I’ve taken methotrexate for two weeks and it wipes me out!! I can handle a day or two a week of this for the "greater good" and all, but then I just got stuff I have to do!! I'm not completely incapacitated, but I am getting really tired of my husband's cooking...God bless him! I even find myself pining to do the stuff I used to complain about doing! Will the fatigue gradually get better as my body acclimates?
Oh the fatigue. I deal with it too on a weekly basis. Methotrexate can cause severe fatigue, but there are good news. Slowly but surely the methotrexate will build up in your body and your side effects will become less severe. I can’t promise you that the fatigue will go away. It does for some, but others can be on methotrexate for years and still experience fatigue. That said, one of the first signs of a medication working can be having more energy. This means that although you may experience a fatigue for a few days after you take your medication, you may end up having more energy the rest of the time.
RA and fatigue go hand in hand. In fact, people with RA have a higher need for sleep and when your disease is more active, it’s common to be more tired. Have you heard of the Spoon Theory? It’s a way of explaining how people with chronic illness often have to be more cautious about how they use their energy. You may want to read our tips on managing energy levels with RA.
There are ways of managing side effects from medication, including fatigue. You may want to talk to your rheumatologist about your fatigue. Sometimes getting a prescription of folic acid can help reduce it. Other tips include scheduling your meds for the day before the weekend allows you to take it easy and give your body the rest of needs. Sleep in, try to have low-key days, nap when you need it. When you and your husband cook, make more than you need for one day, put it in the freezer, so you have food to warm up when you’re not up for doing much.
I completely understand the anxiety of not being able to get up and do what needs to be done. I’ve developed some tricks that can help, even on your tired days. I make a list of things that need to be done throughout the week. Instead of overdoing it before I take my methotrexate (which makes the fatigue even more severe), I try to distribute the chores out throughout the week. Say there are 5 important chores that need to be done throughout the weekdays. Instead of doing two or three of them the days before you take you methotrexate (as we tend to do because we know the fatigue will knock us out) do one chore a day, even on the day you take your methotrexate. If you can't accomplish it, then put it on the list for either the weekend or the next week. You will find that it you don't overdo it before and after you take the methotrexate the fatigue won't be near as bad.
I hope this helps. Good luck and best wishes!
I started MTX about 5 weeks ago. I have increasingly gotten fatigued, and very depressed. I had no idea this came from MTX. I didnt take my meds today, not sure I should take them or not. The depression scares me though.
Make sure you talk to your rheumatologist and let him know what exactly is going on. He may want to raise your folic acid as well to combat the side effects. What helped me with fatique was talking vitamin B12 supplements as well, but make sure you ask your rheumatologist first. I am sending good wishes your way and hope you feel better soon! Good luck and best wishes!
I would definitely follow up with your physician and let them know your side effects and concerns. Weigh the pros and cons; determine the safety for you!
I've also used methotrexate and boy, does
it ever pack a wallop in the beginning.
As the treatment progresses, your body will adjust and the fatigue
should start simmering down soon. With
any drug like this, it's a good idea to make sure that you eat regularly and
stick to a balanced diet, high in fruit and vegetables. I find that making the rest of me as healthy
as possible can help reduce the side effects a little bit. You can also speak to your doctor about it -
maybe you need to start at a lower dose and increase it gradually, giving your
body a chance to acclimatize over time.
Good luck with it!
I have been on methotrexate 2 1/2 yrs and still suffer from the wallop it causes. Next day I am out of commission, all I want to do is sleep. I have a med to take the day after helps alittle but not completely. I have just accepted this is how it is. Benefits out weight the side effects.
you're right - often, it's abotu weighing cost and benefit and if the meds are working, it's a small price to pay.
I forgot to mention I take folic acid, pacqunel, lyrica daily for Systemic Lupus Eyrthamatous is what I am being treated for. Methotrexate is to suppress my immune system. I don't know differences in rheumatoid arthritis and lupus. I do know I have constant pain, nausea, fatigue on a daily basis. I just take it one day at a time. Have a strong support system family and friends who are there to help me whenever I need it. I try to do as much as I can on my own but somethings I can no longer do which really sucks. Depression has not been a problem thus far.
there's a fair bit of overlap between lupus and RA, but also some differences. One of our writers, Leslie, has both RA and lupus — you may want to check out some of her posts.
The impact on your ability to live your life with RA and/or lupus seems to be very similar. I'm glad you have a good support system. It makes all the difference.
I too have SLE and have been put on Methotrexate injections. I am only on my third week and noticed the next day following my dose I am just totally wiped and unable to do much if anything at all. I was told of the possible nausea and problems with the liver but fatigue was never discussed. I just started to research this and am, well I guess happy is not really a good word, but happy to see that I am not crazy or alone in these reactions. I cannot say if the benefits will outweigh this since I am so new to this medication but am willing to give it a try. I feel like an absolute slug.
I have been on methotrexate for more than 3 years - have gone off it twice to see if there was a difference. No. The fatigue is overwhelming. I thought it would decrease as time went on but it has not. I take 8 pills on Saturday - even tried spacing them out (half and half, at my doctor's advice), to no avail. I spend the entire Saturday on the couch in a half-dream state. My house is a mess. I'm limited in what I can do cleaning wise anyway due to the pain from the RA and OA and Fibromyalgia. The folic acid does help a little little bit but not enough. There has to be something one can take to fight off the fatigue and bring back some energy to my tired old body. Any suggestions out there?
Methotrexate sure does take it out of you. When I was first put on it I had headaches and an upset stomach which could last a day or two. The next time you go to the doctor as about taking Folic acid. I found this helps me rebound from the effects of the methotrexate. I have been on methotrexate for 12 or so years and I am currently taking 17.5 mg a week. I take Folic acid on a daily basis and it really helps to the point I rarely feel the effects of the methotrexate.
Compared to some here it seems I'm realatively lucky. I suffer from Psoric (spelling??) Arthritis and am on 25mg a week of Methotrexate, taken in one hit on Sunday night. I'm pretty much wiped out from fatigue and a little nausea for most of monday, but I'd rather feel down and out at work than on the weekend!
For me the secret to knocking the fatigue on the head is some excercise!! I stumbled across this purely by accident. I take my daughter to swimming lessons every other Monday and decided to do a couple of laps while there with her. I quickly found the more I swam, the better I felt. The natural endorphins seemed to wipe out the fatigue and the depression that often accompainied it.
On the weeks that I don't swim with my daughter the hard part is finding the will to over come the fatigue and get some excecise .
This will not obviously work for all, but if you can find something you can do excercise wise you might find it helps.
Well I feel silly after reading my post (my excuse is, it is monday!) I'm on 150mg weekly not 25!
I take 20 mg of methotrexate a week. I always plan on getting extra sleep the night that I take it. I totally agree with the exercise thing. I swim about three times a week (followed by a hot tub soak and then a sauna). I also lift weights to strengthen the muscles around my joints. I also take folic acid and stay hydrated (especially after taking the methotrexate).
I can only give you my experience. I've been on Methotrexate for about a year, taking 25 mg a week. I take it by injection, subcutaneously. It's a bit of a drag to have to do the injections (I do them myself), but it avoids the nausea I was experienced when I was taking it orally. I do suffer from fatigue, but I don't know if it's related to the Methotrexate. Perhaps not, because I take the Methrotrexate usually on Monday night, and my fatigue seems to peak on Wednesday and Thursday. One thing that seems to help is exercise. This may seem like it would have the opposite effect, but I think just getting the blood pumping and the body working really helps.
Hello, Methotrexate is an immune supressant drug and supresses the immune system. Yeah it does make one tired. We are already immune supressed just by the rheumatoid. When y add Methot. or Arava they make system even more supressed. (depressed ?)
Methot. works well for some and not for others. I am off it and feel much better.It was not working for me - does not work for everyone. However some do really well on it.
After 6 months or so ask yourself if it is really working. Ask your Rheumy if you can go off it to see if there is any difference. Go back on if there is.
Take calcium (citrate), check your Vitamin D levels, iron levels, thyroid too as this can effect RA.
All of you should investigate the elimination diet. Jill Harrington wrote an excellent book about it titled "The Lupus Recoveryt Diet" and I have been following it for 32 days. I stopped my 50mg of methotrexate per week and 20mg of plaquenil per day. As of now, I have no pain and I don't expect to have any. I ran into an MD from The Netherlands who is an emunologist and a professor an the medical school in Amsterdam. He has connecting tissue, put himself on the diet, takes no medication and is controlling his disease. His words to me were "Your medications will kill you."
I noticed the date of your post was a few months ago. I was wondering if you are still doing well with diet changes alone.
I was also wondering if anyone out there was aware of a hereditary condition which affects folic acid metabolism. I believe it is a lack of an enzyme MTHFR. If i understand it correctly meth depletes folic acid. If one also suffers from a deficiency, i would think the depletion would be more severe. I have only begun taking methotrexate two weeks ago and am taking a prescription folic acid supplement - ive experienced severe headache and nausea but so far - not the fatigue.
I have been on it for about 5 years now and it never goes away and I always ache. It never goes away unless I have an infection and I"m off my meds.
Woke up with a sore red throat this morning, extreme all over body aches and pains. Fever and chills all day long. Have only been on MTX for two weeks, but did not take my 10mg dose today as really felt awful. Is it okay to miss a dose ? Oh , and the fatigue has been terrible, with a constant 24 /7 headache since beginning the stuff :(
Just to add, Rheumy not working this weekend, only Saturday today. GP full and unable to fit me in. Emergency department would mean at least a 6 hour wait in a cold room on a hard hurtfull chair.
Do you have walkin where you live? They may be able to help with the illness. I've gone off all my medications excpet for my anti-inflammatory Melioxacam and something for my stomach when I take it. I was so tired of being sick and tired. Do pretty well and I don't get as sick as much as I use to. But I do have stomach issues with the aniti-inflammatory so there are occasions that I have to go off it for a while and I feel like I've been hit by a truck. But once I start taking it again, I'm fine.
Went to the emergency department Monday night as fever 104F/40C. Tongue puffy and dry from dehydration....unable to drink much water by this stage. Breathing was tough like I had a rubber band around me. Also a constant hacking dry, non productive cough. They took lung x-rays........pneumonia !!!!! Not well advertised on the list of side effects, but there is a very rare chance of a this side effect of MTX......"MTX induced pneumonia". Sad experience whilst there, as a nurse tried to put up an IV therapy in my swollen hand area. I specifically told her my rheumatoid arthritis was extreme, and the skin was glowing from the swelling. Yet she poked and poked until she blew the vein. I insisted a Doctor try the second time and he found a vein in my forearm. Only people who suffer from RA truley understand the associated pain. No more MTX for me as I cannot tolerate it. I take my hat off to those that can persist through all the headaches, constant fatigue, etc etc etc. Not for me. I have a life to live. I have packed on the pounds since becomming immobile, so that's the first port of call. To lose weight !! So.......slow walking, gentle swimming excersises, and I will be trying that Paleo diet someone mentioned in one of the comments on this blog. It's based on an anti-inflammatory diet approach. Just love my cakes :( But maybe just a little piece now and then, for the greater good.
I am taking mtx for severe facial seborrheic dermatitis (although I hope I don't get rheumatoid arthritis, I've got one parent with RA and it looks like I've already started down the autoimmune disorder pathway at my young age-- 20's). Anyway, I've taken three doses of mtx so far (three pills per week). I take it on Friday nights and sleep in on Saturday until about 10 or 11 AM. I haven't experienced fatigue (although if I did, I'm not sure I would've noticed, school keeps me so sleep-deprived/stressed/tired anyway lol). But I don't think I was extra-tired. I am taking daily folic acid supplements, plus I have a super-healthy diet-- veggies, brown rice, low-fat, cooked in olive oil+ extra olive oil poured on top of my food. I don't know if that has anything to do with it.
My chiropractor warned me I would be tired with Methotrx, she was right! I take Plaquenil, Folic Acid, Ultram (to manage pain)and Methotrex. The day after I take my Methotrex I am sooo sleepy and it seems to stay with me for a few days, BUT, I am starting to feel better. I'm not back to "normal" but I can walk down stairs now. It is frustrating to be tired after taking this drug and my boyfriend asks me why I'm so tired since I slept all day anyway. I work 12 hr night shifts at the hospital as a nurse intern and it's nice to hear others say this drug makes them tired too. I was just feeling like a lazy bum!
i wish i had an answer i have rheumatoid artiritis and i take a 20 mg dosage of methotrexate , thats 8 pills once a week always on thursday ...by friday morning i am sick as heck from nausea to moderate headaches to fatigue , but on the bright side im not in pain anymore and i once weighed 120 i went down to 102.6 lbs from being sick with rheumatoid . i am now a healthy 113.4 lbs and can walk fully erect and make a fist and straighten out my arms thanks to the methotrexate ...the side effects of it or the only down part ..any suggestions oh and i take 1 mg of folic acid to help with the side effects
I guess I am really fortunate. I am also a little disturbed, but glad to see that what disturbs me is something that is normal to most who take Methotrexate. I have Psoriatic Arthritis. I have had psoriasis for 42 years, and only the last 2 years has the pain progressively worsened. Prior to 2 yrs ago I didnt have pain. But 2 years ago it started and WOW it just got worse and worse. Dr kept acting like I was crazy. He would ask where was the pain, I would tell him, here and here and here and here and he I guess thought I was coming for drugs or something stupid. QUACKS!!!! Finally a rheumetologist diagnosed me and we are off and running. I started out with Methotrexate 5 pills a week along with Folic Acid script, and Celebrex. Well that did NOTHING!!!! So went back after 5 weeks and he put me up to 7 methotrexate a week, with folic acid daily and Loritab 7.5 3 times a day ( I only take it when I have to have it, dont like narcotics) this is temporary until they get tests back on TB, Chest X-Ray and Liver profile. (Liver Blood work was also dont prior to starting 5 weeks ago). Well, I am due to go back on August 8 and they are going to ask for my decision to add Humara or Enbrel. (I am really undecided on those, SCARED of them). I got up this morning however, after taking my 7 MTX pills last evening and was soooooo feeling the blues and the fatique. I cried some and layed down, got back up and pushed on, took my bath, went to dentist appt, grocery shopping and felt much better!!! I think if maybe we try to push thru it and not give in to the fatique (ITS HARD!!!!!!!!!) But will help us feel alot better quicker. I understand when you say you cant I felt the same way, I just didnt think I would make it but I did and I am going to continue pushing, and fighting, anything has to be better than suffering!!!!!! Let me know how you all deal with it and how your doing with your managment.
I started two weeks ago and also am overwhelmed by the fatigue and a bit of nausea for two to three days after. I started out with 4 2.5 mg pills, the second week was 5 of them. This week I go to six 2.5 pills (15 mg total) and I'm already dreading it after my experience this past week with 5. I took it on Thursday morning and it took until Sunday night/Monday morning for me to feel well enough to do anything. I was exhausted and felt so unwell, even after sleeping. I have begun to really fear Thursdays however it does give me hope to see that some people do eventually get used to the drug after it builds up in your system. I take 5 mg of folic acid on the days that I don't take the mtx (6 days a week). I am also starting on a biologic, Remicade which consists of IV infusions. I have had 1 so far which actually made a very noticeable difference in my psoriatic arthritis. It lasted for a few days but kinda wore off which is to be expected after only one dose. Next Remicade dose will be next week (week 2) and then again at week 6. After that , it's Remicade infusion every 8 weeks while continuing with the weekly 15 mg of MTX. I have heard from others that if nausea is a problem, ask to switch to the injections instead of the pills. I had been on Stelara for the past year which totally cleared my psoriasis 99% but did nothing for my psoriatic arthritis. So I'm fortunate in that I'm starting with MTX and Remicade with clear skin already. I'm ahead of the game in that way. So now to see if the Remicade will work for the arthritis which has gotten so bad. I was on Enbrel for 11 years and it worked GREAT until about a year and a half ago when it just stopped working. Tried Humira which did nothing at all. Stelara as I mentioned cleared the skin which was wonderful but eventually the pain from psoriatic arthritis became too much. Interested to hear from others on Remicade - apparently the MTX is required with it in order to stop your body from rejecting it because it is made from a mouse protein and not a human protein (true story! not an internet rumour..lol). Is anybody on Remicade alone and finding it working without the MTX? And is anybody taking both and has noticed the MTX side effects calming down? Or to ALL taking MTX that DID eventually notice the side effects lessening, how long did it take? Thanks to everybody for posting. Each and every post here gives me hope and show me that I'm not alone. It IS worth it to go through some discomfort in order to beat these nasty diseases we suffer from. Thanks again and please feel free to contact me directly. Located in Toronto Canada here.
Hi there - thanks so much for sharing your story. I just started a couple of weeks ago as well. Please see my post. Thanks!
I've been on methotrexate for about a year. I take 8 pills Sunday evening in one fail swoop. I find I'm down till Wednesday, extreamly tired. I've also noticed, it's been getting progressivly worse. We are going to be starting Enbrel next...I am VERY nervous about this new med!!!