RA in remission. Why is SFN not better?
 

My rheummy and neuro both agree that my neuropathy was caused by my RA. I was diagnosed with both in 2007. Now that my RA is in medicated remission (with enbrel and leflunomide) why is my neuropathy (both legs and arms, hands) not getting any better? I thought if you control the cause then it would get better or even resolve. I have a positive marker for connective tissue disease, but I do not have any other diseases. My rheummy checks me over and does lots of blood testing every 2 months.

Shouldn't my sfn be getting better?

It may be the leflunomide:

http://www.medscape.com/viewarticle/538209

You can join medscape for free easily. They have a strict copyright so I cannot copy things here from there.

This drug has always been controversial, and FDA at one point was accused for favoritism for approving it in the beginning.

The damage done to nerves takes a long time to repair itself, even longer if the axon is damaged. To expedite this you should be doing everything you can to provide an optimal environment for your nerves to heal, nutrition, supplements, exercize, avoiding substances or medications that are toxic to nerves.

Thank you, mrsD. I never thought about the leflunomide. I was put on it after I couldn't handle the methotrexate. I actually had sfn symptoms before RA symptoms and prior to being put on any meds. I will discuss with my rheummy on my Monday appointment.

Thank you, echoes. I am working on all your suggestions. Exercise is difficult because my left leg is weak and causes me balance problems so I have been using a cane for the last 2 years. I just moved to an apartment with a small gym, so I will try the treadmill at very slow speed and hang on to the sides. I also need to quit smoking.

I haven't been able to exercise, but I did quit smoking on Aug 1st of last year.
I used Chantix for 12 weeks and it worked quite well to reduce the urge to smoke. I haven't smoked in over 6 months.

Catloucle i was just listing things that could help nerves to heal. I know firsthand how hard it can be and sometimes impossible to do everything that someone else may be able to do. All we can do is our best. If you cant do the exercize thing as much as you would like,maybe you could concentrate more on the supplements, diet and as Dahlek points out here from time to time, find out about those side effects and interactions with medicines and herbs.

EXERCISE is anything you can do to Move your body! there are ex. to be done from a chair....etc

Hi, Bob. Whenever I hear Chantix it makes me shudder. My husband had used it a couple of years ago and never stopped smoking the entire time. And it turned him into King Crab-***.

Hi, mrsD. I spoke to my rheummy about the leflunomide and he said if it did effect my sfn that I would be the first in all his years of practice. I told him that I was always special. He is very afraid of my falling out of remission since it took me 3 years to attain it. He suggested that I take half my dose (10mg instead of usual 20) and see how I feel after 3 weeks. If I flare after 3 weeks to go back on usual dose. If still ok, then I could stop taking it and keep taking the fish oil. And of course to stay on the Enbrel injections.

Here are some medical studies on this drug:

http://www.ncbi.nlm.nih.gov/pubmed/17229252

http://www.ncbi.nlm.nih.gov/pubmed/19916579
Benefit-risk assessment of leflunomide: an appraisal of leflunomide in rheumatoid arthritis 10 years after licensing.