Recovery Rheum

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Recovery Rheum John D. Carter, MD provides comprehensive rheumatology care for those with autoimmune & inflammatory conditions.

He is a multiple year winner of Tampa’s Best Doctors, Castle Connolly and multiple other patient care awards Carter, MD provides extensive care for those suffering from rheumatic diseases and conditions, including Rheumatoid arthritis, Systemic Lupus Erythematosis (Lupus), Psoriatic arthritis, Ankylosing spondylitis, Inflammatory bowel disease-related arthritis, Non-Radiographic Spondyloarthitis, Gout, Giant cell arteritis (Temporal Arteritis), and Polymyalgia Rheumatica. Prior to Recovery Rheum LLC, Dr. Carter was the former Chief of Rheumatology at USF and Tampa General Hospital for 17 years.

10/27/2026

A positive anti-CCP or rheumatoid factor test with no joint symptoms is one of the hardest
results to sit with. You feel fine, and you have been told something might be coming.
These antibodies can appear in the blood years before rheumatoid arthritis shows up in the
joints. Not everyone who has them develops RA. The risk is higher with joint pain, both
antibodies positive, or high levels.
Over the past decade researchers have tried treating people at this stage. Hydroxychloroquine
and a statin did not prevent RA. Rituximab and abatacept delayed it, and the effect faded after
treatment stopped.
So the honest answer today is delay, not prevention. What helps now is not smoking, the
strongest known risk factor, and being seen quickly if morning stiffness or swelling in the small
joints of the hands begins.

10/25/2026

The urine albumin-to-creatinine ratio is one of the most useful tests in medicine that most
people have never heard of.
It looks for albumin, a protein that should stay in your blood. When it starts leaking into your
urine, it is an early sign that the small blood vessels in your kidneys are damaged, and those
vessels behave the same way in your heart and brain. Higher results predict kidney disease,
heart attack, stroke and heart failure.
It costs around fifteen dollars and needs one urine sample. A routine urinalysis is a different
test and can miss early leaks, so ask for it by name.
Results are in mg/g. Under 30 is normal. 30 to 300 is moderately increased. Over 300 is
severely increased. A single high result should be repeated.
If you have diabetes, high blood pressure, heart disease or lupus, this belongs on your list.

10/24/2026

About one in four people with rheumatoid arthritis test negative for the usual antibodies,
rheumatoid factor and anti-CCP. Doctors call it seronegative RA.
Patients tell me what comes with that word. Doubt. From family, from employers, sometimes
from doctors.
Two studies look past the standard tests. One found DNA from damaged mitochondria, the
energy-making parts of your cells, running 19 times higher in people with RA. It tracked how
active the arthritis was, and it was just as high whether the blood test was positive or negative.
The second found an antibody against a mitochondrial protein, mitofusin-1, that flagged which
seronegative patients went on to joint damage. It is early, small and not yet a test you can
order.
What it shows already: joint pain and swelling with a negative test is still inflammation.

10/23/2026

Disability paperwork for autoimmune disease asks questions no lab test can answer.
How many pounds can this person lift, and how often? How long can they stand? Can they use
their hands for a full working day? Social Security wants to know whether someone can keep it
up eight hours a day, five days a week.
A rheumatologist is the right person to document the disease: the diagnosis, how active it is,
the joint damage, the treatment. Measuring sustained physical work is a different skill.
That is what a functional capacity evaluation is for. A physical or occupational therapist tests
lifting, carrying, standing, walking, grip strength and repetitive hand movements over several
hours.
One limit worth knowing: it captures one day. With rheumatoid arthritis, lupus or psoriatic
arthritis, good days and bad days both count, so keep a symptom diary too.

10/22/2026

For years, a lot of people on methotrexate heard the same advice: not a single drink.
The reason was sensible. Methotrexate is processed by the liver, and so is alcohol. Nobody
knew where the safe line was, so the safest answer was zero.
Then a UK study followed 11,839 people with rheumatoid arthritis on methotrexate. Up to 14
units of alcohol a week — about six glasses of w**e — carried no more liver risk than not
drinking. Above 21 units a week, the risk rose by 85 percent.
Two things the number does not cover. It measured weekly totals, so it says nothing good
about saving it all for one night. And it applies to a healthy liver. Fatty liver disease, hepatitis or
abnormal liver blood tests change the answer.
Your liver blood test is the best guide you have. Ask to see yours.

10/20/2026

Are you taking a biologic for an autoimmune condition? Here’s a quick health reminder.
If you use a TNF inhibitor (like Humira, Enbrel, or Remicade) to manage conditions like psoriasis, rheumatoid arthritis, or Crohn’s disease, it’s important to know how it affects your skin.
🔬 The Facts: The official FDA package inserts point out an increased risk for non-melanoma skin cancer. Because these medications calm an overactive immune system to stop inflammation, they can also reduce your body’s natural ability to clear out damaged skin cells before they turn into common skin cancers.
This primarily includes:
• Basal Cell Carcinoma (BCC)
• Squamous Cell Carcinoma (SCC)
🧴 How to Protect Your Skin:
1. See a Derm: Schedule a total-body skin exam with a dermatologist every year.
2. Lather Up: Apply a broad-spectrum SPF 30+ sunscreen every day, rain or shine.
3. Check Regularly: Keep an eye out for any new, changing, or non-healing spots.
Stay proactive about your health! Talk to your doctor or specialist if you have any questions about your routine.

10/19/2026

Patients have been telling doctors about this for as long as there have been doctors, and for
most of that time we told them it was coincidence.
It is not coincidence. Studies in knee and hip osteoarthritis have repeatedly found barometric
pressure tracking with pain. There is even a plausible mechanism — work on cadavers shows
that outside pressure changes do alter the pressure inside a joint.
What nobody can agree on is which way. Some of the best studies found more pain as
pressure rose. Others found the reverse. Temperature and humidity move at the same time,
which makes pressure hard to isolate.
So the folklore got the phenomenon right and the explanation wrong, which is a more
interesting result than being simply wrong.
Your joints are a real instrument. They are just not a barometer.

10/18/2026

Elimination diets have a trap in them, and it is not the food.
If you cut out tomatoes and feel better three weeks later, that feels like proof. But arthritis
fluctuates on its own. People usually make a change when they are having a bad spell, which
is exactly when things were most likely to improve anyway.
That is why patient surveys keep finding nightshade sensitivity and trials keep failing to. The
surveys are measuring a real experience. They are just not measuring the cause of it.
The cost is real too. Tomatoes, peppers and potatoes carry fibre, vitamin C and beta-carotene,
and the list of removed foods rarely gets shorter over time.

10/16/2026

My son has never had an autoimmune disease. He painted this anyway.
What struck me is what he put where. The face is underneath. Exhausted, eyes closed, but the
jaw is set — this is not a person who has given up, it is a person who is enduring. And above
her, wearing her almost like a crown, is the thing with teeth.
That is the part most people get wrong about autoimmune disease. They imagine tiredness.
They do not imagine something with a mouth, living on top of you, made of your own immune
system.
I have spent twenty-five years trying to explain this to families who cannot see it. He did it in
one image, without a single word.
What would your version of this painting look like?

10/16/2026

Retrospective diagnosis is a parlour game with a serious edge, and it is worth saying out loud
what it can and cannot do.
Nobody examined Frida Kahlo with modern tests. The 2022 paper arguing for antiphospholipid
syndrome is working from letters, medical notes, photographs and her own paintings. It is a
careful argument and it is still an argument.
What is not in doubt is the timing. Antiphospholipid syndrome was described in 1983. She died
in 1954. Whatever she had, the name for it did not exist while she was alive, and her doctors
were working without it.
That happens now too. People sit in clinic for years with a collection of symptoms that does not
match anything in the textbook, and they get told it is stress.
Sometimes the textbook is simply not finished yet.

Address

2919 W. Swann Avenue, Suite 402
Tampa, FL
33609

Opening Hours

Monday 8am - 5pm
Tuesday 8am - 5pm
Wednesday 8am - 5pm
Thursday 8am - 5pm
Friday 8am - 5pm

Telephone

+18136961681

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