Methotrexate and sulfasalazine both deplete folate. Did you supplement this?

When people end up here, with dead ends from doctors and lots of time spent with little improvement, it is time for the DNA testing for methylation errors.

MTHFR mutations are common and if one is heterozygous for them, they manage for part of their lives at substandard levels, and finally crash when aging.

23andme is one OTC affordable place to get tested. I'd seriously consider it.

Once you get that gall bladder out, you might feel much better.
A low grade infection with inflammation there can make one very ill.

I am still curious if your art activities are exposing you to some toxin...pigments, solvents?