The fatigue that comes with arthritis has been compared to walking through thick mud, working 24 hours a day or having a 100-pund pack strapped to your back. Fatigue has been widely ignored as a smyptom even though for many people with arthritis it may be more of a problem than pain.

While fatigue may make it hard just to get out of bed, a little activity can help a lot. So can a frank conversation with your doctor, as fatigue is sometimes a symptom of an underlying medical problem such as anaemia, chronic pain, medication side effects or an underactive thyroid.

Evolution may be partly to blame for autoimmune diseases such as rheumatoid arthritis, new research suggests.

Scientists have found that gene variants linked to the autoimmune disease may have brought about a survival advantage in humans that prevented these ‘faulty’ genes from being bred out by natural selection.

Researchers at Stanford University’s School of Medicine conducted a genetic study which revealed that several mutations associated with an increased risk of rheumatoid arthritis had been increasing in prevalence.

Usually, versions of genes that cause disease or premature death are selected out under the process of natural selection, because affected individuals tend to be less likely to have children and pass on the mutation. However, the research suggests that, in order to increase in prevalence, the mutations for rheumatoid arthritis must have conferred enough of an advantage to ensure they were passed on to new generations.

According to the research article, which is published in the Public Library of Science One, one possibility is that the faulty genes may have provided our ancestors with some protection against certain viruses or bacteria, such as tuberculosis. The study authors wrote: “There is a stark correlation between populations having higher incidence of tuberculosis also having lower incidence of rheumatoid arthritis, and vice versa.

“It has been speculated that genetic variants enhancing resistance to tuberculosis underwent positive selection and provide the genetic basis for rheumatoid arthritis susceptibility today. Our analysis is completely compatible with this theory.”

My name is Laura, I was diagnosed with juvenile arthritis (JA) when I was 10. For me the news came as a relief at last I had an answer as to why I was in so much pain. At first I just accepted that I have arthritis but as I got older I wanted to learn as much as possible about JA.

I began to really struggle with having arthritis when I was 16. I found growing up with a disease that wasn’t visible to the eye difficult. I had difficulties in school until I explained to each of my teachers how JA impacted me .I explained that I get tired quite easily, I find it difficult to concentrate, I find it difficult to sit for a long time, and I feel worse in the mornings. Once I explained this to my teachers I found things a lot easier.

However I was once told that I was too sick to go to college and perhaps I should undertake something a little less challenging. This has made me more ambitious and determined to succeed. I finished school and I went on to complete a bachelor of business & finance, a masters in finance and I am currently undertaking professional chartered accountancy exams.

I get angry and frustrated sometimes when I can’t do things that others find so easy. When I have a bad flare up I tend to feel frustrated I like to be able to move about. I find that listening to my ipod helps me to drift away for a little while.

I’ve always been quite open about having arthritis. For me I find each life stage brings different challenges. While I was in school my peers knew I had arthritis but I found it difficult to tell people as I got a bit older so when I went to college I knew people would ask me “ oh what happened ” when I was wearing splints or if I was using crutches. My first assignment in college was a communications presentation. I presented a case study about a young adult who has arthritis. I got up and spoke about this girl and about how arthritis affected her and then at the end of the presentation I told my class that the girl was me. I found by educating my class they were more understanding. For me this was the easiest way to tell everyone at once and they treated me the exact same as everyone else but with a little understanding when I needed it. If I missed classes because of my arthritis they would email me their notes.

After my junior cert I got a scribe, someone who toke down my notes and wrote for me during exams. I used a scribe until I finished college. During exams I had a separate room so that I could move about and take rest breaks. I was also given extra time for exams. As soon as I went to college I registered with the disability officer. She gave me great support from exams to special voice recognition software for my laptop. The disability officer tailored a plan for my requirements and emailed all staff I came into contact with to make them aware of how JA affects me, that I may miss time from college, that I am on medication that affects my concentration, and that I am under the care of a medical team who I need to see on a regular basis.

I surrounded myself with good friends when I moved away from home this helped when I was having a bad day. I found an apartment on campus a short walk from college and the shops. I found this was the best option as a management team looked after the student village so if I ever needed anything they were on hand. The weekly shop proved to be quite difficult I found it next to impossible to get the groceries back to the apartment. I started eating junk food and take-aways because I couldn’t carry the shopping back to the apartment but pretty soon I was feeling rubbish eating so unhealthily. I came up with a number of ways to combat this I found a supermarket that delivered, I went shopping with friends once a week and we shared a taxi and I did a big shop once a month to get all the heavy items.

Even though I had the food in the apartment I sometimes found cooking difficult I didn’t have the energy or my hands where quite sore. I bought frozen vegetables as a back up so I didn’t have to cut them, I could throw them straight into a stir fry. I also found making a couple of extra portions of my favourite meals and popping them into the freezer quite useful. My friends & I did cooking nights we dedicated one night where we all helped make a slap up meal or took turns to cook.

My first couple of weeks away from home bought many late nights and with a party to attend every night, I soon found the fun catching up on me and I was bought back to reality with a bad flare up which took me a while to recover from. I learned my lesson the hard way and from then on things changed. To prepare for nights out I make sure I have a lot of rest before and after, I make sure its safe to drink alcohol with my medication and that I don’t overdo it, I let my friends know if I’m not feeling great sometimes I still go out but make sure that I have seats reserved in the bar. It’s important to find a happy middle ground by overdoing it I found that I was the one who suffered in the end which meant that I was missing out. It was difficult realising I couldn’t do everything but I was able to have more fun by finding a balance.

When I was sixteen my parents decided I should take responsibility for my own health. At first I found this very difficult I had to arrange my own blood tests, pick up my medication, ensure I remembered appointments. This was quite daunting but I find the best way to manage is to keep a small diary; I keep of note how I feel, medication I take, when I have my bloods done, when my appointments are etc… It all helps for when I see my consultant and allows me to keep track of my own health. It also helped the doctors see how I responded to various treatments.

The lack of understanding around JA is something I’ve really struggled with. People have a lot of misconceptions about arthritis. I was diagnosed when I was 10 many people thought I was “ faking it” as I got older other people struggled to understand that I can have good days and bad days or that my pain is severe at times and can vary throughout the day.

It took me a while but I’ve come to the realization that you can’t change everyone’s mind. In my experience quite often negative opinion stem from lack of knowledge. I can do something about that by creating awareness of JA and other forms of arthritis that affect young people. I attended one of the ‘Living Well with Arthritis’ courses which are run by Arthritis Ireland, where I discovered that I have the ability to take control of my arthritis and there is a lot I can do help myself.

The one thing I regret is not meeting others with arthritis at a younger age. It wasn’t until recently I met other young people with arthritis. Before I never felt like I needed to meet others with arthritis but within the last year I made a number of good friends with people my age who have arthritis. I can’t express how much of a benefit this has been to me. It’s great being around people who know exactly how I’m feeling and we share an understanding that even your closest friends may never truly understand.

When it comes to starting a relationship when you have arthritis, it can be somewhat daunting. Initially it caused me a great deal of stress. I thought my boyfriend would run a mile once he found out I had arthritis or when I had a flare up. I didn’t want him to see me differently nor did I want him to think I was made of glass. He was very understanding and supportive though. I have to strike a balance and take it easy and look after my health which I had more of an issue with than he did. Sometimes I found it frustrating not to be able to fully keep up with him but as time went on our routine just came naturally. Pretty shortly after we met the realisation that I have an auto immune disease hit home as a meningitis outbreak hit my college. I had to take medication and extra precautions like having to avoid large groups of people. At first I was ashamed to ask for help when it was needed I would try to do everything myself. I didn’t want to be mollycoddled. I put myself through intense pain trying to do my hair to look nice.

I would try to hide how I was feeling but I wasn’t fooling anyone but myself. One day we went for a walk I was doing ok for the first few minutes then I couldn’t move I was in so much pain . He picked me up and bought me home where he got all of my favorite things together so I didn’t have to move and cooked my favorite dinner. He made a bed for me in the sitting room so I didn’t feel I was missing out. Just by having him there making me laugh I was distracted from the pain I was in.

He understands I cant’ do everything but we always find ways around things I find going to the cinema tough, sitting down for hours makes me stiff so we will go to an earlier show as I get quite sore late at night. Sometimes I don’t feel up to going out so we do something at home instead like getting a take away and watching dvd’s.

If I had one piece of advice to give it would be not to waste time thinking about how arthritis will affect your relationship. He/she is clearly interested in you because of who you are. Yes, your arthritis impacts your life but there are ways around everything.

I thought my boyfriend would run a mile as soon as he knew I had arthritis but six years later we are still together we haven’t looked back and to be honest our relationship is just as great as anyone else’s.

When you have arthritis, it’s especially important to have regular eye examinations. Certain forms of arthritis are associated with problems that are potentially harmful to your vision. For example, inflammation of the eyes (uveitis) – particularly the iris (iritis) and muscles that focus the eye (iridocyclitis) – is common with juvenile arthritis.

Conjunctivitis (inflammation of the membranes covering the whites of the eyes and inner parts of the eyelids) and iritis can accompany reactive arthritis and ankylosing spondylitis.

Dry eye is a hallmark of Sjogren’s Syndrome, a condition characterised by inflammation of the tear producing glands, which often occurs with auto-immune conditions such as RA and lupus.

Certain arthritis medications can cause eye problems too. Corticosteroid use can lead to glaucoma (damage to the optic nerve) and cataracts. Hydroxychloroquine can produce pigment changes in the macula, the central part of the retina, which can cause blurred vision.

Scientists have discovered that hydrogen sulphide (H2S) – the gas associated with the smell of rotten eggs – is present in the fluid inside the knee joint and may help to protect the joints against inflammation.

A research team at the Peninsula Medical School and the Royal Devon & Exeter NHS Trust compared the levels of H2S in blood and knee-joint synovial fluid samples from patients with rheumatoid arthritis, osteoarthritis and healthy volunteers.

They discovered that patients had much higher levels of H2S in their synovial fluid than healthy people. Synovial fluid levels were up to four times higher than the levels found in patients’ blood and that the higher an individual’s levels of H2S, the lower their number of inflammatory cells. According to the researchers, this suggests that H2S may help the body to control inflammation.

Dr Matt Whiteman, who led the study at the Peninsula Medical School in Exeter, said: “Traditional anti-inflammatory drugs are very potent and safe, but they can sometimes damage the stomach lining in some individuals leading to further complications.

“By identifying a clear link between levels of H2S in synovial fluid and inflammation … we leave the way open for the development of H2S-based therapies that provide the benefits of traditional anti-inflammatory drugs without their unpleasant side-effects.”

Dr Whiteman added that it may be possible to manipulate the body’s H2S-producing enzymes to boost an individual’s ability to deal with inflammation and tissue damage.

The findings are published in the Annals of the New York Academy of Sciences.

Researchers found a protein triggered by rheumatoid arthritis could undo the “tangles” in the brain that are thought to cause Alzheimer’s.

Memory loss associated with the disease was partially reversed by the protein, GM-CSF, which also lowered the risk of getting the illness.

Scientists at the University of South Florida have even found that in some cases the memory impairment was completely reversed after the new treatment. The protein is commercially available and known as Leukine.

As people with rheumatoid arthritis suffer swollen joints, the protein stimulates scavenger cells in the body. In tests on mice, these cells removed deposits left by Alzheimer’s in the brain.

Scientists said they were excited by the research, published online in the Journal of Alzheimer’s Disease. Prof Huntingdon Potter, a molecular medicine expert involved in the study, said that he hoped the treatment could soon be tested on humans.

“Our findings provide a compelling explanation for why rheumatoid arthritis is a negative risk factor for Alzheimer’s disease,” he said.

In the study, scientists used two groups of mice, one healthy and the other genetically modified to develop Alzheimer’s like symptoms, including memory loss.

Half of the mice were injected with GMCSF, the other with a placebo saline solution. After 20 days, researchers found the memories of Alzheimer’s mice injected with the protein had improved substantially compared with mice treated with a placebo.

“We were pretty amazed that the treatment completely reversed cognitive impairment in 20 days,” said Dr Tim Boyd, the scientist who led the study.

The research could provide new hope to almost 44,000 people who suffer from Alzheimer’s Disease, the most common form of dementia in Ireland.

Yoga may do more than just calm your mind and stretch your muscles. A new study suggests that regular yoga may also reduce body wide inflammation – the driving force behind many conditions, including arthritis, heart disease and type-2 diabetes.

Researchers at Ohio State University in Columbus divided 50 women with an average age of 41 into two groups – those new to yoga and experts at the practice.

Scientists then turned up the women’s stress, a proven source of inflammation, by having them perform tasks like holding their feet in extremely cold water and solving difficult math problems without the aid of a paper and pencil. Blood samples were taken several times before, during and after the stressful activities.

Researchers then looked at their levels of several markers for inflammation including C-reactive protein, or CRP; tumor necrosis factor alpha, or TNF-alpha; and interleukin-6, or IL-6. These proteins play a large role in the disease process in people with inflammatory, autoimmune conditions like rheumatoid arthritis.

The research team found that women who were not used to doing yoga had a much greater inflammatory response to the stressful tasks than women who were regular practitioners.

“Practices, such as yoga, that help to tune down stress responses may also be really good for your immune response,” says Janice Kiecolt-Glaser, PhD, professor of psychiatry and psychology at Ohio State and lead author of the study, which was published in the journal Psychosomatic Medicine.

In fact, levels of the protein IL-6 were 41 percent higher in the novices than they were in the experts.

“The experts, when we stressed them, had a smaller stress response in terms of interleukin-6 than the novices. And that would be a good thing as you’re going through your daily life,” Kiecolt-Glaser says. “Yoga may do some measurable good against stress.”

Revised classification criteria for rheumatoid arthritis have been published by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR), which will allow the study of treatments for the disease at a much earlier stage.

Researchers use classification criteria to define a disease in a standardised and accepted way, helping to standardise recruitment into clinical trials and other research studies. The last criteria for rheumatoid arthritis were created in 1987, but there have been significant advances in therapies since that time.

Dr Gillian Hawker, senior author of the new criteria, revealed: “The 1987 criteria actually posed a major barrier to the study of treatments designed to prevent joint damage in rheumatoid arthritis. “Many patients did not fulfil the previous rheumatoid arthritis classification criteria until their disease was well-advanced and – in many cases – joint damage had already occurred. This truly limited rheumatoid arthritis researchers from studying the disease at its earlier phases, which is critical to the development of new treatments to prevent damage.”

The new criteria are published in both Arthritis & Rheumatism journal and the Annals of the Rheumatic Diseases and are based on three phases of work, which were started in 2008. In the first phase, which was led by EULAR, scientists reviewed existing data on patients with early arthritis to determine the factors that indicate a high risk of disease progression. The second phase, led by the ACR, sought to reach a consensus on which factors were most important in determining an individual’s chances of developing chronic joint damage. Finally, the third phase brought together the findings from the previous two phases, enabling researchers to determine the optimal cut-off point to define rheumatoid arthritis.

Professor Alan Silman, Arthritis Research UK’s medical director who initiated the project, explained that in order to be classified with ‘definite’ rheumatoid arthritis, a patient must have a score of at least six out of ten on the agreed scoring system. He revealed: “The scoring system takes into consideration the number and site/size of involved joints, laboratory tests of inflammation and auto-immunity, and symptom duration.”

Dr Hawker added that the revised classification criteria will now be used to develop up-to-date diagnostic criteria for use by practicing rheumatologists.

A spokesperson for Arthritis Ireland said: ‘This is hugely encouraging news. Early diagnosis and treatment is essential for good patient outcomes in the long-term. The revised classification for RA should help not only earlier diagnosis, but will also allow and encourage reasearch at earlier stages of the condition.’

Do you find that your arthritis flares after a ‘Full Irish’ breakfast or your joints ache more after a glass of milk? You’re not alone. For years science has failed to show that a particular diet is helpful for RA, but recent research suggests food allergies may worsen pain and stiffness for some people. How can you tell if certain foods are influencing your arthritis? Stop eating them – for a few days at least – and note whether symptoms improve. Then slowly reintroduce foods you elimiated to see when/if symptoms return.

Check out the Arthritis Ireland booklet on Healthy Eating and Arthritis for some tips on chosing the right foods, organising yourself and your kitchen to eat well, and for more information on food allergies and supplements.

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