Rheumatoid arthritis (RA) can be mild, moderate, or severe, with symptoms that vary widely across people. There is no set timeline for the course of RA, but without adequate therapy, the illness often worsens over time and progresses through phases.

Fortunately, modern drugs show hope in halting the disease's course. Managing RA with right medication can help you live a better life and be healthier in general.

Stages of RA

RA progression involves distinct stages, each bringing different changes to the body. Some are visible and felt, while others are internal. Each stage comes with unique treatment goals.

Stage 1: Early RA

In this initial stage, joint pain, stiffness, or swelling are common. Inflammation occurs within the joint, causing the tissue to swell. For example, in the hands, early-stage RA may cause stiffness and discomfort in the finger joints and knuckles, which may improve with movement.

At this stage, there is no damage to the bones, but the joint lining (synovium) is inflamed. Symptoms are often subtle, making early diagnosis challenging. However, if diagnosed and treated within 12 weeks, there is a high chance that RA may go into remission.

Stage 2: Moderate RA

During the second stage, synovial inflammation starts to damage joint cartilage and nearby bone. Cartilage, which lines the ends of bones in joints, begins to degrade.

This injury can result in discomfort, diminished mobility, and restricted joint movement. Hands are typically rigid and difficult to flex. Blood tests may not always identify RA antibodies at this point, especially in cases with zero-negative RA, which occurs when antibodies are lacking despite symptoms.

Stage 3: Severe RA

By stage 3, RA is considered severe. Cartilage damage worsens, and bone destruction begins. With the cushion between bones diminished, bones may rub together, causing significant pain and swelling.

Symptoms often include muscle weakness, reduced mobility, and permanent changes in joint appearance, such as twisted fingers or thickened knuckles. Severe RA may also compress tendons, leading to carpal tunnel syndrome or tendon rupture. Early detection of these issues can prevent complications.

Stage 4: End-Stage RA

In the final stage, joint inflammation subsides, but joint function is severely impaired. Destruction of the joint may lead to bone fusion (ankylosis).

Symptoms include persistent pain, swelling, stiffness, and muscle weakness. Mobility loss may occur, such as difficulty bending knees or flexing hips. End-stage RA does not occur in all cases; ankylosis affects less than 1% of individuals with RA.

While progression through all four stages can take years, some people experience periods of remission or slower disease activity.

Signs RA is Progressing

Most individuals with RA notice a gradual worsening of symptoms. Flare-ups, marked by increased disease activity, often alternate with periods of relief.

RA progression can depend on factors such as:

1. Family history of RA
2. Age and stage of diagnosis
3. Presence of RA-specific antibodies
4. Smoking status

Disease triggers specific to the individual

Doctors evaluate these factors to better understand how RA is progressing. However, predicting the exact course of RA remains challenging, as each person's experience with the disease is unique.

Treatment Adjustments as RA Progresses

Treatment plans for RA are tailored based on the disease stage, symptom severity, and any accompanying health conditions.

Common treatment options include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids: Reduce inflammation and pain.
• Disease-modifying antirheumatic drugs (DMARDs): Suppress immune responses to protect joint tissue and slow disease progression.
• Biologic drugs: Target specific immune pathways to modify inflammatory responses.
• Surgery: In later stages, surgery may address severe joint damage, repair tendons, or replace joints.

Lifestyle changes can complement medical treatments. Moderate exercise, stress management, maintaining a healthy weight, and following an anti-inflammatory diet are often recommended. Quitting smoking can also significantly slow disease progression.

RA Remission: Is It Possible?

Remission occurs when RA disease activity decreases significantly or stops entirely. Sustained remission may last several months and is increasingly common with advancements in treatment.

Clinical criteria for remission often include:

• Fewer than one swollen or tender joint
• Low self-reported arthritis activity
• Minimal levels of C-reactive protein (an inflammation marker)

Early diagnosis and targeted treatment increase the likelihood of remission. If remission is achieved, doctors may gradually reduce medication while monitoring disease activity.

As anti-obesity medications like Ozempic and Wegovy become increasingly popular, American employees are making career choices based on access to them. A recent poll found that 1 in 5 Americans would be willing to switch jobs to get insurance coverage for these in-demand medications. But as the craze for GLP-1 drugs takes hold of the workforce, the question is—are we becoming a healthier society, or merely taking a medically approved shortcut?

In a world where job benefits such as remote work, unlimited time off, and child care allowances drive the benefits discussion, there's a new player in the mix: weight loss drugs. A 2024 survey by 9amHealth found that 67% of Americans would remain at a job they disliked if it included retaining access to drugs such as Ozempic and Wegovy. And if workplaces don't pay for them? 20% of respondents would actively seek another job.

This behavior is not without purpose. Out-of-pocket expenses for GLP-1 medications such as Ozempic can run over $1,000 monthly. Confronted with this expense, some users report skimping on necessities such as food and entertainment in order to pay for their monthly supply. Coverage under employer-sponsored insurance, thus, becomes not only a benefit—but a necessity.

What is the Frenzy of GLP-1 Drugs?

Contrary to older weight loss drugs that normally achieve a 5% drop in body weight, newer GLP-1 medications provide up to 20% weight loss or more. Their impact has been so significant that Science identified GLP-1 medications as the 2023 "Breakthrough of the Year." The medications act by emulating a hormone that controls blood glucose and hunger, leading to both enhanced metabolic function and reduced hunger.

Initially approved for type 2 diabetes, Ozempic and other medications such as Mounjaro have been used extensively off-label for weight loss, driving stratospheric demand. In February 2023 alone, over 373,000 prescriptions for Ozempic were filled—a 111% increase from the year before.

Ozempic: High Demand, Higher Costs, and Potential Misuse

But with increasing demand comes increasing expense. Ozempic and Mounjaro were among 800 drugs that experienced a median list price increase of 4.5% this year, the Wall Street Journal reported. Some large institutions, such as Ascension Health and the University of Texas System, have even withdrawn coverage in light of skyrocketing prices—reporting a 233% increase in expenditures related to them.

There's also an increasing worry about the abuse and stigma surrounding these medications. Although Ozempic is now a cultural buzzword and an alleged "magic bullet" for rapid weight loss, physicians warn that it's not a sustainable solution in and of itself. "Without robust support for behavior change, weight loss is generally short-term and tends to be followed by weight regain," experts in endocrinology and metabolic care stated.

In fact, 38% of respondents to the 9amHealth poll confessed to exploring black market sources prior to settling on FDA-accepted treatments—courageous behavior that reveals the desperation and lack of education about obesity management.

Why Obesity is an Expensive, Long-Term Health Problem Employers Can't Dismiss?

Over 40% of American adults qualify for the CDC's definition of obesity, a BMI of 30 or more. The disorder is a significant cause of comorbidities such as type 2 diabetes, hypertension, and cardiovascular disease—a combination frequently called "cardiodiabesity." Alone, obesity costs the U.S. healthcare system $173 billion per year and accounts for $6.38 billion in lost productivity in the workplace.

With these daunting numbers, employers are finally realizing that managing obesity up front may be cheaper in the long term. In 2023, only 25% of employers were covering GLP-1s, but this might increase to 43% in 2024, says health consulting company Accolade.

But selling prescription medications without complementing them with health support is a lost chance. Specialists recommend a combined approach—of accessible pharmaceuticals along with dietary advice, exercise routine, psychiatric help, and regular medical follow-up.

Medical Experts Call for Balanced Approach

While the temptation of GLP-1 medications can be tempting, specialists advise against its use as a single solution. Pills can trigger weight loss, but long-term health is derived from behavioral modification. Fitch and others suggest addressing obesity as any chronic illness, with long-term, multidimensional management.

Employers who are seriously interested in tackling obesity in the workplace need to look beyond providing coverage. They must make available comprehensive health packages that consist of individualized interventions, ongoing tracking, and lifestyle change support systems for enduring change.

For the time being, it appears GLP-1 medications are not only changing waistlines, but also workplaces. Workers are willing to make drastic life adjustments—including job-hopping—for access to these drugs. Whether this is a significant shift in corporate healthcare priorities or a troubling shortcut remains to be determined.

One thing is certain: the workplace is emerging as a central front in the battle against obesity. And as the stakes grow higher, so does the onus on employers to provide intelligent, sustainable, and equitable solutions for the long-term health of their employees.

A baby's first steps are one of the biggest newborn milestones for parents. It is a sign that your baby is growing healthily and happily. However, when these steps are delayed over the period of time kids are expected to walk, that is a cause of great concern for parents. Many worries like whether the kid had an injury, or does it have any cognitive or motor disability that could be causing this delay?

Usually, it is not a big concern for there to be a little delay; consult your pediatrician and follow their advice. Not all delays are bad, and a new study shows that babies who take a little more time to walk actually do better academically. According to the study published in the Nature Human Behaviour journal, late steps could be linked to better academic performance in kids.

Why Is Taking Longer To Walk Better?

Researchers have made a significant discovery about why some babies walk earlier than others. They've found a strong link between the age at which a baby takes those first wobbly steps and the genes they get from their parents. Even more surprisingly, their research shows that the very same genes that decide if a baby walks early or late might also play a part in how well they perform in their schoolwork. This means that our bodies' blueprints could influence both our physical development, like learning to walk, and our brain development, which helps us learn at school.

The study also hints at another possible good thing about taking a bit longer to start walking. The researchers found that babies who walk later might have a lower chance of developing something called Attention Deficit Hyperactivity Disorder, or ADHD. This is a condition that can make it hard for kids to focus and sit still. So, it seems that taking your time to walk might have some unexpected benefits for how kids' brains develop and how they behave as they grow up.

What Role Do Genes Play In A Baby’s Growth?

Researchers found that the same body instructions that make some babies walk later are also linked to doing better in studies and being less likely to have ADHD. She said that this was the first time scientists had looked at so many body instructions and how they relate to when babies start walking and other things like learning and attention.

Experts also pointed out that there's a big range in when babies start to walk. Some start as early as eight months, while others take as long as two years, and most start around 18 months. Until now, scientists didn't really know all the reasons why some babies walk much earlier or later than others. This new study helps us understand some of the things that cause these differences in when babies take their first steps.

Strong Link Between Genetic And Baby Development

For a long time, scientists knew that things around a baby, like having space to move, affect when they walk. But this new study gives us strong proof that the instructions inside our bodies, our genes, are also very important. The scientists looked at the body instructions of over 70,000 babies and found 11 specific parts that seem to be connected to when a baby starts to walk. This shows us that both what's inside us and what's around us help shape how we grow and develop, even when it comes to taking those first steps.

High blood pressure affects millions of people worldwide. If left unmanaged, it can lead to hypertension. US Centers of Disease Control and Prevention (CDC) categorises people with hypertension as those who have a blood pressure of more than 130/80 mm Hg, while the normal rate is 120/80 mm Hg. Therefore, it advises hypertension patients to follow this one rule while eating, that is, to eat very carefully. It is because there are certain foods that can elevate their blood pressure and thus, put an enormous strain on their heart.

Careful Measures For People While Eating, As Per Experts

Dr Amir Khan, a well-known US NHS doctor, has shared straightforward and practical ways that people can take control of their blood pressure from the comfort of their own homes. Taking to social media, he shared the following tips focussing on simple lifestyle adjustments that can have a significant positive impact on blood pressure levels without necessarily requiring immediate medication.

Cut Down on Salt

Drastically reduce your daily salt intake to no more than one teaspoon (six grams). Be mindful of hidden salt in processed foods and flavor meals with herbs and spices instead of salt. Choose tinned food in water and unsalted nuts.

Eat Potassium-Rich Foods

Increase your consumption of foods high in potassium, such as bananas, tomatoes, and carrots. Potassium helps to balance the effects of sodium in your body and can contribute to lower blood pressure readings.

Get Active and Maintain Healthy Weight

Engage in regular physical activity, like brisk walking or cycling, to strengthen your heart. Achieving and maintaining a healthy weight also reduces the strain on your heart and blood vessels, helping to manage blood pressure.

Stop Smoking

Quitting smoking is crucial as it damages blood vessels and raises blood pressure, significantly increasing your risk of heart disease and stroke. Avoiding smoking is a vital step for cardiovascular health.

Moderate Alcohol

Limit your intake of alcoholic beverages. Excessive alcohol consumption can lead to a rise in blood pressure over time. Adhering to recommended guidelines for alcohol intake is important for blood pressure management.

Ignoring persistently high blood pressure can lead to a cascade of serious and even life-threatening health problems down the line. When your blood pressure stays too high for too long, it puts extra strain on your heart, blood vessels, and other vital organs. This can significantly increase your risk of experiencing things like heart attacks and strokes, where the blood supply to the heart or brain is blocked. It can also lead to heart failure, where the heart can't pump blood effectively, and kidney disease, where the kidneys can become damaged and unable to filter waste properly. Taking steps to manage high blood pressure is therefore crucial for protecting your long-term health and well-being.

One concerning thing about high blood pressure is that it is similar to cholesterol, it does not have any obvious symptoms. While you can monitor with at-home devices, one must take proactive steps to ensure they are not going overboard. Unchecked high blood pressure can have big consequences for your health. The National Health Services England explains that reading of 140 over 90 (written as 140/90 mmHg) or higher when taken at a pharmacy, a doctor's office, or a clinic indicates high blood pressure. However, at home, a reading of about 135/80 mm Hg or higher is considered high.