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.

The importance of folic acid.

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.

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.

It's important to share our experiences and keep an open mind.

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.

Being informed enhances confidence.

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!

This or That

Does psoriatic arthritis make sleeping more difficult for you?

By providing your email address, you are agreeing to our privacy policy.

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.

Join the conversation

or create an account to comment.

Community Poll

Do you or someone you know have gout? (Select all the apply)