An exhausted woman holds her head in frustration as she struggles copes with the side-effects of a medication

What I Wish I Knew Before Starting Methotrexate

If I could use one word to describe my time taking methotrexate (MTX), it would be: sluggish. Frankly, I felt like a zombie sometimes. I had no energy and was very tired all the time. And I had lots of other not-so-fun side effects, like nausea, cankers, and hair loss.

I used MTX at two separate times, both for about a year. Neither time went well; even though my progress was decent, the side effects were too much to handle. Nothing seemed to help, such as taking my dose during the weekend to rest up while I had time off or even taking anti-nausea medication.

Methotrexate treatment for psoriatic arthritis

Years after the fact, having talked to others, I realized there was a reason why I likely couldn't tolerate the medication. When I learned that folic acid supplementation is recommended when using MTX to treat arthritis, things started to make sense.

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MTX works by preventing the body from absorbing folic acid. Usually, when patients are prescribed MTX, they're told to take folic acid to take days following a dose. Somehow, no one ever told me to take folic acid either time.

I'm still a little surprised about this, to be quite honest, as I was being prescribed other vitamins at the time. I was even given medication to manage nausea.

Looking back, I think this likely would've helped with the things that were bothering me. It made sense why my exhaustion lingered and felt like it got worse over time. I was also dealing with hair thinning and constantly getting canker sores.

The research is out there!

I am so grateful to be in the age of the internet. I wouldn't have been able to learn so much about psoriatic arthritis without the help of patient blogs, support groups, and reliable resources to fact-check.

While the internet doesn't take the doctor's place, it can be a great supplement. Learning about folic acid, arthritis hacks, and other things might seem small to some, but it makes a world of difference for some of us!

Of course, there are times you'll hear about bad experiences. And I think it's essential to learn about those too, but keep an open mind. I never wrote about my bad experience with MTX, fearful it would keep someone from getting on a treatment that would help them.

Had I not opened up and said something, I might not have learned - or been able to share this learning experience.

What I've learned after taking methotrexate

Knowing what I know now, I would feel confident to give MTX another shot if it came down to it. My doctors and even my parents did see an improvement in my condition, even though I didn't notice it at the time.

But this time, I would come to the table more prepared and know to ask about folic acid (if my physician didn't bring it up first). As a patient, being informed gives me confidence in my treatment decisions!

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Psoriatic-Arthritis.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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