Your Rheumatologist will want to put you on various meds without testing you to determine which one might help. They will likely suggest you start with trying Humira to see if it helps. That is the insurance mandated first course regardless of whether you have TNF-A as the culprit for your disease. There is a cytokine panel that can determine this, but it isnt covered by insurance typically. They would rather you risk serious side affects experimenting than authorize a pricey test thats actually less expensive than the drugs. It's absurd. You're much better off consulting a functional medicine dr, dr of nutrition and physical therapy dr. The conventional course of action on autoimmune disease is designed to make money at the expense of patients' health. If you cant determine what is triggering your disease yourself, get rid of the cause(s) in your iwn, and wirk to heal your body with better nutrition and movement on your own, a functional medicine dr can help better than a Rheumatologist can. Something in your life is triggering and your disease. Think of it like an allergy on steroids. Like allergies, the best thing to do is avoid them. It could be something in your environment from home candles and pets to pollen and insecticides, something you eat - gluten to broccoli and whatever in between, or relationships stress. That will be your journey of discovery and evolution. Good luck. 😌🙏

The expectations written above are all excellent ! I don’t have much to add other than keep your expectations low to begin with. Some Rhuematologists prefer to send you to pain management than to start you on a pain killer. In over ten years with my first Rhuematologist I’m am waiting to go see a new Doctorwho will be my 4th doctor. To start out thinking my first doctor would be the best in over a ten yr period proved to be grandiose.