Another day another question. What on earth did I spe... - NRAS


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Another day another question. What on earth did I spend my time thinking about before all this?


Thanks everyone who replied about my question on missing a weeks MTX. As a result another question has come up! I mentioned that I was looking forward to a slightly less relaxed attitude to my weekly alcohol units, assuming that if I wasn't taking it this week that I effectively had a "free pass" for a week, but then again I have no idea how the body works!! It would appear that I might have been wrong about that and was wondering if I am alone in this misconception. Is the liver under constant extra stress or is it only through the time it takes for the stuff to be processed? ( sorry about this - I don't even have the vocab to explain what I am trying to get at!)

The other question that comes to mind is have people found that the occasional "sod it" evening where caution is thrown to the winds has a direct result on their bloods?

Sending love and gratitude to all of you who so patiently answer my never ending questions.


6 Replies

MTX does hang about in your body, so although your liver works extra hard on MTX day that doesn't mean to say it's not doing anything on other days. So I don't think you have a completely free pass, after all your liver might like a bit of time off too!

What I've been told is one, or max two, drinks a couple of nights a week are probably ok now I've tolerated MTX for a while with no problems. But what I should never do is binge.... and it's not just about blood test results and getting told off my your rheumy, but looking after your liver. They are wonderful things, as can repair themselves from all sorts of abuse, but try to be nice to yours and not stress it out too much during your week off.

My own experience was that MTX took about 5 days to drop out of system and after 10 days it is like starting first time i got all the same side effects all over again. As for the drink i was quite a drinker, probably 3 bottles of red a week, so half a bottle a day ish or 2 large glasses BUT i then didnt drink for a good while due to MTX and Cymzia and hydroxychloroquin making me feel so ill. I went to a christmas do, took a chance on a small bottle of beer, half way down it i could feel myself boiling up and feeling awful and next thing i just made it into disabled toilets and was projectile vomiting until i had nothing left in stomach. It does say on all those meds avoid alchohol, obviously i didnt take it seriously enough, it took me 2 days to recover and i felt like i had been hit by a truck. Needless to say i never touched alchohol again. It may be different for you and you may get away with enjoying a drink, but be aware you may not.


I was on Mtx for 7 years & had a glass of wine most evenings. My Rheumy said as long as my liver function tests stayed stable I could I did, but I never binged...couldn't take the headache the next morning!

But ask your rheumy.....I presumevyounare not thinking a bottle of Vodka a night?


My Rheumy said it is OK to have the odd drink - wine in my case but never over do it. I found with time 1 glass is enough ( I was quite a drinker before RA) but I try not to drink a day before or after MTX as advised here on HU. It also says coffee and black tea is not advised in gallons!!

I've been on Mxt for 2 years and I still drink, a glass of red every day and sometimes two. I've never had a bad liver test and the rheumatologist says it's fine. Everyone's different it seems.

Many meds we take are excreted through the liver, they're necessary if we're to be as controlled as possible so if we're able to relieve some of the pressure by regulating what we put it through then every little helps. It's a hardworking organ before we start swallowing tablets, it performs many, many functions, over 500 & is the one organ that has the ability to regenerate itself but put it under too much pressure & it will cause problems.

I could go on about what a hard working organ it is but if you didn't sleep well last night it'd be a sure fire way of sending you off to sleep but a few are listed below

- it detoxifies the blood to rid it of harmful substances such as alcohol & drugs

- it stores Vitamins A, B12, D, E & K, iron & glucose

- it converts stored sugar to functional sugar when the body’s glucose sugar levels fall below normal

- it breaks down hemoglobin as well as insulin & other hormones

- it converts ammonia to urea, which is vital in metabolism

- it destroys old & damaged RBC’s

- it provides blood clotting factors

There are plenty more but really but you'd think me a real nerd if I listed them all let alone lose the will to live but there's lots of info out there about what an important organ/gland the liver is & why keeping it in as good a condition as poss is really helpful. My Consultant never believed that I don't drink when I had usually high LFT's but nevertheless said he didn't mean wine or beer, as long as I didn't drink spirits! This was in Spain & as we know wine & beer are not alcohol lol, but what I took from that is have a wine or a beer, just avoid the hard stuff! 😜

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