Is Rhumatologist right about my pains?
Hello I am a 48yr old man and was diagnosed with psioratic arthritis 5yr ago and take Methotrexate weekly. I've suffered from aches and fatigue for 6yr and put it down to my condition however both times I have seen the Rhumatologist he insists that because my blood tests are "perfect" then my condition is "fully under control" and any pain or fatigue is caused by something else, the first follow-up appointment he said I need to exercise more so Ive walked to work ever since (takes an hour a day). This time he said he doesn't know what the problem is and I should contact my doctor. What do you think? Thanks for reading and any advice would be gratefully received.
Marc
I don’t believe in trying to second guess doctors, particularly other people’s doctors. But, no, your rheumatologist is not right, but also not wrong. PsA is a seronegative disease, meaning there are no anti-bodies present to test for. Many with PsA have labs that present as 100% normal, even when their disease isn’t 100% under control. So, even with normal labs, you can still be suffering symptoms of PsA, and any rheumatologist who says that it’s “fully under control” is being really, really optimistic. That being said, it is pretty common for those of us with PsA to suffer other immune system diseases, any one of which could cause aches and fatigue completely separate from PsA. If your labs were perfect, then I’m assuming your TSA and T4 levels were checked, ruling out issues with your thyroid. So, while your rheumatologist may be right in asserting that your symptoms aren’t being caused by your PsA, he’s wrong to do so simply due to the absence of abnormal lab findings. And he certainly should try to get to the bottom of it with you. You are your own best advocate, so be firm that you want your doc to look into this for you.
Thank you for your reply, I will speak to my doctor this week and try to get to the bottom of it all.
