Methotrexate - best way to deal with side effects - any advise?

[TheOriginalMerylStrop]

My lovely mum (an otherwise super healthy 77) has been diagnosed with Inflammatory Arthritis, and - after 9 months and every test imaginable - has been prescribed Methotrexate. Steroids had been helping with her joints but she has been utterly exhausted all the time which is not like her at all.

Anyway she's taken her first dose, and as per predicted side effects, feeling nauseous on top of the knackeredness. Not taken her folic acid until tomorrow. Any suggestions re diet/coping strategies?

Thanks so much, I feel so sorry for her - she's getting really fed up.

I have a bottle of Coke on my bed side table for a Saturday (I take my methotrexate on a Friday night) this helps immensely with my sickness. I have found it calms down once your a while through the drugs.

If it doesn't calm down she can talk to her rheumatologist about taking folic acid every day (what I do now) this has made a difference :)

My side effects (nausea, headaches) definitely got better within a couple of months so she should try to stick with it if she can. I would definitely recommend taking it at night so you sleep through the worst of it. Advice seems to vary hugely about how much folic acid you can take, but I was initially told I could take it every day except the methotrexate day.

For what it's worth, it has been a great drug for me and has given me my life back - I hope the same is true for your mum.

I found the whole Methotrexate experience a bit like morning sickness - so I was snacking a lot to keep the nausea at bay. I found drinking lots of water the day I took it and for a couple of days after helped. Also things like fresh fruit or green olives or gherkins could be good.

I know a lot of people say taking the Methotrexate before bed is a good idea. I actually found this led to a poor night's sleep as I was kept awake with stomach cramps and feeling sick.

To be honest, a person's response to this is just so individual you really have to work your own way through it. I didn't feel sick for the first few months and then it started, getting worse each week. I switched to the injectable form and while I lost all the stomach cramps the nausea became much worse and lasted longer. I'm now off the stuff ...

Is it methotrexate tablets or injections? I found the side effects and especially the nausea was much reduced when I was on the injectable version. But on the tablets I found that small light portions of food worked best. The folic acid will help a treat, ask the rheumy if she can take more folic acid, some on the day and some 48 hours after .... I took a large dose 48 hours after my dosage and a small dose every day but obviously that was just my choice and wouldn't suggest it without medical advice.

Turmeric and ginger can help reduce underlying inflammation. Its as effective as naproxen but without causing ulcers. There is also some evidence that a good quality multi-strain prebiotic supplement can help stomach issues on metho. Also, metho is processed by the liver so milkthistle can help improve liver function and get it cleared as efficiently as possible. Make sure you run any ideas past your rheumy nurse to make sure it doesn't interact with other medications but it should be fine.

The exhaustion is an absolute fucker. By far the worst part of my illness. when it's bad it's like the worst pregnancy tiredness ever, after you have run a marathon and been denied sleep for 48 hours. and the foggy confusion is debilitating. It's mind blowing that your body can make itself feel so god damn awful. So just help her however you can. Maybe employ a cleaner, set up regular food deliveries to reduce trips to the shops....this means that when she is feeling up to it she can use her energy for things that she actually enjoys instead of wasting her good days on boring monotonous stuff. That alone helps keep your mood up and makes the world of difference.

Good luck!

Thankyou all so much, I think my mum will really benefit from hearing about your experience.