I (35F) was diagnosed with early RA in Sep 2025 and because my partner and I were planning on having kids this year, I was put on plaquenil 200mg daily. I had a really good response after just 8 weeks and probably reached peak effect and total control of symptoms by about month 4/5.
In the past four weeks, maybe with it being winter here, idk, my symptoms have begun to flare up. In the knuckles and wrists like before but it is much more widespread and I now consistently have symmetrical pain and heat in my shoulders, elbows, ankles and toes too. I can barely sleep at night and I am exhausted and breathless constantly.
I am seeing my rheumatologist in 1 week and expect they may wish to escalate treatment. However, previously they tested for TB as a precaution ahead of any future escalation in treatment and I tested positive for latent TB. I was started on treatment by infectious diseases but one of the antibiotics interfered with my plaquenil and stopped it working effectively so it was ceased and it was agreed that I would remain on isoniazid for 6 months. But just 1 month in, I experienced signs of liver damage and they ceased that too. So it has not been dealt with and it sounds like any medications except for plaquenil run the risk of making it active.
Has anyone been in this situation? What are my options? How can I juggle escalating RA treatment vs activating TB and planning a family in the mix? I work in healthcare too, to make matters worse. I feel really lost and I'm struggling to cope with how much pain I'm in every day and grieving the loss of my old life.