Methotrexate - Side Effects?

[SnarkyTexan]

Howdy y'all,

A real quick rundown of my dose of Methotrexate. Also, note that my dermatologist is a man. But I interact more with the resident under him, who is a woman. So if I get gender-confused, that's why haha

My dermatologist had me start a daily regimen of folic acid 2 days before she had me start the MTX (that I skip on the days I take MTX). I was taking the MTX on Tuesday's. But because of the required labs and the clashing with my job, I had to move the dose to Wednesday. 


1. I started a 2-pill dose on April 23. 

• The first labs came back normal. I discovered I am anemic based on my lab results. I didn't know but had an idea that I am. 
  
• I also had serious heartburn. There was also occasional pressure under my sternum like gallstones. I had experienced gallstones 15 years ago after having my son. Never had that issue resolved but the pain stopped after a couple of years. I emailed my dermatologist about this symptom and she says it is not related to the MTX and to contact my primary. 
  
• No change in psoriasis
  

2. Took the 4-pill dose on May 1. 

• Labs again were normal. But I've started having issues with my job. I couldn't concentrate. Distractibility was high. 
  
• 2 days after this dose, I had a full-blown gallstone attack that had me down and out for a couple of hours. Then again another attack the next day. No clue what triggered the attack
  
• A small change in psoriasis.
  

3. Took the 6-pill dose on May 8.

• Labs were normal so dr upped the dosage. 
  
• Emailed my dr about the fatigue, distractibility and how it affects my very unique job. 
  
• Inverse psoriasis has begun to clear up.
  

4. Took the 2nd 6-pill dose on 14. (current dose)

• Fatigue has been kicking my butt. My boss has given me permission to take off early if I can't work with a clear head, providing I have the vacation/sick hours to cover.
  
• Distractability wasn't an issue until today (5 days post-dose). 
  
• I feel like my mind goes blank sometimes. I'll be doing something and stop and just think "what was I doing?" That actually happened while I was creating this thread.
  
• The inverse psoriasis was almost cleared up but seems to be making a come-back.
  
• Plaques/guttate has started clearing up on the larger areas but itches like hell. Anytime I scratch, I bleed all over the place.
  
• Psoriasis had started moving down my legs more but seems to have stopped progressing.
  

Since starting MTX, I have had a very hard time getting up for work in the morning. I find myself hitting snooze 4 or 5 times before I will draaaaag myself out of bed. My sleep patterns are all jacked. 

Today, I'm seriously freaking tired. I went to bed last night an hour earlier than I normally do. I am considering ducking out early so I can sleep some more. 

I can't figure out if it's the MTX or what going on with me. It is affecting my job. I am paid by the speed I work. My pace has slowed considerably. 

Are my symptoms normal or am I experiencing something else?

Thanks for any feedback. 

[Turnedlight]

Mtx in any dose can make you tired, I found it got worse as the dose got higher. Also though, having compromised skin is tiring for your body too, I find with a flare up if it gets past a certain coverage it feels a bit like having the flu. Hopefully you will get some results with the mtx and your dose can be reduced to a maintenance dose which you might find more able to tolerate.

If it were me (here in UK) I would go back to my derm and say I can’t tolerate the drug and it’s interfering with being able to go to work, and hopefully move on to the next level of treatment.

If it was starting to work and then stopped, perhaps you are already becoming resistant. It only worked for me for about a year, then it just stopped working even though the derm increased the dose.

[SnarkyTexan]

I am scheduled to take the next dose on Wednesday. If this dose doesn't make a difference in my inverse (which is my biggest problem), then I am going to ask to move forward to the next option. This fatigue is hurting me too much to keep it up. My dr seems to be loathed to taking me off MTX until I've gone at least 2 mths of treatment. But I can't risk my job over my skin. 

Yes, when my inverse is particularly bad, showers are very very painful and I feel just flat out sick. I don't want to do anything or move.

[Turnedlight]

Just in case it helps, have you tried using sudocrem out of the tub (not the tube version) it’s got a lot of zinc and I find it soothing on areas which are prone to inverse p. It’s basically a nappy (diaper) cream.

[jiml]

Hi SnarkyTexan and welcome to the club, I'm glad you Were able to find us. You will find a lot of information about methotrexate here, some get on well with it and some hate it
Foir me I tried it and used it for almost a year but I found it increasingly difficult persuading myself to take the tablets  I found tiredness and lethargy a big issue plus constantly feeling unwell and nauseous. I asked to come off as I would rather have psoriasis than keep taking methotrexate
I think for you it's unlikely to get easier with side effects and would be telling your dermatologist you are unhappy and should be moved on

[JohnB]

Hi Snarky Texan, I don't think we have crossed paths yet so firstly  warm welcome to our club

I am currently on a break from MTX while a chest infection disappears. I did have similar muzzy head/tiredness for the first week or so but this fortunately went away.  The heartburn thing though I haven't had even though I do have a hiatus hernia. Indigestion/heartburn/gastric reflux is a recognised side effect. Maybe antacids could help with this and here comes the but, many of these can have an adverse effect causing the body not to get shut of the MTX as quick as it should.
I can understand the Dermys' reluctance to try something else but if you are not tolerating MTX now it will only ever get worse and I would be looking to try something else.

I don't have that much experience with MTX but if you need any more advice just yell out, somebody will be happy to help

JohnB

[Fred]

It always made me feel like a zombie. I always felt tired and nauseous, and on top of that I also found I would get the odd mood swing.

You do have to go through the hoops to get to a treatment that works for you, and what works for one may not work for another. It's all about starting at the bottom and working your way up, but at the end of the day ............. It's your body they are playing with and you have to decided if a treatment is for you or not.

[SnarkyTexan]

Just in case it helps, have you tried using sudocrem out of the tub (not the tube version) it’s got a lot of zinc and I find it soothing on areas which are prone to inverse p. It’s basically a nappy (diaper) cream.

I have not tried that brand. My mother and I used to use Gynalotrimin. Tho it's used to treat yeast infections, it seemed to keep the inverse at bay. It's very hard to find and at some point we a gave up trying to keep up with it. 

My mom has suggested using deodorant, like Dove, on certain places where the skin won't stay dry.

[JohnB]

Just in case it helps, have you tried using sudocrem out of the tub (not the tube version) it’s got a lot of zinc and I find it soothing on areas which are prone to inverse p. It’s basically a nappy (diaper) cream.

I have not tried that brand. My mother and I used to use Gynalotrimin. Tho it's used to treat yeast infections, it seemed to keep the inverse at bay. It's very hard to find and at some point we a gave up trying to keep up with it. 

My mom has suggested using deodorant, like Dove, on certain places where the skin won't stay dry.

When I was an awful lot younger I had a very itchy damp area on my left groin. I never got it looked at but my dad suggested cornflour (a granny remedy). It did help relieve the itch. The patch kind of disappeared but it was quite a while before I had noticed the change.

[Caroline]

I never got so far as you are describing.
When I see your description only one thing comes to my mind. Quit. This cannot be good for you.
In my own situation, with quite different problems, I also have heard doctors say: “this is not caused by your Psoriasis.”, but they don’t have an explanation of what else. So for me it is clear, the Psoriasis is the cause and in your case I suspect the MTX has been causing the gallstone attack. MTX is quite some stuff, through the liver it will also reach your gall bladder, who knows what it does over there ?