Methotrexate and Food: I started Methotrexate when... - NRAS

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Methotrexate and Food

purplecyclist profile image
35 Replies

I started Methotrexate when diagnosed with RA in December. I was advised to cut down on alcohol and follow a Mediterranean diet, I also read to avoid things unpasteurised etc cos of infection.

but no specific foods to avoid when taking methotrexate.

I noticed that folk taking methotrexate for other conditions may be advised to avoid milk.

Has anybody here been given advice about methotrexate and certain foods? Thanks.

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purplecyclist
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35 Replies
AgedCrone profile image
AgedCrone

People with other diseases quite possibly would be taking far stronger doses of Mtx than those with RA….hence could need to avoid some foods.

If you needed to avoid any particular food your rheumy team would be sure to tell you.

Most cow’s milk you would buy would be pasteurised....hence regarded safe unless you had a dairy allergy.

Eat what you enjoy but sensibly, if you tend to gain weight, watch out the kgs don’t pile on.

purplecyclist profile image
purplecyclist in reply toAgedCrone

Thanks that sounds very sensible advice, I don;t really hear much from any Rheumatology folks, I've only been to the department once and a few phone calls, advice here is very useful though. I also went to an NRAS webinar about diet on 26/6/24 and it was very interesting, it is still online. One thing Ailsa Bosworth mentioned was cutting out butter and cheese which was what first started me to look into why. It sounded a general thing rather than specific to her.

AgedCrone profile image
AgedCrone in reply topurplecyclist

You have got it in one…Be Sensible……..I was diagnosed in 1997.I spent many years very successfully on Mtx - during which time …with the full support of my rheumy, I had a glass of wine with dinner each evening. I am not a big eater…I do eat meat…but in moderation,I do not eat burgers or kfc…because I don’t like them…not because I avoid them for health reasons.

I have NEVER been told by a rheumatologist to cut out anything from my diet….

Was any clinical reason not to have butter on your bread, or cheese on your pasta given? If anything upsets your digestive system…just don’t eat it!

These days such a variety of healthy reasonably priced fresh food is available …as long as you eat sensibly…..if you are over weight the magic phrase is “Eat less move more” Before the deluge from those unfortunate enough to be unable to exercise….. I don’t mean starve & run marathons …just stretch out when you stand up & before you get out of bed every motning & save the chocolates for high days & holidays.

I’m sure you will do fine. Hey…it’s a holiday…grab a chocolate 🤗

KittyJ profile image
KittyJ

I agree with all that AC has already said, I’ve been on mtx for over 25 years and have never been told to avoid any foods. Alcohol to start with to see how your liver reacts. Did Ailsa explain why you should avoid butter and cheese because I’ve never been told that either ?

purplecyclist profile image
purplecyclist

She said it near the beginning of her intro of the guest like everybody knew it.

youtube.com/watch?v=IB3rVl1...

When I checked the NHS website there was nothing. So curiosity about her comment led me to google which I usually avoid and there were some references to mtx and milk so I wondered if that was it and so I asked my question.

Paula-C profile image
Paula-C

It's more or less what a pregnant woman is told about food. (Picture of advice in mtx booklet). I do drink alcohol on mtx, I've been very open about it, my bloods are always okay. That's me, and I'm not saying everyone else will be okay.

Mtx advice in food
KittyJ profile image
KittyJ in reply toPaula-C

That must be old or not updated because etanercept is not a new med. You would think they’d update information wouldn’t you 🙄

Paula-C profile image
Paula-C in reply toKittyJ

I've just googled it and the advice is still the same regarding what foods to avoid.

Motherofcats2 profile image
Motherofcats2 in reply toPaula-C

That’s good to know Paula-C. I didn’t get that information (about food or drink) when I started on MTX back in January. I am taking it because of my Psoriasis but was never told to avoid alcohol and the information I received from the consultant was not extensive. I’ve always had to do my own research then ask questions when I saw them. To be fair, I am seen every 3months along with the usual blood test before the appointment. Not sure if that is good for NHS..?

I am taking 7 x 2.5mg tablets (increased from 6). They have been wanting me to increase to 8, but to date, I have managed to keep it at 7.

I am due to go on a cruise - with a drinks package. Shall I just ask for a refund for the drinks package and just stick to water?? 😅🍹

colli123 profile image
colli123 in reply toMotherofcats2

Enjoy your holiday including drinks. 🍸🍹🍰

Motherofcats2 profile image
Motherofcats2 in reply tocolli123

Thank you! 😀

Paula-C profile image
Paula-C in reply toMotherofcats2

I'm going on a cruise in November and we've paid extra for the drinks package. Ours also includes gratuities, wi-fi and eating at certain pay for restaurants. It worked out that if you had over 4 drinks per day it was a no brainer. Apart from alcohol drinks it includes soft drinks, bottled water and certain coffees. From what I know about drink packages if there's 2 in the cabin both have to purchase one each. I'm in remission so I tend not to take mtx when I'm away on holiday. I do think and this is my opinion only that the no alcohol drinking is for people on higher doses of mtx. Enjoy your cruise.

Motherofcats2 profile image
Motherofcats2 in reply toPaula-C

Yeah, same. We were advised to have a drinks package to include the soft drinks and beverages + alcohol as it worked out cheaper.

I’ve never thought about stopping the MTX whilst on holiday as I’ve always been worried about drinking whilst taking it. My psoriasis is very mild at the moment and the Dermol lotion seems to help, so I might do the same. I’ll only be missing one week.

Any advice from anyone about this is greatly appreciated as I’m still new to this MTX . 🙏 thanks

AgedCrone profile image
AgedCrone in reply toMotherofcats2

No….but as my rheumy told me…..just don’t drink the whole bottle yourself!

Motherofcats2 profile image
Motherofcats2 in reply toAgedCrone

😂

Peacox profile image
Peacox

this is very interesting. I’ve never ever been told to avoid any foods. I’ve been on MTX for a few years. My consultant just said be careful with alcohol & don’t exceed recommended units. It’s so confusing when medical professionals all seem to say different things! Watching with interest.

Motherofcats2 profile image
Motherofcats2 in reply toPeacox

I agree, Peacox. I was never told to avoid any foods, including cheese (see Chester1975) or alcohol as I said I was a social drinker and they seemed fine with that. 🤷‍♀️

Chester1975 profile image
Chester1975

you should avoid soft cheeses that ripen with mold, such as feta, blue cheese, brie, goat cheese, and Camembert. These cheeses can cause fungal infections if your immune system is compromised.

CagneysMum profile image
CagneysMum

Although a Mediterranean diet is recommended by health professionals I’ve never been told to avoid any particular foods and my consultant says it’s ok to drink in moderation ……. Therefore I enjoy a glass of wine (occasionally 2) most evenings. I eat whole foods in moderation which includes butter and all cheeses. I use full cream milk to make my own kefir. My bloods over the last 5 years (checked every two months) suggests all is good so far. I’m 62 and a little overweight but life’s too short to deny these little pleasures, however everyone is different.

Boxerlady profile image
Boxerlady

I don't drink anyway but haven't been told to avoid any foodstuffs and haven't - I LOVE my blue cheese and have milk and butter (yum!) every day.....so far, so good 😁

BoneyC profile image
BoneyC

I've taken MTX for over 40 years and never ever been told to not eat x, y or z.

Tonkie profile image
Tonkie

I was told not to drink full stop and if I do want a drink one week I’ll have to come off my MTX that week. Luckily I don’t drink anyway. Wasn’t told about any food but I can’t eat anything rich now or spicy. Everything has to be bland or I feel so sick 😞

I'm over the moon for you that you were given dietary advice. When I was put on Methotrexate they made me aware of the side effects. Nothing else.

purplecyclist profile image
purplecyclist in reply to

Yes I was advised about Mediterranean diet and cutting down on the wine when i started methotrexate. I also found the Versus Arthritis booklet about diet very good (and free), the NRAS helpline sent me some info from their website, the talk I mentioned in this thread with NRAS was really informative and well researched.

DavidT profile image
DavidT

I have been on Methotrexate for over ten years and have been told not to drink Alcohol on the day of injection or day after and not to over indulge for the rest of the week (Not a problem for me as I don't drink much) Also told to beware of certain foods and that I may find certain foods upset me. I found that when drinking coffee or eating fish I would feel sick. I am still not able to tolerate coffee but can now have fish so long as it is a couple of days away from injection day. As also been said elsewhere I am able to miss an injection when I go away on Holiday with no side effects. You just need to be sensible.

purplecyclist profile image
purplecyclist in reply toDavidT

I had never thought of a holiday from medicine before

CoastalLiving profile image
CoastalLiving

Personally I think it is pretty shocking that the NHS still don't train in and advise on nutrition and when they do it is basic or out of date info. The reality is food does add to inflammation but it is individual. A AIP diet is a good start, or doing an elimination protocol and slow reintroduction to find out what affects you personally. I have found that on this front it is better to do your own research rather than rely on doctors or rheumy team being any help and there is masses of growing research and evidence around AIP.

purplecyclist profile image
purplecyclist in reply toCoastalLiving

what is AIP? can you recommend something useful to read on it?

Chester1975 profile image
Chester1975 in reply topurplecyclist

Auto immune protocol diet x

CoastalLiving profile image
CoastalLiving in reply topurplecyclist

So sorry I have only just worked out where you see replies on this forum 🤦‍♀️ I followed a book called the Inflammation Spectrum by Dr Will Cole, however there are loads of resources not the web if you look up Auto Immune Protocol diet.

Sheila_G profile image
Sheila_G

Hi I was told I could eat anything I wanted but if it affected my RA stop eating it. Common sense really. The only thing I have heard about food is that pineapple and grapefruit are too acidic for us.

Poshcards profile image
Poshcards

I was on 25mg Metho for over 10 years and never given dietary advice, but was told to give up alcohol, which I did xx

15pixel55 profile image
15pixel55

Don't eat live Yoghurt

purplecyclist profile image
purplecyclist in reply to15pixel55

are the cultures used to make the yoghurt harmful to you? I always thought they were good for the guts

Boxerlady profile image
Boxerlady in reply to15pixel55

I've never heard/been told that 🤔

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