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Rheumatoid Arthritis and Autoimmunity: Connecting the Dots

Rheumatoid Arthritis and Autoimmunity: Connecting the Dots

Tracy Tranchitella is a Doctor of Naturopathic Medicine integrating the scientific principles of Functional Medicine with the sensibility and holistic view of traditional naturopathy.

Autoimmune disorders are complex conditions in which the body’s immune system mistakenly turns against itself, attacking healthy cells, tissues, and organs. This misdirected immune response can cause widespread inflammation, tissue damage, and chronic illness. More than 80 autoimmune disorders have been identified, including lupus, multiple sclerosis, type 1 diabetes, inflammatory bowel disease, and rheumatoid arthritis (RA). At Sunrise Functional Medicine, Dr. Tracy Tranchitella, ND, works with patients living with autoimmune disorders like RA, guiding them through the layers of diagnosis, treatment, and lifestyle support needed to manage these conditions effectively.

What Makes Rheumatoid Arthritis Different

Rheumatoid arthritis is distinct from other types of arthritis because it is autoimmune in nature. Instead of being caused primarily by wear and tear on the joints—as in osteoarthritis—RA develops when the immune system attacks the synovium, the lining of the joints. This immune response leads to painful inflammation, thickening of joint tissues, and eventual joint damage.

A hallmark of RA is the presence of autoantibodies, such as rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA), which mistakenly target the body’s own proteins. These immune markers help confirm a diagnosis of RA and highlight its autoimmune foundation.

Common Symptoms of RA

  • Joint pain and swelling – Often symmetrical, affecting the same joints on both sides of the body.
  • Morning stiffness – Typically lasting more than 30 minutes, sometimes for hours.
  • Warmth and redness – Signs of active inflammation.
  • Systemic symptoms – Fatigue, low-grade fever, malaise, and even organ involvement such as nodules, lung disease, or cardiovascular complications.

RA’s autoimmune nature is what sets it apart, making it a systemic condition that extends beyond the joints.

Why RA Often Overlaps with Other Autoimmune Conditions

Patients with rheumatoid arthritis are more likely than average to experience additional autoimmune disorders, a phenomenon called polyautoimmunity. Conditions such as lupus, psoriasis, and Sjögren’s syndrome commonly overlap with RA.

Several factors explain this clustering:

  • Genetics: Variations in immune-related genes, especially in the HLA-DRB1 group, increase susceptibility.
  • Environmental triggers: Smoking, infections, and even hormonal or dietary factors can provoke immune system dysfunction.
  • Chronic inflammation: The persistent immune activation in RA creates fertile ground for other autoimmune processes to develop.

This interconnectedness underscores the need for a holistic, whole-body approach to treatment.

The Immune System at the Core

At the center of RA is immune system dysregulation. Immune cells such as T-cells and macrophages release cytokines—chemical messengers that fuel inflammation. In RA, cytokines like tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) perpetuate inflammation, damaging tissues and accelerating disease progression. Mechanisms like molecular mimicry (when immune cells mistake self-tissues for invaders) and cross-reactivity (when immune responses overlap across tissues) help explain why someone with RA might develop additional autoimmune diseases.

Challenges in Diagnosis

Because RA shares symptoms like joint pain, fatigue, and stiffness with other autoimmune conditions, diagnosing it can be difficult. Physicians rely on:

Bloodwork: Testing for RF, ACPA, ANA, ESR, and CRP.

Imaging: X-rays, ultrasound, or MRI scans to detect joint damage and inflammation.

Comprehensive evaluation: Thorough history-taking and physical exams to look at the bigger picture, including family history and lifestyle factors.

This multi-layered approach helps distinguish RA from other forms of arthritis and identify whether multiple autoimmune disorders are at play.

Functional Medicine and Personalized Treatment

Dr. Tranchitella emphasizes that managing rheumatoid arthritis requires looking at the whole person—not just the joints. Functional medicine is well-suited to autoimmune conditions because it identifies root causes, explores triggers, and addresses lifestyle patterns that influence the immune system.

Conventional Therapies

Many patients benefit from medications such as:

  • DMARDs (Disease-Modifying Antirheumatic Drugs): Methotrexate, sulfasalazine, and others help slow disease progression.
  • Biologics: Targeted therapies like TNF inhibitors or IL-6 blockers offer precise immune system modulation.
  • Corticosteroids and NSAIDs: Useful for flare management, though not ideal for long-term use.

Functional and Lifestyle Approaches

Diet and nutrition: Anti-inflammatory eating patterns, such as the Mediterranean diet, help lower systemic inflammation. Identifying and removing potential food triggers can also improve outcomes.

Movement: Low-impact exercise strengthens muscles, maintains joint function, and reduces stiffness.

Stress reduction: Practices like meditation, yoga, or breathwork help regulate the nervous system, which in turn influences immune balance.

Sleep and recovery: Rest is vital for managing fatigue and preventing flare-ups.

By combining these strategies with medical treatment, patients often gain better symptom control and improved quality of life.

Living with RA

Rheumatoid arthritis is not just a physical condition—it also impacts emotional health and daily life. Many patients face challenges with fatigue, mobility, and the mental strain of living with a chronic illness.

Effective coping strategies include:

Education and self-management: Understanding one’s condition empowers better choices.

Practical adjustments: Using assistive devices or pacing activities to conserve energy.

Support systems: Connecting with others who have RA, whether through support groups or counseling, provides encouragement and shared wisdom.

Long-Term Outlook

Because RA is a chronic condition, ongoing care is essential. Monitoring allows providers to adjust treatments, track progress, and intervene early if new autoimmune symptoms develop. Collaborative care—bringing together rheumatologists, primary care providers, and functional medicine practitioners—creates the best outcomes for patients.

Rheumatoid arthritis is more than joint pain—it is an autoimmune condition that requires a comprehensive, personalized approach. With the right blend of medical treatment, lifestyle adjustments, and functional medicine support, patients can significantly improve their health and quality of life. Dr. Tracy Tranchitella and the team at Sunrise Functional Medicine help patients explore these pathways, addressing the root causes of immune dysfunction while supporting resilience and long-term well-being. Learn more and request a consultation today >>>