Rheumatoid Arthritis

Ρευματοειδής Αρθρίτιδα


Rheumatoid Arthritis is an Autoimmune Disease that mainly affects the joints of your body. The alteration of the synovial fluid leads to a painful inflammatory process over time that lead to chronic systemic inflammation.

Rheumatoid Arthritis is one of the hundred types of arthritis, with some of the most common types, being Osteoarthritis, Gout Arthritis and Psoriatic Arthritis.

All types have different causes, but the common factor is pain in the joints and eventually destruction.The disease affects 0.8 – 1% of all populations and is considered the second most common rheumatic diagnosis after Osteoarthritis.

It tends to affect two to three times more women than men.


Rheumatoid Arthritis Symptoms

Symptoms of Rheumatoid Arthritis mainly include pain, stiffness, swelling and redness around the joints. Patients tend to have symptoms in their hands, shoulders, elbows, hips and knees.

Usually, patients will have exacerbations followed by recessions, accompanied by a progressive deterioration of joints and damage caused by systemic inflammation.

The disease usually begins late in two thirds of patients and is often not diagnosed in the early stages.

Because of the systemic inflammatory nature of the Disease, additional symptoms include malaise, fatigue, loss of appetite and general aches.


Rheumatoid Arthritis & Immune System

Rheumatoid Arthritis is both an inflammatory arthritis and an Autoimmune Disorder.

In the early stages of the disease, before the inflammation of the joints occurs, a series of events occur in which the immune system loses the ability to distinguish between the tissues of the body (itself) and foreign tissue. This results in your immune system mistakenly attacking your own body, which in the case of RA is your joints, but it can also affect the surrounding tissues, including muscles, ligaments, tendons, and even other organs.

As the tissues begin to deteriorate due to repeated inflammation and immune activation, the joints may become deformed due to tissue damage.

Η λειτουργία της άρθρωσης μπορεί επίσης να ανασταλεί ή ακόμα και να σταματήσει στα προχωρημένα στάδια της νόσου.


Rheumatoid Arthritis Causes

Traditionally, Rheumatoid Arthritis is considered a Chronic Idiopathic Inflammatory Disorder, meaning the cause is unknown. There is evidence that the majority of patients are genetically predisposed to the Disease.

There are additional causes such as environmental toxins, food sensitivities, allergies, stress, trauma, infections, bacterial overgrowth (dysbiosis), leaky gut syndrome and hormonal imbalances.


Rheumatoid Arthritis Diagnosis

The doctor diagnoses Rheumatoid Arthritis through a physical examination, blood tests and possibly some imaging tests.


  • Joint pain and morning stiffness (over 30 minutes) with history of previous episodes
  • Family history of Rheumatoid Arthritis
  • Characteristics of systemic flu and fatigue
  • Three or more swollen joints and sensitive areas (simultaneously)
  • Symmetric involvement in the joints in the hands and / or feet
  • Pain when pressure in the arms and legs (joints MCP or MCT)
  • resence of rheumatoid nodules (skin tightly pieces) that are in common pressure points on the body, usually on the elbows.

Blood Test

  • Rheumatoid Factor (RhF)
  • Erythrocyte Sedimentation Rate (ESR)
  • C-Reative Protein (CRP)
  • Antinuclear Antibody (ANA)
  • Anti-Parental Cell Antibody (APCA)
  • Cyclic Citrullinated Peptide Antibody (CCP)

Imaging tests

An X-Ray will reveal signs of bone damage in your hands and wrists, but this is usually observed at later stages of the Disease.

It is important to note that many patients will suffer for many years with chronic pain as they may not meet the “official” criteria for diagnosing RA in the early onset of the Disease.


Rheumatoid Arthritis Treatment

The usual treatment involves prescribing NSAIDs, steroids, and even drugs.

Unfortunately, these treatments only cover the Disease and long term use will usually cause unpleasant side effects, such as fatigue, rashes, intestinal discomfort and bleeding and anemia.

In addition, the effectiveness of treatment will decrease over time and may even aggravate the pain in the long run.

With the diagnosis of Rheumatoid Arthritis, drug therapy in collaboration with a rheumatologist is considered the gold standard of care.

Your doctor will usually prescribe traditionally used Disease-Modifying Anti-Rheumatic Drugs (DMARDs) such as Methotrexate or Plaquenil, which focus on slowing down the immune process, leading to reduced inflammation and slowing joint damage.

The newer biological drugs DMARDs focus on very specific immune cells that may be involved in the disease process, rather than targeting the entire immune complex. While these treatments are effective for many, they are at best comforting and do not provide treatment for the disease.


Rheumatoid Arthritis Causal Treatment

Effective treatment of Rheumatoid Arthritis can often be achieved through a combination of treatment approaches and management of traditional and Functional Medicine.

While medication is often needed during acute exacerbations, a skilled practitioner of Functional medicine can help you identify and treat the underlying causes of disease, to effectively eliminate the disease.


Possible causes may be:

  • Imbalance of DHEA / cortisol ratio / S lgA
  • Increased intestinal permeability
  • Bacterial parasitical infections
  • Hormonal imbalance
  • Fatty acid imbalance
  • Micronutrients and aminoacids deficiency
  • Oxidative stress

At the same time, always applying the right anti-inflammatory diet along with the appropriate physiotherapy helps to integrate the disease into a comprehensive therapeutic approach.



Dr. Nikoleta Koini, M.D.

Doctor of Functional, Preventive, Anti-ageing and Restorative Medicine.
Diplomate and Board Certified in Anti-aging, Preventive, Functional and Regenerative Medicine from A4M (American Academy in Antiaging Medicine).




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