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Suggest Medical Tests To Rule Out Rheumatoid Arthritis

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Posted on Thu, 4 Aug 2016
Question: Started having nodules in my finger joints, and knots developing on the back of my fingers and some toes. Painful joints and fatigue. Diagnosed a year ago wth diabetes type two but stopped all carbs, lost 35 lbs and my a1c is now 6.0. Felt so bad and went to the doc who did Ra factor, CBC, testosterone, and 4 other test. RA factor came back and over 30...........testosterone low. He has now orders some nuclear test for autoimmune diseases. Once that test comes back I have to go back. My questions are
How do I know it is RA and not something like lupus...... though I don't think lupus causes bony growth on the back of finger joints
2. He is going to discuss testosterone therapy in the form of shots..........are they proven safe and would you begin this ?? Thanks for your help XXXXXXX
doctor
Answered by Dr. Mirjeta Guni (56 minutes later)
Brief Answer:
It is rheumatoid arthritis and i would also recommend testosterone .

Detailed Answer:
Welcome and thank you for asking on HCM!

I read your concerns carefully.

I am trying to clarify your queries. Regarding to rheumatoid arthritis, you are right, rheumatoid factor is not very specific for rheumatoid arthritis but you have the typical symptoms of arthritis. Anyway, Anti-cyclic citrullinated peptide (anti-CCP) antibody testing is particularly useful in the diagnosis of rheumatoid arthritis, with high specificity, presence early in the disease process, and ability to identify patients who are likely to have severe disease and irreversible damage.

Regarding to low testosterone level it may be due to andropause or a complication of diabetes, I would also recommend to start treatment with testosterone because low testosterone level may cause osteoporosis, fatigue, muscular weakness, risk for cardiovascular disease etc .

It will not have side effects if you take the proper dose because it is a hormone that lacks in your body and should be substituted preventing the above mentioned symptoms and side effects.

Hope the information is helpful.
Please close and rate the answer if you do not have further queries.

Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Mirjeta Guni (45 hours later)
thanks so much for the response. My RA factor was over thirty and you see the physical problems I am having. THe doc just called and said my nuclear antibody test was negative so its not Ra at all. He offered no other explanation but wants me to start the testosterone shots. WIth all the physical manifestations I have, I certainly don't want to wait to find out whats wrong with me. Any ideas on what path I should take or maybe just see how the testosterone might help first ? I cannot continue to ache in my joints and be this fatiqued all the time. Thanks so much. XXXXXXX
doctor
Answered by Dr. Mirjeta Guni (36 minutes later)
Brief Answer:
Start treatment for both problems.

Detailed Answer:
Welcome back!

Low testosterone and the problems with joints are two independent problems.
As i've suggested above you should start the treatment with testosterone shots and check the testosterone levels frequently.

Even if your treating doctor didn't confirm the rheumatoid arthritis, it doesn't mean that your symptoms should not be treated. You should not continue to live with pain. In these cases the physical examination helps a lot to decide the stage of the arthritis (rheumatoid or not) and the treatment plan.

So the treatment should be started in parallel for both problems.
Wish you good health!
Kind regards,
Dr.Mirjeta
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
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Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2414 Questions

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Suggest Medical Tests To Rule Out Rheumatoid Arthritis

Brief Answer: It is rheumatoid arthritis and i would also recommend testosterone . Detailed Answer: Welcome and thank you for asking on HCM! I read your concerns carefully. I am trying to clarify your queries. Regarding to rheumatoid arthritis, you are right, rheumatoid factor is not very specific for rheumatoid arthritis but you have the typical symptoms of arthritis. Anyway, Anti-cyclic citrullinated peptide (anti-CCP) antibody testing is particularly useful in the diagnosis of rheumatoid arthritis, with high specificity, presence early in the disease process, and ability to identify patients who are likely to have severe disease and irreversible damage. Regarding to low testosterone level it may be due to andropause or a complication of diabetes, I would also recommend to start treatment with testosterone because low testosterone level may cause osteoporosis, fatigue, muscular weakness, risk for cardiovascular disease etc . It will not have side effects if you take the proper dose because it is a hormone that lacks in your body and should be substituted preventing the above mentioned symptoms and side effects. Hope the information is helpful. Please close and rate the answer if you do not have further queries. Kind regards, Dr.Mirjeta