should I take MTX while unwell

Reona

Hi

I'm new to this and this is my first post. I started taking 15mg Methotrexate just 4 weeks ago and overall it hasn't been as bad as I had anticipated. I've had the results from my first 2 weekly blood tests and everything was ok (next bloods in the morning). My medication day is Sunday but I was really sick on Friday night (vomiting but no diarrhoea) and although I'm not been sick anymore I still feel a bit under the weather and nauseas. Should I take my meds tonight or delay it a day and talk to the nurse/doc/pharmacist in the morning?

[Deleted User]

Hi Reona,

Welcome to the forum. I apologise for the lateness of my reply, your post didn't appear when I checked last time.

Well done on managing so well with your meds, I'm glad there aren't any problematic side effects of them so far.

It's best to check with your rheumy nurse if you have any infections - including tummy bugs and especially as you are so new to the meds as well.

Here is a leaflet produced by Arthritis Research about Mtx which you might find useful

https://www.arthritisresearchuk.org/~/media/Files/Arthritis-information/Drugs/Methotrexate 2247 15-1.ashx

Please let us know how you get on

Take care
Yvonne x

Reona

Ah, thanks Yvonne. It was just my luck to have this happen on Friday night & the weekend when doctors/nurses are not available! Anyway, started feeling a lot brighter this afternoon so have taken them safe in the knowledge that I'm seeing the nurse first thing in the morning. I'll definitely keep you posted and really appreciate your interest.

frogmorton

Hello Reona

I big welcome from me too

This is a lovely forum full of great helpful people. Do come on in and join us.

Love

Toni xxx

dreamdaisy

Hello, it's nice to meet you though I am sorry you have had to find us.

I have been taking meth for some years now and, on the advice of my hospital, always miss a dose (sometimes more) if I am unwell with a bug or infection. I do not have too much trouble with the medication itself but I have become more tasty to gnats and midges since I began it and, if I am bitten despite my precautions, I miss one dose to help things heal. I know from reading on here that other patients are advised to carry on taking the immuno-suppressant med but that makes no logical sense to me.

I hope you are feeling better, it is best to let your rheumatology unit know that you have been unwell and seek clarification from them. I always leave a message on my rheumatology Helpline if I am missing doses just to keep everyone in the loop. Keep your bloods up-to-date too, these will show if an infection is lurking. DD

Reona

Ah, thanks everyone, I'm obviously in very good company. Things seem to have settled down a bit now and I see my rheumy consultant next week anyway so I'm sure that will allay any fears.

I count myself fortunate because my consultant is a lovely man, my GP is also very supportive (and knowledgeable) and I'm treated like a VIP (very important patient). Last week I also had a long chat with my local pharmacist at her request (another lovely person) and she gave me some ideas about trying to boost my immune system naturally. She's recommended plenty of turmeric, chai teas, ginger, honey, almonds, spinach, broccoli, live natural yogurt and berries in my diet which I'm trying to incorporate so I'm acknowledging that my whole system is feeling a bit shell shocked!

I'm looking forward to getting to know you all better, it's great to know that you're all here for each other.

dreamdaisy

You're more than welcome, we all know our stuff and are happy to share experience and knowledge. I began aged 37 and am now 58, I have both an auto-immune and osteo arthritis so know it from both sides of the fence.

One of the troubles us auto-immuners face is the lack of general knowledge about why it happens, which can lead to well-meaning people giving us faulty, inaccurate or poor advice. It is an over-active immune system which is the root cause of auto-immune arthritis so further stimulating it is not a very good idea. The meds prescribed by the rheumatologist are designed to suppress the immune system in order to reduce disease activity, thus minimising the potential for joint damage. DD

daffy2

I'm wondering if it was anti-inflammatory foods she was talking about - not the same thing as immune system boosting.
This is an american arthritis site but is a good summary of the kinds of foods that might help with inflammation.
http://www.arthritis.org/living-with-arthritis/arthritis-diet/anti-inflammatory/anti-inflammatory-diet-14.php
In theory a well functioning immune system will fight off inflammation, so it would seem to make sense to boost it, but as DD says the meds are trying to do the opposite - damp it down - so dealing with inflammation side of things has to be more targeted and specific.

Reona

Hhhmmm, this has got me thinking. It was definitely immune boosting that she was referring to so taking previous comments on board maybe this isn't the way forward. As I said, I'm seeing my rheumy next week so I'll talk it through with him. Having said that, I do like the stuff she has recommended so maybe it will be everything on moderation.

stickywicket

DD and daffy are right. They usually are. Those of us with an autoimmune form of arthritis have over-active immune systems and the purpose of DMARDS such as methotrexate is to dampen them down. Unfortunately this can leave us more prone to colds, viruses etc.

I always skip my meth if I have anything like a sore throat, snuffly nose or upset stomach just to give my immune system a fighting chance of dealing with it. I also ensure I have my flu jab in good time every year.

In normal circumstances, though, we don't want to encourage our immune systems but I would doubt that eating the sort of foods your pharmacist suggested would do any harm. Most of them would constitute part of a healthy diet anyway. Taking them as supplements would be a different matter.

Please do ask your rheumatologit about it amd, if you would, let's know the definitive answer

dreamdaisy

I love the typo, Sticky! I have had one rheumatologit in my time, the one who told me I didn't have arthritis. Twerp. Luckily my further two rheumatologists recognised my symptoms for what they were, even if they couldn't name my particular flavour of the disease.

It is a muddly world, Reona, I'm over twenty years in and it still confuses me. I have been in great pain but my bloods have been fine, I have felt fine and my bloods have been awful. On the meds front I have had to redefine the term 'working' to mean that my bloods are lovely even though nothing else is. The faster one is diagnosed and the quicker one begins the meds the better the outcome can be, I've witnessed that for myself. I went for five years without treatment due to my then GP's ignorance and am paying the physical price for that. Nowadays GPs are much better informed about the shenanigans involved with auto-immune conditions and that is a very good thing. DD

Reona

It does indeed seem to be a muddy world!

I've been struggling for a good 5 years now (I'm only just 59) and had to really push my previous GP to give me a referral to a rheumatologist. Up until then she preferred to use acupuncture to try to relieve some of my aches and pains. I'd had 2 really serious "flare ups" which had required hospital treatment via ambulance but as soon as they maxed me on morphine thus making the pain bearable they discharged me.

The first Consultant I saw said there was nothing wrong other than a bit of arthritis which was normal for a woman of my age and she commented that I had really good joint mobility. She suggested I lose weight and keep active, the latter which is very difficult when you can barely walk!

In the end we paid for a private consultation and that's when I was diagnosed with Spondyloarthropathy which had been triggered by Hypermobility Syndrome and Dysfunctional Breathing Syndrome which in turn caused secondary Fibromyalgia. So in a way the first consultant was right about one thing, I do have a lot of joint mobility, in fact way more than is good for me!

Anyway, I've been trying to get things under control with steroids, I did lose weight and started swimming and yoga. But as I was still getting joint pain and swelling, and uttered fatigued it was decided that the next course of action was MTX. I've been unable to work for over two years and eventually given early retirement on ill health grounds which in itself was a stressful process.

When I said that my bloods were fine, I was referring to the liver function tests etc. which showed no cause for concern.

But it's early days and there's a long way to go. Reading all your comments is great but I guess it just goes to prove that everyone is different. As my consultant says, there is no quick fix, it's just a matter of finding the right treatment to help me cope and that might take time.

stickywicket

To be fair to consultants, diagnosing any inflammatory form of arthritis can be very difficult. This article by ARUK might help to explain (or maybe confuse :roll: ) matters. http://tinyurl.com/p9nyzpp

There are no clear cut tests or meanings of tests for many people. Even hypermobility is not necessarily a problem. Many sportspeople use it to their advantage.

Most of us on here have used steroids as a means of regaining some control over our bodies but, equally, regard them as a last resort because they bring their own medical problems in their wake often while affording us a wonderfully enticing glimpse of 'normality'

dreamdaisy wrote:

I love the typo, Sticky! I have had one rheumatologit in my time, the one who told me I didn't have arthritis.

:oops: Sorry, though it was quite a good one, wasn't it? Arthritic fingers and touch keyboards are not a match made in heaven - well, not for me, anyway :roll: