Is anyone on 20mg of injected methotrexate having trouble with their ALT levels? If so what did your doctors do about it? My levels are more than double what they should be and my lymphocyte count is very low, so they said I may have to come off it but the problem is they don't want to put me on steroids as I'm diabetic. Have any of you been offered any other medications? At the moment they just have me stop the drug the odd week here and there and then my levels return to normal but as soon as I'm back on it the levels go up again. They're worried about stopping it as my lupus has never been that controlled and they don't want to cause a flare up but neither can they afford to damage my liver. I feel like I'm stuck between a rock and a hard place.