Hiya! I currently am on Imraldi, methotrexate and steriods for my RA, everything has been going OK but since April I've been doing a very calorie restricted weight loss plan (121plan) to improve my over all health (800cals), I've loss just over 3 and a half stone, but for the past few months my blood have flagged up a an issue with my liver function. The rheumy has sent a letter saying to stop methatrexate and referring me to a liver specialist. He also says although losing weight is important restricting whilst on steroids can cause issues.... My GP has said that's crazy and of course losing weight will only have a positive effect on my health and said I can carry on with the diet plan until I have my appointment with the liver doctor....has anyone experienced issues with their liver due to dieting or methotrexate... Im really worried about what's going to happen :(, I don't know if I should just stop dieting (I'm 15stone now) until I have my appointment or listen to the gp and keep ploughing on.
Thanks in advance xx
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Ouchyjenna
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Hi, sorry to read you are having issue with your liver function/tests.
Over 3 stone since April is alot of weight to have lost, my dad whilst he isn't on steroids had lost 5 stone in a short space of time and his liver function tests were abnormal, he was told by his consultant that it was too much weight loss in too short of time and his body didn't like it, he's since slowed the weight loss down and his liver results have gone back to normal.
Of course this is my dad and not you (he's got other medical issues) 😁
Your liver plays a large role in glucose metabolism and regulation and steroids also affect this so personally I would go with your consultant here. I always think consultants over ride GPs but thats just me !
800 calories like you say really is quite restrictive, I lost about 4 stone in about 2 years and I was eating about 1600 calories a day (im 5ft 9 ), I used my fitness pal and it calculated my daily calorie amount that I could eat and still be in a calories deficit and did loose the weight.
You've done amazingly well to loose 3.5 stone, hope you feel better for it, I really need to do the same so I will take you as Inspiration. I know I couldn't ever do 800 a day as its too low for me (again I'm using my height etc for this) but I need to do something.
As I said I would listen to your consultant, maybe not so much under your daily calorie allowance, up the calories a tad but not enough to gain ?
I agree that in all matters of RA and the meds we take I would follow the advice of my consultant rather than the GP. My daughter’s periods stopped when she was on the 800 calorie diet so it can clearly have a significant effect on the body. As soon as she increased her calorific intake they retuned!
If you want to continue dieting then perhaps allow yourself more calories per day so you don’t put your body under such strain.
The liver results must be worrying for you, I have to say I do agree with the others that maybe you do need to heed your consultants advice. I think it's always going to be harder with RA and the medications your taking to change your eating habits, I appreciate you want to lose weight, have you thought of following a Mediterranean eating plan, just healthy eating of all the healthy foods? You may lose less weight but it may be more slow and steady that your body and medication may prefer. Look after yourself.
Thank you for your advice, this is the first time I've stuck to a diet plan however my liver is more important. I will ask for a dietician referral at my appointment.... I feel really down in the dumps about it all...
I can imagine you do feel down in the dumps, it's understandable, good idea to ask for a dietician referral / advice, they will be able to guide you. All the best. Let us know how you get kn.
The 121 plan has a great reputation for quick Weight losses. However we all need a calorie intake that is suitable for our:-age - gender - weight and what weight we wish to loose. I used to be a WW lead and sliming world before rhumi!! You’ve done amazing loose 3 and a half stone. My suggestion is that until you’ve spoken to your consultant and stabilised your meds - be kind to yourself. 1250 may be a good place to be for a while. Use the calories on extra portions. I’m looking at the moment at foods that help us with this rotten disease. Avoid all nightshade veg 🤦♀️ and as I’m have a major flare up I cant face it yet 😂🤣.
I haven't had any liver problems after 19 years on mxt. You have done amazingly well with weight loss but I think 800 calories is far too low. In my opinion that can't possibly be healthy long term.
Here’s a new diet idea 💡 I’ve been following the Second-Nature diet programme which is endorsed by the NHS. It’s less drastic, no calorie counting and is a lower carbs programme. It about changing and developing good habits in eating, exercise and sleeping. It’s all on line. It is working well for me and I’m losing weight easily. The big plus is that by developing better eating habits I’m hoping not to put the lost weight back on again afterwards.
Oh dear! Doctors disagreeing is usually a sign that nobody knows! But, seriously, you have lost a lot of weight. 800 calories is a very, very restricted diet for anyone healthy never mind someone on your medications.
Methotrexate can affect the liver - that's why liver function tests are part of the monitoring. Mild disfunction can be caused by even mild alcohol consumption but a few weeks off it and the liver goes back to normal. I don't think alcohol, in sensible amounts, and Imraldi disagree with each other. My guess is you are losing weight too quickly. Perhaps a 1200 calories a day diet would be better. Even 1000 is quite severe.
It was actually the doc who recommended me looking at Cambridge, because I was considering having a bypass... But I agree, I've had no issues before and I dont drink alcohol so maybe my system is just not handling the fat weight loss. I have an appointment Monday with the consultant and discuss what my options. Thanks
Just a little update, I had an appointment with my consultant today, he had ok'd temporarily upping to another Step of the plan which is more calories and incorporates normal food rather than replacement so I'm happy, as it means I can still be healthy but with the slower weight loss, but he thinks it is the methatrexate causing my liver issues, so more tests and steriods to control my flare. Feeling more positive, so thank you for your advice, I was feeling down about the situation and your support was really appreciated
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