a discussion in another thread brought up the connection between CYP2D6 polymorphisms (common mutations in this P450 - liver enzyme that processes a number of drugs including codeine and tramadol) and the spondylarthropathies:

http://hmg.oxfordjournals.org/content/9/11/1563.full

other articles too but required subscription:

section 5.3 of this paper looks interesting in this regard:

Genetics of the Spondyloarthropathies

so, if you are HLAB27 negative, have a spondy, and have had issues with either codeine and/or tramadol having little to no effect, this could be the connection. i wonder if this is the link for me, have known since my 20s that codeine has no pain relieving effects for me, just puts me out, so have suspected that i have a mutation in this gene. some googling indicated that this gene can be genetically tested for. wonder if i should request this, will ask doctors.


sue

Spondyloarthropathy, HLAB27 negative
Humira (still methylprednisone for flares, just not as often. Aleve if needed, rarely.)
LDN/zanaflex/flector patches over SI/ice
vits C, D. probiotics. hyaluronic acid. CoQ, Mg, Ca, K.
chiro
walk, bike
no dairy (casein sensitivity), limited eggs, limited yeast (bread)