Rheum to Grow TX, 2500 Fondren Road, Ste 235, Houston, TX (2026)

10/23/2026

One of the most confusing lab findings in autoimmune disease is anemia that doesn't seem to make sense.

Your iron intake is fine. You're eating red meat, taking supplements, doing everything right. But the hemoglobin is still low. And the iron studies come back looking strange.

This has a name: anemia of chronic inflammation. And it's one of the most common issues we see in patients with autoimmune disease.

Here's what's actually happening.

🧬 The body is hoarding iron on purpose

When there's inflammation, the immune system releases a cytokine called IL-6. IL-6 tells the liver to make more of a hormone called hepcidin.

Hepcidin is your body's iron traffic controller.

When hepcidin goes up, it does two things:
👉 Blocks iron absorption from the gut (so the iron in your food doesn't get taken in efficiently)
👉 Traps iron inside your cells (specifically in macrophages, so it can't be released to make red blood cells)

The result: your body has iron, but it can't use it well. Iron sequestration is one of several ways inflammation suppresses red blood cell production.

⚡ Why the body does this

Believe it or not, this is a defense mechanism.

Bacteria and pathogens need iron to grow. When the body senses inflammation, it hides the iron so invaders can't use it.

The problem is that autoimmune inflammation isn't an infection. There's no invader to starve. But the body doesn't know the difference. So it keeps the iron locked up while your red blood cell counts drop.

🩸 Why iron supplements often don't fix this

If your iron studies show anemia of inflammation, taking more oral iron often doesn't help much. The gut still won't absorb it well. The iron you already have is trapped.

The real solution is controlling the inflammation. Once the disease activity comes down, hepcidin drops, and iron becomes usable again.

🔗 Link in bio.
✨ Comment "ME" for the Discovery Call Link

10/22/2026

My Child’s ANA Is Positive. Does That Mean They Have Lupus?

Your child's lab comes back: Antinuclear antibody: POSITIVE.

Cue the late-night Googling and a lupus spiral by midnight.

ANA is one of the most misunderstood tests in pediatrics. Here's what it actually means.

🧬 What ANA is
ANA stands for antinuclear antibody. It looks for antibodies the immune system might be making against the body's own cells.

A positive ANA can show up in autoimmune disease. It can also show up in completely healthy kids who will never develop one. It's a clue, not a diagnosis.

📊 The numbers parents need to know

👉 Up to 20% of healthy children have a positive ANA
👉 Up to 25% have a low-titer positive (

10/21/2026

Board certified pediatric rheumatologist, integrative medicine doctor, and RA patient here.

I'm rating the most common anti-inflammatory food claims for autoimmune disease from 1 to 10. Let's go.

1️⃣ Mediterranean-style eating: 10/10
Strongest research base across multiple autoimmune conditions. The winner.

2️⃣ Fatty fish and omega-3s: 7/10
Real evidence in RA and lupus. Modest, but consistent.

3️⃣ Extra virgin olive oil: 8/10
Contains oleocanthal, a genuinely anti-inflammatory compound. Don't be afraid to use it generously.

4️⃣ Dark chocolate, 70% or higher: 7/10
Flavanols are real and anti-inflammatory. Watch the sugar content and stick to small portions.

5️⃣ Coffee: 7/10
Rich in polyphenols, which carry real anti-inflammatory effects.

6️⃣ Cutting sugar and ultra-processed food: 9/10
One of the most evidence-supported changes you can make, regardless of your autoimmune diagnosis.

7️⃣ Cutting gluten (without celiac): 3/10
Can be higher if you have celiac, an IBD flare, or a documented sensitivity.

8️⃣ Cutting dairy: 3/10
Neutral for most people. Only cut it if you're sensitive to it.

9️⃣ Avoiding nightshades: 1/10
A persistent myth in autoimmune communities. Tomatoes, peppers, and eggplant are actually anti-inflammatory.

🔟 Carnivore diet: 1/10
No controlled evidence in any autoimmune condition, and it cuts out the fiber and plant compounds that do help.

Celery juice, ACV, bone broth resets: 0/10
Save your money.

AIP (Autoimmune Protocol) diet: 4/10
Very restrictive. Some patients feel better, especially in IBD, but it isn't proven to change disease activity long-term.

The bottom line: no single food fixes autoimmune disease, but consistent patterns over time genuinely matter.

10/20/2026

Why Is My Child Getting So Many Cavities Despite Good Dental Hygiene?

You brush twice a day. You floss. You skip the sugary drinks. And yet your child keeps getting new cavities.

This is one of the most frustrating things in pediatric dentistry, and it's usually not about hygiene.

It's often about saliva.
🦷 Why saliva matters so much

Saliva isn't just spit. It's actively protecting your child's teeth all day long. It:
👉 Neutralizes acid after meals
👉 Washes away food particles and bacteria
👉 Delivers calcium and phosphate that help repair early decay
👉 Maintains a healthy pH in the mouth

When saliva is reduced, teeth become vulnerable, even with perfect brushing.
🩺 Common causes of dry mouth in kids

Most cases come from things parents would never think to connect to cavities:
1. Mouth breathing (allergies, enlarged adenoids, chronic congestion). One of the most common and most missed.
2. Asthma inhalers. Especially long-acting steroid inhalers. They dry out the mouth significantly, particularly if kids don't rinse after using them.
3. ADHD medications. Stimulants are one of the most common causes of dry mouth in kids.
4. Antihistamines for allergies, especially when taken daily.
5. Dehydration. Active kids who don't drink enough water during the day.
6. Autoimmune disease. Pediatric Sjögren's is rare and usually doesn't show up as dry mouth first, but when paired with recurrent parotid swelling or persistent fatigue, it's worth considering.

🔍 Clues the cavities might be dry-mouth related
👉 Cavities showing up in unusual places (near the gumline, on smooth surfaces, on the tips of teeth)
👉 Multiple cavities at every dental visit despite good hygiene
👉 Tooth sensitivity
👉 Bad breath that doesn't improve with brushing
👉 A coated or sticky tongue
👉 Cracked corners of the mouth
🔑 What helps

🔗 Click the link in bio to book a call with Dr. Singla
👉 Comment “STACK” to receive our free guide: The Pyramid Stack

10/19/2026

If you or your child has been denied medication by insurance, take a breath.
Sometimes a denial is not the end of the road and instead, the beginning of the approval process.
Here's the general framework I share with families when this happens 👇
1️⃣ Don't panic about the first denial
Newer medications, off-label treatments, biologics, and JAK inhibitors get denied all the time. Especially in rheumatology, where many of our most effective options are used outside of strict FDA labels.
A first denial is common. It is not a verdict.
2️⃣ Read the denial letter carefully
Look for the exact reason listed:
👉 "Not medically necessary"
👉 "Experimental or investigational"
👉 "Off-label use"
👉 "Step therapy required"
👉 "Insufficient documentation"
The wording matters. It shapes the appeal strategy.
3️⃣ Loop in your rheumatology team right away
Ask:
👉 Will they be handling the appeal (in most cases, they will!)?
👉 Who coordinates the process/who should you be reaching out to there?
Most successful appeals are a team effort.
4️⃣ Request a Letter of Medical Necessity (most offices will already be doing this)
This is the cornerstone of most appeals. A good letter includes:
👉 The diagnosis and severity
👉 Other treatments that have been tried or failed
👉 Why this specific medication is needed
👉 Why delaying treatment could cause harm
👉 Published research supporting its use
5️⃣ Ask if a Peer-to-Peer Review is possible (sometimes written on the denial letter)
This is a direct call between your doctor and the insurance company's reviewing physician.
A lot of approvals happen right here.
6️⃣ If denied again, request an External Review
Most states allow an Independent Medical Review by a physician outside the insurance company. Their decision is often binding.
Deadlines matter, so move quickly.
🔑 A few things that help most families:
👉 Stay organized (notebook, spreadsheet, dates, names)
👉 Be polite but persistent
👉 Ask about manufacturer copay or patient assistance programs
👉 Lean on your clinic's expertise

10/16/2026

Your illness isn't your identity.
It might feel like it sometimes.
The appointments. The labs. The flares. The medications. The way it shapes your week, your year, your plans.
But it isn't who you are.
It's one part of a life that has many parts.
Here's what I see happen sometimes.
The diagnosis takes up space. First in your calendar. Then in your conversations. Then in how you describe yourself.
And eventually, in how you see yourself.
It's understandable. The illness IS demanding. It deserves attention.
But there's a difference between knowing your disease deeply and letting it become the entirety of who you are.
The goal isn't balance.
The goal is to make sure your identity has more than one place to rest.
A hobby. A friendship. A creative outlet. A role. A passion that has nothing to do with being sick.
This isn't a distraction from your healing.
It's part of it.
Because when your sense of self has multiple legs, you can lose one and still stand.
When it has only one, even a really strong one, that loss feels like a collapse.
So lean into the other parts of yourself.
The reader. The gardener. The mom. The artist. The friend who makes everyone laugh. The one who notices the moon.
Not to escape the illness.
But to remember that you were never just one thing to begin with. 💛

10/15/2026

Why Does My Child Still Feel Unwell Even When Their Labs Improve?

You walk out of clinic with good news. The labs are better. Inflammation is down. Complement is back up.

So why does your child still feel tired? Still ache? Still not quite themselves?
This is one of the most emotionally confusing parts of pediatric lupus care. And it's actually really common.

Here's what's happening.
Labs are a snapshot of inflammation. Recovery is the whole story.
When labs improve, the immune system has settled. But the body that just lived through a flare needs time to rebuild.

🌙 Why symptoms can lag improved labs

👉 Post-flare fatigue. The body uses an enormous amount of energy fighting active disease. After a flare, recovery takes weeks, sometimes months.

👉 Sleep architecture is disrupted. Inflammation, prednisone, pain, and worry all chip away at sleep. Restoring it takes time.

👉 Medication side effects. Prednisone, methotrexate, and other immunosuppressants can cause fatigue, mood shifts, and low energy, even when they're doing their job.

👉 Deconditioning. Weeks or months of reduced activity during a flare lead to real loss of stamina. Bodies need to be eased back, not pushed back.

👉 The emotional toll. Pediatric lupus is hard on kids and families. Anxiety, low mood, and worry are common, and they directly affect how recovered a child feels.

🩺 What this does NOT mean

It does NOT mean your child's labs are missing something serious.
It does NOT mean the treatment isn't working.
It does NOT mean every child with improved labs feels bad. Many feel great.
It means lupus recovery is nonlinear. And labs catch up faster than bodies do.

🔗 Click the link in bio to book a call with Dr. Singla
👉 Comment “STACK” to receive our free guide: The Pyramid Stack

10/14/2026

This is what arthritis looks like inside a child's joint.

Yes, a child's joint.

JIA (Juvenile Idiopathic Arthritis) affects about 1 in every 1,000 kids, sometimes starting as early as infancy. It happens when the immune system attacks the joint lining, causing swelling, pain, and stiffness that can affect growth, movement, and everyday childhood.

Here's the part that matters most.

You can't see this level of inflammation from the outside. And sometimes, you can't even see inflammation on labs...they look completely normal!

What we CAN see on a clinical exam is the physical signs: swelling, warmth, joint guarding, restricted range of motion, or a subtle limp. Those signs matter. They're how we catch what's happening inside.

But too often, those signs get missed or dismissed. Parents are told it's growing pains, an old injury, or just a busy season. Meanwhile, inflammation keeps damaging the joint.

The logic is simple:

Early evaluation = early treatment = better outcomes = better life.

If your child has joint pain, morning stiffness, or unexplained swelling for more than 6 weeks, don't wait. Ask about a pediatric rheumatology referral.

Early treatment protects joints. And it protects childhoods.

📞 Comment "ME" to book a free call with Dr. Singla. Let's talk about how Rheum to Grow can help your child thrive.

10/13/2026

You don’t have to be fearless to move forward, you just need the right team and a clear path. Parenting a child with an autoimmune condition can feel like balancing Jenga pieces with shaky hands. The Pyramid Stack gives you sequence and support: build from the bottom up, strengthen what matters first, add the right supports, and grow resilience in your child and your family. This isn’t about doing more. It’s about doing what works, in the right order, with less stress and more stability.
Ready to stop guessing? Comment STACK to receive the link to download the guide.

10/12/2026

Today is World Arthritis Day. 💚

About 1 in 5 adults in the U.S. has diagnosed arthritis. That’s more than 53 million people!

👉That’s not just a statistic.
👉That’s someone you know.
👉That’s someone you love.
👉That’s someone like you.

And it’s not just adults. Kids get arthritis too, and it’s often missed because people assume it only happens to older adults.

Arthritis affects all of us. Share this post to remind someone they’re not alone.

For resources and support, visit arthritis.org.

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