What should I expect the GP to do? Swollen hands every morning

[Gptoday]

I have a GP appointment coming up. Wondering what I should be expecting them to actually do?

I have been having swollen hands every morning for going on a year now - especially in my right hand. They are painful and throbbing but no numbness or tingling. I cannot really use my right hand in the mornings due to the swelling and associated pain. The swelling goes down eventually though. I have had the GP previously try antihistamines Incase my right hand has been bitten as it was summer, I then had an X-ray last year of my hand which came back normal however I am going back as the problem hasn't resolved and it's been a long time now and my left hand is also swelling slightly but the right is still definitely the worst.

What should I expect (if anything)? I am not the best at advocating for myself but this is going on and on and I'd like to get to the bottom of it.

Other symptoms which may or may not be related:
Itching in my hands when they are swollen
Weight loss
Very very tired (but could be low ferritin as every blood test I have that)

An update: all bloods normal bar my ferritin which is lower again. December it was 15 now it's 8. Perhaps it is ferritin as the cause after all.

Edit: also a bit strange as no periods due to contraception - how and why is all my ferritin going?! I have a follow-up soon so will chase that up.

I hope you solve this!

I am also very low on ferritin (9 last month), and, like you, this is a chronic issue. I do still bleed, but not excessively - my periods used to be quite long and plentiful when I was younger, but are no longer that way.
I had a colonoscopy last week to see whether I was losing blood from the GI tract, all clear. I have no idea why I lose iron stores. This latest finding was even taking 35 mg elemental iron daily for a number of years to try to stave off iron deficiency, which obviously did not work.

My symptoms are disturbed sleep and palpitations, but I don't feel as tired as I did when it was 6 - at that time, I thought I was seriously ill.

I kind of get this in winter, but come the warmer months like now it goes away. I've had all bloods done for other reasons but everything was fine bloods wise, apart from low vitamin D. I've also started drinking 2.5 litres of water a day and I have been doing for a few months.

@Slavica I'm sorry you are also having trouble with ferritin. I can relate to the feeling of being seriously ill, I feel pretty bad! GP once did mention a colonoscopy but it never happened due to my stool sample a few years ago being normal.
I am hoping it isn't unreasonable to ask them to look into it further as currently they are just re testing in a few months time.

@OooohAhhhh I will definitely try to drink more and see if it helps. Thank you for taking the time to reply..

Did you get your Vit D level tested OP?

The other thing that it would be an idea to look into is whether you are absorbing iron that you get from food. Are you eating iron-rich foods? If so, then maybe you are also eating/drinking things that prevent the iron being absorbed.

For example, if you drink a lot of tannin-containing drinks, like tea, coffee or wine. Or if you take a PPI and/or have low stomach acid. Or take Calcium. Eat a lot of eggs. Have too many oxalates (such as occurs in spinach). Get too many polyphenols (cocoa, coffee, apples, blackberries, blueberries, raspberries. Eat a lot of foods containing phytates (walnuts, almonds, sesame, dried beans, lentils and peas, and cereals and whole grains).

I think it's worth analysing your diet in case this is happening unwittingly!

Op- I had same symptoms and X-rays and blood tests all fine. I insisted on referral to a local early arthritis clinic and was diagnosed with psoriatic arthritis. Early medication is really important to slow down progress.