Can High Rheumatoid Factor Levels Return to Normal? Insights and Advice

Is it possible for a high rheumatoid factor to decrease to normal levels?

Hello Doctor,
I would like to ask you a question.
I have recently measured my rheumatoid factor twice, and both times it was very high, around 200.
The second measurement was even higher than the first.
My doctor suggested that I go to bed earlier to see if it can help lower the levels, but I am feeling quite anxious and sad, which often leads to insomnia or poor sleep quality, even when I try to sleep early.

I would like to know if you have encountered patients with very high rheumatoid factor levels who were later able to normalize them.
Currently, my symptoms are not very pronounced, except for experiencing brief morning stiffness in my finger joints (lasting 1-2 minutes) and occasional mild discomfort and pain in my joints.
My primary physician has not only recommended that I sleep earlier but has also prescribed Salazine to be taken once in the morning and once at night.

I look forward to your response.
Thank you very much.

Ms. Li, 40~49 year old female. Ask Date: 2022/09/04

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your question.
A high rheumatoid factor is an indication of immune dysfunction and, in principle, will not return to normal solely due to strict lifestyle adjustments.
A higher rheumatoid factor simply suggests that you have a greater likelihood of having a rheumatic disease; it does not indicate that you have a serious illness.
Additionally, as we age, the number of abnormal results that can be detected in our bodies tends to increase, similar to how an older car requires more frequent maintenance.
Therefore, I recommend that you do not become overly fixated on abnormal blood test results.
Instead, pay more attention to joint symptoms.
If joint swelling and pain worsen, you should schedule an earlier follow-up appointment.
If the symptoms remain mild, there is no need for excessive concern.
It is advisable to maintain a regular routine and engage in moderate exercise, which can help prevent joint function decline and also assist in alleviating tension, potentially improving sleep as well.
This is for your reference.
Best regards from the Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare.

Reply Date: 2022/09/04

More Info

High rheumatoid factor (RF) levels can indeed be concerning, especially when they are significantly elevated, as in your case with readings over 200. However, it is important to understand that a high RF level does not necessarily indicate a definitive diagnosis of rheumatoid arthritis (RA) or any other specific autoimmune condition. RF is a marker that can be elevated in various conditions, including infections, other autoimmune diseases, and even in healthy individuals, particularly as they age.

To address your question about whether high RF levels can return to normal, the answer is nuanced. In some cases, with appropriate treatment and lifestyle modifications, RF levels can decrease. However, this is not guaranteed, and the focus should primarily be on managing symptoms and improving overall health rather than solely on the RF number itself.

Your doctor’s advice to maintain a regular sleep schedule is beneficial, as sleep is crucial for immune function and overall health. Chronic stress and poor sleep can exacerbate inflammation and may contribute to elevated RF levels. If anxiety and sleep disturbances are significant issues for you, it may be helpful to explore stress management techniques, such as mindfulness, cognitive behavioral therapy, or relaxation exercises, which can improve both your mental well-being and potentially your physical symptoms.

Regarding your symptoms, the brief morning stiffness you experience is a common sign in various rheumatic conditions, including RA. The fact that it resolves quickly is a positive sign, but it is essential to monitor any changes in your symptoms. If you notice an increase in joint pain or swelling, it would be prudent to follow up with your healthcare provider.

As for the medication you are taking, Salazine (sulfasalazine) is often prescribed for inflammatory conditions, including RA. It can help reduce inflammation and may contribute to lowering RF levels over time. Consistency in taking your medication as prescribed is crucial for managing your condition effectively.

In summary, while it is possible for RF levels to decrease with treatment and lifestyle changes, the primary goal should be to manage your symptoms and maintain your quality of life. Regular follow-ups with your healthcare provider are essential to monitor your condition and adjust treatment as necessary. If you have concerns about your treatment plan or if your symptoms change, do not hesitate to seek a second opinion or further evaluation from a rheumatologist. They can provide more specialized insights into your condition and treatment options.

In addition to medical treatment, consider incorporating a balanced diet, regular physical activity, and stress-reduction techniques into your routine. These lifestyle factors can significantly impact your overall health and may help in managing inflammation and improving your well-being. Remember, you are not alone in this journey, and there are resources and support available to help you navigate your health concerns.

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