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Date: 20.03.2014
From: rea

Subject: CCP? Positive test?

Hi All - hope you can help with this. I recently went to my GP with severe fatigue. I have hypothyrodism and pernicious anaemia, both autoimmune diseases. Despite adjusting the meds I'm on for the above I still felt rubbish. GP did some test and bloods showed I was severely deficient for Vit D and I had slight iron deficiency for which I have been given supplements. However, GP did some further blood work and I had something called an anti CCP come back positive. He's explained that this is indicative of RA and he repeated the test because it was an unexpected result. Away - he rang yesterday to say that its come back "high" again and that he's referring me to rheumatology at hospital. Now, I've never really heard of RA so I googled it and now I'm beginning to panic! I do have some of the symptoms - ie achy joints - but not pain, sore neck, shoulder joints etc, but nothing I would have gone specifically to the docs with. My eyes are bad - sore, watery achy. I don't know what to think! Any advice?
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Date: 21.03.2014
From: Sean

Subject: Re: CCP? Positive test?

Hi Rea

Anti-CCP can be positive many many years before full RA symptoms develop.

They are a marker of the immune system that is having trouble dealing with an antigen - CCP are proteins that have been incorrectly modified by the immune system whilst trying to produce antibodies against something else (bacterial, viral or dietary).

This is technical but CCP's are evidence of what the Immunologists call epitope spreading. It's a bit like Chinese whispers - initial invader is attacked by antibodies but the immune system often makes too many antibodies (which is why we feel bad when we have a cold) - the immune system is then supposed to remove the antibodies that are not specific for the invader but it doesn't so the next "whisper" is made and spreads to create antibodies that attack different joints.

A rheumatologist will want to stop these reactions with medication.

In my view with Iron deficiency and low vitamin D they should also test for Celiac and anti-gliadin antibodies. With a damaged gut micro-vili due to gluten or another food intolerence iron and vit d are low!
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Date: 21.03.2014
From: rea

Subject: Re: CCP? Positive test?

Hi Sean
Thank you so much for this! Makes much more sense. Luckily my GP tested for coeliac and thankfully that came back negative - so don't have to worry about this. My date to see the rheumatologist is 22 April. I'll try and keep calm until then!
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