Fatigue getting worse

Hi, I’m in a very similar position Cara123. Have RA and been on methotrexate 7 years now. The last year or so I’ve had frequent flares and now am in permanent pain and really, really struggling with fatigue. The pain is manageable, but the fatigue is crippling. I’m flopped on my bed right now, unable to do anything. In tears because it feels like there’s no power in my muscles at all and I’m just wasting my spare time and missing out on doing things. Gone round in circles with the health service trying to get new/ different meds. Been advised to try hydroxychloroquine, but now have to wait for a referral to secondary care to get the prescription.

Thank you for the food advice Arciere. Gonna try that.

@Cara123 @sarahmcl @Naomi33

MTX takes 3 months to nobble & hobble your immune system sufficiently by reducing the supply of attacking T Cells based on dosage. Your immune system when fighting a foe, real (virus) or imagined (auto immune), consumes a huge amount of your resources, that is why both flu and RA make you feel so tired. HOWEVER, consider that if the imagined foe is actually something in your gut, food or a microbe, triggering your immune system, causing it to run on overdrive even on MTX, leaving little resource for your brain & muscle… then consider removing that trigger. How do you know what to remove? How do you know it’s even in the gut?

Well, most of your normal immune activity is in your gut. Try water fasting after consulting your GP, for 7-10 days. Make careful notes each day for any changes. Most people find symptoms easing on day 10, energy returning - yes even if you haven’t eaten your body will use fat to keep going.

Then remove all the usual suspects of trigger foods:

gluten

beans (lectins) - toxic plant defence toxin proteins to stop you eating them as unlike animals, plants can’t run. Normally your gut wall prevents these from reaching your blood, but if it’s been damaged, some will get through. These plant toxins can be quite potent as Georgi Markov found. Red kidney beans are more common example.

Soy products

lecithins (found in processed food, emulsifier)

Cow dairy (A1 casein & lactose)

eggs (unfortunately because chickens are usually fed on animal feed derived from soy)

farm animal products including fish where the animal was raised on animal feed (ie, soy protein)

Nightshade veg (aubergine, peppers , potatoes, - can be reintroduced later but right now your immune trigger is highly sensitised). The most extreme of these is deadly nightshade (belladonna) which contains atropine.

avoid sugars EXCEPT glucose & dextrose. Glucose is made by the liver if absent from the diet, your red cells can only burn glucose. However you need very little, your entire blood stream only has 4grams, and insulin is needed to keep it low. Dextrose is just 2 glucose molecules.

Avoid all the other oses - sucrose, fructose, lactose, etc.

Think of your poor inflamed gut like your arm that’s been badly bruised and grazed, until new skin forms to cover up the wound, it will be horribly sensitive to everything.

After your fast, eat something in a very small portion to see how you react over 24hrs. Make your own safe list, mine was plain boiled rice. Ultra boring but no pain or hot joints, no energy issues either. Added steamed veg later. Try goats milk yoghurt, small portion, this has A2 casein, unlike cow A1.

Take it slow and make notes.

It sounds as though your disease isn't really under control because I usually only feel that intense exhaustion when I am flaring. Much rarer for me these days.

Arthuritis is absolutely right in my opinion and from the research I have done that the biggest part of our immune system is in the gut so eating a good healthy varied diet is essential. I hope you heard what he said about consulting your GP before attempting any water fasting diet.

My own diet is vegan and I feel confident it has helped me a lot avoiding animal products and eating a varied (colourful) diet including plenty of protein. I also eat kimchi (fermented food ) most days and avoid alcohol, smoking etc.

I have read things about oral (dental) health being potentially relevant so take extra care with my dental hygiene never missing a check up too. I exercise daily unless I am in real trouble and even then always do range of movement.

Wishing you best of luck

Toni x