Starting Methotrexate | Arthritis Information

Sigh. Still no official dx, other than polyarthritis, but I guess that is good in case an early round of methotrexate can knock this thing out. Looks just like RA, it's just not symmetrical, and that's making everyone hesitate in dx.

Right wrist/hand has been inflammed since December, I have lost range of motion. Got a second opinion, he was worried, said be aggressive with MTX b/c damage may be permanent (and writing gets harder and harder every day, and I am a lawyer). Now my left ankle is definitely involved, although Mobic controls pain. I just want certainty, but I guess I wouldn't have that in any case. I have so much fatigue, I'm really hoping the meds will help with that. I have complained about this a million times, but it feels good to vent.

So I start on 10 mg of MTX tomorrow night. Then go back in a month (with blood mointored in interim). Have a scrip for Folic Acid too. I'm REALLY worried about losing hair b/c I just lost a ton postpartum, last summer, and then I had another extreme shedding phase (even shedding shorter hairs that were just growing in) that took place in February. I think from the stress of December, or NSAIDs, or ? My hair is fine to start with.

Any tips or advice on what to expect? I'm going with Saturday nights so my husband can take the kids to church and I can sleep in Sunday morning, in case I'm not feeling well.

Thanks a million!

Katie

I forgot to ask--what about fertility? I thought there was supposed to be no issue with that once it's been out of your system for 3 months (and that you shouldn't get pregnant on it). We already have 2 kids, but we'd (ideally) like a third in 3-4 years (my husband is a stay at home dad, or my wrist would be truly snowed).

My rheum gave me this speech about how MTX could permanently mess up ovulation, and I needed to consider that. Really?

KatieG2008-03-28 17:46:04I don't know anything about the fertility part, but I don't think you need to worry about hair loss on the dose you're at. If you do notice any unpleasant side effects, ask for leucovorin. It's a stronger version of folic acid.

I'm wondering if your past hair loss is due to the stress of your career. I worked with attorneys for many years as an assistant, and I know what goes on behind the scenes. It's a tough job with a lot of stress and constant deadlines. You'll need to keep your work-related stress under control so that it doesn't aggravate your illness. Please keep us posted on how you're doing.

I take my MTX on Friday nights so that I have 2 days for recovery. It doesn't hit me super hard, but I get fatigued and mildly nauseous. Drink lots of water, it helps to flush it out. Definitely take the folic acid because MTX depletes your body's folic acid which causes the side effects. I started my folic acid a couple of days before my first dose of MTX just to be ahead of the game. Good luck I take 5mg of Folic acid on Wednesday, followed by another 5mg on Friday, then the MTX on Saturaday. I started on 7.5 MTX, but have moved up to 25 mg. of MTX. I take the pills at night and go to sleep so that I don't have that nauseous feeing. I lost a lot of hair, but taking 1 mg. of folic acid 7 days a week and 50 mg. of leucovorin 8-10 hours after MTX has slowed the process down. It's a bummer. I hope your hair doesn't thin out, that's a side effect but not for everyone. Good luck.Hey Katie. Welcome to AI. We're glad you're here.

I went into menopause after I guess maybe a year on MTX. I was 32 or 33 at the time....hard to remember now. I think it's rare....but it does happen.

The MTX is unlikely to help with the fatigue. It might actually make it worse; especially at first. It's a great med though.

Wishing you good luck. Hope to see more of you here.

Hi Katie and welcome to AI!!! Unfortunitly you *have* to be here but you have come to the right place. There are soo many helpful people on here. Feel free to vent away, we all know what your going through...

In answer to your questions *as best I can*

I have been on Methotrexate *Mtx* since almost the begining of my diagnosis *been on it about 4 yrs, was diagnosed 5 yrs ago*. Initially I was on the pill form and for 2 years I did fine on it...Really didnt have any horrible side effects *got tired from it was my biggest issue* then I started having a lot of tummy problems and my RD stitched me to the injection form which I have been on for almost 2 years now. I seem to get more tummy problems now then before *that may be due to the fact im really bad about taking Folic Acid like I should* But I see a major difference between when I have had to be off of it due to illness and when I am on it...I decided I *could* live w/ the tummy issues *more bothersome then anything* then go off of it and feel bad.
My RD has also said to be off the MTX for at LEAST 3 months *my uncle has Chrons and is on it as well and he had to be off it that long as well when him and my aunt were trying to get pregnant* I did speak w/ my OB/GYN and he said that its "OK" to be on Humira/Enbrel while off the Mtx when you are trying to get pregnant and while you are pregnant *they advise that for the first Trimester you are off it and IF you need to be, you can go back on it but most times you can go through remission while pregnant*

How old are your kids? How awesome that your husband is a "stay at home dad" and is able to help you w/ all of that, espically being a lawer.

Welcome Katie,

I've been on mtx for 1 year now. It doesn't seem to bother me tummy-wise, very minimal hair loss. My hair is actually growing faster now than before, probably because of the vitamins- kind of expensive side effect since I have to have my roots re-done more often. Now, while I don't have those side effects, the fatigue and foggy feeling is there after taking mtx and that is a tough one. Mine tends to hit about 24 hours after taking. I take mine on Tuesday nights and just leave Wed/Thurs nights free since I may be in bed early. At work, I try to not schedule anything late in the afternoon on either day since I know I may not be at my best. As you find out how you react to mtx, just keep in mind the bad days and try to prioritize so you aren't overdoing it on that day (or days) of the week.

Take care

Cathy

I take 15 mg MTX with no problems other then fatigue that I blame on it.Thanks everyone! And thanks for the info on the risks. I'm that happened to you Lovie! I guess, since I already have 2 kids, I'm willing to take the risk. I'm 30, so I don't think that would weigh one way or the other.

Being a lawyer is very stressful. Thanks for the warnings about sleepiness. What about caffeine? Has anyone ever been told to avoid it? I only have a soda or two a day (or occasionally a red bull when I have something that's got to get done). I'm trying to make sure I'm in bed 8 hours a night no matter what.