Is this normal

All my bloods from day one have all come back with in normal ranges, no inflammatory markers ever. My diagnosis was based from medical history and a ultra sound on hands, wrists and feet where a build up of fluid was found with swelling around joints, hands were very bad. Why are there no other indicators is that normal, I saw a locum GP due to having a cold who said o you may not have RA it could be something else, this really worried a worrier :-) any comments or advice welcome

14 Replies

  • The locum GP should learn to keep his or her trap shut I feel! Its nonsense that everyone with RA gets raised inflammatory markers - there are lots of people on this site for whom all bloods reveal nothing whatsoever. The worst thing about this is that doctors take longer to diagnose the inflammatory arthritis and sometimes important time is wasted and damage done.

    Ultrasound is a much more reliable way of measuring inflammatory arthritis - I've never been checked this way so am lucky that my inflammation has so far shown up in my blood. But I also don't believe GPs know nearly enough about the various diagnostic tests, medication or the different types of arthritis - so its very presumptuous of this locum to day such a thing. My GP is good at shrugging and leaving it to the experts when necessary. If you have been diagnosed by a rheumatologist then its not for a locum GP to undermine this diagnosis. A locum GP told me that MTX is a kind if poison when I went to him with nausea last summer. He was probably right on one level but it didn't allay my anxieties about taking it one bit!! Tilda x

  • Thank you so much for your comments and reassurance it's difficult enough at present time without comments from this locum GP. Your so right many thanks

  • Spot on Tilda. both about inflammatory markers, and about ultrasound (and about GPs assumptions too!)

  • Sorry to hijack a blog yet again, but I thought you might like the following. Many moons ago my oncologist told me that MTX is like a very clever weed killer which floats around and kills off all the rapidly reproducing cells which are causing the problems, so that the body is much healthier. I still remember this each week when I stick the needle in and it makes me think of the MTX as a caring friend helping me to get better rather than something nasty which wants me to feel yucky ...... And I am sure it makes me feel happier! Xx Virge (well it works in my little world! X)

  • Will also bear this in mind on Metoject days then thanks Virge. X

  • I think thats a lovely thought that reassures me. Thanks for this

  • Hi Will

    I have been to see rheumy today and my esr and crp have not been raised when I asked her about this she said that they are not always raised and that in some people they are never raised. I had ultrasound and clinical signs of inflammatory arthritis along with raised RF and whilst they are not sure what type of disease I have it is some type of inflammatory arthritis. I had felt that maybe it was all in my head but was reassured today that I am not going mad and I still have some disease activity so have had another steroid jab.


  • Fear this will happen to me tomorrow! Seeing Rheumy after really pestering them due to lumps and pain in hands and feet and now worrying in case they are not there to be seen tomorrow, but its just the nature of RA, you sometimes feel really bad but the tests dont show or i have had it where the test were high but i felt ok !!! Very strange, but you have something going on as it shows in your ultrasound. My rheumy often went on the swelling and medical history and painscore!

    Dont let them worry you too much, locum gp's are not Rheumy consultants!!!!! My GP didn't know what Humira or Arava was.......i actually dropped my mouth at that one!! lol

    lots of love Axx

  • My ESR and CRP generally refuse to budge above normal, even when I'm crawling across the floor - or rather not crawling as knees hurt too much to move at all! In fact most of the time my ESR is a perfect 5...which is just marvellous for someone my age. At the absolute worst it managed to creep up to 21, which in other people would be laughable and probably indicate that they were getting close to remission! But yes, on x ray and ultrasound you can see the RA in all it's glory. So forgot locum GP and his/her ill informed comment. Your rheumy has much more experience of all the different types of inflammatory arthritis so is the person to listen to. Afetr all, they are far too busy to add another patient to their lists if there's any chance it isn't an inflammatory arthritis.

  • Back in the days I was getting bad headaches & asked my GP whether she thought they might be a side effect of mtx. She was adamant, absolutely adamant that headaches & mtx are not connected. Lookd at the leaflet in mtx packet & there it was top of the commonest side effects list: headache. Some of these people are a joke, not so much if they just don't know but when they pretend they do.

    I suppose though, looking at it from their point of view, they are talking talking all day long & sometimes might just come out with an ill-considered comment or twenty. And RA can be a shape shifter, diagnosis is difficult. But even if you did turn out to have one of RA's buddy diseases it probably would not be anything to worry about because you've got what you've got and the other inflammatory arthritis things are no worse than RA. Luce x

  • The Spondyloarthritis family can be just as severe or as mild as RA depending on how aggressive a version you have and they have sero-negative blood results so perhaps this locum was referring to these. Anyhow I thought I'd quote from my last rheumy letter re blood results as it seems relevant. "She (i.e me) is concerned that her ESR remains elevated. This of course is only one factor to consider. Whilst I will obviously take note of this I think it is important to treat symptoms and signs rather than blood test results at this stage". I hope this and the experiences of others on this blog make you feel a lot better about your blood not speaking up for you. TTx

  • Thank you all for the positive reassurance it's needed at times I to thought I was going bonkers and is all this swelling and pain something else, it took me a very long time before diagnosis.

    I'm going to ignore what this locum said to me.

  • Hello, I'm one of those whose blood test results don't always necessarily reflect what's actually going on in my body - thankfully I have just started to be seen by a new Rheumy (who is totally lovely :-)) and who is going to rely on imaging (MRI and ultrasound to see what is going on with me in the future.

    Please try not to worry too much about what the GP said and listen instead to your specialists - the clue is in the title _general_ practitioner, they know a little about everything but not enough to understand the complexities of this joyful affliction! Ignoring the locum is probably the best option!

  • Thank you

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