Methotrexate Side Effects and Benefits for One Rheumatoid Arthritis Patient

Patient Expert

Last year due to my husband changing jobs, and health insurance, and annoying "pre-existing condition", I had a hard time with keeping my doctor's appointments as well as keeping all my medications filled. I know, I know, it's not really the best way to fight rheumatoid arthritis. So now, per my "New Year's Resolutions", I have already seen my rheumatologist and filled my prescriptions and am ready to start this year new, as sort of a rebirth now stronger and more ready to fight my rheumatoid arthritis.


"Holly, I am putting you back on 20 mg of Methotrexate." Time stood still and I am not quite sure I had heard anything after that as it all was a blur. The appointment had been great up to that point. I had talked to my rheumatologist about losing 30 pounds last year, which has helped my joints more than I had ever expected. I had told him that even though I have been through some of the worst pain in my life, I was surviving and still fighting this disease to the best of my ability. But, as if having rheumatoid arthritis wasn't terrifying enough, I was instantly thrown into a place within myself filled with pure terror the instant I heard him say methotrexate.

My side effects from methotrexate

Some people never have any side effects from methotrexate, unfortunately I was not one of those people. From my first dose of only 5 mg my side effects were extreme. My rheumatologist at the time called it "severe alopecia" but I liked to call it "oh no, I have even less hair on my head", or "where did all these bald spots come from?" Then there was the nausea and the dizziness that knocked me on my butt for days at a time. The fatigue was so bad that it felt like I was literally never able to get out of bed. It always seemed that by the time I was starting to recover from the methotrexate, it was time for my next weekly dose.

Weighing the pros and cons

I once had a rheumatologist that told me that the only way to survive this disease was to be proactive in my own treatment of the disease. She told me she had patients that refused to take prednisone because they had experienced or heard that it causes weight gain. She made a point to tell me that with each medication prescribed I would have to make my own decision if it was worth it. I was to weigh the pros and cons. So I did exactly that with the methotrexate and I took myself off of it. I had spent the last year working so hard on bettering myself mentally and physically and I thought that there would be no way I would be able to do that while battling the fatigue, hair loss, and nausea the methotrexate would bring.   So here I am sitting here dwelling on the fact that I have to start this dreaded medication. I am here weighing the pros and cons once again. But this time is different. How, you ask? I am starting to realize that this medication will help me.   It will help better me physically. And learning to live with the side effects, well... I am fully confident it will help me mentally. I guess what I am trying to say is that it is very important to be proactive in your own medical treatment. You must weigh the pros and cons and decide for yourself if it is worth it. If you feel that a medication isn't worth it, then you owe it to yourself to talk to your rheumatologist about it. But please remember, this also may be the medication that changes your life.

It is worth it

What about me and the methotrexate, you ask? I had forgotten, until now, how much relief it provided.   To live with the hair loss I had about six different wigs, in different colors, and in different lengths. And that was kind of fun. The nausea, you ask? Well, it sure gave me an excuse to eat the things I enjoyed the most when I could. And, as far as the fatigue, well... I think that is something I will continue to battle. But knowing that I am taking the right medication to best fight my disease for the time being...that's just priceless!

See more helpful articles:

Hair loss In Rheumatoid Arthritis: Causes and How to Cope

What You Need to Know about Methotrexate

How Effective Is Your RA Treatment?