After a dalliance with reducing my MTX by half, finding it was doing far more than I thought and putting it back up to 20mg, I am now finding that I am getting so tired every afternoon, often falling asleep if I dare to sit and relax. I take 5mg of Folic Acid on a Friday (Monday is MTX day). I am also on 1.5mg Pred but I do not feel I have I have readjusted since mucking around with the MTX dose as I wake in pain every morning and do not start to feel less achy until after lunch!!! I am sure I have read that many others take a daily dose of Folic Acid and I am wondering if that may help this daily attack of fatigue. Should I ask my GP or Rhuemy for a daily does? What daily dose are people taking please? Thank you. (I tried searching for Folic Acid but it takes me away from the PMR pages. Also couldn’t find anything in FAQ).
Could Daily Folic Acid help constant tiredness? - NRAS
Could Daily Folic Acid help constant tiredness?
Hi. I take Folic 6 days a week (not Mtx day). It didn’t make any difference to fatigue levels ☹️.
I don’t find it makes a difference to fatigue, I take it as it reduces the nausea for me.
When using the search box you can filter your answers for just this group if that helps 😊
I take folic acid 6 days a week and still feel fatigue. Makes no difference. Good luck.
The fatigue is probably due to your condition not being under control rather than the mtx. Although saying that my fatigue isn’t great and I’ve been in remission for 8 years. I take 5mg of folic acid six days a week.
Thank you Ruth - that is helpful. The annoying thing is that I felt much better than this, on exactly the same levels, before I tried to reduce the MTX! Maybe time will help.
i take vitamins b12 and it helps reduce tiredness. However,I'm no longer o methotrexate. When I was on methotrexate, I took a folic acid everyday.
Thank you for replying - all this information is helpful.
I used to take folic acid one day a week then a different consultant said I should be on it 6 days a week. Hope this helps
Morning, Like many others I take it 6 days a week.but don't think it helps much with fatigue.
Sorry to hear how tired you are feeling but I don’t think the folic acid increase will make you less tired but could help with hair and bone issues. I have always been on 5mg of folic acid every day except the methotrexate day of which I am on 15mg. I hope this helps.
Similar experience. I'd dropped the MTX dose to 10 and was happy with that until March. Then cold weather hit and pains returned with a vengence. Gp said the PMR had morphed into rheumatoid arthritis so I needed more MTX. Now trying 15 but still very achy. 20 again for June I fear. I take folic acid six times a week but still have weary days.
Thank you very much. It is so useful to hear other's experiences.
so the standard dose for folic acid is 5mg once a week, however it can be increased to 6 x a week. It’s usually increased for the nausea. I’m on 6 days a week, I still suffer fatigue and need a 2hr nap most days. Vit B12 may help, although if you’re on PPI you’re best with a sublingual form as PPIs reduce absorption of Vit B12.
Not sure if you realise this isn’t the PMR site, but RA site. I assume you’re taking it as a steroid sparing drug. Depending how long you were on lower doses, it may take a while to get back to a therapeutic level. So a flare up in your condition may be contributing to the fatigue.
Ah, I didn't realise that I was on the RA site - I thought I didn't recognise many of the names! Thank you for your most useful information. I don't take a PPI unless I can't take my meds with a meal - which isn't very often. I am definitely hoping that I will get back to where I was soon - I went from 20mg to 10mg for 5 weeks, then to 15mg for 8 weeks, then I've been back to 20mg for the last 5 weeks. I really hope it gets back into my system soon - although I am not looking forward to the return of all the other side effects I had of constant colds, cold sores, warts and verrucas - but they are still better than almost constant pain and discomfort.
I used to be on the PMR site, as I had PMR & GCA in 2011-2016, then was diagnosed with ankylosing spondylitis. I recently missed 3 weeks MTX due to infections, returned for 1 week, then missed another 2 weeks after having my 7th covid vaccine last month. I’ve had so much pain in my feet and elbows, and despite restarting 3 weeks ago, the pains are not settling. Keeping fingers crossed it settles soon 🤞
Hello, like others I take folic acid 5mg 6 days a week - not MTX day - to counteract some of the side effects. It could definitely be worth talking to your rheumatology team about an increase. As Runrig01 has mentioned above though, reading your post I wondered if the additional fatigue may be due to an increase in symptoms, following the dalliance with a lower dose. In which case, it may ease once you've been back on 20mg MTX for a while.
Thank you, yes - maybe once I have been back to 20mg for a few more weeks things may improve. Best Wishes
Like KittyJ I was advised to take folic acid 6 days not day of MTX, to reduce the nausea symptom. Not noticed it help with fatigue which is a bane of ones with RD.
When I was on methotrexate/ metoject initially the first consultant said 5mg once a week, was feeling so tired all the time & nauseas & saw on here most were taking it 6 days a week, spoke to new consultant who agreed to do that, unfortunately that didn't work either & after 18 months on methotrexate/ metoject I decided enough was enough & swapped to sulfasalazine (along with all the other meds 🙄🤣) still get days where I'm absolutely shattered but not the awful sickness or feeling like I'm hungover or drunk x
so my rheum also suggest I take folic acid every day but mtx day. I also have fatigue regardless. She told me that you can take mucinex dm and the dm (dextromethorphan) part actually can help with fatigue and that they give it to children who are on chemo with much higher doses of mtx and it works. She just recommended it to me and I havent tried it yet but I’m hoping it will help. I’m not too fond of trying another medicine but if it helps that would be amazing. Hope this helps others as well!
Now that is very interesting. I am guessing that is a prescription drug - I will 'google' it.
its actually a cold medicine. You can get it over the counter at least where I live. My dr said it counteracts the neurological effects of the mtx
Thank you, I'll have a chat with my lovely Pharmacist about that then. Best wishes
Thank you for sharing this info - very interesting! Anything that reduces MTX side effects is helpful to know about!
Hello
The same as most have said on here, I take it 6 days a week, but my fatigue is still awful. I’m on 20mg of Mthx plus Sulfa. I recently had more bloods and my Consultant also tested my thyroid and ferritin - turns out I have an underactive thyroid and low iron - I’ve been on 50mg of Levothyroxine for over a month and iron pills and I still feel exhausted 🤷♀️. My RA is ok at the moment, my ESR is much lower than it was and my CRP is normal, so I’ve no real idea about the fatigue, other than I’ve come to accept it.
😞
Hi, I take one everyday except metho day, but this was because I was losing my hair, I still get awful fatigue xx
only take folic acid one day a week, methotrexate Friday, folic acid Sunday
I’m not on Methotrexate a few years ago I’m sure you will be fine taking 3/4 check it out with Rhuemy nurse 1 st .
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