Treating Rheumatoid Arthritis: Hair Loss and Other Medication Side Effects
Modern-Day Treatments Ease Symptoms of RA
So far, there is no cure for rheumatoid arthritis (RA), a debilitating joint disease that causes chronic inflammation in the lining of the joints. Those living with the condition experience pain, swelling, and stiffness, and may have difficulty performing everyday tasks.
Over time, RA may erode the bones that make up the joint. Modern-day treatments can help ease inflammation and pain, and slow down the progression of the disease. Unfortunately, for many, some treatments also come with potential side effects.
Treatment #1: NSAIDs
In the early stages of RA, doctors may recommend you take over-the-counter pain relievers. Called non-steroidal anti-inflammatory drugs (NSAIDs), these medications help ease inflammation and soothe pain. Common brands include Advil, Motrin IB (ibuprofen), and Aleve (naproxen).
Though considered safe for occasional use, NSAIDs may cause side effects when used long term. The American College of Rheumatology notes that the longer you take the drugs, the greater your chance of side effects, including:
- stomach upset and bleeding
- high blood pressure
- fluid retention
Infrequent, but severe side effects include skin rashes and heart and kidney problems.
Treatment #2: Steroids
Corticosteroid medications (also called glucocorticoids) are most often used to relieve acute pain. They can be very helpful in calming inflammation and easing pain and stiffness. However, as the body adapts over time, they can lose their effectiveness. Doctors typically recommend only a limited number of steroid injections, or a few months of steroid tablets.
Side effects of steroids depend on the dosage. Low doses can lead to fragile skin, osteoporosis, and fatty deposits in the face. Long-term use at high doses can increase risk of:
- heart disease
- high blood pressure
Treatment #3: DMARDs
Disease-modifying antirheumatic drugs (DMARDs) include brands such as Trexall, Arava, Plaquenil, and Azulfidine. They’re thought to block certain chemicals involved in the inflammation process. By doing so, they not only ease symptoms, but help slow down the progression of the disease.
These medications are frequently prescribed upon diagnosis, and may be taken for long periods of time.
There are a number of different types of DMARDs. Side effects can vary depending on which one medication you take. Like NSAIDs, all types of DMARDs may cause stomach upset. Potentially serious but rare side effects vary, and may include:
- liver injury
- mild hair loss
- mouth sores
- muscle aches
Treatment #4: Immunosuppressants
Rheumatoid arthritis is an autoimmune disease, which means that some malfunction in the immune system causes the body to attack the lining of the joints.
Immunosuppressants help to combat this immune overreaction. By taming the immune system, immunosuppressants ease symptoms like swelling and pain. However, they can also dampen your defenses, which can leave you at greater risk for infections and even cancer.
Less serious side effects may include:
- digestive problems
- trouble sleeping
- abnormal hair growth
- tremors or shakes
Treatment #5: TNF-Alpha Inhibitors
TNF-alpha inhibitors reduce the formation of tumor necrosis factor-alpha, which is an inflammatory substance produced naturally by the body. This class of medications is also called biologics.
Like immunosuppressants, TNF-alpha inhibitors can increase your risk of infections, particularly tuberculosis. When used long term, they may also increase risk of fungal infections and certain types of blood cancers.
More common side effects include:
- hair loss
- injection site reactions
Treatment #6: Other Drugs
Though most drugs fall into one of the categories mentioned, there are others that target inflammation in unique ways. These may be used alone or in combination with other medications.
Rituxan is one such drug. Often used in combination with steroids, it works by reducing specific white blood cells thought to be involved in attacking joints.
Possible side effects include skin and mouth reactions, injection site reactions, chills, body aches, low white blood cell count, and fatigue. More serious and rare side effects may include:
- the reactivation of hepatitis B virus
- stomach and serious bowel problems
- heart and kidney problems
- serious infections
- tumor lysis syndrome
Dealing with Side Effects
Each person has unique body chemistry, and is likely to react differently to different medications. Ask your doctor what the risks are, so you can be prepared, and report any side effects you may be experiencing. Your doctor may have other medications you can try, or may be able to change your dosage.
You may also be able to reduce stomach upset by eating something before taking your medications, or by taking the medication before bed.
Weigh the Risks and Benefits
All drugs have potential side effects. Your job is to talk about the benefits and risks with your doctor, then make a decision. Changes in your body and lifestyle often require an adjustment in your therapies. Most likely, you’ll need to modify your treatment as you go.
- Steroids in Rheumatoid Arthritis. (2002, Sept. 6). NRAS. Retrieved on November 27, 2013, from http://www.nras.org.uk/about_rheumatoid_arthritis/newly_diagnosed/which_drugs_are_used/steroids_in_rheumatoid_arthritis.aspx.
- The Tumor-Necrosis-Factor Alpha (TNF-a) Blockers: An Overview. (2013, Apr. 18). Spondylitis Association of America. Retrieved on November 27, 2013, from http://www.spondylitis.org/press/news/583-TNF-a-blockers-overview.aspx.
- NSAIDs: Nonsteroidal Anti-inflammatory Drugs. (2012, Aug.) American College of Rheumatology. Retrieved on November 27, 2013, from http://www.rheumatology.org/Practice/Clinical/Patients/Medications/NSAIDs__Nonsteroidal_Anti-inflammatory_Drugs/.
- Patient.co.uk - Trusted medical information and support. (2011, Dec. 15). Patient.co.uk. Retrieved on November 27, 2013, from http://www.patient.co.uk/health/disease-modifying-antirheumatic-drugs-dmards.
- Rheumatoid Arthritis. (2013, Nov. 27). Mayo Clinic. Retrieved on November 27, 2013, from http://www.mayoclinic.com/health/rheumatoid-arthritis/DS00020.