Rheumatoid Arthritis is a multifactorial condition sometimes refered to as idopathic, meaning unknown cause.  Causality is thought to be the result of a faulty immune response, possibly due to physical, chemical, or mental trama.  Below are some factors thought to contribute to the development of this imbalanced condition called RA.

Each of these in itself may not be enough but together they caused everything to collapse.

Age
Allergies
Anemia
ANS
Antibodies
Celiac disease
Dental
Diet
Drugs
Environmental
Genetics
Glucose
Hormones
Metals
Microbes/ Bacteria
Obesity
Sleep
Steroids
Stress/Trauma
Sugar
Tobacco
Vaccines
Vitamin D

Viruses

  • Epstein–Barr virus (EBV) - Alpha-viruse
  • Chikungunya - Alpha-viruse
  • Cytomegalovirus (CMV)
  • Parvovirus B19
  • Hepatitis B, C and E viruses
  • Alpha-viruses Chikungunya
  • Parvovirus
  • Rubella
  • Human T-lymphotropic virus type-1
  • Enterovirus
  • Dengue virus

Age

Juvenile Rheumatoid Arthritis is the most common rheumatic condition in children.(1,2)  Rheumatoid Arthritis prevalence increases with age and is highest among females. As of 2010, RA prevalence rates have also increased significantly since 1996.  Factors contributing to the increase in prevalence overtime may be attributed to an increase in the aging background population.(3) 
 

Allergies

One must differentiate food allergy (IgE-mediated) from food intolerance that can be cause for a variety of etiology including malabsorption (1), and celiac disease in which the gluten intolerance is due to the glyphosate sprayed on the wheat before harvesting. Food intolerance is more frequent in children as seen in cow's milk allergy.  Food allergy symptoms mostly affect the respiratory tract, the skin, and the gut. Skin prick tests are helpful to test for food allergens that can trigger severe reactions, e.g., peanuts, eggs, fish, and milk ( Koike Y, et al., 2018)If you have lactose intolerance, then loose stools may be a problem. People with lactose intolerance don’t produce enough lactase, which is an enzyme necessary to break down dairy.  If you have certain chronic health problems such as irritable bowel syndrome, celiac disease, Crohn’s disease, dumping syndrome, ulcerative colitis, hyperthyroidism, or bile acid malabsorption, then you’re more likely to have loose stools.  The lactase gene shut down when you get older (1).
 

Anemia

Hematologic manifestations of rheumatoid arthritis (1)  Estimates in studies from the early 1980s suggested a prevalence of anemia of about 30 to 70 percent.(5,6)  A 2004 analysis of the available data dating back to the 1960s was similar, with an estimated prevalence of 54 percent.(7) In a study from Ukraine, in which anemia was observed in 46 percent of patients with RA, the presence of anemia was associated with high RA disease activity.(8)  Similarly, a study from China found an association in patients with RA of anemia with erosive arthritis.(9)
 

Autonomic Nervous System (ANS)

Studies have found that autonomic imbalance precedes the development of established RA which could also be relevant for other immune-mediated inflammatory diseases. This work supports the rationale for future studies on measures aimed at the prevention of RA by restoring the balance in the nervous system before arthritis develops. Read More: Nerve Damage (1)(2),(3) RA Feet (4)
 

Antibodies

Nearly 100 years ago, Hanganutziu and Deicher independently described human heterophile antibodies that agglutinated animal erythrocytes, as occurring in patients with serum-sickness, who had received therapeutic animal antisera (12). Similar antibodies were later reported in patients with various diseases, despite no prior exposure to animal serum (3). Characterization of the antigenic determinants of these Hanganutziu–Deicher (H–D) antibodies occurred when Higashi et al. and Merrick et al. demonstrated that at least some of the major epitopes recognized were gangliosides containing a sialic acid (Sia) called N-glycolylneuraminic acid (Neu5Gc) (45). This discovery spurred further research and H–D antibodies were also described in sera from patients with multiple pathological states such as rheumatoid arthritis...https://www.frontiersin.org/articles/10.3389/fonc.2014.00033/full
 

Celiac disease

The prevalence of celiac disease in patients with juvenile chronic arthritis is increased.  Meta-analysis of genome-wide association studies in celiac disease and rheumatoid arthritis identifies fourteen non-HLA shared loci between both diseases.   Celiac disease blood test can identify IgA or even IgG antibodies against gliadin. For reasons that aren’t well understood, a small amount of the patients are IgA deficient, meaning they aren’t able to produce any IgA antibodies (*), (1) in general, so in this case they’d need to have an IgG screening test done.  (*) Exposure to Gonorrhea, tuberculosis, S. pneumoniae, E. coli, salmonella (14) in Blood type 'B' can wipe out the IgA antibodies. Read More
 

Dental

Naturopaths have always claimed that the root of Rheumatoid Arthritis lies in the number of cavities, mercury/tin-based fillings, gum disease and when left untreated advances on to cardiovascular disease.  The Journal of the American Dental Association is a treasure of information pertaining to the materials and the 750+ bacteria species, humans host in their mouths.  Studies have linked the increased abundance of Prevotella species at mucosal sites to localized and systemic diseases, including rheumatoid arthritis.(1)  In addition, periodontal disease has been associated with a higher risk of having RA. The postulated mechanism is citrullination produced by gingival bacteria.(2)  Children gow to experience Mercury released from dental" silver" fillings as adults thus provokes an increase in mercury-and antibiotic-resistant bacteria in oral and intestinal floras of primates.(3)

Diet

Studies conclude that lectin may be a contributing pathogenetic factor in RA. When a diet is excessive of fat, sugar, and alcohol, it results in the impairment of glucose level by altering the binding of insulin at the receptors. Diet is an important factor when diagnosing illness as the type of fatty acid changes phospholipids composition thereby changing membrane fluidity and insulin signaling; in the early stages of the disease, the aggressive regimen used to treat RA will eventually cause RA. Lectins or proteins that are in foods can kind of coagulate so it's either going to penetrate your stomach wall which will cause a food allergy (like dairy products) or it gloms up and causes an antibody reaction within the gut or bacterial overgrowth. The best practice is to write down the food consumed within the last 24 hrs when a flare-up occurs to help pinpoint which foods your body is reacting to.  In addition, plants such as potatoes or tomatoes contain small amounts of nicotine; when they form a significant part of a person’s diet it is possible to build up a large enough residue in hair and tissue samples to show up in tests.

Drugs

Neurological Involvement in Rheumatoid Arthritis Safaa Ali. Mahran, 2019

Environmental

Environmental exposures date back when families often kept fires burning in their homes for warmth and protection (Mosquitoes). Exposure to chemicals and pollutants could heighten your risk of RA. Found in the form of air pollution, food and product chemicals, pharmaceuticals, second-hand smoke, and insecticides, these toxic substances are all parts of our external environment that are known to have a negative impact on the body. This makes them prime candidates for creating the painful joints suffered by RA patients. Radon https://en.wikipedia.org/wiki/Radon 2.. Radium. https://en.m.wikipedia.org/wiki/Radium Crystalline silica is among the environmental exposures associated with increased risk of autoimmune diseases including rheumatoid arthritis. Silica exposure has also been related to the development of ANCA-associated vasculitides (AAV).  (1)(2), (3).  

Genetics

We are conditioned to believe that our inherited genes create diseases but scientists have discovered that it is not our genes that create diseases but that it is our own biochemical, physical, and emotional reaction to our environment that 'switches on' certain genes in our body that creates diseases. Markers in a genetic makeup give one a tendency to develop RA and so it is believed that an environmental factor such as a virus, may trigger the development of RA in the 'B' blood type persons while bacteria may trigger the development of RA in the in 'A' blood type.  The growing knowledge about the pathogenesis of SARS-CoV-2 infection is leading to the introduction of drugs commonly used for the treatment of rheumatoid arthritis (RA) even for the management of more complex cases of COVID-19. (1), (2) 
 

Glucose

The role of glucose metabolism in the pathogenesis of RA (1)  GYS1-mediated glycogen accumulation plays an important role in regulating rheumatoid synovial inflammation by blocking excessive AMPK activation, providing a novel approach to understanding the mechanisms of RA. The suppression of GYS1 or the hyperactivation of AMPK may be a novel strategy to control various chronic inflammatory diseases, including RA.  Source: https://www.frontiersin.org/articles/10.3389/fimmu.2018.01714/full
 

Hormones

Estrogen is an important contributor to RA pathogenesis (1). Due to the staggering proportion of women who develop RA, some experts feel that there is a strong link between female hormonal changes and the onset of RA symptoms. As levels of pregnancy hormones (estrogen and progesterone) decrease in women with age, the hormonal shift could be a potential disease trigger for RA (2). All the lipid hormones are made out of cholesterol and if you are given a prescribing drug to lower cholesterol then you don't have the available materials to build the chemical messengers that communicate organ to tissue so you end up with negative results. Blood pressure drugs, Diuretics, Methotrexate, Anti-inflammatories, Motrin, Advil, Aleve, all of these can cause diseases because they have control above the genes, they're going to control gene expression and they're interrupting that communication from the organ to the tissue. 

 

Stress/Trauma

Stress can cause cortisol levels to increase resulting in an autoimune disease.
Spirit – refers to someone's will and physical strength.  Chronic fatigue syndrome is an old definition now it is more properly called Myalgic Encephalomyelitis.  Myelitis stands for inflammation while myalgic is about muscle pain.  Myalgia without a traumatic history is often due to viral infections. https://www.gaia.com/lp/rewired?utm_source=youtube+paid&utm_medium=cpv&utm_campaign=st-rewired&utm_content=trailer&utm_term=&ch=st&gclid=Cj0KCQjwyur0BRDcARIsAEt86IBVX3rs4fidjvSuKAoaJO96cKanLpLSZOa1cjdfLMZcozONDVI9jaMaAgJ4EALw_wcB
Unresolved emotional conflicts, anxiety,  and depression
Psychosomatic factors (psychological causes)

Emotional stress (separation, loss of work ...)

Physical stress (gut dysfunction, teeth/gum infection, a broken leg, ...)Traumatic events could be enough to stimulate an immune response and trigger RA symptoms as trauma has no boundaries, it moves beyond the physical. Any past emotional or physical trauma can alter how the body reacts. These types of issues are also thought to perhaps contribute to the eventual development of RA because emotional stress is shown to activate or trigger an immune response, which in turn worsens the disease and its symptoms. In this case, certain individuals who have experienced a high level of stress or trauma and who have a genetic predisposition to RA are at higher risk.

The fight-or-flight response is a physiological reaction that occurs in response to a perceived harmful event, attack, or threat to survival. In this state, the sympathetic nervous system firers up, preparing humans for fighting or fleeing. Australian Aboriginals have one of the lowest prevalence of RA, while the Australian white population has one of the highest rates of RA, near 2% (1) 

William Osler in 1892 wrote in his textbook of medicine, " rheumatoid arthritis is a nervous system disorder caused by worry and stress". 

Obesity

As for non-genetic risk factors, researchers consider the possibility that obesity and poor health, could be potential contributing factors in developing RA. These lifestyle factors are known to compromise an otherwise healthy immune system, making it easier for joint-related conditions like RA to take hold. Case in point: Research has shown that many patients suffering from RA are diagnosed with obesity before developing the disease. (1) This link could be explained by the fact that fat cells store cytokines, which are inflammatory chemicals. The more fat cells you have, the more inflammatory chemicals your body stores. Making positive lifestyle choices can also reduce RA symptoms. (2) Thus, if you’ve already been diagnosed with this disease, losing weight improving your health can potentially make treatment easier and more effective. Almost 1 in 5 children with juvenile psoriatic arthritis (JPA) were obese and more than one-third were overweight. (3)
 

Sleep

Lack of sleep can suppress your immune system up to 70-percent and switch off genes associated with your immune system. Lack of sleep due to pain caused by inflammation or arthritis can interfere with a night of good night sleep, so wearing splints is helpful as that's when they are most effective.
 

Sugar

Sugar protected the brain's of infants' evolving in a post-traumatic environment. It enabled them to recover quickly after traumatic experiences. Sugar was the fuel the brain needed to quickly over-turn the trauma that was done to the body. Their called, resilient. The problem is, sugar can be addictive provided your body was in a state of dysbiosis (a term for a microbial imbalance or maladaptation on or inside the body, such as an impaired microbiota), and that addiction can lead to an overload of stored energy if not used up will decay and leak through the cracks.  In the end, sugar promotes inflation.
Prolonged intake of refined sugar (and other refined products) is a major contributing factor in arthritis. Refined sugar depresses vitamin C stores.  The highest concentration of vitamin C in the body is in the adrenal glands, and chronic vitamin C deficiency (hypoascorbemia) leads to adrenal exhaustion.  With prolonged adrenal deficiency, there is a deficiency of endogenous (body-produced) cortisone.  Rheumatoid arthritis is the end result of this prolonged attack of sugar on the adrenal glands.
Source:  https://irp-cdn.multiscreensite.com/…/Dmso%20Nature%27s%20H…
https://irp-cdn.multiscreensite.com/73bf25b2/files/uploaded/Dmso%20Nature%27s%20Healer%20-%20Morton%20Walker.pdf
 

Steroids

When cell are treated with estrogen and then given steroids, it increases their capacity to be inflammatory, so we think that if these white blood cells are more capable of causing inflammation which means even if women are given an increased dose of steroids it may actually do more harm than good. Which medicines contain steroids?  Prednisolone.
Read More: Steroids
 

Vitamin D

meta-analysis on the Association between vitamin D intake and the risk of rheumatoid arthritis', concluded that of the 215,757 participants, "low vitamin D intake is associated with an elevated risk of RA development. Furthermore, available evidence indicates that vitamin D level is associated with RA activity." (GG Song, et al., 2012)
 

Tobacco

Nicotine contributes to the induction of inflammation, in a study published in the Journal of Leukocyte Biology, Volume 100, November 2016, researchers say that nicotine activates specific white blood cells called neutrophils to release molecules resulting in increased inflammation (1) F.A. Koopman, et al.EBioMedicine. 2016, concluded that "As expected, individuals at risk of developing arthritis (AR) tended to be younger than RA patients. Significantly more ‘ever smoker's’ and ‘smoking pack-years’ were identified in individuals at risk of developing arthritis (AR) subjects and RA patients compared to healthy subjects (HS)" (2)  Plants such as potatoes or tomatoes contain small amounts of nicotine; when they form a significant part of a person’s diet it is possible to build up a large enough residue in hair and tissue samples to show up in tests. WHO REPORT on The Global Tobacco Epidemic, 2008
 

Metals

Heavy metal exposure may be of importance in the development of inflammatory rheumatic diseases. (1)  Exposure to inorganic Hg can also induce Kawasaki disease in children which results from a weakening of the immune system.  Exposure to some metals, such as mercury and lead, may also cause development of autoimmunity, in which a person's immune system attacks its own cells. This can lead to joint diseases such as rheumatoid arthritis, and diseases of the kidneys, circulatory system, and nervous system.(2) 

Microbes/ Bacteria

A good start to a healthy gut microbiome is having been born via the birth canal rather than C-section. If your mom passed on beneficial bacteria/microbes and you feed or nourish them (i.e., high fiber diet) over time then they are still going to be there as you age unless you have been exposed to excessive use of antibiotics which can completely wipe out those beneficial bacteria/microbes that prevented you from developing many illnesses. Some bacteria are replaceable like the microbes found in yogurt, Lactobacillus casei, and Lactobacillus acidophilus. These species reduced joint inflammation (1) and they also keep the whole gut microbiome in a balanced healthy state. The bacteria Prevotella copri is strongly correlated with disease in new-onset untreated rheumatoid arthritis (NORA) patients. (1) 
 Colitis is an inflammation of the colon. Colitis may be acute and self-limited or long-term. It broadly fits into the category of digestive diseases. Colitis is the primary symptom before the onset of Autoimmune Diseases. (1), (2) More recently, the American Gut Project has proven that micro-organisms play an aetiological role in not just rheumatoid arthritis but numerous other diseases as well. In humans, epidemiological evidence points to possible links between dysbiosis and rheumatoid arthritis, asthma, and atopic dermatitis (Björkstén, 1999Penders et al., 2007Vaahtovuo et al., 2008). Elinav E, Strowig T et al. (2011) cell, study indicates that deficiencies in the NLRP6 pathway should be added to the list of host genetic factors that may drive disease-specific alterations in the microbiota, which in turn may promote disease in these hosts or in individuals who have been exposed to these microbial communities and who have also experienced disruption in their gut epithelial barrier function due to a variety of insults.
Read More: 

  • Proteus mirabilis, Specific Escherichia coli, Mycoplasma fermentans, Klebsiella pneumonia, Porphyromonas gingivalis,  Salmonella, Yersinia, Chlamydia trachomatis, Shigella, Campylobacter

Above is a List of microbes involved in RA [35,188,189]
Source:  Medicinal plants used against various inflammatory biomarkers for the management of rheumatoid arthritisS SinghTG Singh, K Mahajan… - Journal of Pharmacy …, 2020 - Wiley Online Library
 

Vaccines

Since the beneficial effects of vaccines are a result of changes in the immune system, it would not be surprising if some of the adverse effects were also a classification of immunologic reactions that can cause disease. (Coombs and Gell 1968). Vaccinations and risk of systemic lupus erythematosus and rheumatoid arthritis: A systematic review and meta-analysis by (BinWang et al., 2012) conclude, "This study suggests that vaccinations are related to increased risks of SLE and RA. More and larger observational studies are needed to further verify the findings above and to assess the associations of vaccinations with other rheumatic diseases."
 

Viruses

Below is a List of viruses involved in RA [35,188,189] Source:Medicinal plants used against various inflammatory biomarkers for the management of rheumatoid arthritisS SinghTG Singh, K Mahajan… - Journal of Pharmacy …, 2020 - Wiley Online Library

  • Epstein–Barr virus (EBV), Cytomegalovirus (CMV),  Parvovirus B19, Hepatitis B, C viruses, Chikungunya

Probably 90% of us have a trace Epstein-Barr virus or have antibodies to it. There is no source that informs us of how much and how many viruses the healthy human houses although it would not be surprising to find most people with an immunized compromised immune system would have a least half a dozen, e.g., cold, enterovirus, flu, herpes, hepatitis, rhinovirus, and, from earlier years, measles, mononucleosis, and mumps, maybe cowpox.

Epstein Barr Virus (EBV) infection can be actively causing chronic issues and inflammation in several autoimmune disorders including Rheumatoid arthritis. In 2018 it was announced that the Epstein Barr Virus Antibodies were found in 100% of MS patients.  A blood test to rule out EBV as the causative agent in your inflammation: Epstein-Barr Virus Full Ab Panel.
Source:
1. https://www.healthcare.uiowa.edu/path_handbook/handbook/test2681.html
2. https://www.childrensmn.org/references/lab/serology/epstein-barr-virus-(ebv)-antibodies.pdf, including rheumatoid arthritis.
 (1) 


Viral Arthritis Characteristics and Diagnosis By Carol Eustice Updated on January 06, 2020
How Viral Arthritis Develops:  Viruses can directly invade a joint which leads to an infection of the synovium or surrounding joint tissues. Viral particles (whole virions or viral antigens) may act as the antigen in immune complexes which form in response to a viral infection. In such cases, the immune complexes may be deposited in the joints. The other mechanism of action involves persistent viral infections which lead to immune dysregulation and chronic inflammatory reactions.

Causes:  The most common viruses that have been linked to arthralgia or arthritis include:

Parvovirus, Hepatitis B, Hepatitis C, Rubella, Epstein-Barr Virus

  •  Joint symptoms occur in 60 percent of infected adults
  • 10 to 25 percent develop arthritis
  • 2 to 20 percent develop arthritis
  • Incidence of arthritis is up to 30 percent of infected females and 6 percent of males
  • Mosquito-borne RNA viruses increasingly common in travelers to endemic areas
  • Common in patients taking biologic drugs

Other viruses that may also be associated with viral arthritis, but less commonly, include

  • Hepatitis E
  • Human T-lymphotropic virus type-1
  • Enterovirus
  • Dengue virus

Chikungunya virus:

  • The chikungunya virus, an alphavirus which has caused disease in Africa and Asia primarily
  • is spread by Aedes mosquitoes
  • Acute chikungunya usually lasts for up to a week, but it is associated with arthritis that persists for up to 36 months
  • Usually, the symmetrical arthritis of chikungunya affects the fingers, wrists, knees, and ankles
  • Relapsing and remitting symptoms occur in 60 to 80 percent of those affected, according to Clinical Medicine
  • The outbreak of chikungunya that has occurred in the Caribbean is likely to increase the prevalence of this specific type of viral arthritis since it is a hot spot for travelers.(2)

If a viral infection is suspected, serology should be performed immediately and again after 2 to 3 weeks.
An acute IgM antibody response followed by IgG antibodies against a specific virus confirms a viral cause.
An increase (4 times or more) in IgG over time is associated with recent infection whereby the initial blood sample was taken too late to detect IgM, It could also be indicative of reinfection or a recurrence.
Stable IgG levels do not support the diagnosis of a recent viral infection.

It may be indicative of an old viral infection not associated with arthritis which later developed.

Blood tests are also usually ordered in an effort to rule out other possible causes for the joint symptoms. For example, rheumatoid factor, anti-CCP, sed rate, and CRP would typically be ordered.
https://www.verywellhealth.com/what-is-viral-arthritis-4138…