A Rheumatologist Explains: What to do with a +RF and neg CCP
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- เผยแพร่เมื่อ 29 มิ.ย. 2024
- Getting a positive Rheumatoid Factor (RF) test back may seem like it's a slam dunk for a diagnosis of Rheumatoid Arthritis (RA), but it's not. Rheumatologists use a collection of tests to help them diagnose RA, including the anti-CCP antibody test. This blood test is known to be much more specific for RA, but when it is negative in someone with a +RF, it can lead to a lot of confusion!
Learn how your doctor thinks about this scenario so you don't end up frustrated and in the dark!
🔗 Links:
Your Appointment Home Run Handbook - Rheumatoid Arthritis edition! - connectedrheumatology.com/app...
Everything you need to tell your doc your story and find out if you have RA once and for all!
⏱Time Stamps:
0:00 Intro
1:21 Is this you? You have RA. You don't have RA? You maybe have RA?
4:23 Other diagnosis to consider
7:08 How your doctor decides what to look for
10:20 What to ask your doctor
🎥 watch more:
5 Things to know about your positive Rheumatoid Factor: • 5 Things you need to k...
Top 10 Facts about Rheumatoid Arthritis pt1: • Top 10 Facts about Rhe...
Top 10 Facts about Rheumatoid Arthritis pt2: • Top 10 Facts About Rhe...
5 Things to know about your +ANA: • Top 10 Facts About Rhe...
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About me:
👩🏻⚕️ Hello! I am Dr. Elizabeth Ortiz and I'd like to thank you for stopping by Connected Rheumatology. I am a board certified Internist and Rheumatologist with over 12 years experience practicing Rheumatology and am passionate about teaching & empowering patients to partner with their doctor.
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We discuss all things Rheumatology, Immunology, Diet & Movement & Mental Health & Wellness because we believe IT IS ALL CONNECTED!
* The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional. Any comments and/or recommendations made in the comment section by anyone other than Connected Rheumatology does not reflect the opinion or recommendation of Connected Rheumatology.*
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Your presentations are excellent and spot on. I'm a health practitioner and really appreciate ( the few) Doctors like you. Such a help for people like me trying to get thru to ailing friends who haven't wakened up yet to the fact that their bodies heal themselves when you us more beneficial supplements and take out toxins!
This was very helpful ☺️ thanks for the question to ask during my next visit. Sometimes your not sure what to ask or how to ask. 🙏🏾
Thanks,you explained that really well as I tested positive for RF & CCP was negative! So back to my doctor for more tests ! 😊
I'm so happy I found your channel. :)
I was undiagnosed for 11 years for Rheumatoid arthritis and Sjogren's, until a few of my fingers started to get deformities 3 years ago. Now, they have me on prednisone, hydroxychloroquin, and methotrexate.
Hiya...im so sorry that you went through all that stress. I'm actually in the process of finding out what's wrong with me. I have arthritis in my neck and pelvic bone..they have found erosions in both hands and wrist...they ruled out rheumatoid cus I have no inflammatory in my blood work...now I have issues with my jaw and shoulders....im just worried cus ihave 4 small children....its very stressful
What about a video on sero negative for mctd, but with symptoms of ra, lupus and ms
Hi! Thank you for your channel. It’s very informative. I was diagnosed 10 years ago, but because my symptoms were almost non existent, I opted not to get on prescription meds. Two years ago I started taking Plaquenil, fish oil, vitamin D, and turmeric. I definitely am not a test case and wonder sometimes if it really is RA. My send rate and CPR have always been normal but my RF and CPP positive. I do not experience the morning stiffness although if I sit too long I am stiff. I don’t have swollen warm joints, but what I describe as more of a soreness, as though sore from over exercise. I used to have fatigue but no longer do with my change in diet and eliminating sugar. I do have extremely dry eyes, but not mouth. A complete contradiction! Lol
Thank you for this very informative video, and all of your wonderful and helpful ones as well! I do have a question, If you test positive for both RF and CCP, do numbers matter, or is the fact that they're both just present what matters for a definitive diagnosis? My blood tests showed they are both present, but they are low, but I have debilitating arthritis so I am very curious. Also, are CCP's related to any other conditions? Thank you so much for your work! This information is so valuable and helps us to better understand all of these tests and conditions.
Thank you for all the information 🤩🤩🤩💖💖
Thank you for your prompt response dr ,I am receiving physical therapy, for hip and foot ,I get bursitis a lot in the same hip as well anti inflamitories make me very wheezy as I have asthma ,and I had one bad reaction to cortisone about three years ago when my wrist and hand were extremely swollen and sore to the totch And it got a lot more swollen after the cortisone .so my gp told me to stop taking it , I have not taken it since ,u have a real calling as a doctor ,your gunine concern for all of us on utube ,wish I had u as my doc ,unfortunately I live in Ireland ,well I love living in Ireland but I won’t get to see u in person ,my doctor is very good ,I suppose when he meets his patients ,he is so busy ,we can only get a certain amount of time as there is a big shortfall of immunologist and rheumatologist in Ireland ,may God continue to bless guide and protect u .
Great video thank you for the info the was my case thank you so much
RA is rare.
A general practitioner can go years without coming across someone with RA. The odds are 1 in a a few hundred.
So most doctors will automatically assume that there are other issues causing the joint pain. Unfortunately for most of us with RA it is a battle to convince doctors that you have flare ups. Most of us have gone down a road of denial, flare up, recovery, remission.
When in remission it is often easy to self doubt and start thinking that you have conquered whatever it was that was causing you severe debilitating joint pain.
AND THEN... Out of nowhere you are crippled. Putting on your shoes can be a battle that can wipe you out for the day.
The problem is that early diagnosis can be so very important in avoiding long term and irreversible damage to your joints.
Keep fighting guys. Your quality of life depends on it.
I think it's only rare because Dr's. just aren't properly diagnosing. 😕 They have to do better.
I’m a hair stylist and three of my clients have RA, I’ve known so many more people with it.
The only way is go to a doctor in another country.
It is not rare, not even close
Thank-you for the video. I learned quite a bit : ) Could you possibly do a Video [in the future] on *Psoriatic Arthritis* re: Tests / Bloodwork etc ? In closing, I always appreciate your info, insight, suggestions & encouraging demeanor ~ Again, Thank-you & HAGW !! : )
th-cam.com/video/KnJzZIQyuLM/w-d-xo.html - there's always more I can get into, I've added your rec to my list!
You are great at explaining these concepts. If I may just propose, if you could use a lapel microphone, your videos would be so much more effective. It is difficult to hear with, Im assuming is the computer microphone. Thanks for your work.
Hello Doc thank you ❤❤❤
I believe rheumatism or rheumatoid arthritis can be cured because my mom has rheumatism when I in high school and it is gone. She just used ginger juice with coconut oil every night. And my dad has arthritis also 6 years ago, he can’t even walk for 1 year. Mom also used ginger juice and coconut oil to my dad every night plus medication and healthy food. I only follow what my parents are telling me to eat and they encourage me not to be afraid of medicine. I am about to go back in the Philippines on December because I believe that I will recover fast there, through the help of medication, fresh fruits and vegetables, fresh air in the sea and off course my family is there to help me take care of my son while I’m dealing with this painful arthritis. Fighting 💪😊
I am glad you found something that works for you! Being in a supportive, loving environment is certainly a vital component of any treatment plan.
I was diagnosed with Fibromyalgia several years ago, but my current doctor has doubts. Ten weeks ago I had a laparoscopic hysterectomy and bilateral salpingo oophorectomy. Two weeks ago I saw my first rheumatologist and she ordered 18 vials of blood drawn. I see in the portal that I have positive RF and negative CCP results along with a few more positive results.
My follow-up appointment is still 2 weeks away so I don't know what any of it means. I expect more tests before a diagnosis. Last week I went to the Emergency Room for fainting/syncope with continuing dizziness, chest and ribcage pain with pressure/tightness, palpitations, shortness of breath, nausea, diarrhea, and stabbing headaches. I had hypokalemia, high blood pressure (for me), and chest XRays showed pneumonia.
They admitted me, ran tests and scans, kept me 2 nights and ran more tests and scans, then said I was fine and sent me home. They said it was atelectasis in my lungs, not pneumonia, and told me to breath deeper. They also want me to wear a cardiac monitor for 30 days, but I can't get into the cardiologist until next month.
I'm wondering about good questions for the follow-up appointment. I also live 3 hours from a Mayo Clinic, and my insurance actually covers them. I am wondering at what point is a good time to contact them? Sooner so they can do all the testing in a consolidated time frame, or drag out the testing myself, hope for a diagnosis and then go to them as a second opinion?
That's assuming they'd accept me at all without a diagnosis in the first place, which I don't know. I wasted a lot of time and money just getting to this point and I only now feel like I might have a hope at answers and relief. I do hope it's true.
Anyway, I appreciate your videos. Thank you for educating with empathy.
I highly recommend Dr. Osaka on TH-cam channel, who helped me in getting rid of my Sle Lupus disease, It Amazing seeing myself free from the deadly diseases with the help of Dr. Osaka, I'm forever grateful Doctor.
I have arthritis right now , at first it was just inflammation. It started with in when I was in Albania last June. When I went back here in Dubai, I started my medication and it was getting better. But first week of October I started to feel pain again and almost everyday the whole day I feel pain an I can’t really do my task specially for my son. When I went back to my Doctor, she told me that I have arthritis. I started to feel this when started to exercise with force. I guess walking and yoga is the safest exercise when you have inflammation. I am doing everything to heal, I eat the right food plus medication.
hi , thank you for the great info , what could it mean that the RA is high and the HLA-B27 is negative ?
Have you gone over seronegative ra? What's your opinion? I know this is is a old video but I'm hoping someone can answer.
Thanks for this very clear video.
I'm continuing to struggle to find out what is wrong. A little over a year ago I had RF of 786. So many specialists and so many tests - all negative except unexplained fatty liver on ultrasound and a gradually rising ALT over last two years. In process of testing - sleep apnea and Barrets Esophagus dx and treated. I have taken methimazole for 18 yrs in varying amounts to control Graves. Otherwise healthy, and have lived a very healthy life, early sixties and at a loss as to what I should do next? Any suggestions?
TIA
Did it happen after Covid jab?
This is a very useful video. Thank you ! I went to the doctor with severe neck and shoulder pain along with intermittent fever and night sweats. All the blood work came ok except RF +52. MY CCP and lupus anticoagulant tests have come out negative though. My doctor is not sure what should be done next as I don't have any other symptoms. I'm concerned around cancer possibilities but my Dr thinks it's really low risk as all the other blood tests have come out normal. I'm still wondering what if they are missing something and get diagnosed for something really bad in the future. Please share your view.
The uncertainty when we are trying to figure it all out can be nerve wracking for sure! Neck and shoulder pain aren't typical RA or cancer symptoms, so I would agree with your doc that RA is lower on the list. What I didn't speak to in the video, is that sometimes this process of going through the different diagnostic possibilities can take time, more time than we usually want. But time is also a key component in coming to the right diagnosis as time can show us whether something gets better, worse or if new symptoms arise. Given how local your pain is (neck/shoulders), it may be worth asking your doc if any imaging (x-ray or mri) could be useful. Hang in there!
@@ConnectedRheumatology Thank you so much for your thoughtful response. I will keep an eye on the symptoms and get in touch with my doctor.
I have tested today Rheumatoid Factor 135.1 and positive Anti nuclear antibody but Anti CCP is 7.00 u/ml.
Please advice doctor
i am 27 years old male with bmi 21 and I dont have any pain right now and i general also but my RA factor is 20.6 IU/ml(positive) and anti ccp is 2.26 AU/ml (negative). my crp, ana and aso are negative but esr is 19mm/hr and hlab27 negative . do i have RA ?? if not can i have RA later on in my life ?? i did these tests because i had low back pain for 2 months which my doctor told is due to bad posture . do i need to worry about any auto immune disease due to RA factor being 20.6 IU/ml. Also my joints like knuckles neck and low back makes popping sound when i consiously crack them but without any pain
6 yrs ago I had a positive RF and positive CCP but I don’t have swollen knuckles, but I’ve also tested positive once for sjogrens, lupus and fibromyalgia. I is I coudetlewere
Is there a video on positive ccp and negative RA factor?
Any tips on lowering anti ccp levels?
I have a negative CCP and RF. And I had MRI that showed synovitis on my right hand. Is that enough to diagnose RA? Or should my rheumatologist keep trying to look for some other reason. I have positive ANA only. She put me on MTX and folic acid only. That made me swell. When before I had pain wirhout swelling. Go figure! Very frustrated!!
mctd is infection of the fingers, can you tell me a little about this cream?
After having covid in 2020 I'm convinced I have rheumatoid arthritis. I have all the symptoms including fevers. I have an appointment with a rheumatologist march 21, and I'm hoping to get a diagnosis. I was completely healthy before covid but now I'm always in pain and sick. My doctor says it's long haul covid but I think its rheumatoid arthritis.
Same situation here, however I don't have fever nothing swallon, but my joints has been killing me right after covid. So I did blood test for uric acid negative, then RHEUMATOID factor came at 51 percent, and the doctors said I have RA. When I take RA medication no changes. Until someone said I must try alkaline powder, I tell you if I drink alkaline the pain goes away. My feet iches and burns
I highly recommend Dr. Osaka on TH-cam channel, who helped me in getting rid of my Sle Lupus disease, It Amazing seeing myself free from the deadly diseases with the help of Dr. Osaka, I'm forever grateful Doctor.
mam my brother is 20yrs old nd he is suffering from joints pain last 9 months , his reports showing positive CCP nd CRP but negative RA factor,, nd doctors and not talking about what is it,,, please help please please,, he is in pain
I am anticcp positive and rf negative with joint pain. They've slapped me with a label of fibromyalgia (which my rheumatologist sent me back to my pcp for). I feel like my rheumatologist is ignoring my physical symptoms because there isnt erosion of joints yet on xray. How do i advocate for myself better?
What about a negative RH factor or normal and a high CCP
I have very high positive CCP and a positive rheumatoid factor can CCP change from positive to negative can RF also change from positive to negative
I first tested positive for RA factor in 2020 but CCP was negative. I tested positive again for RA factor this week and the numbers were higher but CCP is still negative. Unbearable joint and bone pain every day all over and flare ups. It is extremely hard to get out of bed becaue of the pain. Very weak and exhausted every day. Started with dry painful eyes a few months ago. I was only prescribed Meloxicam and Gabapentin which I hate. I feel ignored and super depressed as it has progressively gotten worse.
I m beign treated for mctd , ra, lupus and Ms ra beign the most prominent, but am sero negative for all inflamitory markers, I m on plaquenil and has helped a lot, but past 4 months have, hibtear, tendonitis and bursitis in my left hip and problem with bones in my left foot, most of my symptoms on left side, any comment Dr please
When someone has had multiple conditions for a while and then a new symptom or complication arises, it can be difficult to tease out if and/or how it is related to the ongoing conditions that person is already dealing with. You described tendon, joint and bone issues, which 1) may be due to active inflammation, 2) may be a consequence of old inflammation or 3) may be completely unrelated. The distinction between these possibilities is important because it will dictate how you and your doc approach it. I recommend keeping a symptom diary of your hip and foot pain and then discussing with your doc if physical therapy could be beneficial. Hope this helps!
What about -RH AND + CCP ? The rheumatologist I went to does not acknowledge this fact...no treatment for me and have to live with my increasing health problems 😢
My Blood work:
RF: 70
CRP: >10
CCP: 16 (Neg)
ANA: Neg
I deal with very bad inflammation. My left fingers on my left hand are numb wrist and ankle pain. My primary care doctor is stumped.
What was ur RA and now ur fine
I m totally stress out
Hello doctor plz i will appreciate it if u answer this my ana test come weakly postive at 1:100 my doctor said no need to do ENA test and DNA test since the result is not significant and asked to repeat the test after 3 months. I only have joints pain please do I need to worry ?your opinion please🙏🙏
It can be so confusing, I know. In general, "low positive" ANA results (however your lab defines that) only need to be chased if someone has many autoimmune symptoms. As frustrating as it can be, time can also be a very useful tool for both you and your doc in judging how to think about ANA results. Joint pain can come and go for a variety of reasons and watching how you do, (does the pain get worse? do new symptoms pop up?) can be very telling. A good symptom diary between now and your next visit will help you and your doc alot when trying to decide what the best next step is. Hang in there!
Had 146 r factor nothing else showing up one more set of blood test to see. I have small fiber neuropathy ( burning feet) would this mean an auto immune type ? Which small fiber are those ? Sed rate c reactive ana neurologist ordered blood work all look good waiting on Rehumotologist blood work in 2 weeks. No joint issues.
I highly recommend Dr. Osaka on TH-cam channel, who helped me in getting rid of my Sle Lupus disease, It Amazing seeing myself free from the deadly diseases with the help of Dr. Osaka, I'm forever grateful Doctor.
Can a positive CCP and RF later become negative. If not should I start medication now rather later
RF can, CCP cannot. The earlier you start medications, the higher the chances of remission and preserving healthy joints amd organs.
My ra is 40 and ccp is 7 crp is 0.5...i have different joints pain that goes with painkiller no stiffness n swelling no small joint pain n swelling ...what are the chances that i have ra???
I highly recommend Dr. Osaka on TH-cam channel, who helped me in getting rid of my Sle Lupus disease, It Amazing seeing myself free from the deadly diseases with the help of Dr. Osaka, I'm forever grateful Doctor.
Whats your update now?
Can RF value reverses or decreases ? If we change food lifestyle,yoga daily?
The RF level can definitely decrease with treatment and/or improvement in disease activity. It's not as reliable as we'd like it to be, but it can be an encouraging marker if you see it go down.
@@ConnectedRheumatology thank you so much !! I recently seen RF factor of 38 UI/ml in blood report .is it is worry about?
Ra can be cured completely with diet and meditation.....leave ur medication...follow strict diet and mental pece
For the viral category - can Epstein Barr virus reactivation be a cause of joint pain?