Liver Function

[Sin123]

Just had routine bloods done as on methotrexate. My GP has just called to say there’s an issue with my liver blood results and to hold off from taking my MTHX next week until she hears from my rheumatologist. I’m only on this plus hydroxychloroquine and have not had any issues to date.

I just wondered if anyone has had this issue?

Many thanks

[PMRpro]

It is a common adverse effect of mtx and as your GP says it is dependent on how elevated the readings are and what the consultant thinks. It is standard for the blood tests to be done and the dose to be only allowed if they are acceptable. The GP does the blood test but rarely have the expertise to make the decision. We have a few people on the PMRGCAuk forum on mtx who have had the same problem - sometimes it rights itself.

[Sin123 in reply to PMRpro]

Thanks. Wondering if this is in any way linked to my hair thinning which I’m currently experiencing- probably wishful thinking.

[PMRpro in reply to Sin123]

Except for unbelievable fatigue, the worst adverse effect I had with the short experience I had with mtx was my hair starting to fall out in clumps, not just single hairs, within a week or so. Did no-one sit down with you and explain the use of the drug? Give you a list of adverse effects and what to watch out for?

How much folic acid are you taking? Maybe you need more - some doctors start on 1mg 1x a week - others use 5mg 6x per week, on all the days EXCEPT mtx day. You need what you need

[Sin123 in reply to PMRpro]

I’ve had the hair falling out issue a couple of year ago with MTHX and yes, they sat me down and explained the possible side effects. They upped my folic acid and reduced mthx. I know my current hair loss is not due to this issue sadly but probably Covid19 stress causing an autoimmune reaction to attack my hair follicles. I was just clutching at straws when I mentioned hair loss due to liver function issue!

[PMRpro in reply to Sin123]

I don't know if liver issues go for hair to be honest. It can be a sign of some liver disease so I suppose some liver changes must affect hair. But autoimmune disease in general tends not to be good for hair!

[Cakedec03]

Hi, I've been on methotrexate for 6 or 7 years now. My hair falls out and my liver function is always elevated. It is probably your GP being extra careful. Once you have had a discussion about it you can move forward. I'm sure your rheumatologist will see you if there is anything that needs to be done. Good luck with it