instruction: hello doctor I want to lose 50 pounds I have ra and steroids have caused me to gain a lot in the last six to eight months I started the veto diet two weeks ago but blood works is showing elevated liver enzymes which are causing issues with a medication I have to take for ra what diet is best for people who have elevated liver enzymes due to methotrexate what can I do I really need and want to lose excess weight I am currently taking levothyearoxine methotrexate multivitamin and hydroxychloroquine
output: hi intermittent fasting will give rest to the stomach and hence enhance metabolism and use stored fat to energy in the absence of food for physical and psychological activity a balanced diet with increase of fruits and vegetables is considered to be best or you can try mediterranean diet I still need many details for proper medical intervention so that I can provide a customized diet plan till then follow these tips increase the high protein diet and include six almonds six walnuts and two dates per day fish green leafy vegetables egg whites and poultry do muscle strengthening exercises increase fluid intake do take eight to nine hours of sleep manage stress with meditation do breathing exercises manage to follow small high calorie frequent meals do take 1700 cal diet if required need to add a supplement I hope this helps