Starting Methotrexate but scared of the side effects? Folic acid can help!

#methotrexate #medicine #RA
Methotrexate in Rheumatology:
Methotrexate is a very old drug and is known to be chemotherapeutic. Let us see how this medication reduces inflammation, alleviates joint pain, and slows down disease progression. We'll see some dosage, administration, and monitoring considerations as well as the benefits of Folic Acid if taken along with Methotrexate.
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Rheumatology 101 by Isabelle Amigues, MD. #health

[@rosalindpinder9346]

Thank you. Very helpful

[@captainbuck5969]

Great, to the point video. Very informative. Thank you.

[@johndee9806]

I don’t know what it is but I am hooked and want to watch your teaching every second and learn. Thank you

[@Rheumatology101]

Thank you so much!! Next live will be postponed today by two hours but I’ll be there :-)

[@louisliberty8390]

What a beautiful, intelligent, articulate woman. Thank you for a clear, concise explanation. I wish I lived in Denver! I just started back on MTX with Hydroxychloroquine and Folic Acid after 3 different infusion drugs and Xeljanz failed.

[@Rheumatology101]

Thank you. Wishing you the best!

[@rebeccanaylor63]

Excellent clear information many thanks

[@Rheumatology101]

Glad it was helpful! Thank you for your feedback

[@Rheumatology101]

Thank you! Very happy it is useful :) Thanks for the feedback

[@captainbuck5969]

I saw one video that recommended not to take folic acid the same day as your Methotrexate dose. It said to take your folic acid the following day. Probably insignificant, but I thought it was interesting.

[@jamiemcmahon9638]

Just took my 1st 10mg dose of Methorexate! I am horrified by all of the videos I have watched & all the comments I have read. I will know tommorow how I will tolerate this med. Wish me luck

[@UnabridgedMD1]

Hopefully our video reassured you.

[@lindamerrill928]

How are you feeling? I started last weekend - 15mg. Did not experience any immediate side effects. Taking my next dose tonite

[@markbigelow2608]

I had a little upset stomach the next day but then ok. Take the folic acid🙂

[@jamiemcmahon9638]

@@lindamerrill928 I had no side effects with my 1st dose last week. I took my 2nd dose last night & I have no side effects again. So far so good. Next week I will increase from 10mg 1 time per week to 15mg 1 time per week.

[@jamiemcmahon9638]

@@markbigelow2608 I do take 1mg of folic acid daily. I took my 1st dose of 10mg Methotrexate last week & I had no side effects. I took my 2nd dose last night & again no side effects. I also take 200mg of Hydroxichloriqine daily. When I 1st started the Hydroxichloriqine I had a little stomach cramping/upset but it passed within 2 days.

[@juliekolosso5591]

Starting on Friday. A little nervous but trust my Rheumatologist.

[@UnabridgedMD1]

The first step towards remission. You got this!

[@alishaparker315]

So is methotrexate the safest RA medication?

[@floydffrogfloydffrog7453]

I was on MTX for 4 months but noticed zero difference in pain levels. I actually dialed back on the folic acid to the minimum recommended amount in the hopes that would help but there was no benefit. Otherwise I had zero side effects other than some mild stomach upset for the first few weeks after starting MTX. After that I tried a carnivore diet. Within 3 days I noticed a 50% reduction in pain levels, but stopped the diet after 3 weeks for various reasons. I returned to a maintenance dosage of prednisone but also made a point of avoiding so-called inflammatory foods: specifically wheat and sugar. After another month or so I'm starting to be able to reduce how much prednisone I'm taking. It's still early and the difference is small so far but it's the right direction, so fingers crossed.

[@Rheumatology101]

Very interesting. I wonder if you had the wrong diagnosis. Just a thought.

[@ckk5491]

I start my first dose today, hopefully I will not have serious side effects we shall see tomorrow

[@Rheumatology101]

Im sure you will do great! Think of all the good things this will bring you: no more joint pain, swelling or morning stiffness. (not your doc, but assuming you may have some of these symptoms). Best of luck we are rooting for you!

[@kimc451]

Wouldn’t the methylated form-methyl folate work better than the synthetic form-folic acid??

[@Rheumatology101]

Most studies have been done with folic acid. That said when there is evidence of overdose we may want to use folinic acid.

[@MissCBager]

Hi im a bit nervous about the hair loss ... imon 10mg weekly, just started 3 weeks ago..... how much hair can I expect to lose if I take folic acid daily? I would like to keep some hair....!! Thank you :)

[@Rheumatology101]

You shouldn’t have much hair loss with that dose :) although everyone is different and responds differently to it. You got this!

[@MissCBager]

@@Rheumatology101 thank u so much 🙂🌈🐬

[@lemonchicken3740]

Is there any difference / benefits from taking 5-MTHF rather than the synthetic folic acid with Methotrexate?

[@Rheumatology101]

I do not think I have read any studies about that. Did your rheumatologist recommend this?

[@lemonchicken3740]

@@Rheumatology101 I get really bad nausea. My rheumatologist has increased my folic acid 20mg the day after my injection but I am still feel sick. I also take nausea medication which helps a little bit. I have read that I might not be absorbing the synthetic folic acid this is why I could be getting nausea 🤷‍♂️

[@ajnabiyeh291]

Very helpful but I found the background music so intrusive…

[@NKUSHWA]

I am on 15mg MTX for over an year. My Dr. Hhs prescribed 5mg Folic acid. But shouldnt we take active forms of folates - methylfolate or folinic acid .

[@Rheumatology101]

What a great question! Studies were done mostly with folic acid. Truth is: when you want to revert completely the effect that is when we use folinic acid. That’s not what you want, unless you have side effects. Hope this helps explain :)

[@dindin0294]

Hi, i just want to ask if i can take my multivitamins while taking Methotrexate?

[@Rheumatology101]

I unfortunately cannot give medical advice. It’s a very easy question to ask your rheumatologist who will respond to you knowing you. ❤️

[@anganeenobbee7129]

Hi my doctor put me on mtx tablets 2 times a day for 3months is that safe i am feeling very scared to start it i have to the doctor next 3 months with my blood works my doctor also said i have to do an eye test is that normal

[@Rheumatology101]

It’s always scary to start. But it really is something we have a lot of knowledge about for a very long time. Reach out to your rheumatologist to get reassured. Rooting for you

[@janmarieroa3407]

Hi dr I’m taking methotrexate, and I’m having rashes on my face, what do i do with it?

[@Rheumatology101]

I cannot give you medical advice. Do reach out to your rheumatologist. They will know what to do. Best

[@markbigelow2608]

I'm wondering if 10mg Mex once a week and 200mg hydroxychloroquene every day is even more effective?.

[@Rheumatology101]

There are studies that show that it indeed is!

[@jamiemcmahon9638]

Wow that is what I take now. 10mg Methotrexate 1 time per week & 200mg Hydroxichloriqine daily. With 1mg folic acid & 10mg prednisone daily as well. I was taking 20mg Leflunomide with all meds listed above minus the Methotrexate. The meds worked very well to control the awful CPPD & inflammatory arthritis in my hands & fingers. Unfortunately, about 4 months after the 20mg Leflunomide was added to my meds I began to experience hair loss. So my Rheumatologist took me off the Leflunomide for 3 months. Now she had added the Methotrexate in its place. Hopefully I get the same relief without the hair loss.

[@markbigelow2608]

@@jamiemcmahon9638 I hope it works out for you🙂

[@TygerBleuToo]

MTX works very well for MOST people. Unfortunately it had too many adverse effects for me. Despite taking a double dose of folic acid, the fatigue was severe and I continued to have flares of my PsA.

[@Rheumatology101]

Fortunately we have many more options :)

[@TygerBleuToo]

@@Rheumatology101 Yes. I start on apremilast as soon as my doctor can work things out with my insurance.

[@adaniodebaz7305]

Doctor what if I took methotrexate a day earlier by mistake ?

[@Rheumatology101]

Hi and thank you for your question. I cannot give medical advice here. So please make sure to ask your rheumatologist. Theorically, this shouldn’t be a problem!

[@lgee9027]

Has anyone had mouth ulcers on roof of mouth? How do I treat them? Im on 10 mg MX weekly 2 mg folic acid

[@Rheumatology101]

That is actually pretty common. A trick that some of my patients find useful is to “chew” the folic acid and put it all over your mouth before swallowing it. Let us know if it does the trick for you!

[@lgee9027]

@@Rheumatology101 ok Thank you!!! Im gone let the dentist take a look to make sure its nothing else

[@cassandracummings115]

Metho was not good for me the first 6 months. Yes i had a lot of vomiting and yes my hair shedded really bad. It wasn’t the best but over time it’s ok for this disease, polymyositis.

[@Rheumatology101]

I’m sorry to read this. Even splitting the dose and with folic acid? It sounds like you’re doing better so that’s wonderful!

[@jennifersmith4829]

​@@Rheumatology101should i take methotrexate a day before folic acid

[@OliviaNamyenya]

I was on methotrexate,l found out l was pregnant, what is your advise

[@Rheumatology101]

I cannot give medical advice and recommend you seek your doctor’s help. We know how to take care of these situations and they should be helpful! Rooting for you.

[@Sparkle835]

The background music is a huge distraction 🫤

[@eclipsetotal91]

the music is a little loud.

[@Rheumatology101]

Ah… the joy of creating a channel. Thank you for your feedback. I’ll try to see if it can be adjusted.

[@Poppin_Robin]

Folic acid cause the worse pain in my hands…OMG!

[@Rheumatology101]

That is odd. Go and see your rheumatologist to discuss this with them. I’m sure there is an answer for this

[@MzFlowerchild]

I was on Methotrexate for close to 20 years & had to stop it as it was giving me Cirrhosis of the Liver ( I have never been a drinker) I have been on Plaquenil now for 3 months but am not finding much relief. I am hoping to give Medical Marijuanas Oil a try soon, am hearing of great results.

[@Rheumatology101]

I’m sorry to hear about your liver. This shouldn’t have happened as we follow closely patients who are under methotrexate and can pick up liver damage (which usually happens because of another liver injury- think another drug potentially causing liver damage or alcohol or fatty liver etc) way before it can lead to any non-reversible damage. So I am very sorry! I hope you feel better very soon. We have tons of other treatments than methotrexate so I’m hopeful for you!

[@MzFlowerchild]

Thank you for the reply, I am hopeful that with diet & a alternate medication the damage to my Liver can be reversed. I had been on MTX for a very long time & it gave me great relief for many years along with Folic Acid. I have researched plant derived CBD quite a bit & seeing & hearing great things, maybe wishful thinking but perhaps it will be a more natural remedy or relevant for me. I have also researched - OLUMIANT, XELJANZ, RINVOQ & XELJANZ XR)11 but to me their possible side effects are horrific. Like most people suffering from RA you get to a point that you become tired of pushing pills down your throat. With RA you have to have a positive attitude & I am sure the right treatment is out there for me & so many other sufferer's of this dreaded disease. Cheers, Cal @@Rheumatology101