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    RA and altitude
    Anon_233185 posted:
    Is there any connection between the two? I first came down with symptoms 2 years ago while staying in our summer place in the mountains. It seems as though I have a flair up within a couple of weeks upon our return.
    heat1bjm responded:
    Dear Anon - my RA started about 2-1/2 years ago. I live in Southern California. In June, 2011 I was in Colorado for 4 days at about 5,600-5,800 ft elevation. Within 24 hours, I experienced almost a complete remission in pain and disability. I did not get a flare upon my return, but my symptoms returned.

    I've done a lot of research trying to find a connection to altitude and RA, and have found virtually nothing. Even the Arthritis Foundation in Denver found no studies or definitive info.
    sanshen11 responded:
    In Feb. 2009 i went to Santa Fe, NM (i live in northeat PA). We hiked around the tent rocks in sandy soil, and my husband asked me how my feet felt.......i said my feet feel fine and wondered why he was asking. I had no pain anywhere in my body ( i have Lupus, Sjogren's Syndrome, Fibromyalgia and Raynaud's). I am a person who is always hurting everywhere in my body, and, here in Santa Fe, 7000 ft above sea level, i completely forgot how much i hurt!!! It was wonderful & unbelievable. And, i can tell you that i did not hurt for exactly two weeks at which point that old familiar pain kicked back in at 300-some feet above sea level. I firmly belive it was the altitude and the lack of humidity and dampness, etc. I want to live in NM very much, as it is so beautiful and i felt so much better. The rheumy i had at that time told me it wasn't the altitude, and that it was called "vacation". I totally disagree, because, vacation or not, i was still in an airplane sitting for many hours........very hard on someone like me. And yet, for two weeks i felt good for once.
    kathgirl replied to heat1bjm's response:
    We lived in San Diego for 9 years, where I had RA for 6 of the 9 years. The pain was unbelievable. We moved to AZ, neat Tucson, 5 years ago. The humidity for most of the year is very low, 7 to 14 percent. I feel 100 percent better. I am no longer hunched over using my cane. We are also at a higher altitude. Although I have a little pain, I seldom need to take a pain pill.
    Scott Zashin, MD responded:
    I am not aware of the association. I will tell you that patients may have increased symptoms of RA with an increase in barametric pressure. I treated a patient who found that when he was in Dallas,he required all his RA meds to control his symptoms, but when in Florida, he did not need any. He attributed his improvement in Florida to an increase in barametric pressure there. I conducted a study for him using a chamber that increased barametric pressure and found that patients with different type of joint conditions did feel better with the higher barametric pressures.You can determine if this is the case by keeping a diary for a month of your pain levels and saving newspapers for one month. After the month, check the pressures or change in pressure each day and see if there is a correlation to your symptoms.
    heat1bjm replied to Scott Zashin, MD's response:
    Thank you, Dr. Zashin for your response. There have been no sstudies relating to altitude and symptom relief, but there have bbeen more than just the 4 of us who posted here who have experienced this effect of altitude and symptom relief. I really think a medical study is in order ... is that something you would be interested in doing?
    heat1bjm replied to Scott Zashin, MD's response:
    Thank you, Dr. Zashin for your response. I looked up the barametric pressure in the area in Colorado where I was for 3 days, and the barametric pressure back at home the next 3 days following my return home. There is no appreciable difference between the 2 - Colorado was 29.8 to 29.9; California was 29.81 29.83. After 24 hours in Colorado at 5,600-5,800 ft elevation, I experienced almost complete relief. After 24 hours home, all my symptoms returned at the same intensity. There appear to be no medical studies relating to altitude and auto-immune disease symptom relief. Perhaps you might be interested in being involved in such a study? Thank you.
    Nancesoir replied to Scott Zashin, MD's response:
    My family & I live in Colorado at an elevation between 7000 & 8000 feet. My daughter was diangnosed with JRA at the age of 14, she is now 16. She also has Perno. She is always in pain & has given up many of her activities. We are still trying to find a combination of drugs that will work and will be trying an infusion drug in the fall. Please note my daughter was born at this elevation. When she went on a school trip to Hawaii last April her pain level was much less. She still was in pain but it was bearable. I can say for a fact that higher elevation does not improve my daughter's JRA. Hopefully her Doctor will find a combination of drugs that will let her live the active lifestyle she once had.
    jenfisch responded:
    Hi Anon,
    I have RA (18 yrs now) w/several other associated issues(Sjogren's Syndrome, Fibromyalgia, RLS, Raynaud's and Hyperthyroid) I live in Wisconsin and have visited Colorado, Nevada and Palm Springs CA several times - I always feel better in thoses states! Esp Nevada no pain at all.

    I personaly think it has more to do with the barametric pressure than altitude. Our pressure can change hourly in WI and the humidity is killer - I have tracked the weather and how I feel (what hurts and how much), can say it definalty has to do with changing pressure for me.

    My friends come see me to find out when the weathers going to change (they gage it by how badly I feel) - it's kinda of fun to see if I predict the weather correctly, sometimes it's better than our local weather people. LOL

    Take care - be well.
    Scott Zashin, MD replied to heat1bjm's response:
    I think the study you propose would be very interesting although challenging. One could consider doing it in Denver wtih a 5000 ft elevation and a mountain resort. Another option is a place like NASA. Here in Dallas, I think it might be difficult to do as we do not have that type of topography or equipment. The other issue is funding for a study like this which may be quite costly-often over $ 100,000. If you have a source for funding and an interest, I can pass along your idea to some medical centers.
    heat1bjm replied to Scott Zashin, MD's response:
    Thank you so much, Dr. Zashin. I will begin researching possible funding sources. I deeply appreciate your interest and support
    rockymtngal67 replied to Scott Zashin, MD's response:
    Dear Dr. Zashin,
    I too have RA and have had it now for 15 years. My last rheumatologist made a passing comment not long ago when I was having a bad period. He said, "You might consider moving to lower altitude". I did not think much of it because moving is not an option. I am now curious about it and why he said it. I have lived a 9000 feet and had zero issues, run to the top of Pikes Peak with no issues, climbed in the Himalaya and had no issues and have lived in the same place at 9000 and have had HUGE issues. So for me it is hard to say. I would be happy to round up funding if someone else can manage the study - I don't have the bandwidth to be a primary coordinator right now. I am a grant writer and live just outside the Denver Metro area at about 6500 feet now. I do believe that a lower humidity place seems beneficial. I don't know why and I understand the etiology of the disease fairly well. I wonder if the higher altitude negative impacts might be this. Our blood is often filled with antibodies (more than most), when at higher altitude our blood also thickens as a result of more hemoglobin. The two together would thicken the blood which then affects the circulation of oxygen and causes hypoxia. This can cause all sorts of "bad" feelings -- lethargy, muscle pain due tp low oxygen levels etc. Do you think there is anything to this? Couple that with the lower barometric pressure and it can add up to a flare. At the same time when folks talk about feeling BETTER at high altitude they might be able to attribute that to lower humidity. The crux of this disease is that it is so different in every sufferer and there are so many variables that it is challenging to study unless you virtually eliminate external variables. The internal ones, genes, attitude, pain tolerance, etc. are impossible to eliminate!
    Scott Zashin, MD replied to rockymtngal67's response:
    I will look into this. Please re post if I have not provided any additional information before Christmas.Thank you for your input.
    StevenG responded:
    Hi -- I know this is an old thread, but just in case someone hits it fresh (as I just did), I thought I'd throw in a data point. I'm in the latter part of year 2 of an RA experience and diagnosis, currently under good control (inflammation and joint pain in fingers and toes down to nearly zero, no other symptoms) thanks to weekly MTX doses. (a big shout out to my rheumatologist at Kaiser!)

    I live in the San Francisco Bay Area -- relatively dry, and quite at sea level. Just went over the long MLK weekend for a skiing trip to Lake Tahoe, for the first time since the RA diagnosis, where we were staying at about 5k feet and spending the days going up and down between there and 10k feet of elevation. Had a huge flare up -- worst pain (especially in my feet) I've had. And no, not from the impact of the snowboarding and its requisite boots . . . the situation worsened overnight each night, after 14 hours of rest from the board/boots, and it was as bad in my hands (unused in boarding, once you figure it out) as it was in my feet. By the third day there I was wondering if this is the end of skiing/boarding for me, which would be a bummer.

    With just 24 hours back at sea level today, everything's back to normal. Not even any pain from the 15-mile fast bicycle commute to work this a.m. Go figure.

    llk53 replied to StevenG's response:
    Steven, Interesting, my trip to Lake Tahoe prompted me to begin research on this. I am orig from and diagnosed in Pennsylvania, and have moved to Sacramento, symptoms were much much more severe in PA, and have almost subsided while in Sacramento, however during my recent trip to Lake Tahoe, they were the worst I have felt in a long time. It was so painful. I have also noticed quite the difference when I am at a higher altitude then when I am close to sea level. I'm curious as to what factors (barometric pressure and/or altitude) might play a role in the symptoms.

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