Pillar six of six in the lifestyle medicine series. Social connection has some of the strongest evidence of any pillar in this series, and it's the one most often left out of a medical visit entirely. Here's why it matters, how it ties into autoimmune disease specifically, and what helps.

Pillar five of six in the lifestyle medicine series. This pillar is usually framed as avoiding risky substances broadly. I'm keeping it focused on the two most commonly used: tobacco and alcohol.

I can't remember the last week that's gone by without a patient asking me about Ozempic or Wegovy. Used to be strictly about weight. Now it's just as often about their joints. Could this help my RA too? My lupus? My psoriatic arthritis?

Let's start from the beginning.

Pillar four of six in the lifestyle medicine series. Stress isn't something you can just remove from your life. But how you respond to it changes its effect on you. Here's what stress does to your body, how it ties into autoimmune disease and pain specifically, and what helps when you're in the middle of it.

Pillar three of six in the lifestyle medicine series. Food affects inflammation, chronic disease risk, and how your body functions day to day. Here's how it works, what the research shows for rheumatoid arthritis specifically, and how to change what you eat without flipping a switch overnight.

Pillar two of six in the lifestyle medicine series. Movement is one of the most effective tools we have for long-term health, and that includes autoimmune disease. Here's what it does, and how to build it into your life.

A cheap, low risk medication my patients ask about a lot. Here's what I've seen in clinic, and what the research supports.

Pillar one of six in the lifestyle medicine series. Sleep isn't just something autoimmune disease disrupts, it can make the disease worse. Here's why I start the series here, and what can help.

This is the first post in a new series on lifestyle medicine, the six daily habits that shape how you feel and how your autoimmune disease behaves. Here's what it actually is, and where it fits alongside your treatment.

An independent review of the FDA-approved SetPoint System for rheumatoid arthritis. Find out how this vagus nerve implant works, the risks, and who qualifies.

I work for you, not the insurance company.

That one sentence explains most of how this practice runs. There's no third party deciding how long we get to talk, what counts as a billable problem, or whether the thing you came in for fits the visit. It's you and me.

These patients clearly have spondyloarthritis (the joint pattern, the enthesitis, the dactylitis, sometimes inflammatory back pain) but don't have any of the defining features that would put them into one of the specific subtypes. No psoriasis. No inflammatory bowel disease. No recent infection that triggered it. No clear axial disease pattern that meets the criteria for ankylosing spondylitis.

Reactive arthritis is joint inflammation that develops in response to an infection somewhere else in the body. The joints themselves aren't infected. Instead, the immune system's response to an infection at another site triggers an inflammatory reaction in the joints, usually a few weeks after the original infection.

Joint involvement is one of the most common extra-articular manifestations of inflammatory bowel disease. Roughly 20 to 30% of patients with IBD will develop some form of joint disease over the course of their illness.

Ankylosing spondylitis is an inflammatory condition that attacks the spine and sacroiliac joints, causing chronic back pain in young adults that worsens with rest and improves with movement. Because early disease doesn't show up on standard X-rays, recognizing this distinct pattern is critical to protecting spinal mobility.

Psoriatic arthritis is a chronic inflammatory condition affecting about one in three people with psoriasis, occurring when the same overactive immune system attacks the joints and tendons. Because joint pain often surfaces years after the skin condition—and can mimic simple wear-and-tear or overuse injuries—connecting the dots early is essential to preventing irreversible joint damage.

Spondyloarthritis is an umbrella term for a group of related autoimmune conditions that cause systemic inflammation, distinct from mechanical wear-and-tear or rheumatoid arthritis. While it literally translates to inflammation of the spine, it frequently targets tendons, fingers, and toes without ever affecting the back.

Hydroxychloroquine is a cornerstone treatment in rheumatology that modulates the immune system to quiet inflammation without actually suppressing your body's defenses. It is so effective at preventing flares and protecting long-term organ health that it serves as the foundational, pregnancy-safe anchor for conditions like lupus and RA.

Lupus is a highly variable autoimmune disease that can affect almost any part of the body, making it notoriously difficult to diagnose early on. Because no two patients look quite the same, a proper evaluation requires putting together a complex puzzle of symptoms, physical exams, and specialized blood work.

Lyme arthritis often surfaces months after a forgotten tick bite, typically presenting as a massively swollen but surprisingly painless knee. Because it can mimic a sports injury or flare up during the winter, it is easily missed or misdiagnosed. If you have an unexplained swollen joint after a season outdoors, an evaluation can determine if Lyme is the culprit and get you the right treatment.