Methotrexate and impact on general health

[EllieQ]

I've been on methotrexate for psoriatic arthritis since summer 2017. It's been going reasonably well - had a flare-up early this year so the dosage was increased, but this made me feel ill and exhausted so the dosage went back to 20mg per week during the summer. My arthritis is manageable at this level (I also take prednisone & sulfasalazine). I take the methotrexate on Friday evening, feel wiped out on Saturday, but usually feel ok by Sunday.

However, I really feel as though methotrexate is having an impact on my general health. I'm currently off work with a cold/ virus/ bad cough, and this is the third time I've had a week off work since August. I feel as though I catch everything going, and any illness affects me more than it would other people. I've now hit a trigger point at work for sickness absence (though my manager is understanding), Xmas shopping and planning is delayed, and I feel guilty that it's always my husband looking after me and our 3 year old DD while I'm ill.

So my question is: does anyone else have the same issue with methotrexate? Any advice to improve my health? Should I ask my rheumatology consultant about other medication instead of methotrexate? I already have early signs of osteoporosis due to taking prednisone so can't increase those.

Bump for the evening.

What are your blood tests like? I was only on mtx for a short while because it started to play havoc with my immune system and liver function so had to stop it immediately. I'm now on humira and it's been brilliant, zero side effects and about 95% effective.

I’m not on it, but my DH is.
Do you take it orally or by injection?
He was on an oral dose & it had that effect, switched to an IM injection & is much better.

I take methotrexate (for eczema) and don't appear to have any ill effects - but am only on 20mg.

Worry a bit about my hair falling out (male), and try to remember to take folic acid the other days.

Had tried loads of other eczema things which had horrendous effects.

EDIT - 15mg

I take it orally. Does your DH have to inject himself?

Blood tests have been fine, but the latest ones showed changes in my kidney function when there had been no changes for the past few months. Had more blood tests done - I need to chase my GP for the outcome, haven't felt up to doing it this week.

Yes he does have to inject himself.
When he was on the oral dose he got quite miserable as always felt so unwell.
He’s only had one off day really since he’s been on the injections. He’s got RA though.

If mtx is having adverse effects then talk to your rheumatologist about going onto biological such as Humira, it may be a bit of a fight because they are expensive and they like you to fail on other cheaper meds first, my dh who also has psioratic arthritis has been on humira for 6 years and has been in total remission since he started taking it. Also sulfasalizine is now classed as pretty useless drug that does more halm than good in autoimmune arthritis.

Have you looked at the Disability Discrimination Act in regards to work? Inflammatory Arthritis can be classed as a disability which can give rise to 'reasonable adjustments' at work. One of those adjustments can be that absence through your illness (or treatment) doesn't add to the 'triggering' totals.

my hubby was on methotrexate during is psoriasis (not rheum) treatment. It didn't work and left his skin vvvvvvvvvv fragile. He has been on Humira (second biological) for 3 years now and fingers crossed it has worked and continues to work. He injects (pen) every three weeks.