Not taking your Folic acid while on Methotrexate

[DBT776]

Hi There I have RA and stopped taking my Folic Acid for the last 2-3 weeks I have been unbelievably tired this last week and started it again. Could the tiredness be down to me not taking the Folic Acid? I am on Methotrexate.

[Boxerlady]

I'd say yes as that (and other side effects) decreased when I increased my folic acid from 1 to 6 times a week. Why did you stop taking it?

[DBT776 in reply to Boxerlady]

Thank you (Lovley boxer dog) it was really silly of me to stop. I don't like taking tablets and didn't think it would make much difference to me, however I seem to have been wrong and won't stop again. I have never felt so tired. What other side effects changed for you?

[Boxerlady in reply to DBT776]

I also felt a bit low and weepy; I just assumed that it was coming to terms with my diagnosis but the rheumy nurse thought not and it only lasted for a couple of days after my methotrexate each week so had to be connected. Interestingly, all of this went after a few weeks and then returned for a few weeks with each dose increase so definitely not coincidence.

[DBT776 in reply to Boxerlady]

Thats interesting thanks for sharing that. I have just had my first increase! So it must all be related.

[Soundofmusic52]

If I don’t take my folic acid I am tired and very nauseous but don’t take it on day of methotrexate that’s what I was told 💐

[helixhelix]

Absolutely! I also get a stonkimg headache if I forget the one I take the day after MTX. And your B12 vitamin levels may also drop which can increase tiredness too as well as cause other problems.

Folic acid is a pretty basic drug to take - just think of each tablet as like eating 2.5kg of cooked spinach.....

[DBT776 in reply to helixhelix]

Your so right. My B12 was also due I’d been feeling amazing and last week I felt dreadful

[dawkin_S in reply to helixhelix]

I love that analogy 😀 - I mean I know spinach cooks down to nothing, but 2.5Kg would surely be harder to eat than one teeny tiny folic acid pill 😂

[helixhelix in reply to dawkin_S]

Ah no...2..5kg cooked, so heaven know how much raw!

[dawkin_S in reply to helixhelix]

😂😂😂 to paraphrase Jaws, "we're gonna need a bigger pot!"

[Andstretch]

I was wondering just when you all take your folic acid? I do my methotrexate injection on the Friday and was taking the folic acid on the Tuesday but moved it forward to Monday to try to prevent the mouth ulcers, 'cracking' at the corners of my mouth and general blah feeling! Any thoughts on taking it even earlier?

[Hidden in reply to Andstretch]

I take folic acid 6 days a week. The one day I don’t take it is my methotrexate day

[bubblyalex in reply to Andstretch]

I take it two days a week. On Tuesday I take the 15mg MXT and on wed (must be no less than 24 hours later) I take the 1st Folic Acid, with the second the day after.

I’m going up to MXT 25mg and as injections on Tuesday this week so will start Folic Acid 6 days a week ... again leaving 24 hrs between the MXT and the 1st Folic Acid.

[Andstretch in reply to bubblyalex]

Thats very interesting - my injection is the 15mg but only ever prescribed a single 5mg dose of folic acid to be taken 3-4 days afterwards! Have a telephone consult with my specialist nurse on Tuesday, will definitely make some enquiries. Thank you so much.

[Andstretch]

Thanks for that. I might call the specialist nurse team tomorrow, see if they think maybe taking a little more folic acid may help me.

[bubblyalex in reply to Andstretch]

Definitely a good idea to do that because that is what it is there for. It ought to make a difference for you.

[Andstretch in reply to bubblyalex]

Here's hoping! Thanks again.

[Hidden]

Folic acid I'm told also protects your liver from the methotrexate as well. My rheumatologist said i can take the folic acid 16 hours after my injection. And then i take it daily for 5 days.

[Soundofmusic52]

That’s why they prescribe folic acid with methotrexate I thought anyway 🥴 maybe I was wrong !!!!