Do You Know?
Methotrexate is a cancer medication, when used in high doses.
In lower doses it is used to slow the progression of auto-immune diseases such as lupus and RA. This drug can be taken by mouth or by injection and results in rapid improvement (it usually takes 3-6 weeks to begin working). It appears to be very effective, especially in combination with infliximab or etanercept. In general, it produces more favorable long-term responses compared with other DMARDs such as sulfasalazine, gold sodium thiomalate, and hydroxychloroquine.
Weekly methotrexate therapy became popular among rheumatologists in the 1980s and continues to be one of the most commonly used disease-modifying antirheumatic drugs (DMARDs). Methotrexate is an antimetabolite and interferes with folic acid metabolism and purine synthesis.
Particularly methotrexate, has been the standard for aggressively treating RA. Recently, studies have shown that the most aggressive treatment for controlling RA may be the combination of methotrexate and another drug, particularly biologic response modifiers. The dual drug treatment seems to create a more effective treatment, especially for people who may not have success with or who have built up a resistance to, methotrexate or another drug alone. Doctors now are prescribing combination drug therapy more often and studies continue. It appears that these combination drug therapies might become the new road to follow in treating RA. Here are some medications your doctor may suggest you combine with methotrexate: lefluonomide (Arava), etanercept (Enbrel), adalimumab (Humira) and infliximab (Remicade).
If you are taking methotrexate, you need extra folic acid.
Taking methotrexate can cause folic acid deficiency, which can result in problems such as hair loss, mouth sores, stomach upset and even low blood counts.
What your doctor didn't tell you, however, is that in most cases it is possible to get enough folic acid through diet alone – if you are diligent about consuming the right foods. Foods rich in folic acid include beets, boysenberries, brown rice, veggies in the cabbage family, cantaloupe, citrus fruits, eggs, green leafy vegetables, haddock, halibut, salmon, tuna, soybean sprouts, asparagus and spinach. Eating five or more servings of the above fresh fruits and vegetables and three servings of fish a week should be more than adequate to decrease the side effects of methotrexate.
If you consume plenty of foods rich in folic acid and still experience symptoms of folic acid deficiency, you will need a folic acid supplement. The dose of folic acid that is generally recommended with methotrexate is 1 milligram (mg) daily or 5 mg per week. Your doctor can tell you which dosing schedule and particular folic acid preparation would be best for you.
If you find that you must take a supplement, don't be too concerned. Side effects are rare and are usually offset by the supplement's benefits. In addition to reducing the side effects of methotrexate, folic acid supplementation may, among other benefits, stimulate appetite, improve brain and liver function and increase red blood cell formation. It may also lower levels of homocysteine, an amino acid associated with strokes and heart disease."
And what difference does this knowledge make for my RA? Nothing, haha. I have to take it anyway. Well...inquiring minds want to know. Or is it the curiosity that kills the cat? Hehe.
But you know, this is all temporary earthly inconvenience that will be replaced by everlasting heavenly happiness one day:-)
2 Corinthians 5:1
For we know that if our earthly house, this tent, is destroyed, we have a building from God, a house not made with hands, eternal in the heavens.