Sorry to hear that you have all these health issues. I was diagnosed with RA at age 42 (now 59)- I was started on Methotrexate for many years but I was having side effects and no improvement. Finally I found a good Rheumatologist that tried different medications (little improvement- I was in pain 24/7) and then 3 years ago he prescribed Xeljanz 5mg twice a day and finally I felt better. I still get some flares but not as often or severe (I use heat, Tylenol and some Ibuprofen when I have a flare). My daughter told me to try a gluten free diet- that is helping with my inflammation (my blood work 2 months ago showed no inflammation). I am taking the Xeljans now only once daily. Unfortunately, now I'm seeing pain management because I have damage (arthritis) to my cervical spine, lumbar spine and feet. I hope you find a medication that really helps with your RA symptoms. Good luck and God Bless you...