My R has been treating for me Gout and has now decided i may have Gout and RA even though when i first went to see him he said they could not co-exist. He has jumped straight into Methotrexate which i find somewhat alarming. I accept a lot is known and the dose at 7.5 mg oral is probably not great. I also have a friend who takes it and has had little side effect. I see from the forum experience is mixed. My concern is that some side effects need not be reversible. I was diagnosed with RA in the early 90s and treated with steroids and sulphasalazine. These also had side effects but somewhat less physically challenging. The RA went into remission until 2008. Can i hold off Mxt for a while and use steroids to see how it goes. I am not incapacitated and the problem is limited to my right wrist and right ankle, though i do feel more fatigued and find exercise hard.