In October 2023 I had my yearly check-up with gynecologist and knew I had gained 50 pounds in the past year. I found out I was in perimenopause at the age of 47. I wanted to figure out how to get my weight under control because I have multiple autoimmune diseases as well as I know how to lose weight with diet and exercise-I used to run marathons, be a Biggest Loser coach, teach extreme for classes, etc. However, this hormone thing with perimenopause was causing chaos within my body I couldn’t get control of. My gynecologist sent me to a nutritionist that is affiliated with their office so they could help me with diet. My first meeting was my PA and we discussed the compound version of “the shot.” I was completely against it as I didn’t want any medication that might take something away from those who might need medication for their diabetes as my nephew is T1 and my husband is T2. She assured me that it didn’t take away from anyone, but then shared that there was an off label side effect of reducing inflammation. You see I have severe Rheumatoid Arthritis along with Lupus symptoms and other autoimmune conditions. I live in pain daily due to inflammation. When I heard this-I said,”sign me up!” After two months on their medication they talked to me about Zepbound so that I wouldn’t have to pay so much. I haven’t had many side effects since starting and my inflammation is still down. It feels amazing to not be in complete pain every day. I choose the shot not for weight loss, but for the inflammation factor. I eat according to what my nutritionist has recommended. My rheumatologist fully supports this new addition to my regimen as my symptoms have improved. I consider Zepbound a part of my autoimmune defense protocol. I just took my 2nd shot of 5mg this past weekend. I stayed on 2.5 mg for 2 months before that. Since the week of Thanksgiving 2023 to today, 05/29/24, I have lost 45 pounds.

Hi all,
In the past two weeks, I've suddenly started waking up with what I'm pretty sure is radial nerve compression in my left hand, (numbness on the back of my hand below the pointer and middle fingers, temporary inability to extend my fingers,) and I'm trying to figure out why this has just started happening. It's happened about four times in the past two weeks, and two of those times were last night.
Has anyone else here experienced radial nerve compression during sleep, and did you figure out why it was happening? Did you figure out something to stop it?
My current and recent theories are:

1. For reasons I've written about below in the "My background" section, I recently started wearing new elbow splints for cubital tunnel, and I've been wearing them more tightly and pulling them higher up my arms to reduce the possibility of them sliding out of position. My current best guess is that I'm wearing them too tightly on my upper arm, and that's cutting off the radial nerve.
2. I've been a stomach sleeper most of my life, and recently I've been successful in sleeping on my side more. (Though it's mostly just my lower body and head that's on my side, I've been sleeping with my shoulders more flat on the bed.) During the night, my sleeping body almost always turns over onto my back, and I thought maybe I've been rolling from my side onto my hand. However, I slept fully on my back last night, and I don't think I rolled onto my hand. It is kind of hard to tell though, since when I wake up with numbness I'm immediately in panic mode and moving my arm around to wake up my hand, so I quickly forget where the hand was in the first place.
3. In reading about radial nerve compression, my understanding is that it mostly happens from compression of the forearm. I loosened the part of the elbow splint on my forearm after the first incident last night, but a second, even worse incident still happened after I fell back to sleep, so I doubt tightness of the splint on my forearm is why this is happening.

My background:
I've been wearing elbow splints for my cubital tunnel syndrome for years now. Previously, I was sometimes waking up with numb ring and pinky fingers. Now, I rarely have incidents of numbness at night as a result of the splints, and I never have symptoms during the day. I also wear wrist splints to bed as a preventative measure and also because they help prevent the elbow splints from wiggling off in the night.
I recently saw a doctor about some elbow tendonitis (likely the result of some injuries during weightlifting) and a potential onset of arthritis (possibly genetic), and he basically disregarded both of those to focus on the cubital tunnel syndrome instead. He had me get an EMG, which confirmed cubital tunnel (though just in the left arm, my dominant arm,) advised me on purchasing some new elbow splints (Hely Weber) and also asked me to seriously consider getting surgery. I'm currently not inclined to do so as I don't think my ulnar nerve symptoms are severe or getting worse since I became aware of them, though my mind could change about this later.

I genuinely don’t know where to go right now. I’ve had Psoriatic arthritis since I was 21 (now 28) and AS since 25. I was fairly well medicated initially on methotrexate, but as of around 3 years ago, it began attacking my spine and my diagnosis was expanded to being AS. I’m in the Uk so we have the nhs, in terms of the cost of medicine this is a blessing, in terms of wait times a curse. It took me a year of infrequent appointments (If I have a flare up I can expect to wait 6 months for an emergency appointment), an MRI which took almost a year to wait for, and then only after a further year did I finally get on a biologic. I literally couldn’t sleep for more than a few hours at a time, I was in so much pain for those years.
These 9 months have been the best in terms of my health, my condition has improved 95%, I’ve felt normal again. They even listed me down as being in “semi remission” but now the company which provides my biologic have reached out to let me know that my doctors haven’t reached out to them to renew my prescription, they said they have been trying to reach out to my doctors to no response. I am absolutely terrified that because I’ve responded “so well” to this biologic medicine they have perhaps taken me off it to save costs. I have reached out to my rheumatologist but they only have an email help line and a response can take 5 working days. In my most recent letter sent by my rheumatologist 1 month ago they listed my biologic as part of my medicine list, but why wouldn’t they renew my prescription?
I am absolutely terrified of going back to how I was before, has anyone been through a similar situation :(

I genuinely don’t know where to go right now. I’ve had Psoriatic arthritis since I was 21 (now 28) I was fairly well medicated initially on methotrexate, but as of around 3 years ago, it began attacking my spine. I’m in the Uk so we have the nhs, in terms of the cost of medicine this is a blessing, in terms of wait times a curse. It took me a year of infrequent appointments (If I have a flare up I can expect to wait 6 months for an emergency appointment), an MRI which took almost a year to wait for, and then only after a further year did I finally get on a biologic. I literally couldn’t sleep for more than a few hours at a time, I was in so much pain for those years.
These 9 months have been the best in terms of my health, my condition has improved 95%, I’ve felt normal again. They even listed me down as being in “semi remission” but now the company which provides my biologic have reached out to let me know that my doctors haven’t reached out to them to renew my prescription, they said they have been trying to reach out to my doctors to no response. I am absolutely terrified that because I’ve responded “so well” to this biologic medicine they have perhaps taken me off it to save costs. I have reached out to my rheumatologist but they only have an email help line and a response can take 5 working days. In my most recent letter sent by my rheumatologist 1 month ago they listed my biologic as part of my medicine list, but why wouldn’t they renew my prescription?
I am absolutely terrified of going back to how I was before, has anyone been through a similar situation :(

This is a long one but I would really appreciate it if people have the time to read and offer their own experiences/validate/point me in the right direction. My main question is: is there a blood test that definitively shows whether someone has an issue with their immune system? (I’ll get to why I’m asking that question)
Back story Im 30year old female with late diagnosed AuDHD. Ive been hyper mobile my entire life with issues in childhood particularly(but not limited to) my ankles, knees and hips. I’ve also had other symptoms of hEDS and of co-occurring conditions like pots, dysautonomia etc. since childhood but nothing was ever explored due to a family who were very into homeopathy and very skeptical of mainstream healthcare… anyway all of my symptoms got so much worse after I had covid and through meeting other people with hEDS and doing research (looking at the diagnostic criteria on the EDS website) I’m quite convinced that I would potentially meet the criteria for hEDS if not then hypermobile spectrum disorder.
So I’ve been to different gp’s on many occasions, had a referral to rheumatology turned away because initially they were exploring rheumatoid arthritis and they decided without seeing me that it’s not that and that I should go to physio. Went to a physio who said it’s nothing sinister probably fibromyalgia and that she doesn’t think it’s hEDS… and I can see how maybe it’s fibro as well as something else but I struggle to see how all of my symptoms could be caused by just fibro so I went back to the gp and pushed for further exploration. She made me feel like I was making it all up and I cried but then I insisted that I showed her my joints (she hadn’t even looked at them) then she asked why I hadn’t seen orthopaedics as a child and said she was putting a referral through to orthopaedics and that it would be a long wait. (And told me not to come back about this issue again 🙃)
So today I went to the doctors (a different one to the one who made me cry) because I’ve had what I think is a cold sore for nearly 3 weeks and now all of my lips are spotty and painful and the pharmacy said they recommend I go to the gp. The gp says I can’t have a cold sore for the first time without catching it from someone and that it would be weird for me to have impetigo as a ‘healthy’ adult but just use Zovirax and come back it if gets worse. I made a comment that I don’t think I’m a healthy adult and so he looked at my notes and declared that my blood tests are all normal, that they have tested for issues that would show problems with the immune system and they’re all fine. He also said that his colleague has referred me to rheumatology but there’s no response for that yet (she told me orthopaedics which I did think was odd but I’m just grateful for anything at this point).
But my point in this post is that every time I go to the gp they tell me I’m fine, there’s nothing wrong with me, there’s nothing else they can do and yet my day to day experience is pain, fatigue and struggling with all the other symptoms that go along with hEDS. So can a blood test really show that my immune system is totally fine? I’m grateful that they have put in a referral to rheumatology and I really really hope they don’t turn it away this time but I can’t help feeling like medical professionals think I’m making this all up and then I really do doubt myself. Any advice appreciated!

religious objection

"Title VII of the Civil Rights Act of 1964 (as amended in 1972) goes beyond just banning religious discrimination by employers; it requires employers to exempt sincere religious objectors even from generally applicable, neutral employment rules, unless granting the exemption would work an "undue hardship." "her body is a temple for the Holy Spirit that she is duty bound to honor. She does not believe in putting unnecessary vaccines or medications into her body, or going to the doctor or allowing testing of her body when it is not necessary." https://reason.com/volokh/2024/05/27/religious-exemption-claim-brought-by-employees-who-objected-to-covid-vaccination-and-testing-can-go-forward/

TV

Netflix, "Maniac tells the story of two strangers, Owen Milgrim (Jonah Hill) and Annie Landsberg (Emma Stone), who sign up for a mysterious pharmaceutical trial. Owen is a man struggling with schizophrenia, while Annie is dealing with a traumatic past and a strained relationship with her family...a trial at Neberdine, a pharmaceutical company, for a new drug that promises to cure all disorders." "Have you ever been hospitalized for mental illness?" https://www.giantfreakinrobot.com/ent/mind-bending-psychological-comedy-drama.html

Dogs

"Pets were a deterrent against self-harm and thoughts of suicide...They can improve cardiovascular health, decrease your body’s production of stress hormones, lower your blood pressure," https://www.psychologytoday.com/us/blog/its-not-just-in-your-head/202405/companion-animals-and-mental-health

rehab

canada, "In order to receive compensation from her insurance company under a disability claim, Elizabeth says she was required to provide her insurance case manager with her counselling notes, in which she mentioned that she drinks alcohol in her personal time off...made her “feel like a criminal”...“She never asked if alcohol interfered with my professional life...conflicts of interest, are extremely problematic." https://pressprogress.ca/bcs-medical-services-plan-is-funding-out-of-province-substance-use-treatment-for-workers/

physical pain

"As the severity of rheumatoid arthritis disease activity increases, so does the prevalence of depression, a new study found." https://www.hcplive.com/view/major-depressive-disorder-is-the-most-observed-psychiatric-comorbidity-in-ra Since I've had spinal arthritis since age 18, the same time I became depressed.

False Claims Act

west virginia, "they said he [J.P.] viciously attacked his roommate. He never touched him." https://wvpublic.org/man-held-at-sharpe-hospital-sues-state-officials/

coated poison

"most antipsychotics needed to be taken with food...coating that not only reduces unwanted weight gain but also boosts serotonin levels by more than 250 percent...gut microbiome." https://www.disabilitysupportguide.com.au/talking-disability/australian-breakthrough-could-reduce-antipsychotic-side-effects

personal experiences

May 28 nightmare about new psych ward.

I was only granted two years for my SSDI, and I'm stressed out not knowing what happens when those two years are up. What do I need to do to continue my SSDI?
After seven long years, I finally won my disability case, but they only gave me two years because they believe I have disabilities that will get better. This is absolutely absurd due to the fact that my disabilities are not going to improve.
I have ehlers-danlos type 6, scoliosis with a curve that's at 50 degrees, chronic pain, rheumatoid arthritis which causes flare-ups that render me unable to walk, hypotonia, major depressive disorder, and severe anxiety.
*At the time when I was going through the process, I hadn't received my rheumatoid arthritis diagnosis yet. So this is a new issue that I don't think they are aware of yet.
My biggest problem when I was trying to even get approved for SSDI is my age. Since I'm 38, they view me as too young to qualify for assistance. It was a miracle that I finally was at least approved for the two years. My lawyer was a real miracle worker helping get this far. But she wasn't helpful in telling me what happens after those two years are up. All she said if keep going to your doctors.
I've been worried sick that I'm going to have to go through that hell all over again. Those seven years were absolutely miserable. I don't think I can mentally go through it a second time. I ended up having a nervous breakdown after my hearing was over. The stress of being overwhelmed by thinking I probably lost destroyed me.
I'm definitely continuing all my doctor appointments, plus I've seen several new doctors concerning my problems. Like at the time of hearing, I didn't have a doctor for my scoliosis, but I'm in the process of seeing one now.
So that's why I need extra help knowing what I need to do to continue my benefits after the time frame they gave me is up. There is no way that I'm able to go back to work. Between the chronic pain and flare-ups that leave me bedridden, there's just no way I could do it.
Any help is much appreciated. Also, I'm in the US if that helps any.
*Edit - Thank you to everyone for being so helpful and helping me understand better what my approval letter meant. I apologize if I used any incorrect terminology. I was just confused and unable to understand what the two year thing meant. Now I have a better idea of what to expect. It's nice to get a little peace of mind over my misunderstanding.

I recently accepted employment in private practice as a psychologist working with people with chronic illness and pain. I have already signed the contract and all relevant legal documents, of which there were about 10.
I have a complex medical history. When my photo was taken for the website, I told my boss that I have essential tremor, which is a slight shaking of the hands, so she knew I wasn't nervous.
Today was my first day, which was significantly modified to how I was told it would go originally. I only sat in on sessions with my boss, and did not see clients one-on-one. My photo has not been added to the website, despite the initial urgency to take my photo.
I was given a form that has asked me to declare my health conditions. To be specific, the following:
"Are you aware of any circumstances regarding your health or capacity to work that would interfere with your ability to perform the duties of the position? Yes/No.
In answering this question yes or no you are also required to cover factors such as: existing or exposure to infectious diseases, taking of medication/treatment on a regular basis (daily, weekly, monthly).
If yes, what adjustments do you need to perform the genuine and reasonable requirements of the employment (if any)?
Do you have an existing injury or condition or pre-existing injury or condition that could be affected by the nature of the proposed employment?
Existing is a condition for which treatment is still being received. Pre-existing is where an injury or condition/s is present, but treatment is not required.
If yes, please provide details of the injury or condition(s). If yes, what adjustments do you need to perform the genuine and reasonable requirements of the employment (if any)?"
Then, there's a statement saying that I agree to a health assessment by a medical practitioner, I'll be sacked or sued if I don't tell the truth, and my health declaration will be kept on file.
What's wrong with me? Well, I have systemic lupus erythematous, and most of my health problems are secondary to this. They include rheumatoid arthritis, endometriosis, idiopathic intracranial hypertension, lymphedema, GERD, and fibromyalgia. I also had stage one uterine cancer in 2021. It's been treated and is in remission. I take 10 medications.
How much do I need to declare?
Thank you!

High-risk pregnancies are those that have a higher chance of complications for the mother, baby, or both. Several factors can contribute to a pregnancy being classified as high-risk.
Here are some common ones:

Maternal Age

• Advanced Maternal Age: Women who are 35 years or older at the time of delivery are at higher risk for complications such as preeclampsia, gestational diabetes, and chromosomal abnormalities like Down syndrome.
• Teen Pregnancy: Pregnancies in teenagers (especially those under 17) can also be considered high-risk due to potential complications like preterm birth and low birth weight.

Pre-existing Medical Conditions

• Diabetes: Women with pre-existing diabetes or those who develop gestational diabetes are at higher risk for complications like preeclampsia, birth defects, and macrosomia (having a large baby).
• Hypertension: Chronic high blood pressure can lead to conditions like preeclampsia, placental abruption, and preterm birth.
• Autoimmune Disorders: Conditions such as lupus and rheumatoid arthritis can increase risks for both the mother and the baby.
• Thyroid Disorders: Both hypothyroidism and hyperthyroidism can affect pregnancy outcomes if not properly managed.
• Heart Disease: Women with heart conditions are at higher risk for complications during pregnancy and delivery.
• Kidney Disease: Pre-existing kidney issues can worsen during pregnancy and lead to complications like preeclampsia and preterm birth.

Pregnancy-related Conditions

• Preeclampsia: Characterized by high blood pressure and signs of damage to other organ systems, this condition can be serious for both mother and baby.
• Gestational Diabetes: This type of diabetes develops during pregnancy and can lead to complications such as high birth weight and preterm birth.
• Multiple Gestation: Pregnancies with twins, triplets, or more increase the risk of preterm birth, gestational diabetes, and preeclampsia.
• Placenta Previa: When the placenta covers the cervix, it can cause severe bleeding during pregnancy and delivery.
• Preterm Labor: Labor that begins before 37 weeks of gestation can lead to complications for the baby, including respiratory issues and developmental delays.

Lifestyle and Social Factors

• Smoking: Increases the risk of preterm birth, low birth weight, and developmental issues.
• Alcohol and Drug Use: Can lead to fetal alcohol spectrum disorders (FASDs), preterm birth, and congenital disabilities.
• Obesity: Associated with gestational diabetes, preeclampsia, and the need for a cesarean delivery.
• Lack of Prenatal Care: Inadequate medical care during pregnancy can result in undiagnosed and unmanaged complications.

Obstetric History

• Previous Preterm Birth: A history of preterm birth can increase the risk of future preterm deliveries.
• History of Pregnancy Loss: Recurrent miscarriages or stillbirths can indicate underlying health issues that need careful management.
• Previous Cesarean Delivery: Increases the risk of complications in subsequent pregnancies, such as uterine rupture or placenta accreta.

Genetic Factors

• Family History of Genetic Disorders: Conditions like cystic fibrosis, sickle cell disease, or other inherited disorders can pose risks.
• Previous Child with a Genetic Disorder: Having had a child with a genetic condition can increase the likelihood of recurrence.

Infections

• Sexually Transmitted Infections (STIs): Infections like HIV, syphilis, and herpes can affect pregnancy outcomes.
• Other Infections: Conditions like urinary tract infections, cytomegalovirus, and rubella can pose risks to the mother and baby.

Environmental Exposures

• Exposure to Toxins: Exposure to certain chemicals, pollutants, or radiation can affect pregnancy.
• Work-related Risks: Physically demanding jobs or exposure to harmful substances at work can contribute to complications.

Psychological Factors

• High Levels of Stress: Chronic stress can impact pregnancy outcomes, potentially leading to preterm birth or low birth weight.
• Mental Health Conditions: Conditions such as depression and anxiety need to be managed carefully during pregnancy.

Women with high-risk pregnancies typically require more frequent prenatal visits, specialized care, and possibly interventions to manage potential complications. Consulting with a healthcare provider early and regularly can help in identifying and mitigating risks to ensure the best possible outcome for both mother and baby

Several factors increase the risk of developing lung disease. Understanding these risk factors can help in identifying individuals who might be more susceptible to such conditions. Here are the key risk groups:
1. Smokers and Former Smokers:
Tobacco Smoke: The primary cause of chronic obstructive pulmonary disease (COPD) and lung cancer. Smoking damages the airways and the alveoli, leading to chronic bronchitis, emphysema, and malignancies.
Secondhand Smoke: Non-smokers exposed to secondhand smoke are also at risk of developing lung diseases, including lung cancer and COPD.
2. Occupational Exposures:
Asbestos: Prolonged exposure can lead to asbestosis, lung cancer, and mesothelioma.
Silica Dust: Workers in mining, construction, and sandblasting are at risk for silicosis.
Coal Dust: Coal miners can develop coal workers' pneumoconiosis (black lung disease).
Chemical Fumes and Dust: Exposure to various industrial chemicals and dust can cause occupational asthma and other pulmonary conditions.
3. Environmental Factors:
Air Pollution: Long-term exposure to polluted air, including emissions from vehicles and industrial processes, can increase the risk of asthma, COPD, and lung cancer.
Indoor Air Pollution: Exposure to indoor pollutants like radon, mold, and certain household chemicals can also contribute to lung disease.
4. Genetic Factors:
Family History: A family history of lung diseases such as asthma, cystic fibrosis, or alpha-1 antitrypsin deficiency increases the risk.
Genetic Mutations: Certain genetic predispositions, like those affecting the CFTR gene in cystic fibrosis, can lead to lung disease.
5. Age and Gender:
Older Adults: The risk of lung diseases increases with age due to cumulative exposure to risk factors and decreased lung function.
Gender Differences: Historically, men have been at higher risk due to higher smoking rates, but rising smoking rates among women have increased their risk as well.
6. Pre-existing Health Conditions:
Chronic Health Conditions: Conditions such as HIV/AIDS, rheumatoid arthritis, and other autoimmune diseases can increase susceptibility to lung diseases.
Respiratory Infections: Frequent respiratory infections, especially in childhood, can cause chronic damage and increase the risk of developing lung diseases later in life.
7. Lifestyle and Socioeconomic Factors:
Sedentary Lifestyle: Lack of physical activity can contribute to poor respiratory health.
Poor Diet: Nutritional deficiencies can impair immune function and lung health.
Socioeconomic Status: Lower socioeconomic status is often associated with increased exposure to risk factors like smoking, air pollution, and poor access to healthcare.
8. Geographical Location:
Living in High Pollution Areas: Urban areas with high levels of industrial pollution and traffic emissions can increase the risk of lung diseases.
9. Immunocompromised Individuals:
Weakened Immune System: Individuals with weakened immune systems due to conditions like cancer treatment, organ transplants, or chronic steroid use are more susceptible to lung infections and subsequent lung disease.
Preventive Measures:
To reduce the risk of developing lung diseases, individuals can take several preventive measures:
Quit Smoking: Avoiding tobacco smoke is the most effective way to prevent lung disease.
Protective Equipment: Using masks and other protective gear in occupational settings.
Reduce Exposure to Pollutants: Minimizing exposure to both indoor and outdoor air pollutants.
Healthy Lifestyle: Maintaining a healthy diet, regular exercise, and adequate hydration.
Regular Check-ups: Regular medical check-ups, especially for those with a family history or other risk factors, to detect any early signs of lung disease.
Recognizing and mitigating these risk factors can help in the prevention and early detection of lung diseases, leading to better health outcomes.

44M, 5'11", 190 pounds, caucasian, extreme fatigue and constant dizziness, no existing medical issues, slowly discontinuing SSRIs (about 10 mg duloxetine, down from 60 mg in August 2022), don't drink, don't smore, no drugs, from Canada.
So... I started to feel some serious fatigue at random times last Spring. At one point, I couldn't climb a small mountain with my kids (7 and 8 last year) when I used to be able to walk 10 miles into any mountain day or night. I wanted to do some bloodwork at the time, but I felt better soon and forgot about it. It came back in Fall, more serious, but after a couple of weeks I felt fine again.
About one month and a half ago, the extreme fatigue came back with a vengeance and never left. Also, I started to feel dizzy. And not only a bit dizzy, but enough that I sometimes feel like I've drink 3/4 of a bottle of wine. I can still function, but I need to concentrate. I feel some confusion as well (I talked to my sister today and had to ask her to slow down as she was talking too fast for me... never happened before), and has some GI problems (like constipation... which I never had in my life). I also have really bad headaches, which I never had as well. I also have a somewhat blurred vision. Not enough to impair driving, but it seems like everything is in some kind of fog. Maybe that's brain fog, maybe not, I don't know, but I don't see as well as I used to it seems. Some random nausea as well, but nothing serious yet and didn't lose more than a couple of pounds. Still, feel a bit queasy nearly all the time.
Three weeks ago I had a colonoscopy and it was fine. I had some blood test and everything is normal. Last Saturday I had a brain CT scan and I don't have the results yet but from what they told me if there was anything they would contact me first thing on Monday, so it should be OK (I hope so...).
What's left? What about multiple sclerosis? Or vagus nerve dysfunction? What else? I ate more tuna in the last months so could it be linked to mercury? What can I ask my doctor about; which test to run? My mother has some auto-immune disorder (rheumatoid arthritis) so don't now if it could mean I am more likely to get something like it.
I am pretty worried because it seems to be going fast. I feel more dizzy now than last week. More headaches too. Fatigue is constant and I feel like a hero simply because I can still work. I am slower than I used to and sometimes I space out a bit when people are talking.
What the hell is up with me? If brain scan is negative, what could it be?
Thanks!

Since 2020 I have been suffering with stiffness in the lower back, it seems to be when I engage in an activity for any length of time. So this can be sitting reading, at the computer, walking for over 30 minutes, gardening. My back just starts getting really stiff, this would make sense if I just sat there for an hour but this happens with pretty much any activity. I've had an MRI on my spine and apart from the usual wear and tear for a 48 year old woman whose had children, there's nothing they can see that causes concern. Rheumatogy ruled out arthritis, but it runs on both sides of my family both rheumatoid and psoriatic arthritis. I do pilates once a week which helps loosen things up. But it baffles me as to why my back starts getting stiff when I walk, I have to stop and stretch to ease the stiffness. Are there other conditions other than arthritis that cause such issues.

I first went to a doctor about an exercise/ stress induced rash I had developed after giving birth. This rash was painful, embarrassing and really bothersome. The doctor wanted to do some testing to rule out autoimmune disorders.
That test came back with a very low positive ANA 1:40, CCP of 26, and rheumatoid factor of 14.
She felt these numbers were too low to indicate any problems. I was also experiencing extreme fatigue, hand and feet swelling, brain fog, severe headaches. This was during a very stressful time in my life- husband was deployed, in school full time, and caring for 2 kids under the age of 5.
I talked to a psychiatrist who put me back on ADHD meds. Between the meds and my husband returning, life got much better. Fatigue cleared up, although I do still occasionally have swelling of hands and feet and headaches. The psychiatrist requested my labs to ensure I was healthy. She was concerned by my ANA, CCP numbers and some symptoms I had.
I saw a dermatologist for the rash and for newly developed Raynaud symptoms. The dermatologist also expressed concern over my lab results and referred me to a rheumatologist.
The rheumatologist looked over my numbers, talked about my symptoms and diagnosed me with seropositive rheumatoid arthritis. He prescribed folic acid and methotrexate. I was very wary about all of this because I actually feel a lot better than I did a year ago. I am exercising regularly, and feel like I am in a good place physically. The swelling of hands and feet still happens on occasion. I also experience pain in my wrists, elbows, and neck that will occur for around 2 weeks, clear up, and then reoccur. This pain can be very uncomfortable but isn’t debilitating. Overall I feel like I have a fairly good quality of life.
So I took my first dose of methotrexate and was very tired for about 48 hours. I had no energy and basically laid around all weekend. I was nauseous but did not vomit or have any real GI problems. It just made me feel kind of gross and tired.
I dread the idea of taking this medication every week forever. I feel like it makes me feel worse than the swollen joints and I have not really fully accepted that I was given the correct diagnosis. My numbers are low and from reading others stories, my condition seems to be nowhere near as bad as others.
TL;DR
Mostly I am looking for support. Is there anyone else who had very low numbers and mild symptoms, but received a very quick diagnosis? Did you immediately medicate? How did you cope with the idea of having a lifelong disease, but feeling overall fairly healthy?
Thank you for anyone who took the time to read all of this, I tried not to ramble too much.

Hi everyone! I am a 29 year old mom of a 11 month old baby. In my teen years and up to early 20s i was quite active etc. Then i started working in a call center ( sitting 8+ hours) when every compain started mostly in my back. Then at 28 i had a baby with C section and apart from walks with my baby and trying to entertain my baby I do not excercise unfortunately. So eventually ( after giving birth) I started noticing that when I sit or even lay down for even 10 minutes, when i get up to walk I have pain in my ankles which resolves after walking even a bit. Also I notice a bit neck stifness if i try to turn to look behind for example and now my left wrist has decides that with certain moves it hurts quite a lot which I dont think that I hurt it or whatever. I may have to add that my mom is diagnosed with rheumatoid arthritis since her mid 40s. I am a bit worried because I think I am quite young to complain about my joints but it’s there!!! And I know that I have to start excersing regularly but I would like to know if anyone has any simialr experience or knows anything or any advice for me. Thanks everyone in advance.1

Hi,
Many of you suffer from the lack of diagnosis and sometimes the lack of trust from doctors or family/friends or even yourself, as to wether you really have a disease, or wether you are "faking it" or simply psychosomatic (an actual medical condition).
The reason for this difficulty, is that many chronic illnesses symptoms are rather unspecific, even more so at the early stages (e.g. in the case of autoimmunity), such as unlocalized pain, tiredness, etc.
I have studied the topic of cytotoxicity which is an almost universal common component of diseases and its biomarkers.
We have routine biomarkers that often allows to almost localize and or rule out entire organs, for example transaminases (and a few others) for the liver, lipase/amylase/glucose for the pancreas, creatinine for the kidney, creatine kinase for muscles and the heart, etc
While those biomarkers are excellent for the above reasons, when they shows up negative there still remains a very large list of systemic diseases.
Diseases are characterized by inflammation unfortunately CRP and ESR only shows up in a minority of inflammatory conditions.
There is another widely available biomarker, LDH, that by design quantify in a non organ selective way, the amount of cell death (because LDH is contained in every cells and is not normally present in much quantities in blood unless it leaks from dying cells)
So it is one of the closest thing we have that approximate an universal marker of inflammation and therefore of diseases. In light of this understanding, it has recently been tested on 48 diseases and found to shows up as elevated in 46 of the 48 diseases, which is impressive.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8217520/
The normal range is up to 153 u/L but in many conditions it is only slighly elevated in the 150s-170s a result that is often ignored despite being indicative of disease activity.
LDH serves three key purposes, 1) to observe that there is a disease activity/cytotoxicity 2) to quantify the extent of the systemic toxicity 3) to assess the effect of medications and supplements on cytotoxicity by observing or not an LDH reduction post treatment, consistently.
While LDH is not truly universal and there are many diseases where it will not shows up, it still is according to this study the most broad biomarker of the presence of a disease.
And in my opinion its use (complement and does not replace other biomarkers) for assessing 2) and 3) is underatted, being a direct marker of the quantity of cells death.
It is important to note that LDH is largely useless to actually diagnose which disease you have (unless it is extremely high) and this probably is why it is sadly underused in practice.
There are other markers that are even more universal than LDH, the markers of oxidative stress (such as malondialdehyde levels) however unfortunately those markers are a bit expensive contrary to LDH.
While I'm at it, some specific biomarkers I consider are underused:
For neurodegenerative diseases, there is a recently developped, universal marker of brain neurons/axons damage. The neurofilament light chain in CSF.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380627/
It unfortunately is not available everywhere and it probably costly. Moreover while it assess for neurotoxicity and is useful for point 2) and 3), as for LDH, it usually does not allows a specific diagnosis, still their uses outlined are very useful and their broadeness in scope makes them particularly fit for people that fails to be diagnosed.
Another broad biomarker are free light chains in blood, the name is similar but their use is radically different. Except for a few conditions like amyloidosis, free light chains does not allows a specific diagnosis, however there are papers showing it often is elevated in many (most?) autoimmune diseases
such as: Rheumatoid arthritis, sjogren
https://pubmed.ncbi.nlm.nih.gov/16569685/
lupus
https://pubmed.ncbi.nlm.nih.gov/21312346/
etc
As for LDH, they do not allows a diagnosis, however they allows to quantify 2) disease activity and 3) the effect of medication(s)/supplements.
https://pubmed.ncbi.nlm.nih.gov/24099109/
https://pubmed.ncbi.nlm.nih.gov/21221683/
Free lights chains are not proven to be an universal marker of autoimmunity but it stills is the most proven biomarker to shows up in different autoimmune diseases.
Those recents scientific discoveries about correlates of old biomarkers, are in my opinion a scientific revolution for the clinical practice of chronic illnesses.
As said, while those markers won't always shows up they are the most broad ones available, they are widely available (except neurofilament), and hence is a major tool to help undiagnosed people to be considered and further investigated despite not allowing diagnosis.
Moreover the ability to monitor disease severity and to partially (doesn't replace other biomarkers and methods) quantify the reduction in disease cytotoxicity by therapeutics is an essential tool of precision medicine that can improve the quality of life and prognosises of patients and allows for fast, empirical trial and error of different therapeutics instead of blindly believing the current therapeutic combination is empirically the optimal one (maximal reduction).

I last saw my endocrinologist in March and my TSH was 2.39. She had me alternating dosages between 0.88 mg and 0.112 mg. I told her I felt best when my TSH was briefly around 1.0 or even 0.9, and she agreed to up my dose just a tad “because I was so close to being hyperthyroid”.
I then dropped the 0.88 mg dosage and only took 0.112. I just got my blood done yesterday, fasted, bright and early at 7:00 AM, and my TSH has gone UP to 3.10!
My Free T4 is 18 pmol/L and my Free T3 is at 4.5 pmol/L.
I have such terrible IBS issues, my anxiety is now bad enough I may consider some medication, my PMS symptoms are worsening, I cannot shed weight even though I’m doing the right steps, I feel absolutely exhausted every single day. My body feels so sluggish some days that my bones and joints ache. I literally got tested for Rheumatoid Arthritis because I have such bad joint pain. My eczema is worsening. I have very low libido already and feel myself less and less interested in general. My mood is pretty low.
I’m so frustrated. I see her every 3 months and every time I see her, I hope my TSH has crept closer to 1.0 again but yet here I am…highest it’s been in a few months.
Is there anything I should bring up at my next appointment? Does my T4 and T3 look optimal (although she refused T3)? Is Tirosint better for bringing down TSH compared to Synthroid?
Thinking of adding in Inositol or Chromium, iron supplements, D3, and a B-Complex to maybe help with energy and nudge along my metabolism.

• Name: Calgary Marathon - Half Marathon
• Date: May 26, 2024
• Distance: 21.1 km
• Location: Calgary, AB
• Website: https://calgarymarathon.com/
• Time: 1:55:29 (Chip time); 1:54:16 (Garmin time)

Goals

Goal	Description	Completed?
A	Sub 2:00:00	Yes
B	Sub 1:56:00	Yes
C	Sub 1:55:00	Depends

Splits

Kilometer	Split	Time
5	00:27:18	00:27:18
10	00:27:12	00:54:30
15	00:27:05	01:21:35
20	00:26:58	01:48:33
1.3	00:6:56	01:55:29

Background

I (M40), started running regularly in 2020, but was as casual as runner can get—inconsistent, unaware of the existence of training plans, and injury-prone. My first competitive 10K at the Calgary Marathon in 2021 was bittersweet; I set a personal best, but was also left with severe shin splints due to lack of preparation.
That all changed in 2023. I bought a Garmin, signed up for Greg McMillan's 10K training plan, and tackled the Calgary Marathon 10K again. This time, I smashed my goal with a sub-55 minute finish. Riding the high from this success, I participated in the Canmore Half Marathon a few months later. I completed the race in 2:15:19, proving to myself that I could conquer the distance without bonking. This gave me the confidence to aim for a sub-2-hour half marathon.

Training

Early this year, I committed myself to another training plan (Greg McMillan again), targeting a 1:56:00 finish with a stretch goal of 1:55:00.
Training was smooth and steady—there were no nasty surprises, but no eye-opening epiphanies either. Which is a good thing, I suppose. One oddity in the training plan was the maximum distance of my long runs. My last half marathon plan took me well past race distance during my long easy runs, but this one maxed out at 18 km. This left me uncertain about maintaining my goal pace for the full 21.1 km. Nevertheless, I could notice that I had upped my weekly mileage, averaging 35 km per week over the block and peaking at over 50 km per week in April.
Over this time, I set two noteworthy PB's. In a benchmark run, I clocked my fastest kilometre at 4:21—a pace I previously thought was well beyond my reach. This I credit to all the base building I had done in the off season. Towards the end of my training, I also set a new 5K record, completing it in 24:49. These milestones fueled my confidence and showed the tangible progress I was making.
Finally, I got to see first hand the difference that elevation makes. I ran a couple of training runs at sea level while on vacation. They felt noticeably easier compared to Calgary's 3,400-foot elevation. The numbers backed up my feelz: Garmin calculated my VO2 max a couple of points higher!

Race

Unlike past races, I approached this one with a clear strategy: start slow, monitor my pace and heart rate, and gradually increase speed. I aimed for a 5:30/km pace for the first 2 km, keeping my heart rate below 163 (high Zone 3), then maintaining 5:25/km until 18 km, and finally speeding up to 5:20-5:15/km.
I had studied the course well, and knew which parts would be challenging. At 3.5 km, there was a nasty hill with a 1 km ascent. In their infinite wisdom, the organizers decided to double our fun with two hills for the price of one! Just when you thought you'd conquered it, there was a turnaround at the bottom, forcing us to slog back up. My game plan? Take it easy on the ascents, keep my heart rate under 170, and recover on the way down.
This strategy paid off big time. I cruised through the first 18 km smoothly, feeling that my pace was almost too easy at times. But I avoided the temptation to speed up.
About an hour and a half into the race, I felt the first few drops of rain. Given how well everything had gone thus far, this felt like divine intervention: what better than light shower to cool me off just as my heart rate had begun to creep past 180?
At the 19 km mark, fatigue hit me hard and it hit all of a sudden. I anticipated fatigue, but not this instantaneous crash. Was I bonking? Or was my brain just signaling me to ease off since the finish line was close? I’m not sure, but it was... interesting. Despite this, my splits revealed that I had actually accelerated to a 5:20 pace in the last three kilometers!
Crossing the 21 km marker, I summoned all my energy for a fast finish, clocking in at 1:55:29 for 21.33 km.

Post-race

Post-race was a soggy mess. The rains had picked up, and they were cold and miserable. You could see the misery on the faces of the spectators and runners standing in line to retrieve their bags. On the Calgary subreddit, there are complaints about how the organizers left people's bags out in the open, which soaked their jackets and gear.
That being said, crowd support was phenomenal throughout. I would be remiss if I didn't call out the supporters and volunteers who came out to cheer, play music, hold up hysterical placards, and hand water to the runners. And they stayed—through the cold breeze and colder rain, they didn't budge.

Assessment

Looking back on my performance, I am thrilled with the results. My initial goal, when I started training, was to break the 2-hour mark. With the first few weeks of training going better than expected, I revised my goal to 1:56:00. But at the back of my mind, I was really gunning for 1:55:00 or faster.
I comfortably exceeded the sub-2 goal, finishing faster than my 1:56:00 target. Although I didn't quite hit the 1:55:00 mark, my watch recorded 1:54:16 for exactly 21.1 km, which is a consolation prize I'll happily take. Could I have gone just a wee bit faster? I am not so confident I would. The sudden fatigue at the 19 km mark was a stark reminder of my mental and physical limits.

What's Next

With two successful half marathons under my belt, the next logical step is a full marathon, isn't it? I certainly feel fit enough take on the 42.2 at a conservative pace.
But I don't think I have it in me to manage the volume of training a marathon block calls for. The mental and physical toll of training this year, especially running 50 km weeks, was significant. It drained my energy, affected my productivity at work, and left me fatigued more often than not. I realize that while the idea of a marathon is enticing, it might lead to burnout at this stage of my running career.
Then there's the fact that over the past year, I’ve come to appreciate the journey more than the destination. Chasing numbers is exciting, but what I find truly fulfilling is improving my overall fitness, building stamina, and seeing my physique get leaner. So, I'll keep running, but switch my focus to shorter races for now. Additionally, I plan to incorporate strength training and rowing into my routine, as these activities bring me joy and balance my fitness regimen.
All good essays must end with a quote, and this one will be no different. Pheidippides once never said, "Pain is temporary, Strava is forever," and my Strava now proudly displays a half marathon PR of 1:54:16. So here’s to more miles, more personal bests, and a lot more fun on the journey ahead!
Made with a new race report generator created by herumph.

I’ve been reading up on this new pump from beta bionics (thank goodness for more competition).
I know many won’t like it because you give up control (no bolus or corrections, it’s supposed to do it all for you), but for someone like me with multiple long term illness (I’ve had type 1 for 37 years but I have four other diseases now) I just can’t keep up with the ups and downs. I’m close to burn out and the number of alerts (even in vibrate mode) from the tslim is just too much (esp since I have rheumatoid arthritis and many require me to clear them from the app and digging it out of my pocket is nearly impossible sometimes). I wish tslim would allow me to silence alarms for a period (from the app!) but I’ll stop the rant there about tandem (I’m not their biggest fan).
Anyway, I’m wondering if anyone is using the iLet pump and what they think. I searched here already but only found a few old posts. I know it’s relatively new but I’m thinking within a year maybe they’ll have made the necessary adjustments.