RA + MTX —> joint relief + Nausea. RA + pregnancy —>Joint relief + nausea

Arthuritis

Maybe I am making an observation that wiser people already know about, or have it wrong.

MTX works by depleting folate, which while giving you joint relief, also gives you nausea

Pregnancy also depletes folate, as the foetus has priority on it, and the sudden drop in folate results in nausea, before you adapt your diet to compensate or take folate supplements . (and get cravings).

I suspect gym weight training (anabolic) has a similar smaller impact, as immunity drops temporarily during hard training, and of course muscle tissue repair needs folate. Heavy gym training suddenly (with good joints free of RA) will also deplete folate quickly and give you nausea. Not even Arnold escaped that.

Any mums who had RA, and got relief during pregnancy and then had RA symptoms return after? Any comment on your folate levels?

I suspect those who got no relief had very healthy diets with enough folate for both T cells & foetus to have an ample supply.

stickywicket

For what it's worth, I'd had RA for nine years before my first pregnàncy. No modern DMARDS on offer back then just NSAIDS which I'd to stop on becoming pregnant. To my amazement I was fine throughout. It felt fantastic if a little odd. The RA returneď almost as soon as he was born. Worse than ever.

Finally, we got it under control. I think it was with gold injections. Eventually, we opted for another but no such luck second time around. I was struggling a lot throughout and only allowed soluble aspirin. Again I flared even morè after he was born. Well, it seemed so but it might just have been having to deal with a newborn and a toddler, albeit with some help from my Mum.

I never had any morning sickness or nausea worth speaking of with either pregnancy. I'm sure I never took folic acid until I started on meth some years later. I don't recall any talk of it then for pregnant Mums though I ĺearnt later they were being given to prevent spina bifida. I never had cravings either.

Arthuritis

Thank you for the valuable recollections. It’s good that you mention taking folic acid was not a commonly advised thing back then.

I seem to have found for myself a strong correlation between circulating folate and severity of flares, which might also be partially why you should not take folic acid on the before MTX has been excreted out. I did try, just to see, and it renders MTX almost ineffective.

I guess we need to hear from more women who have or had not any RA relief during pregnancy and their level of folate intake, either with supplements or extra greens. I have found romain lettuce & oranges particularly “flary”! That said, beans of any kind regrettably in meal quantities also trigger my flares, but through a different mechanism I think. (lectin).

You are lucky that MTX 10mg keeps your RA under control, I am at the full 25mg which, DOES give you nausea. When I was ramping up there was no nausea up until 15mg, then it intensified with each 2.5mg increment.