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Low cortisol production by the adrenal gland should be compensated by an increase in adrenocorticotropic hormone (ACTH) production by the pituitary gland, but this was not the case, supporting hypothalamuspituitaryadrenal axis dysfunction 18

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Deficiency of vitamin D (the sunshine vitamin) has been linked to infertility in women

Constant knee pain and stiffness that worsened in the morning Fatigue and difficulty walking long distances Pain and swelling in fingers and toes (dactylitis) Significant reduction in joint pain and stiffness Improved mobility and increased daily energy levels Noticeable decrease in swelling and better finger flexibility Her pain subsided, mobility improved, and flare-ups became rare