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Methotrexate and low white blood cells

I am new here.

help, my mom has RA, she also has very low white blood cell count for about half year, , but no infection or other major problem as of now.

we are told that Methotrexate and many other DMARDs reduce white blood cell count. But without DMARD, her pain cannot be controlled at all, even though she is taking oral steriod.

does anyone has similar situation, what can we do next ?

6 Replies

Worth taking a DMARD and monitoring the white blood cell count. If the inflammation is controlled then the blood count may improve. If the blood count is being monitored as part of DMARD management, then it will be obvious if it's have a bad effect.


Hi, it occurs to me that the levels given as "normal" will not be the same as the normal experienced by those with disease and receiving treatment, i would ensure this is constantly monitored to be sure that the low count is being addressed and considered as part of your moms ongoing treatment.


Which white cells are low? I've had low neutrophils in the past (neutropenia) and had to stop MTX for 3 years before recommencing injectable MTX. My medics always ignore white lymphocytes, but low neutrophils makes you more susceptible to infection. I was told prednisolone and hydroxychloroquine was the treatment for neutropenia , but I was taking those drugs anyway, before it occurred. Other DMARDS didn't work for me and I've tried a few in my 45 year RA history. Hopefully, your mum's white cells will recover and she'll be able to take DMARDS again.


She could have something called Felty's Syndrome, and if so methotrexate is beneficial in raising the white count.


How low are they? Mine are routinely under 4.0 (the minimum in the "normal" range as per Cdn "normal") and it often dips lower whenever I start a new medication or change the dose. I consider 3.8 to be "my" normal and don't fret over it.


Mine went below 3 last year and my G.P consulted the RA Consultant and he reduced MTX for 2 Weeks and went on MTX as my usual 20.hope this will give you some idea. He also advised me to take folic acid for week


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