I am scared as hell to start methotrexate. I hear so many mixed reviews. My doctor wants me to start after Thanksgiving. Anyone out there have any suggestions, information, or experiences that can help me decide if this is the right thing for me? If you lose your hair is it permanent? The med itself causes extreme fatigue…. isn’t that what it is supposed to fix? It’s crazy to think about taking a medication that will knock you on your ass. Do these and other side effects that may arise go away as your body gets used to the medication? Please anyone out there have any information?
Hi Slittleton1211, thanks for being here and sharing some of your fears with us. Starting systemic medications can be quite overwhelming. I haven’t personally used Methotrexate, but I thought you might want to check out the comments on our Facebook page under this Methotrexate article:
Methotrexate has been used for decades to help with pain and swelling, and it can slow PsA progression over time. Folic…
Did you start this medication? It is awful and the side effects are really bad. I had every side effect from sores in my mouth to stomach issues, extreme fatigue. I would tell my Dr. and she would add another pill to help with the side effects. Pretty soon I was taking so much medication it was ridiculous. I finally stopped taking everything and guess what?? I feel SO much better. Yes I have joint pain but you know what, I am okay. I am not going to die from PsA. I had a close friend her dad took MTX for years and it turned his lungs to “mush” as she put it. He passed away due to all of the side effects. Don’t get me wrong not everyone will get the nasty side effects like I did just be very careful with this medication.
My experience on methotrexate wasn’t great. It did eleviate my intense pain. But the side effects were terrible. Mild hair loss that did grow back. My skin looked terrible and I felt tired a lot. I’m not sure if it was related but I tend to think my skin cancer was caused by this drug as my melanoma developed and was diagnosed while on this drug. I know some people that have had some success with it but for me it was not a good experience. I hope you have found success.
For some reason this drug is still the first go-to drug of rheumatologists after NSAIDs. I’m not sure why.
My rheumatologist was going to put me on it but because my AST is slightly out of the standard range she opted to go straight to Humira, which three weeks in is working great.
I, too, have some skin cancer concerns with regards to these drugs that suppress our immune system as when I was young and stupid and in my bodybuilding phase, I spent a lot more time being tan than I should have.
I, too, was afraid to take Methotrexate. I was given the pills first, which quickly increased to the max amount you can take. Within 9 months, I was on the injections. It took a few months to start to see any great improvement. It has been almost a year now. My really bad patches of scaly, bleeding skin are almost smooth and barely noticeable. My skin “peeling” has been greatly reduced. I only get increased “flaky or peeling” when I have a bad flare. I still have minimal “sheading” when I get itchy. I usually scratch in my sleep. I never thought that I would see a lessening of this horrid symptom! I have psoriasis all over my body, including my head, ears and my nails. My face wound get so bad that I refused to leave the house. I can’t use makeup because it burns my skin.
At least I have made some progress.
I have taken methotrexate for over six years. Along with the folic acid and celebrex, it has helped me to regain my mobility and really cut down on my swelling and discomfort. At first I took prednisone also, but have, over time weaned myself off of that particular medicine. Sometimes I think about switching to a biologic, but have been put off by the number and type of side effects that seem too prevalent with those treatments. I would not discount the methotrexate as an option. I am not at the maximum dose, so feel if I were to get worse, I could increase my dose. I am thankful that this medication has worked for me and kept me, so far, from having to be concerned about the biologics and their side effects. I am 66 years old and have had some thinning of hair, but not bad. Tired, yes-but worked up until 2years ago when I retired. I hope you find success with whichever treatment option you choose-
Methotrexate caused me to have a chronic cough. When I went off the cough gradually tapered off. Then to be sure I tried it again with a different rheumatologist at a lower dose. Again a dry chronic cough that lasted over a month. Came close to depression in till my family doctor got it stopped. I do believe that is what caused scarring on my lungs. 2 weeks I see a new rheumatologist who has been highly recommended. No skin issues. Do have trouble getting to sleep and can hardly get put of till till a hot shower loosens me up.
Ive recently started mtx. My course of therapy is a little strange compared to others. Ive been in treatment for 2 yrs and we have JUST now added the mtx.
I know that most ppl who suffer from PsA start with mtx, but i started with SSZ, then added plaquenil, then humira, then celebrex and now the mtx. And yes, if you were wondering, i am currently taking all the medication i just listed. Which is what i meant by “strange course of therapy”.
Its really a pain, taking about 30 pills /day, but we had to be aggressive with treatment. I was in pretty bad shape & now, i am to the point that i can hold down a part time job. [Yay!]
So sorry, your possibly taking Methotrexate by now. I think there is an alternative.
It’s hard to explain how I know this but in short it’s tried and tested.
I stopped eating:
Grains, (Every single one including rice & sugar)
Proof is they all caused some swelling and sever pain.
If I try to eat any in the categories above, I suffer with severe pain in the Spleen, Gut, Bowels, first. Then in joints. But, the pain in my muscles decrease. It’s a really hard life, that no Government official or Doctor can even comprehend.
I refused Methotrexate as I don’t want any more complications in my health. All were caused by Vaccines, Anti-Biotics, and Anti- Depressants.
Funny thing was that all these problems were caused by a Grain intolerance that no Doctor ever picked up on. I’m just the unluckiest person in life where health is concerned. I would never have had depression if I had known I was intolerant to grain. Funny thing is there are many of us out there but they don’t even know about it. Most people with I.B.S problems are told to eat more Fibre which is actually the opposite to what they need to do. Fibre is a grain after all. Their problems then exacerbate.
All I.B.S sufferers need to stop eating grains. If they still have problems then they have a completely different problem. I.B.S should not be taken so lightly it’s actually saying your body is not happy with something your eating. Sorry to moan on out of control but Doctors have been saying the wrong thing for nearly a century. Pain & swelling is the same thing. It’s a reaction to something else. Doctors are always treating the end result and never the actual cause. Methotrexate is actually treating the end result, not the cause. Your choice!
I had taken Methotrexate, I was sicker than a caged parrot, I could not tolerate this medicine, Even changed it to injection, was giving myself Insulin one side Methotrexate the other, I was discharged because I was considered untreatable, I am fighting for my life here, I want an option to try more different drugs, not left in the dark and fed Bull. I tried Acitretin, which knocked out my liver, Methotrexate which just made me very sick, Cyclosporin, which didn’t do jack, and a couple of others, I had a team of medics that delved into different body parts, but no actual treatment. Why?
Hi, what is your dx?
Make it clear so we can all understand. If you don’t have a dx of every symptom, please describe them all. Try not to elaborate. Just facts. Maybe someone who reads this has a help, or possible comfort. Remedies are so rare so please do not get your hopes up! But, fight unto the end my friend. I’ve been fighting for 31 years now myself.
Every person is different in how they respond to various treatment options for PsA. For some, changing their diet gives them a great deal of relief, for others, it does nothing. We cover more about the role of diet and nutrition with respect to PsA in this feature section: https://psoriatic-arthritis.com/spotlight/spotlight-nutrition-and-health/. I hope you find something that provides some relief for you, Donna Marie.
I’m also very scared/worried about taking Methotrexate. I was diagnosed with PsA a little over 2 months ago (after about 2 years of seeing various doctors, multiple tests for things likeRA, Lupus, Fibro, etc.). I was prescribed methotrexate (oral) and Prednisone (short term tapered dose) and folic acid. The methotrexate side effects I experienced included nausea, abdominal cramps and fatigue. I did see some improvement in my joint/tendon pain and also in my IBS, however as I started tapering off the Prednisone those improvements began to revert so I’m now convinced that the Prednisone is what was helping, and I don’t believe the Methotrexate did anything at all. When I reported all this to my Rheumie her response was to increase the dosage of Methotrexate and switch from oral to injections. Why would I want to increase the dosage of something that’s not helping me? And I really don’t want to do injections. At this point I just don’t know what to do. I’m scared and confused. Any advise?
I have been on methotrexate as well. It really didn’t help and the risks with it didn’t seem worth it. Injections aren’t that bad. I have been on Enbrel and Humira but found they really didn’t help me. Th best was Otezla but it is about $2500 a month and I have no insurance.
I too MTX for about 5 years. First by itself, then Humira was added. I took MTX pills first, but the opinion was my body was not obsorbing the drug…so I started taking MTX injections (25mg), still taking Humira. I began having lots of respiratory & sinus infections, colds, etc. My doctor decided to take me off MTX and use Humira only, which worked very well for me for about 2 years. I recently started Cosentyx 150mg at once a month, after a 5 month break off Biologics. (I started 10mg Prednisone because I had a PsA flare at 2 months off any medications.)
While taking MTX, I had mouth sores which taking Folic Acid mostly resolved. I would also have a day where I didn’t feel 100% (tied, nausea), but could still manage. Once I started MTX injections, most side effects disappeared. I would suggest you try injections if you are not getting results from oral MTX. (The injections don’t hurt at all; they are nothing when compared to Humira!)
I was recently diagnosed with PsA after a year-long issue with my ankle. It started with pain, then torn ligament with a boot for 4 long months. I have had fibro for 13 years. I have been on Sulfa for 3 months and MTX pills for 5 weeks. No side effects but I don’t see any real improvement. I am tired and think that I may be experiencing low points which I thought was from being stuck in the house for a year. Was an active person before this. I am sick and tired of this issue. Also developed psoriasis Dec 2017. I think the fibro is confusing my symptoms. Next step Rheumatologist mentioned is shots of embrel. Not sure where to turn next.
Truth be told it’s your diet that’s making you ill. There are so many who do not believe in it that it’s like talking to a brick wall. 16 years research I have only come up with 1 answer. I’m not going into what to eat and what not to eat as I have been explaining myself black & blue. There are 2 main components of your diet you must not eat anymore as they are causing most problems. They are Grains & Dairy. Cut them out and you will feel much better. But, there are others.
Well there are a lot of things you can eat that aren’t dairy products. Fruits and vegetables, lean proteins, legumes. I haven’t gotten to the point of adjusting my diet yet but that is my next step. And the first two things that I am going to eliminate are dairy and gluten. Then sugar. We’ll see if it makes a difference.
I was on methotrexate for 4 mo & it helped. I was tired for 24 hours is all. Then added HUMIRA due to inflammation levels were still high. I started getting sick every 15 days & I have pitichea. Then I became short of breath. Stopped methotrexate. Staying on HUMIRA for now. My back has spondylolisthesis which has been flared up. Pitichea is bad, but the cardiologist told me to stay on Motrin until we pinpoint the inflammation.
They started me on methotrexate 8 years ago after months of not knowing what was up and finally giving me steroids. Then to the methotrexate. After a month or two it started working and I was feeling better. Then the odd infections started. Infections in my elbows, knees and even little ingrown hairs would go from 0 to 60 in a day. I was able to use hot compresses and bactraban to combat them but was still very concerning. Then the methotrexate stopped working. Maybe got 6 months out of it. I tried otezla with no luck. They then wanted me to go to enbrel. I couldn’t bring myself to use it. Side effects really worried me and my RN wife. I’ve used Turmeric, fish oil, hemp oil and tart cherries for my inflammation. Of course Aleve when things get rough which can lead to 2 aleve being used every night for weeks and even months. I’m on a different path now that is working but not the best but no pills or shots.
I’ve been on methotrexate for probably 8 years. I was having a severe psoriasis problem with scales, looked like lizard skin on my legs. Methotrexate alone didn’t resolve the scales so my dermatologist got me on a study for Embrel. Within 8 weeks I was clear of the scales and 90% clear of psoriasis. Never had any of the side effects listed in these posts, but I always take my pills with food during breakfast or dinner and blood is tested every 6-12 months. Then the psoriatic arthritis started up and is bad now. It’s in my fingers (can’t even bend several), hips, lower back and now my feet and toes. I’ve been getting infusions of Simponi. I was on Embrel until I got on medicare last year and it won’t pay for Embrel or Humara. Now the arthritis is making it hard to walk and the doctor wants to put me on one of the new drugs but not sure medicare will approve it. Anyone know of any of the new drugs that medicare will approve??
I have been on methotrexate for four months. The only side effect I have is fatigue about two days after I take it. I don’t know that it has helped with my PSA as I recently had a flareup. So my rheumatologist has added Humira into the mix. And his hope is that at some point he’ll be able to take me off the MTX. The jury is still out on the Humira as I’ve only done one injection so far. Good luck to you. It is such a difficult decision to make regarding these medications because there are so many options, and they all have risks of side effects. But for me I had to do something because my PSA effects my knees which when having a flareup causes me to be unable to walk at all. The next thing I am looking into is changing some things about my diet. But one thing at a time.
I hope you start to feel an improvement in the coming months, lbd428. You mentioned your next step is to start looking at changing your diet and I thought you might find value in this article by one of our contributors as you figure out what gives your body relief: https://psoriatic-arthritis.com/living/finding-a-diet-that-works-for-you/.
Not sure if my input is of any value as I’m new (just signed up and am quite…nervous/scare/hesitant/etc.). But just my $.64, I had no issues with Methotrexate when I was on it. Though my doctor did say the dosage was ridiculously low, so that may be why. Once I was diagnosed with chronic kidney disease, the nephrologist figured out the PsA was contributing to the CKD. I was removed from Methotrexate and put on Costentyx.
So I suppose consider your dosage and perhaps make sure the extreme fatigue isn’t coming from something else. Good luck!
@sved – Thanks for sharing – your input is so valuable! Our community is built upon people like you joining and contributing to the conversation(s) with your unique experience and insight. We learn and grow together – thanks for being here 🙂 -Jake, Psoriatic-Arthritis.com Team
I tried Humira; relief only lasted 2 days. I’m taking sulfasalazine 500 mg ( more than that gives me nausea and fatigue). I’m also taking CBD oil ( THC free)…It works! You have to find your own dosage( I take from 750 to 1400 mg daily). It takes away the pain and the foggy brain. No side effects. This is better than opiates or steroids. I’m back doing exercise and eating fruits, vegetables, chicken and fish. NO RED MEAT, ham or pork. Very little sugar and dairy. I get STRETCH sessions for 30 minutes twice a week. I’m 70 years old and doing all of these changes for 2 months now.
From Colorado. Legal in all 50 states. TryTheCBD,com
Feel better. Get better. It will improve the pain, inflammation and foggy brain ( from my experience)…The problem is preventing the Necrosis Tumor Factor with a medication that will stop or prevent this( CBD doesn’t do this). But, it is better than opiates, steroids or chemicals with side effects. I use bee pollen, turmeric, Omega 3, changed my diet to a PsA designed one, exercise and trying to get away from stress. I’m 70 years-old and finally retiring on June 28th to continue my mission to find a healthier life. Blessings. Any other questions?
I’ve been on MTX for about 4 years, a miracle drug for me. My doctor has always been very cautious; I believe to be an important factor. I began on a split dosage, 5mg at night, 2.5mg in the morning, once a week, for a year. Moderate but comforting improvement. He has slowly increased the dosage to 15mg a week, evenly split between a pm and an am dosage. There have been encouraging improvements along the way, for example, I can make a tight fist w/o pain. When we started this line of treatment, I could not make fist at all.
I hit a snag about a week ago when I ran out of MTX with only a partial dose remaining. I took the 7.5mg on schedule, didn’t get the refill for several days. I was starting to experience significant discomfort before I got the new Rx, took my 7.5mg and then checked with my dr about the resumption procedure. Unfortunately, I need to flush the MTX out of my system before resuming. Next weekend is going to be painful.
I have ceased taking all pharmaceuticals and am going all natural. My neurologist knows I won’t take biologics. Common sense said to me if you have to have your blood tested regularly to see if what you are taking is destroying your liver it probably isn’t a really good idea. I have tried most of them and didn’t really get relief anyway.
So my Doc suggested apple cider vinegar, Alpha Lipoic Acid, ginger root and Turmeric. All come in capsule form and you can buy it over the counter at any pharmacy. He just told me to start CBD with higher THC content. It has been about 6 weeks now and slowly improving. He also told me to do water aerobics because of the low and no impact and great stretching as well as the water is very good for Psoriasis. Then when I get out I use Vanicream moisturising skin cream. The cream was suggested for my granddaughter by MAYO Clinic years ago for a skin condition she has. It works like a charm. It is specifically for sensitive skin and has no dyes, fragrance, formaldehyde, lanolin, or Parabens. Good stuff.
I’ve had Ps since 1970 and diagnosed with PsA in 2001- I’m 55. I don’t know when Enbrel came out just that the old old cranky Dr who diagnosed me put me on some scary meds with Mtx. One of those I was severely allergic to and spent a week in hospital. And another one I had to have my eyes checked by an Ophthalmologist (not optometrist) every 6 months.
Then I switched Drs and tried Enbrel (w/ Mtx) then Humira (with Mtx) and finally Remicaid (with damned Mtx) worked for me for many years. I also moved and switched Drs several times.
I complained about MTX saying it made me nauseous , so I was given needles and vials and told to inject it. Let me say that after a while on Remicaid (10 years ago) I was questioning why I had to take it. I know they said it worked best for most people that way. But I’d never gotten to try anything without that awful stuff and I like to drink alcohol Damn it! So sometimes I just didn’t take it. Lol
Around 4 years ago, because of financial issues I was forced to stop my Remicaid and ultimately every medicine I was on. About 17 prescriptions (topical, oral, inject- I have clotting diseases and bad genes that mean meds too). They didn’t all end on the same day and some meds for my clotting issues can be over the counter – just a lot more than suggested.
After 4 years off most everything I was super scared when my psoriasis started spreading rapidly. By the time I had been to ER, wasted a month with an idiot Dr. in Denton,Texas- I was now covered everywhere but my face and front of my neck. And lucky for me ($80 Uber bill) & my Dallas Dr could see me. He’s kind of famous and an expert. He couldn’t believe what kind of shape I was in. He started me on Taltz and within days my skin was healing. And Glory Be On High NO MTX. I did voice my ,’I hate Mtx and am so glad you’re not telling me I’ll need to take it (instead of my old- I don’t know why I can’t try life without it “ ).
Back when I was on Remicaid the famous Dr I mentioned said if u didn’t want to do shots I could spread the MTX pills dose out over the course of 2 or 3 days. This Dr found the 1st psoriasis gene, teaches and is involved in most drug trials. He was the only one who’d said I could spread it out. Probably the nicest one too. I’m glad I don’t have to take it. I like my bourbon when I want it. I know it’s supposed to be bad but everything is bad. So I’m going to take my Talz, have some bourbon and think about wrapping bacon around my rare Filet Mignon.
I’ve been off the Mtx for about a year or so now 😁😁😁😁!!! After it caused liver damage 😞 in a 35 year old non-drinker (not even socially – makes me deathly ill) young woman. I had been on that terrible medicine for 12 years!!!! Yes, since I was 22 years old I was on both the pills and injections of Mtx😥. Of course, at different times. I’ve tried many things, but luckily recently in the last year my new doctor and I decided to put me on infusions of Orencia every 4 weeks. And thank you Lord Almighty, it was the ticket for me! Now, I’m not cleared 💯% but mostly. And it’s not that noticeable. Also, my joints feel so much better and I find myself taking less pain relievers throughout the day than with prior medications 💊!!! Yay!!! 😁😁😁 Good Luck to the rest of you all out there!!! 😀😀😀😀😀😀😀
IMHO, methotrexate is a med straight from hell. All my hair including my eyelashes fell out to the point I would sweep the hair out of the tub after my shower and vac the bathroom. I had to use Latisse to get my eyelashes back. I will never take methotrexate again.