Methotrexate & Hair Thinning: Anybody experienced this?

screamingmidget

I've been on Methotrexate for years, but only over the last 12-15months have I been taking 27.5mg a week, which I've seen plenty of times for this disease is high, as most consultants limit the weekly dose at 25mg.

Anyway, I've noticed all of my hair has become much thinner than it used to be, but I've only really noticed it in the last 8 weeks or so, as it shows it very thin on the crown area.

Also, thinking back, I did lose bits of hair in small clumps in the shower - I'd find the water in the shower would raise, as the hair had clogged up the water, and I've have to take hair from the plug-hole and put it in the bin - so I now know that will have been when it probably started happening - which would have been circ 6-7 months ago - so around 6 months after upping the dose.

I thought this was a great place to ask, if there's anybody who has (a) taken MTX but also
(b) developed hair thinning, but also
(c) dropped down on the dose of MTX?

Did your hair become thicker over time?

I've read that dropping down can help, but it takes 3+ months for a drop in MTX dose to have any effect on this side-effect, as that's how long a certain dose stays in your system?

Another thing I would often forget to do and that's forget to take Folic Acid, as I never felt nauseous afterwards.

For the last 4 weeks, I've started taking Folic Acid 5mg 6 days a week, and also 10000mcg of Biotin, but not as yet seeing an improvement.

I hope if any of you have gone through this, you can share your experience. Apparently, only 1-3% of people get this side-effect, but I've always been the 1% to get things like this.

The hair coming out in the shower is what is suspecting it's medication related and not age, as the hair is meant to thin over decades, not months. And it's not supposed to come out in small clumps when showing. So this is why I think it's the MTX, since going up on the dose.

Thanks,
Steve

[Deleted User]

Hi Steve and welcome to the Versus Arthritis forums.

Sorry to hear that you are being affected by hair loss which is indeed one of the possible side effects of taking methotrexate. We would all be interested to find out if cutting down on the dosage will in effect reverse this.

I should emphasise that any changes to your dosage should be in strict consultation with your health professional. Our page on methotrexate may hold some additional information for you which may prove helpful:

https://www.versusarthritis.org/about-arthritis/treatments/drugs/methotrexate/

If you need to speak to someone in strict confidence, the do get in touch with our free Helplines on 0800 5200 520 (Monday–Friday, 9:00am – 8:00pm).

Do let us know how you get on.

Best wishes
Brynmor

trepolpen

hi screamingmidget ,

dont see why they up your mtx , I was on 25mg for years , but was taking 6 folic acid a week & sorted the problems I had with raised ALT & hair thinning ,

dreamdaisy

FA is not only for nausea, it helps the whole body. I take it every Friday, I have had very few troubles with side-effects from my injected meth but I take it for the rest of me. I have always had thin hair, it is thinner now and I expect others can see my scalp but I'm not bothered, I'm a 60 year old woman so already neatly shrouded in my invisibility cloak. DD

screamingmidget

trepolpen wrote:

hi screamingmidget ,

dont see why they up your mtx , I was on 25mg for years , but was taking 6 folic acid a week & sorted the problems I had with raised ALT & hair thinning ,

I was upped due to pain and it not being under control. So she upped me from 25mg weekly to 27.5mg weekly.

You mentioned you had problems with hair thinning - when did this start? Could you give some updates on how the Folic Acid has improved things?

As this is the sort of thing I'm looking for. Thanks.

screamingmidget

dreamdaisy wrote:

FA is not only for nausea, it helps the whole body. I take it every Friday, I have had very few troubles with side-effects from my injected meth but I take it for the rest of me. I have always had thin hair, it is thinner now and I expect others can see my scalp but I'm not bothered, I'm a 60 year old woman so already neatly shrouded in my invisibility cloak. DD

For me, this has happened quite quickly, over a few months.
And I lost bits in the shower.

I have however had a pretty traumatic 12 months, not ate brilliantly, had bouts of depression, plus, it could always be the illness and not the MTX.

My gut instinct is that it is MTX though.

stickywicket

DD is right. Folic Acid does more than stop nausea.

I've been on meth for 20 years doses varying between 25mgs at my worst to 7.5mgs at my best but, as that didn't hold the inflammation, now back up to 12.5mgs. The occasional few hairs in washbasin after washing hair. Is it thinner? Probably but then I'm 20 years older. So is Mr SW's but he has no RA let alone meth.

My advice would be to ensure you take the FA at the dose prescribed. I've never heard of Biotin but, unless it's prescribed, do check with your local pharmacist for possible interactions with prescribed meds.

screamingmidget

stickywicket wrote:

DD is right. Folic Acid does more than stop nausea.

I've been on meth for 20 years doses varying between 25mgs at my worst to 7.5mgs at my best but, as that didn't hold the inflammation, now back up to 12.5mgs. The occasional few hairs in washbasin after washing hair. Is it thinner? Probably but then I'm 20 years older. So is Mr SW's but he has no RA let alone meth.

My advice would be to ensure you take the FA at the dose prescribed. I've never heard of Biotin but, unless it's prescribed, do check with your local pharmacist for possible interactions with prescribed meds.

Biotin is a B vitamin. Very important for hair health.

Basically, the point of the thread is to ask for people who have had the hair thinning and whether dropping the MTX dose helped.

One of the posters above, suggests that since he took Folic Acid 6 days a week, it's helped with the thinning, but just looking for confirmation on that.

trepolpen

trepolpen wrote:

hi screamingmidget ,

dont see why they up your mtx , I was on 25mg for years , but was taking 6 folic acid a week & sorted the problems I had with raised ALT & hair thinning ,

we are not qualifed to give advice , but only what happened to us
I started methotrexate in 1998 for RA , I had problems with liver blood test showing inflamation , ALT 170 & they stopped the drug , a year later they put me back on it with 6 folic acid a week & that sorted the liver problems but notice my hair had thicken up but takes some time to grow back , talk to your doctor or nurse

dreamdaisy

I am sorry you have had a tough time, stress and not looking after yourself too well could be another factor. I also apologise for not answering as you wish but when people do improve for whatever reason the forum is no longer of use to them. I do recall people posting about hair loss but I cannot recall anyone coming back to say how things turned out.

Vitamin B might be useful for the health of hair follicles, the bulb they contain is the only part of the hair which is living so it makes sense if they are in better health hair might grow. Many people do not realise / know / understand that visible hair has no biochemical activity within and is classed as being dead. Shampoo ads are farcical.

Meth has never done anything to lower or relieve my pain but as I have OA too that could be why. Have biologics ever been suggested as a treatment? DD

daffy2

Hair thinning is listed as a side effect here https://www.hopkinsarthritis.org/patient-corner/drug-information/methotrexate/ so might be worth raising with rheumatology. However it might end up being one of those trade off situations - the increased dose controls the RA at the expense of hair, which is more important? The hair growth has something like a 3 month cycle I believe so could take a while to show up after any changes.
Re the biotin supplements, this may or may not be relevant, depending on the dose and what blood tests are involved. This is from the USA https://www.womenshealthct.com/your-health/recent-health-topics/biotin-may-interfere-with-lab-tests-says-fda
There are UK references but they are more technical.

screamingmidget

daffy2 wrote:

Hair thinning is listed as a side effect here https://www.hopkinsarthritis.org/patient-corner/drug-information/methotrexate/ so might be worth raising with rheumatology. However it might end up being one of those trade off situations - the increased dose controls the RA at the expense of hair, which is more important? The hair growth has something like a 3 month cycle I believe so could take a while to show up after any changes.
Re the biotin supplements, this may or may not be relevant, depending on the dose and what blood tests are involved. This is from the USA https://www.womenshealthct.com/your-health/recent-health-topics/biotin-may-interfere-with-lab-tests-says-fda
There are UK references but they are more technical.

Thanks for your reply.

The reason why I think it's the MTX is because the hair didn't just thin over time, it actually blocked the shower and the water would rise - my feet would be underwater!

However... I didn't think much of it, until in December, my 40th birthday showed a video of me and I caught a side of the top-right of my head, which showed a bald patch (it isn't bald - just very thin, baby-hairs), so I looked in 2 mirrors and it surprised me. I didn't even notice!

I totally get where you're coming from with regarding the trade-off, although can't MTX be slowly reduced once everything is under control, like with the Pred? And the fact I wasn't taking the Folic Acid most weeks whilst on 27.5mg would certainly explain the side-effects. I've seen my GP who contacted my Rheumy and I'm now on 22.5mg, with Folic Acid 6 days a week, excluding the day I take the MTX.

Regarding the Biotin, I only started that 4 weeks ago, after the bloods.

There's not really any hair loss when showering now. Sure, 5-6 fine hairs might rub off in my hand, but I imagine that's with healthy people too.

I've also improved my diet. It could be several factors added up - MTX, poor diet, slight high blood pressure etc.

Also quite interesting, it seemed to happen shortly after going from 2mg Pred to 1mg in one swoop. I've read a drop in Pred can cause hair loss due to the Adrenal Glands.

daffy2

I suspect you may be right about having several challenging things at once - the body can cope with quite a lot but sometimes there will be just that one thing too many, and something will give. Let's hope you've reached a positive turning point now and things will improve.

screamingmidget

daffy2 wrote:

I suspect you may be right about having several challenging things at once - the body can cope with quite a lot but sometimes there will be just that one thing too many, and something will give. Let's hope you've reached a positive turning point now and things will improve.

I was drinking a lot of alcohol, have been depressed, wasn't eating well - that alone is 3 major things to deal with. Plus, I've read that hair is one of the first things the body 'puts to the back of the queue', when repairing.

mumofboys3

I have noticed my hair thinning considerably on mtx. I was on a lower dose while my ra was quiet and my hair did start to thicken again, I noticed a lot of regrowth. My hair was really thick but its very thin now. I'm back on a higher dose but only noticing strands falling out when I comb or run my fingers through my hair. Hoping it won't thin much more! It started thinning when I was in my early 30s x

screamingmidget

mumofboys3 wrote:

I have noticed my hair thinning considerably on mtx. I was on a lower dose while my ra was quiet and my hair did start to thicken again, I noticed a lot of regrowth. My hair was really thick but its very thin now. I'm back on a higher dose but only noticing strands falling out when I comb or run my fingers through my hair. Hoping it won't thin much more! It started thinning when I was in my early 30s x

What dose are you on now that's made your hair thin?

I'm the same with only fine hairs coming out, but it was very small clumps at one point. This, I think would have been around last summer, a few months after going from 25mg to 27.5.

25mg is the maximum many consultants go with, so maybe there's a reason for that!

screamingmidget

I've noticed my hair thinning a lot down the right side of my head now - but not the left!

So it's like on the crown, but also between my ear and temple.

What's strange though is that I've also had a bit of scalp pain / burning sensation around that area - anybody experienced that?