Rheum Therapeutics

03/11/2026

HELP!!! I'm Having a Gout Attack - What Should I Do?! 🆘🔥

If you're experiencing that excruciating red, hot, swollen joint pain from a gout attack, Board Certified Rheumatologist Dr. Tom Rennie has the information you need RIGHT NOW!

Understanding the Goal:
As Dr. Rennie talked about in a previous video, the goal for treating gout is very simple: You have to get your uric acid level less than 6.0. If your uric acid level is not less than 6, then your gout is not being optimally treated.

The Reality:
Although the goal is simple, gout is one of the MOST MISMANAGED diagnoses Dr. Rennie sees as a rheumatologist. Many patients aren't receiving the comprehensive treatment they need.

The Three Phases of Gout Therapy:
When Dr. Rennie talks to patients about treating gout, he explains there are three phases of therapy. Today we're focusing on the FIRST phase: treating a gout flare or gout attack - when you have that red hot, swollen, and very painful joint.

Treatment Options for an Acute Gout Attack:

Option 1: NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
NSAIDs include medications like ibuprofen or naproxen, but they have to be at their MAXIMUM anti-inflammatory dose to be effective for gout.
A lot of physicians prescribe indomethacin because that's what they were taught, but it can be ANY NSAID as long as it's at its maximum anti-inflammatory dose.

⚠️ Important: Check with your physician first to see if it's safe for you to take NSAIDs. Not everyone can safely use these medications.

Option 2: Colchicine
The recommended dose for using colchicine is:

Take 1.2 milligrams (2 tablets) at the FIRST sign of having a gout attack
Then one hour later, take 0.6 milligrams (1 tablet)

Timing is crucial with colchicine - the earlier you start at the first sign of symptoms, the more effective it will be!

Option 3: Steroids
We also use steroids to treat gout attacks. You have several options:

Take the steroids orally (by mouth)
Get an intramuscular steroid injection (shot in the muscle)
Get a steroid injection directly into the joint having the gout flare

All three methods can be effective - the choice depends on your specific situation and preferences.

The Critical Thing to Understand:
It is important to realize that these treatments are ONLY treating the SYMPTOMS of the gout attack. They are NOT actually treating the underlying cause of gout.

Treating the Root Cause:
To treat the underlying cause of gout, we have to start you on a medication to lower your uric acid level. (Stay tuned for the next video where Dr. Rennie will discuss the medications that lower uric acid!)

The Bottom Line:
When you're in the middle of a painful gout attack, these treatments can provide much-needed relief. But remember - this is just phase 1 of comprehensive gout management. To truly treat gout and prevent future attacks, you need to address the underlying uric acid levels.

Comment below about your experience with gout! Have you tried any of these treatments? What worked best for you? 💬

Also check out our website rheumthera.com to see how we might be able to help you with your gout pain. Your relief starts now!

03/10/2026

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03/09/2026

Neuropathy: The Autoimmune Connection You Need to Know About 🧠⚡

Are you experiencing numbness, tingling, burning sensations, or unexplained pain that no one seems to be able to explain?
This could be a sign of neuropathy - and it might be caused by an autoimmune disease!

What is Neuropathy?
Neuropathy refers to nerve damage that causes abnormal sensations. Common symptoms include:

Numbness (often in hands or feet)
Tingling sensations
Burning pain
Unexplained pain that comes and goes

The Autoimmune Connection:
While most people associate neuropathy with diabetes or herniated discs, autoimmune diseases are actually a significant cause that often gets overlooked.
Specifically, Sjögren's syndrome and lupus are two of the main autoimmune diseases that can cause nerve pain and peripheral neuropathy.

can cause nerve pain and peripheral neuropathy.
When Should You Get Tested?
If you're experiencing neuropathy symptoms but you DON'T have:

Diabetes (the most common cause of neuropathy)
Thyroid disease
A known risk for a herniated disc that could be causing nerve pain

→ It's time to ask your primary care doctor to check some specific labs!

What Labs Should You Request?
Ask your doctor to check:

ANA (Antinuclear Antibody) - a general screening test for autoimmune diseases
SSA (Sjögren's Syndrome A antibody) - specific for Sjögren's syndrome
SSB (Sjögren's Syndrome B antibody) - also specific for Sjögren's
Double-stranded DNA - can help identify lupus

Why This Matters:
Many people suffer with neuropathy symptoms for years without ever discovering the underlying autoimmune cause. If your neuropathy is related to Sjögren's syndrome or lupus, there are specific treatments available that can help manage both the autoimmune disease and the nerve pain.

Sjögren's syndrome, in particular, is known for causing peripheral neuropathy - affecting the nerves in your extremities and causing those numbness, tingling, and burning sensations.

The Bottom Line:
Not all neuropathy is caused by diabetes or spinal issues. Autoimmune diseases like Sjögren's syndrome and lupus should absolutely be on your radar if you're experiencing unexplained nerve pain.

If you're dealing with these symptoms and haven't been tested for autoimmune conditions, talk to your doctor about getting the appropriate blood work done.

Do you experience numbness, tingling, or burning sensations? Have you been tested for autoimmune causes? Share your experience in the comments! 💬

Follow us for more rheumatology accurate information. Visit rheumthera.com - your relief starts now!

03/06/2026

Can Gout Cause a Heart Attack? The Answer Will Surprise You! 🫀

If you think gout is just about painful, swollen joints - think again! Board Certified Rheumatologist Dr. Tom Rennie wants you to understand the serious cardiovascular risks associated with gout.

What Most People Think:
"Gout is just that painful, red, hot, swollen joint that flares up from time to time."

The Reality:
Gout is SO much more than joint pain - and the cardiovascular connection is something EVERY gout patient needs to understand!

The Cardiovascular Connection:

Research has consistently shown that people with gout have a significantly increased risk of cardiovascular disease, including heart attacks and strokes. This isn't just a coincidence - there's a direct biological connection.

Why Does Gout Increase Heart Attack Risk?

Gout is a systemic inflammatory disease. The inflammation doesn't just stay localized in your joints - it affects your entire body, especially your cardiovascular system.

Here's how:

High Uric Acid Damages Blood Vessels - Elevated uric acid levels can directly damage the walls of your blood vessels, making them more prone to atherosclerosis (hardening of the arteries)

Systemic Inflammation - The same inflammatory processes that cause painful gout attacks also contribute to inflammation throughout your cardiovascular system

Atherosclerosis - Chronic inflammation and high uric acid contribute to plaque buildup in your arteries, increasing heart attack and stroke risk

Blood Pressure Effects - Gout and high uric acid are associated with hypertension (high blood pressure), another major heart attack risk factor

Kidney Function - High uric acid can damage kidneys, which in turn affects cardiovascular health

Why This Changes Everything About Gout Treatment:

When we tell patients they need to get their uric acid level below 6.0 and keep it there, it's not JUST about preventing those painful gout attacks. It's about:
✓ Protecting your heart and blood vessels
✓ Reducing your risk of heart attacks and strokes
✓ Lowering systemic inflammation throughout your body
✓ Improving your overall cardiovascular health
✓ Potentially adding years to your life

The Bottom Line:
Gout is NOT just joint pain - it's a serious metabolic disease that affects your entire body, with particularly serious implications for your cardiovascular system.

If you have gout, working with your doctor to properly manage your uric acid levels isn't just about comfort - it's about protecting your heart and potentially saving your life.

Have you been diagnosed with gout? Were you aware of the cardiovascular risks? Share your thoughts in the comments! 💬

Visit rheumthera.com to learn more about managing gout and arthritis pain. Your relief starts now!

02/28/2026

Methotrexate Side Effects: What Patients Need to Know 💊

Methotrexate Side Effects: What Patients Need to Know 💊
If you're taking or considering methotrexate for rheumatoid arthritis, psoriatic arthritis, or another autoimmune condition, Board Certified Rheumatologist Dr. Jane Ayala wants you to understand the possible side effects.

Side Effect #1: Hair Loss

Usually, hair loss is multifactorial - stress, hormones, everything affects our hair. But it IS a valid concern with methotrexate. If a patient already has significant hair loss, Dr. Ayala will avoid prescribing methotrexate.

How we prevent it:

We ALWAYS give methotrexate with folic acid or folate to prevent hair loss
Dr. Ayala also recommends patients take hair, skin, and nails multivitamins

Side Effect #2: Liver Issues

We monitor labs - especially liver function and CBC (Complete Blood Count) to check the size of your cells - every three months as an average for all patients. That's why regular blood work is so important!

When methotrexate is NOT a good idea:

If someone already has liver issues like advanced fatty liver disease, hepatitis B, hepatitis C, or if they drink too much alcohol, methotrexate is not a good medication choice for them.

Side Effect #3: Infections
Yes, methotrexate can increase the risk of infections. But here's important context: In general, prednisone/steroids is even worse for you when it comes to infection risk!

What we recommend:

We tell our patients to stop (hold) methotrexate while they're fighting an infection. Once the infection clears, you can resume the medication.
Why Do We Prescribe Methotrexate Despite These Side Effects?
We prescribe methotrexate to prevent damage in your joints and to change the disease itself - not just to mask the pain. It's a disease-modifying medication that can actually slow or stop the progression of autoimmune conditions.

Our Philosophy:

We encourage questions. We encourage good information and reliable information. It's okay to ask questions - in fact, we want you to! Post some below for us.

Taking medications for chronic conditions can feel overwhelming, but understanding the risks and benefits helps you make informed decisions with your doctor.

Have you taken methotrexate? What's been your experience with it? We'd love to hear from you in the comments! 💬

Visit rheumthera.com to learn more - your relief starts now!

02/26/2026

02/24/2026

Steroids: Pros and Cons - What You Need to Know ⚖️
Steroids (corticosteroids like prednisone) are one of the most commonly prescribed medications in rheumatology - but they're also one of the most misunderstood. Board Certified Rheumatologist Dr. Jane Ayala breaks down the pros AND cons!

THE PROS - Why Do We Prescribe Steroids?
✓ It works FAST - often improves pain and stiffness within hours to days
✓ Powerful anti-inflammatory effect - can calm severe inflammation quickly
✓ Useful as bridge therapy - helps while your disease-modifying drugs start working
✓ Helps control flare-ups - can stop an active flare in its tracks
✓ Can improve function and quality of life short-term - helps you get back to daily activities

THE CONS - Why We're Cautious About Prescribing
✗ It does NOT treat the underlying disease - only manages symptoms temporarily
✗ Long-term side effects increase with dose and duration - the longer you take it and the higher the dose, the more risks

Common Side Effects:

Weight gain (which women hate... men hate it too!)
Increased appetite
Mood changes
Anxiety
Insomnia
Elevated blood sugar, especially for diabetics
Elevated blood pressure
Swelling
Retaining water

Really Serious Side Effects:

Osteoporosis (bone loss)
Increased risk of infections
Muscle weakness
Suppression of your adrenal glands

Long-term use is just not good for you - that's why we're so careful!

So How Do We Usually Prescribe It?
As rheumatologists, we prescribe the LOWEST dose possible for the SHORTEST time possible. This helps you get the benefits while minimizing the risks.

The Bottom Line:
Steroids can be incredibly helpful - even lifesaving - for managing flare-ups and severe inflammation. But they come with significant trade-offs, especially with long-term use. That's why we use them strategically and always aim to taper down and off when possible.
What's your experience with steroids? We'd love to hear in the comments! 💬

Visit rheumthera.com to learn more - your relief starts now!