My wife was recently diagnosed with RA by rheumatologist after blood test, x rays of both wrist and MRI of left wrist to confirm.
She was taking levothyroxine for 6-8 years. Some how her HYPOTHYROIDISM slowly turned into HYPERTHYROIDISM, (may be because of autoimmune disease) and now she takes methimazole to treat hyperthyroidism.
She had total knee replacement surgery in 2008 for right knee and in 2017 for left knee.
Other than mild bilateral wrist pain she is in good health. No other RA symptoms.
She is 66 years old,does regularly yoga and stretching exercise.
Dr is suggesting methotrexate 10mg once a week to start with,increase to 20mg down the road along with Biologicals.
I am retired pharmacist by the way. Our daughter is physician and strongly suggest to start methotrexate to minimize damage.
Myself and my wife are very reluctant to start such a strong medications.
Any suggestion and inputs will be greatly appreciated.
Simply YES, it will settle the immflamtion in her joints, if it works well for her.
and YES, she does need to start off on a low dose, to see how her liver copes, some don't and then they need to stop taking, also needs to take ONLY ONCE A WEEK, with folic acid in the two days after.
I have been taking now for 14 years, keeps my arthiritis under control.
I have been diagnosed for 4 months now and titrated up to 20mg of methotrexate also 200mg bd of hydroxychloroquine as i nurse i did look into this before taking but the pain relief is worth it and now the possibly that I am in remission so review in 3 months may be reducing dose. My understanding is but hit hard with medication and have the possibly of reduction as remission occurs. Hope this helps as I know the questions you will have before starting the meds side effects rec. I had a few but got through them which glad about so not having to change at present time. Affects my MCv at the moment but just starting to drop so fingers crossed can continue
Hello Divya2006. I tried Methotrexate for 12 months / weekly injection. It did settle symptoms, but my liver function became compromised. I changed to Etanercept/Embrel, and it changed my life. I have been on this for 8 years and have been in total remission for most of the time. I am 57 and it has helped me to continue working and live a pain free life. I felt that Methotrexate was too strong somehow. When taking it, I never felt very well. I hope this helps. All that said Lyn1951 has coped really well with Methotrexate, so I suppose it's trial and error. Good Luck.
I was diagnosed two months ago and I started taking 10mg methotrexate.. I'm 49 and still in constant pain.. some days I get a little relief but then it feels like my legs stop working.. I'm giving it a good go so I'm not ruling it out yet.. I've had some horrible side effects but I think they might be easing too.. I still know very little about this illness but I'm trying to gather as much information as I can. I hope you can decide soon what way you want to go.. xx
Hey Sarah, it took me a few months to really start to feel benefits.
Hopefully you’re reviewed by your rheumatologist soon to see if they think they need to adjust your dosage. I had to go up to 25mg oral methotrexate after a couple of months. In fact it then wasn’t for another couple of months and finally switching to subcutaneous injections of methotrexate that benefits became really clear, and my dose is now at 20mg.
A little over a year in, I’m suffering virtually no symptoms currently, so I am hoping that continues. I’ve reduced from monthly blood tests down to 2 monthly - mainly as I understand it, still keeping an eye out for negative effects such as harm to liver function.
Hi, So sorry to hear of your wife’s diagnosis! I was diagnosed in 2005, I was in such pain I thought my life was over! I was put on prednisone, methotrexate, leufonamide and Humira. I got my life back! I am now just on Humira and feel good, very little pain. My doctor told me it needs to be treated aggressively in the beginning to stop the joint damage and then you can back off and see how it goes. I was very worried but I am so glad I followed his advice! If the medication shortens my life at least I lived it pain free while I was here! By the way I am now 69 years young! Good luck to both of you!
Thank you to everyone for a quick response. Going to see primary physician to discuss and get his opinion too. Luckily my wife has very little pain in both wrist so far which is manageable.
Not a big fan of methotrexate. The long term side effects are not really worth it. I was diagnosed with RA in 2014 and it was dreadful. Gradually I am back to my old self although it started in my hip and that will eventually need replacing - but it is getting stronger so surgery isn't necessary just yet. I am down to paracetamol twice a day and a half to one meloxicam. My symptoms have naturally subsided while I radically altered my diet and stuffed in 5000 mg of omega 3 daily to stop stiffness.
I don't want these ridiculously strong drugs. You have to find out what type of RA you have and how to manage it.
I was diagnosed 4 years ago at age 62 with RA. So , like your wife, I ve had to come to terms with both the diagnosis and the meds. I totally agree with your daughter to take the methotrexate to hold back progression of the disease which can cause not only joint damage but also affect heart, lungs and other parts of the body. It also can cause huge fatigue because of the autoimmune reaction ( was the hypothyroidism linked with the auto immune condition Hashimotos?)
Methotrexate for RA is very much weaker dose than when it is used for cancer chemotherapy. You have to have regular blood tests to check liver function. This is the go to drug to begin with and is generally effective. I did not have side effects.
The trouble is you don't know how aggressive the disease will be at the beginning. Only in the wrists sounds hopeful. But mine started in a shoulder , knee and thumb. Within 6 months I was very badly affected and taking highest dose of mxt sulfasalazine and hydroxychloroquine. Fortunately I qualified for a biologic ( I m in uk) which has totally controlled it and brought me remission. I say that to encourage you to engage with treatment not to scare. The NICE guidelines encourage early diagnosis and aggressive treatment in the early stages. I am sure this early diagnosis for your wife and treatment prescribed will benefit.
kind regards
I have only taken 2 doses of methorexate, so can't really tell yet how it's working. But on reading side effects of methorexate and meloxicam. I chose methorexate. I have never read such side effects that meloxicam can cause, which is a risk of blindness. So I guess choose? As others have said and your daughter included, it's wise to do something. Why spend what's left of your life in pain?
My wife saw her primary doctor recently. He advised her also to start methotrexate and said majority of patients tolerate well. So she is going to start tomorrow night.
I sincerely appreciate for encouraging words from all of you.
Well I tell you what my pharmacist said to me ...pharmacist...I can’t tell you not to take this med but I can tell you if a dr prescribed this for my wife or mother I wouldn’t let them ...well I decided to take it awhile but I took 6 1 time a week...I went to a different Dr and she took me off immediately
You wan't believe t. My wife's primary care physician said exactly opposite. He said if my mother or wife had to take it I will encourage them to take it. By the way my wife took her first dose of 4 tablets 10 minutes ago. Just curious to know for how long you took methotrexate 2.5mg tablets.
Will see how well she tolerates.
Thank you Blair... it's good go hear some positive feedback on this drug.. I'm just not easing at all.. I'm in constant pain and I can't see the light at the minute.. but I'll keep hoping for relief.
I too had to go over the unjections once a week, as the inflammation didn't settle at all, rheumo amazed I was taking up so little through my stomach, they did a blood test.
Inflammation tests are ESR & CRP, your regular Dr should be able to test these for you, and you should be seeing a fall in the levels from your previous tests.
I have been trying diet and cutting out ALL WHEAT has helped with inflammation, levels down as low as they have ever been, after 14 years with rheumo issues, why did this not occur me to try this earlier, and it has done me no harm to cut the wheat, just replaced with rice, & corn, although I still do miss a slice of toast, I feel better without it.
I’m so sorry to hear things are bad.
Are you taking pain relief? An anti-inflammatory?
Did you have any course of steroid to bridge you onto your DMARDs?
I had a few months with courses of prednisone at the start, to relieve things while I was phasing onto Hydroxychloroquine and then methotrexate. Prednisone relieved the pain and other RA symptoms... it just also happened to make me act a little weird as well. (I still think it was a small price to pay for the relief from the pain).
I did become pesimistic about how long it would take for my DMARDs to have any impact. It took months. I didn’t spare any pain relief I could be prescribed during that time.
I read with interest about your becoming a little weird on Prednisone. I have been on these on 6 per day reducing every 2 weeks since last October. I have only managed to get down to 3 pills per day before major flare up forces me to increase dose. I was on etanercept for 8 years and it changed my life, been a sufferer for 29 years. I have also been on methotrexate on and off during this time, but my consultant decided last March to double my dose, even though my medical notes said that I could not tolerate high doses of this drug. As a result I developed pneumonitis in July which almost killed me. Off all meds’ except Prednisone since then, awaiting new biological treatment. The last year has been hell. As for the steroid pills, I cannot sleep at night, I manage about 2 hours and ten am wide awake, I have lost quite a lot of my hair, and my face looks round and swollen. I cannot wait to get off these pills ! But a kidney infection is now threatening my start date for new treatment which is Friday 9th. Feel so down.
I think pharmacists are very knowledgeable. Sometimes you can get the best advice there. But I would like to know why he said this. Did you ask him? Could you find out his reasons? Also your new doctor, what did he/she give you in place of it? Will the dr. tell you why he/she took you off them? Thanks....