then a recall from rheumatology. I intend to have a private consultation with a recommended rheumatologist thereafter if I'm still no further forward ( no second opinions in Scotland, only re referrals). Where would I find a functional medical Dr in Scotland ?

I received my thyroid bloods this am , all normal (full thyroid screening, plus)

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Simba1992
Simba1992
in reply to Mmrr

Didyou post the reults on the thyroid forum? Best analysis here. I'll see if I can find something for you.:) X Simba

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Mmrr
Mmrr
in reply to Simba1992

All bang on normal Simba, sitting mid range on everything tested for. But I haven't posted.

Thanks for your help.

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Simba1992
Simba1992
in reply to Mmrr

Ii think you still should post. To be sure. Interpertation can be very complicated.

Here is one contact.

nutritionist-resource.org.u...

This may also be something.

napiers.net/integrative-med...

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Mmrr
Mmrr
in reply to Simba1992

Thanks for the links, I'll wait for my recall to rheumatology, but will explore in the meantime. I undertook a nursing project on Napiers, Edinburgh many,many moons ago. Not a place I would be comfortable in attending , although some people swear by them.

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Jaxine
Jaxine
in reply to Mmrr

I had thyroid bloods done yesterday as I have a lot of pain in my throat whilst swallowing, I assumed it's to do with RA as i have cramps around my neck too. Im new to RA so up until now every new symptom has been worrying. Prior to my diagnosis I've always healthy, energetic, low weight, diet good basically i was the first person friends rang if they wanted a mad party, i didn't worry about a thing! Apart ftom the stress of the menopause since 47 which was shite! But a normal and natural progression for us ladies. Anyway I think it's such a shame that you are put in this situation and predicament about having the added pressure of looking to go privately because you are not getting the answers you need. Wish I could help x

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Mmrr
Mmrr
in reply to Jaxine

It is good that your thyroid is being tested too, some people with RA also have thyroid issues. Best have it ruled out.

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Jaxine
Jaxine
in reply to Mmrr

Do they? That's interesting, never had thyroid problems before don't think I'll Google that one yet!

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Simba1992
Simba1992
in reply to Jaxine

This is not scary googling:) A good idea to sort out what is going on in your body on the hormonal front. Not only thyroid function but estrogene\ progesterone ratio. After menopaus there is a change in the hormonal situation and this change can in in fact push forward the development of RA. These imbalances are easily fixed and may have an effect on your symptoms. Simba

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Jaxine
Jaxine
in reply to Simba1992

That does not surprise me! I've had the journey from he'll with the menopause I wasntcable to take the majority of hrt tablets due to my migraines ( had them since I was 30) also sickness. I've been post menopausal for 7 years. As soon as I was diagnosed with RA stopped my hrt patches as risk factors with hrt too. That was my worry with Mtx as I already suffer from big migraines!

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Simba1992
Simba1992
in reply to Jaxine

The best help for these problems is often found in progesterone supplementing. It is also very protective in the aging processes. Natural progesterone is safe and only give your body good support.Here is some reading that may interest you.

raypeat.com/articles/articl...

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lilyak

Seropositive people have a positive RF or anti-CRP. Seronegative do not have these autoantibodies, but still have RA. These are not inflammatory markers, they are autoantibodies.

Most, but not all, people with inflammatory arthritis have elevated inflammatory markers, these are the ESR and CRP blood tests. Up to 30% of people have normal bloodwork, yet do have active inflammation.

Inflammatory arthritis is the umbrella term. RA is a type of inflammatory arthritis. So is psoriatic arthritis, ankylosing spondylitis, etc.

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Tessthomy

Hi Jax. I’m also sero positive. My understanding is SP is more erosive/damaging than SN. Although SN is slightly more difficult to diagnose/treat. SP also responds better to medication than SN. Both are not great for different reasons. Whichever one we have I do think that this disease can make us stronger people by fighting it. We are all warriors in the Big Fight x

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Gigi71

I have erosive seronegative RD and can assure you in my case very damaging, was dx with Lupus 33 years as a result of the low factor. My inflammation in feet, knees and hands was very apparent to the rheumatogist, was treated very aggressively with steroids. Had many operations and now fairly well controlled with Humira. X

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Mmrr
Mmrr
in reply to Gigi71

Yes, I've read a few studies which suggest seronegative RA can be every bit as erosive as seropositive. Due to the difficulty of receiving timely treatment more damage can be done to joints too.

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Jaxine
Jaxine
in reply to Gigi71

Gosh, thank you you def put that into perspective

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Mmrr
Mmrr
in reply to Jaxine

I'm seronegative and have a few other things going on to. The way I deal with it at the moment is, that as the treatments of SN and SP are the same , I just accept that I have rheumatoid disease.

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Fruitandnutcase

Since going totally gluten free about five years ago to try and reduce my thyroid antibodies (it worked!!!) I’ve noticed that my CRP has reduced too.

Considering I was seronegative to begin with I’m wondering (and worried) now that the rheumatologist will decide I haven’t actually got inflammatory arthritis, he was making mutterings about it in the report he sent to my GP last time I saw him.

I’m taking hydroxychloroquine and still get painful, stiff fingers, fingers and other joints hurt and I take a long time to get de-stiffened in the morning. Can’t straighten up if I do much in the garden etc. Stiff all over - basically all the usual arthritis stuff.

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Jaxine

That s interesting Fruitandnutcase, so obviously not great having a diagnosis of RA, but it seems for you if you're now being told it's not your worry is " then what the he'll is it" I understand that. Prior to being diagnosed I was worried sick I was thinking of all the worst scenarios! I have always been ignorant of RA thought it only happened to old people and the effects of it was not being able to walk. Never thought it was an auto immune system disease. Hope you find out soon, but I think it is RA!

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Fruitandnutcase

Me too.

A three month course of steroids made me feel like a new woman the I started the hydroxychloroquine as I tapered off the steroids. I used to get what I always thought was fibrositis - real burning pain down my neck into my shoulders and that went and never came back. I know it’s RA - should have said the rheumatologist suggested ‘OA ? ‘to the doctor. I don’t think so!

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Mmrr

Hi, I'm going through a similar process at the moment, with mutterings that I don't have an inflammitory arthritis , because of my bloods and lack of swollen joints, toes excepted. I have widespread OA, chondrocalcinosis am stiff beyond belief, ache all over, ultrasound previously demonsrated that had synovitis in every joint in my hands and wrists and hands (now seems to be under control with MTX). Brain fog is my biggest problem.

DMARDs help me a lot, so if it isn't inflammatory arthritis what is it ?

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Jaxine
Jaxine
in reply to Mmrr

Hi there, what is chondrocalcinosis and synovitis? I'm just curious no more no less! Must be so difficult not to be 100 % sure of your diagnosis draining for sure!

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Mmrr
Mmrr
in reply to Jaxine

Synovitis is essentially the swollen joints you get with RA. The lining of the joints, the synovium is inflammed, causing the , heat, pain and stiffness you experience.

Chonrocalcinosis is the Sunday name for pseudogout (not gout) not that common, and a different disease from RA. it is a built up of calcium around the tendons/joints and can mimic RA.

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Fruitandnutcase

Quite worrying Jaxine. The thought of gong back to how I was - my hands hurt all the time - I said t the GP who referred to me that my fingers looked ok and his answer was that if patients are diagnosed and treated swiftly you should no longer see people with nobly fingers - I had no grip, couldn’t pull plugs out of the wall or do anything that needed strength in my hands. Feet don’t feel all that great either.

sciencedirect.com/topics/me...

en.m.wikipedia.org/wiki/Syn...

Both sound incredibly painful!

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Fruitandnutcase

Gosh it all sounds really painful.

Forgot to add (brain fog or just dopey! ) that he wrote to my GP describing me as a ‘pleasant woman’ I didn’t think that was allowed these days. He suggested ‘OA?) lets hope he’s gone next year when I go back. He’s the only one I’ve seen twice in a row in the five years I’ve been going to that clinic. The guy I saw before him wrote to my GP saying he’s sure I’m developing Sjorgens.

I met someone who works in our pharmacy and when I was talking about my prescription she asked who I had seen and it turned out to be the same guy and she was having exactly the same problem - he told her she didn’t have inflammatory arthritis - she wasn’t convinced either. Looks like he is single handedly trying to save the NHS by getting rid of patients. I’ve got a stack of other autoimmune conditions anyway so why he thinks it’s not inflammatory I don’t know.

I’m 70 now but I’ve been stiff in the morning for years. I remember back in 1983 my mother came to stay after we moved into this house. She wanted to go out and I said I’d have to wait for a bit, she asked why and I said well I wanted to wash my hair and she said to go and do it and I said I couldn’t and she asked why and was astounded when I said because I couldn’t bend over the bath to wash it. She asked why not and I discovered that day after asking around that no one else I knew had any difficulty bending over to wash their hair first thing in the morning.

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Mmrr

Your experience is not uncommon. I obtained my GP notes through a freedom of information request, only to find out I have been tested for rheumatoid factor several times. The first in 1989, yet no one told me, RF always negative. I've had stiff and achey periods throughout my life, always a keen walker , very active person so just thought it normal too. Had I known about being tested for RF I might have been more aware and sought help sooner when I became very unwell 2 years ago.

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Fruitandnutcase

I was the same with my thyroid. In those days people tended not to question their doctors. If the said the results were fine then that was it. I’ve since discovered that fine and optimal aren’t the same thing at all. I was tested years ago to see if I was under active and my then GP said she was surprised because I was borderline overactive. If only I’d known then what I know now! I ended up really ill with Graves‘ Disease a few years ago. I suspect I had had it for quite a while before I had a crisis.

I was like you and walked a lot, in fact I was pretty active in spite of being so creaky. I just though everyone was like me. Just goes to show😉

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Simba1992

Before the revolution of Pharma thyroid hormone was often given as a first med for joint issues.:)Simba

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Fruitandnutcase

Dare I say it before the revolution of pharma doctors spoke and listened to their patients and they were treated for symptoms rather than blood test results - certainly thyroid patients. Now they rely on blood tests. So many thyroid patients who are feeling ill and in pain fit within the lab ranges - which are so wide it would be difficult not to.

I shocked an young up and coming endo by saying to her that she didn’t really need me at the consultation - all she needed was my blood tests and she could have sent me an email telling me what to do next - it was usually a bit more levo. They were very pleasant and always asked me how I was but they got my blood test results a week before I saw them and with the best will in the world I always felt treatment was planned before I got there.

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Simba1992

Good for you. The docs need pushback from the pas!👍🏻

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helixhelix

And the NHS needs more support from the government...

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Simba1992

Which they probably won't get.:( So? The pas need to be on top of their situation. Feeling helpless and not respected makes things worse not better.There are actually studies how much a good bedside manner affects healing in sick pas. In EULAR recommendations the good rapport between doctor and patient is the number one target in successful treatment. Seems like many RA patients are trapped in a bad place (?)

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Mmrr

I attended my GP practice yesterday morning to have routine blood DMARD screening. I expected the practice to be bustling with patients as it was the first Monday back after holidays. Nope, I was the only patient in the waiting room. I mentioned how quiet it was to the phlebotomist (who is also a receptionist) who told me all the Drs were doing phone consultations only, there were no appointments yesterday am at all. Face to face appointments today seemingly.

In my opinion, all diagnosis begin with observation, pity help the patients is all I can say. ( but never mind we will have Skype consultations soon )

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Fruitandnutcase

WOW!

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wishbone

The opening sentence of a letter to my rheumatologist from an immunologist she referred me to said...."Thank you for referring this delightful gentleman who has had rheumatoid arthritis for about fifteen years." Ahem, he was obviously a very good judge of character. :-)

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Fruitandnutcase

Definitely a good judge of character 😉

It is nice that they like you as a patient and I’ve had similar comments in the past - it reminded me of how my son rates his Uber drivers and they rate him - it’s just I thought that doctors weren’t meant to comment on their patient’s personal qualities these days. Plus I went off him big time when he decided my inflammatory arthritis might be OA! Might not say I’m such a pleasant lady if he tells me that to my face next time he sees me.

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wishbone

I wouldn't have thought they would put in writing if not allowed but you never know?

I've been called many things in my life but never a 'delightful gentleman'. My wife was baffled by the comment. :-)

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lovemydoggy

Keep posting. I don't know a lot yet about it, but I am finding out tons on this forum. People are willing and eager to help!

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