Speaking from personal experience, if it happens that you have any one of the best available treatments for your rheumatoid arthritis such as Methotrexate, Adalimumab or Infliximab, it is very important that you take an active interest in what is going on with your blood results. As your immune system defence mechanisms are weakened, there are natural means to influence the changes in your blood in order to keep yourself in good shape and avoid many unpleasant side effects.

Haemoglobin (HB)

Red Blood Cells

This is the part of the red blood cells which carries the oxygen around your body. If the levels drop below 11 g/dL for women and 12g/dL for men this means that the inflammation is up. More often than not this simply indicates that your medication is not controlling the disease that well. However, it could also be a direct result of having a cold, flu or an infection. Often lower HB levels result in fatigue and anaemia. Folic Acid commonly prescribed to increase the HB level has side effects like any other medicine. An option from the following fruit and veg taken regularly will solve the problem: all green fruits and vegetables, red meats, beetroot, parsley, tomatoes, potatoes (especially jacket potatoes), apples, peaches, pears, strawberries, blueberries, walnuts, caviar, mushrooms and dried fruits.

Mean Cell Volume (MCV)

The raise in the average Red Blood Cell count, which is what MCV shows, may be caused by either side effects of your disease-modifying drug like thyroid gland being under active, low HB levels, Vitamin B12 deficiency or by alcohol consumption. The normal range tends to be between 80 and 100fL. The best source of B12 vitamin is red meat, fish and dairy products. If it happens that thyroid gland becomes under active, many recommend drinking green tea to get it working normally.

White Blood Cell (WBC) count

White Blood Cells are known to fight infections in our body. The normal range of WBC is usually between 3 and 11x10⁹/L. When the WBC count increases it is a indication of an infection in the body, while decrease of WBC count shows your susceptibility to infections. While you are on the disease-modifying drug treatment, this decrease may also be indicative of the bone marrow being affected by the medicine; however, it is said to be temporary. The synthesis of WBC in your blood may be aided by increased intake of Vitamin B6, which is found in bananas, potatoes (jacket potatoes), pork, dry beans, and yeast found in bread.

Lymphocyte and Neutrophil Count

These tests may show some underlying infections that you may not be aware of. The normal range of Lymphocytes is between 1.5 and 4 x 10⁹/L, which may be lowered while being on disease-modifying drugs. Neutrophil count on the other hand usually increases quite quickly when there is an infection, and its normal range is considered to be between 2 and 7.5 x 10⁹/L. Bacterial infections will result in its increased levels, while lowering of the count will indicate that the bone marrow is being affected. As these two tests are simply more specific measures of more common types of white blood cells the same support in your diet will apply as for above section.

Platelet Count

The common side effect of all the latest disease-modifying drugs for inflammatory arthritis are bruising and bleeding easily as the platelet count may lower making the blood less able to clot. A higher count on the other hand means that arthritis is not being controlled as well as it should. The normal range of platelets is said to be between 150 and 400 x 10⁹/L. Depending on what result you have for the platelets you can adjust the intake of certain products in your diet. Certain herbal remedies such as St. John's Wart, Yarrow, Rose Hips, Oak Bark, Tansy, Horsetail and walnuts have blood diluting effect (lowering platelet count). Others, such as dark chocolate, garlic, lemon, cocoa, coffee and beetroot have thickening effect on the blood.

Liver Function Tests (LFTS

There are two tests that are usually used – ALT and AST. If the results start rising above normal range, thus, indicating liver inflammation your medication will usually be stopped until the results become normal again. One recommendation in such cases will be to try and avoid any foods that are believed to be heavy for the liver such as green apples, oranges, greasy foods/fried, and avoid drinking alcohol.

Kidney Tests – Creatine and urea

The levels of these two waste products put out by the kidneys helps to show they are working well. If Creatine and Urea levels begin to rise above normal range you will know that the medication is affecting your kidneys. However, this is very rare. Make sure to drink plenty of clean water to aid the work of your kidneys, maybe adding a slice of lemon to help protect yourself from any water infections too.

C-Reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR)

These two inflammatory markers indicate the levels of inflammation in your body caused by your arthritis. The CRP is said to be normal between 0-6mg/L ESP is considered normal between 0-15. In this case, avoiding any vaccinations that are known to trigger sudden raise in inflammation, eating plenty of vegetables and fruit, and generally trying to avoid various infections out there (keeping warm, washing hands, thoroughly washing all fruit and veg, etc) have worked for me to keep these markers at the lowest possible levels.

Hope these tips will work for you and will give you more control over your health!