Doctors classify rheumatoid arthritis as either seropositive or seronegative, depending on the presence of specific antibodies in your blood. Your type may influence your symptoms and response to treatment.

Rheumatoid arthritis (RA) is an autoimmune disease that causes inflammation of your joints. While RA can affect anyone, about three-quarters of the 1.3 million U.S. adults with RA are female, according to the American College of Rheumatology.

RA is a chronic condition that causes a variety of symptoms, including:

  • joint pain
  • joint stiffness
  • limited mobility
  • swelling
  • fatigue
  • feelings of discomfort or not being well

Your symptoms, risk of complications, and outlook with RA may depend on which type of RA you have. Keep reading to learn more about each type and how doctors diagnose and treat them.

Diagnosing RA typically involves a series of tests to confirm what doctors find on a clinical exam. These include blood tests that can determine if your body is actively producing an immune reaction to your healthy tissues. These tests check for antibodies — proteins your body produces as part of an immune response.

A doctor may diagnose you with seropositive RA if you test positive for the following antibodies:

Having these antibodies doesn’t necessarily mean you have RA. However, if you do, it can help doctors identify the type.

About 75% to 80% of people with RA are seropositive. People with seropositive RA may experience:

Cases of RA that run in families or are early-onset are also more likely to be seropositive.

Smoking and seropositive RA

Smoking is a significant risk factor for RA, especially seropositive RA. Research suggests that smoking may contribute to the release of RF and ACPA, increasing the risk of seropositive RA.

Read more: “What You Should Know About Rheumatoid Arthritis (RA) and Smoking”

People who test negative for RF and ACPA in their blood can still have RA. Diagnosis isn’t based on just these tests. Your doctor will also take into account clinical symptoms, X-rays, and other laboratory tests.

About 20% to 25% of people with RA test negative for RF and ACPA. They tend to have a milder form of the disease and a better response to treatment than those who test positive.

However, people with seronegative RA can sometimes experience a delay in diagnosis. Because of this delay, people with seronegative RA often have more severe RA symptoms when they first go to see a doctor.

People with seronegative RA sometimes test positive for antibodies later on. At this point, a doctor will change the diagnosis to seropositive RA.

Juvenile idiopathic arthritis (JIA) was previously called “juvenile rheumatoid arthritis.” Medical professionals changed the name to distinguish it from RA since the cause is often unknown (“idiopathic”).

JIA is the most common type of arthritis in children. By definition, doctors diagnose JIA before age 16.

Symptoms may be temporary or last for a lifetime. Similar to RA, symptoms of JIA include joint inflammation, stiffness, and pain. If the disease is severe, it can cause eye inflammation and interfere with a child’s growth and development.

Autoimmune diseases share many common symptoms, making them particularly difficult to diagnose. People with one autoimmune disorder often develop another. Some conditions that are overlapping or often confused with RA include:

RA can also be confused with osteoarthritis (OA), which isn’t an autoimmune disease. Wear and tear of your joints causes OA.

RA treatment is similar, regardless of type. While there’s no cure for RA, treatment can relieve symptoms and help you live a relatively active life.

You’ll work closely with a doctor to determine the best course of action. Your primary doctor may refer you to a rheumatologist for treatment.

Research suggests that people with seronegative RA respond better to medications like DMARDs, even if they have more severe symptoms than people with seropositive RA.

Self-care tips for RA

Along with medication, lifestyle modifications can reduce symptoms of RA. Self-care home treatments can also help improve your quality of life.

For example, a diet rich in antioxidants can reduce inflammation and pain. Increasing your intake of vegetables, fruits, and fish can also help ease symptoms.

Other lifestyle changes to improve symptoms of RA include:

  • getting plenty of rest
  • increasing physical activity as you are able
  • using heat and cold therapy
  • trying alternative therapies, like massage therapy and acupuncture

Doctors classify RA into two types: seropositive and seronegative. A doctor can determine your type by identifying specific antibodies (RF and ACPA) on a blood test.

While people with seropositive RA typically have more severe disease, seronegative RA still requires treatment for symptoms like persistent joint pain and swelling. Poorly managed RA of any type can increase your risk of heart disease and stroke.

Talk with a doctor to learn more about how your RA type may influence your symptoms and outlook.