Does your husband have RA (rheumatoid arthritis)? This is a serious systemic disease and he needs to be under the care of a good rheumatologist. I would get all copies of all his lab work and see what is normal and abnormal and bring the results up with the doctor, if something is abnormal they haven't mentioned. If you feel your husband's condition is worsening and sounds very serious, then I would definitely get a second opinion at a reputable medical center.

Remember, we can like docs and they can be nice, but you also need to make an effort to keep track of his health as well and to bring up concerns with his doctor. They don't have much time with each patient.

The weight issue is an obvious immediate concern that needs immediate addressing, especially if his weight is going up and down by more than a few pounds. You need to make sure his liver and kidney function have been tested and find out what the doctor thinks is causing this.

It sounds to me like to me a very serious problem people on a forum shouldn't be guessing about, but that you should take him to the doctor right away. I would make it clear that you are not satisfied with his current state of health, that you don't understand why he is like this and ask them what they have done. I would ask about the liver and kidneys and possible other testing.

Ensure can be a good way to boost nutrition. I have bad arthritis and all kinds of spinal problems and am drastically overweight. Adrenal problems due to steroid use, infections, liver and kidney problems, infections, a million things can cause these problems but he must go in and be seen soon. To not seek sufficient medical care for him is cruel at this point. You should have guidelines for diet to help him gain or maintain weight, you specifically need to get copies of his lab work, esp. liver tests and albumin and bilirubin and any other important tests and go to a proper medical center's ER and explain. Hopefully, they can get him straightened out in the short term and get him a referral to a competent doctor that you need to take him to to get a real decent opinion. It sounds like either you haven't communicated with his doctors or they are not doing a good job. But these are questions you desperately need to ask them.

And if his doctor is not thoroughly evaluating him, then you need to find a good internal medicine doctor that can do some investigating, order tests, and get you to the right specialists. I go to Mayo Clinic and they are really good for this kind of thing.

I have seen people have multiple ailments and get very sick like your husband and it may not be one thing. His liver might not be strong enough to take some of those immunosuppressants, or he may have another infection or you might be right, but you must take him to a competent doctor to know. And if his current docs are just letting him spiral down, get copies of his labwork and any other tests, and seek out another doctor at a medical center or university. He obviously needs some special care at this point due to his weight and weight loss.

I'm so sorry that you both are going through this and I don't mean to sound mean, I just am worried for him and I have been on the downward spiral before and if I hadn't sought a second opinion, I'd be much worse off now. It sounds like with his weight and condition, it will be up to you to do alot of the work. Don't give up. When I went to Mayo, the first thing they did is call five other doctors and run a ton of tests. And tests at those medical centers for me were much more sensitive than the ones done at a standard lab or doctor's office (unless they have good equipment). That's why some of these medical centers are so famous. The first step is for you to get him to sign releases for you to get his lab work and MRI readings and other test readings and put them in order by date in a binder or in a pile on a clipboard (maybe better). Then any that are recent and abnormal you can ask questions about.

You can also check and see if he looks jaundiced (yellow) especially the whites of the eyes or under the tongue. At any rate, you need to get him in to a good medical center for a thorough evaluation, or get more info from the doctors, and definitely, from now on, always get copies of his lab work and keep them in case you need to go to the ER or another doctor.