Tuesday, February 23, 2010 jgb, Community Member, asks

Q: Hair Loss with methotrexate

I am experiencing hair loss with treatment of RA with methotrexate.

Any way to stop or reduce this hair loss?

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Answers (11)
Hope, Community Member
2/24/10 7:32am

the only way to stop it that my dr. told me was to stop taking the drug.  It took almost a year for my hair to fully come back.  Meth stops cell regeneration, therefore,it prevents your hair follics from working,they die and your hair falls out.  That is how he explained it to me, and that taking folic acid would not help to prevent it or repair it.  I lost a third of my hair.

CBL, Community Member
2/24/10 9:25am

I'm having a hard time stomaching that one. I'm supposed to start my journey with Methotrexate after I get a negative TB test..I'm depressed about the hair loss and is it really true you can't EVER have another glass of wine ?!..anyone have alternative suggestions on RX they are taking without these side effects . I"m not so vain that hair vs chair that hair loss will win in the end but what is a RX that won't do that?  My doctor told me folic acid with over the counter biotin and hair nail and skin vitamin will be  great tools in prevention of this side effect but every time I read blogs its seems most if not all patients claim hair loss.. is there anyone on  Methotrexate without hair loss? and is there anyone who allows themselves an occassional wine or cocktail.? Thanks

Lisa Emrich, Health Guide
2/24/10 9:53am

I'm on methotrexate and haven't really had much hairloss except after very high doses of steroids for the treatment of an MS relapse.


I take daily folic acid (5 tablets of OTC), fish oil (5 large capsules OTC), and vitamin D (5000UL).  These with some synthroid (because I am also hypothyroid) seem to keep the hairloss to a minimum.


If I wish in a social situation, I will enjoy half a glass of wine without any problems.  But that is not even a weekly occurrence.

CBL, Community Member
2/24/10 10:35am

Thank you!  I so appreciate knowing what works for others as I'm sure I will be experimenting along the way. With this drug I seem to have gravitated towards the worst case scenario which isn't normally my personality I'm more of a 1/2 glass full person.. but this drug scares me and I'm having a pity party..In a few days I'm sure I will rebound.. thanks for your info.. Kind Regards

rbates, Community Member
2/25/10 10:53pm

I've been on methotrexate for over 2 years and have not experienced hair loss at all.  I take daily folic acid (6 tablets of prescription) celebrex,  synthroid for hypothyroid and 50,000 UL of vitamin D.  I take a calcium supplement and a daily multi-vitamin.  I also take Nexium daily.  The methotrexate and celebrex combination have worked well for me with little side effect.

Susan, Community Member
2/25/10 12:03pm

I have been on methotrexate for about 10 years. I had some hair loss at the beginning, nothing anyone else noticed and it stopped about 6 months after starting. I drink an occasional glass of wine and even mixed drinks once in a while and have had no side effects. I never have more than one drink in an evening and usually only once or twice a month. 

Deana, Community Member
2/26/10 11:32pm

I have been taking Methotrexate for about 2 1/2 years.  I have had some hair loss - like I am cleaning out my brush more often, but I still have a very full head of hair.  I am taking a multi-vitamin, Folic Acic, and Viactive (Vitamin D+K and Calcium); as well as Enbrel, Prednisone, Tylenol and Aleve.  I do not drink because with all I am taking I am not willing to chance doing damage to my liver and kidneys.  However, I have had a drink on my birthday and didn't notice a problem.  If you are thinking you want to drink all the time - I wouldn't do it:-)


Marie, Community Member
4/ 1/12 6:42pm

Hi, I read your post from a few years ago. How did you do on MTX? I am supposed to start it on Tuesday and i am scared to death. I have a positive ANA 1:64, but all other blood tests are normal. I ache all over, I do have Raynauds, headaches. Not sure if the MTX is the answer???



Mimi, Community Member
6/13/12 9:38am

Hi Marie, I just started methotrexate last week for rhuematoid arthritis. I am sort of scared it's going to leave me bald, but my ankles are swollen and I can barely walk so I am giving it a try. Hoping for the best.

Liz, Community Member
9/ 6/13 7:02am



    I have the same situation and don't waste your money on Biotin or Hair Nails Skin (same thing).  It does NOT work in any form.


           Good luck.  Liz

SnoozyQ, Community Member
4/18/14 8:41pm
I've been on Methotrexate for 6 weeks every Sunday and the hair thinning started almost immediately. The first 3 weeks I took 7.5 mg and am adding 2.5 mg every 3 weeks trying to get up to the 15 mg dose. When I complained to him about the hair loss, he doubled my Folic acid to 2mg 6 days a week and added the 10 mg Biotin. The hair loss has definitely slowed down. WebMD was a wonderful resource for explaining the effects of the MTX, and the Folic Aacid and Biotin interactions. Also, he told me that if I limited my wine consumption to 1/2 glass a day I will be fine. I don't have any wine or Folic Acid on the day that I take the MTX. Occasionally I can have a full glass, but I'm saving up my chits for that! I searched and vetted many doctors before I went to him (and his group) so I have good faith in him... But basically you have to feel and live in your own body. Thinning hair is certainly minor compared to ending up in a wheelchair. Reply
Liz, Community Member
9/ 6/13 6:58am

Hi Hope,

        I have also lost 40% of my hair and stopped Meth. 2 months ago.  I am thinking about trying the products advertized for male hair loss.  I wonder if it would work for out situation. 


                  Good luck  Liz

QueenofPain, Community Member
2/25/10 10:08am

When I was taking methotrexate and Enbril I was experiencing significant hair loss.  A friend suggested I try a supplement called BIOTIN.  I went GNC and puchased a bottle.  I was VERY pleased!  It doesn't stop all of the hair loss but significantly reduced it for me.  Give it a try.


Good luck.

Rebecca, Community Member
3/13/10 12:56am

Can you tell me what dose of Biotin you are taking?  I am on methotrexate and 1 mg daily of folic acid.  Also I take 5mg of Leucovorin 12 hours after the weekly methotrexate.  I know GNC sells different strengths of Biotin and was wondering which dose you have luck with.  My hair has been falling out for about 1 1/2 of the 3 years that I have been on methotrexate.

QueenofPain, Community Member
3/14/10 12:35pm

I take Biotin 5000 from GNC - one per day.  I hope it helps you.  It really helped me.  Good luck.

Rebecca, Community Member
4/ 1/10 6:22pm

I had been taking Biotin 2500 - one a day.  Stepping up to 5000 has already made a difference in my hair loss.  Thank you so much!  I was ready to throw in the methotrexate towel, but I'm feeling much more optimistic about staying on. Thanks again!

Antoinette, Community Member
2/25/10 10:22am

Folic Acid-Have your doctor start testing on different levels.  It doesn't completely stop it, but it does help quite well.

sharon, Community Member
2/25/10 10:36am

I've been on methotrexate for years for the RA.  I take Biotin. Over the counter supplement.  My Dr.'s approve.  I've still got a full head of hair.  If you've already lost hair it may take a couple of months to return completely.  It does work, of course because of it at the age of 67 yrs I still have to shave my legs.  Small price to pay.

Jackie, Community Member
2/25/10 11:22am

I was losing my hair also from methotrexate.  My doctor increasing my folic acid to 4mg a day.  Within a couple of months my hair grew back and is ok now.  Folic acid helps to keep down the side effects of methotrexate.  I hope it works for you. 

amissjune, Community Member
2/25/10 4:57pm

I am taking Methotrexate and have been for 7 yrs. My doctor also has me taking Leucovar the day after I take the Methtrexate. So far I have very, very minimal hair loss.

GISELA, Community Member
2/25/10 7:36pm


stramber, Community Member
2/25/10 9:07pm

No - don't think so as the metho is an immune supressant.


Was on it for 8 yrs. and lost a lot of head hair and all the hair in other parts of my body.  Once off it tho most of my head hair grew back - but get this not the hair under arms and you know where  !!    I win.


Arava was twice as bad I nearly went bald within 4 months.  Got off it quick as it caused other life threatening problems.

sunshinegal43oh, Community Member
2/26/10 2:38pm

I have been on Methotrexate since April of last year. At first I was taking 6 2.5mg pills/week. Then my doctor increase from 6 to 8 2.5mg/week. I have not had any trouble with hair loss at all. I have ultra thick hair to begin with, so maybe that is why. I don't know. All I know is my doctor scared me to death checking me every couple of days...But I never had any problems.

4grandma, Community Member
1/23/11 11:32am

I have been taking methotrexate for 2 1/2 months and have lost 50%+ [according to my hair dresser and what I gee in the drain] of my hair volumn... This needs to STOP asap!  I was glad to see suggestions here - checking with the Dr. immediately!

catwsl, Community Member
7/11/13 6:52pm

I am experiencing hair loss but am already taking 15mg of folic acid a week. Is increasing it likely to help? I suspect coming off methotrexate is the only real option.

Sadly I have no hair loss anywhere else, more's the pity, a bit less leg and bikini line hair removal would be a great trade off!

I drink whatever I want and have done since I first started with sulfasalzine through swapping to methotrexate twelve months ago. I don't drink a lot, usually a bottle of wine per week, occasionaly a little more. When I get together with my best mate, who has moved away so we don't see each other often, we get drunk! Not had a problem, my blood tests all come back within very normal parameters and I have, in fact, just moved from monthly to bi-monthly tests.

I also take anti-depressants and trazadone for a sleep disorder. 

I haven't been told drinking is banned. 

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By jgb, Community Member— Last Modified: 04/18/14, First Published: 02/23/10