Starting MTX

[jiml]

I was like you Dave when on methotrexate I took the mtx on a Monday and folic acid on Friday

[pingu]

Ah looks like my post may have slightly mislead. Indeed I do not take Folic Acid on MTX day.

My first consultant had me taking Folic Acid 2 days after MTX my new consultant has me taking it everyday except when I take MTX.

[D Foster]

Yes Pingu I have done both,when I was on 25mg tablets I took it everyday except when I took the MTX. On the 20mg injections a couple of days before the MTX. Injections are. Much better if you can get them.

[pingu]

I had my consultant appointment today and all is relatively well. One of my blood scores was low due to hydration and my MTX was increased from 15mg to 17.5mg as there is a small amount of psoriasis being stubborn, my butt and a little tiny bit on my elbows. Blood tests are now every two months which makes life easier and I have found somewhere I can get my bloods taken on a Saturday morning.

They have prescribed Eumovate ointment for some small areas and advised I should moisturise more with double base. Issue with that is I am a guy and the whole idea of moisturising is completely alien and makes me feel sticky and dirty as well as needing a hell of a lot of it as I am not a size 8 5ft 2 inch lady person.

Not had the conversation about Stelara yet and next appointment is 22nd September.

On the plus side I did ask about alcohol and se said in moderation ie a couple of pints a night rather than 15 at the weekend. Well it's a hell of a long time since I got close to 15 pints and 3 pints is a bender for me now so really happy to be able to have a couple of cold ones now and again. In reality I probably have about 2 pints a week.

Even with the little bit of psoriasis on my butt and what literally looks like dry skin on my elbows in say 2 to 3 patches total on my elbows about the size of 5pence pieces I can live with that and swim.

My face still breaks out a little when I don't get enough sleep or stress hence the ointment.

I also had to fill out a score card of itchyness and coverage plus joint pain etc, I only have one swollen join which is my middle toe on my right foot that hasn't caused me pain since being on MTX so all in all I can live with that.

Hopefully being sensible with alcohol, MTX etc I will survive the treatment. Sticking to everything religiously but often forgetting my folic acid.

[Fred]

Hello Pingu good to see you again.

Yes moisturising is a bit alien, but it does help a hell of a lot. I use coconut Oil every day, but that's as far as it goes. So don't worry they won't be recommending you apply Lipstick or Eye Liner any time soon.

Enjoy the beer mate.

[jiml]

Good to hear you're happy with the way the psoriasis is going, hopefully that extra tablet may just be enough to get you clear.... But you must make a note of the day or days you take folic acid.  

It sounds as if you will be taking a sensible attitude to alcohol, but it's nice to know you're derm has told you it's ok ... I think many of us enjoy the odd drink    I know I do....

Moisturising is something I'm rather lax with and have tubs of double gel and aqueous cream, but prefer coconut oil as it absorbs easily and isn't sticky

[mataribot]

The folic acid isn't necessary - it's to prevent side effects. Taking too much may mask deficiencies. If you can live the SEs, then forgetting the FA isn't the end of the world.

[Bill]

Fantastic result, Pingu, but how the hell is two pints a night moderation? Maybe the same mindset would classify Boris Yeltsin a responsible drinker?

Folic acid is dirt cheap and I've read that 5 mg a week will do no harm, but as Matari points out it will make your liver look healthier but wont stop damage.

I hope to read more of your continuing success.

Bill

[D Foster]

The folic acid isn't necessary - it's to prevent side effects. Taking too much may mask deficiencies. If you can live the SEs, then forgetting the FA isn't the end of the world.

" Studies have examined the effectiveness of folate supplementation in decreasing adverse effects associated with low-dose MTX. A Cochrane Review evaluated 7 randomized, double-blind, placebo-controlled trials that assessed whether folinic acid or folic acid decreased side effects of MTX in patients with RA. Both folinic acid and folic acid were found to decrease gastrointestinal and mucosal side effects"

As mataribot said it's just to reduce side effects but the studies do show that it works though the other conclusion was that higher doses were no more effective. I use to find that for me when I was on MTX it did reduce the side effects for me.

Dave

[JohnB]

On the plus side I did ask about alcohol and se said in moderation ie a couple of pints a night rather than 15 at the weekend. Well it's a hell of a long time since I got close to 15 pints and 3 pints is a bender for me now so really happy to be able to have a couple of cold ones now and again. In reality I probably have about 2 pints a week.

It never ceases to amaze me just how widely the opinions of the Consultants vary. Pingu's doesn't mind a couple of pints a night. A friend of mine who has been on MTX for arthritis  has no limits set, in yet mine wont even let you sniff the fumes from an open bottle. It would be nice to get some consistency.