Methotrexate Hair Loss

[Abbey17]

This question is aimed at those of you on Methotrexate, I’d really appreciate your input. This is not merely a vanity question, I am starting on it today and believe it causes hair loss. 18 months ago I had a major operation which caused me to lose about a third of my hair and made the rest brittle and had to have several inches cut off. So from long shiny straight hair it went to quite short and very curly. It only started to grow back about 3 months ago really slowly, I have struggled with how it now looks. I now fear that just as it has started to grow I’m going to lose it again . Have any of you found this an issue, and are we talking about a lot of hair loss? Many thanks Wyn

[MrsNails]

There a fair bit about Hair Loss in general & when taking MTX on FAQ - you may find them helpful. Kind Regards

MrsN

[piglette]

It does seem that Methotrexate causes hair loss, although pred makes your hair rather like a haystack in look and feel. Long, lustrous locks are rather out in our case. I had mine cut very short and it was really spiky, people said how much they liked it!!

[jinasc]

Folic Acid ask your Medics to prescribe it.

[Abbey17 in reply to jinasc]

Yes he has thanks x

[jinasc in reply to Abbey17]

Hope it helps. 🤞🤞

[MrsNails in reply to jinasc]

What dose of Folic Acid has he prescribed on how many days?

[Abbey17 in reply to MrsNails]

5mg once a week

[MrsNails in reply to Abbey17]

That’s the lowest option - l’m on 5mg 6days per week - NOT Taken on MTX Day. There’s no definitive recommendation but if you have nausea or other side effects they will usually increase it.

Good Luck 🍀 l’ve written a lot on MTX which you’ll find in FAQ’s

Kind Regards

MrsN

[Abbey17 in reply to MrsNails]

Thanks very much for this. I will check it out, I’ve read quite a bit about MTX but not so much about the FA and am still anxious about it but I’ll give it a go. X

[PMRpro Ambassador in reply to Abbey17]

You need the folic acid because the MTX interferes with a biochemical pathway in the body that produces it and the tablets replace that. It is needed for all sorts of processes in the body - but it isn't a drug as such.

[Abbey17 in reply to PMRpro]

I will ring them tomorrow, I was told you need to leave 3 days between MTX and FA but reading what’s on the forum that’s not the case. I’ll let you know how I get on

[PMRpro Ambassador]

I only took MTX for 4 weeks but the hair loss started after about 2 weeks and it was coming out in small clumps of several hairs together. Other than that I didn't have the usual MTX adverse effects, it was more what are usually pred side effects that I had never had before appeared (it can happen). The worst thing for me was the fatigue and after 4 weeks I stopped it for a trip to South Korea because I'd never have made it otherwise. I never went back on.

My hair changed with PMR, changed again with pred and since lockdown I have grown it out, it is shoulder length and with the right shampoo wavy and shiny and very very white!

[Abbey17 in reply to PMRpro]

Thanks for this let’s see what happens x

[dancersize2 in reply to Abbey17]

I also take 5mg six times a week (not on MTX day). My hair is thin and fine anyway but I think it has thinned even more. I've been on MTX since Jan 2019.

[Linny3]

I am on my third try with methotrexate. I am on 12.5mg 2x's a week by shot.. I have minimal hair loss.My stylist says my hair never looked and felt better. I think it is because I am using a large dose of collagen daily. Also, instead of taking my shot once a week I take it twice a week and I think that has helped minimize the side effects.

Good Luck

[Abbey17 in reply to Linny3]

Thanks I am taking collagen also so maybe that will help x

[Peptink in reply to Linny3]

How do you take the collagen?

[Linny3 in reply to Peptink]

I take Dr. axe's collagen. It seems to be a good product. I usually take 2 scoops 2-3 times a day in water or almond milk with omega 3 oil 1TBS. ( I use the omega 3 once a day.)

[Abbey17 in reply to Peptink]

I take the tablets but you can get liquid form

[Susan1705]

Hi, started methotrexate in July this year and no hair loss!! I take folic acid 5mg on the 6 days I don't take the methotrexate as I get fatigue as the main side effect.

[mgrogers99]

I have been on methotrexate injections since February and hair loss does happen. My hair can get brittle and I need to be more gentle with it. I don't have bald spots and handfuls of hair DO not fall out. The most apparent side affect is my hair looks thinned out. Use good products, not a lot of heat and be gentle. I take Biotin also.

[Abbey17 in reply to mgrogers99]

Thank you I’ll look at Biotin, I’ve been taking supplements since my op and being careful with it and it’s been getting stronger so I’ll keep up my routine x

[mgrogers99 in reply to Abbey17]

I learned many young women take biotin ....all of them have beautiful hair and give biotin some of the credit!

[Abbey17 in reply to mgrogers99]

🙏

[Nightingales in reply to mgrogers99]

I was just about to order biotin because I am going bald but found this on Web MD. “tests: Taking biotin supplements might interfere with the results of many different blood lab tests. Biotin can cause falsely high or falsely low test results. This might lead to missed or incorrect diagnoses. Tell your doctor if you are taking biotin supplements, especially if you are having lab tests done. You may need to stop taking biotin before your blood test. Most multivitamins contain low doses of biotin, which are unlikely to interfere with blood tests. But talk to your doctor to be sure.” Do you know anything about this.

[Abbey17 in reply to Nightingales]

I didn’t know that but have just been to the chemist to get some Biotin and the pharmacist said not to until I’ll checked with the GP for the same reason

[Nightingales in reply to Abbey17]

Interesting. Maybe someone else will chip in. If not I will do a seperate post. What collagen do you take and what dose. That’s another supplement I have been thinking of because I really am getting to the stage of no hair.

[Abbey17 in reply to Nightingales]

I’m taking Boots 1000 mg you need to make sure it is marine / fish collagen. Holland and Barrett also have good ones. I have noticed a difference with my hair and skin. I also use Lee Stafford hair growth reactivation shampoo & conditioner . It won’t bring hair back obviously but it’s good. My hair has started growing in the last few months and is in much better condition- just want to hold onto that if I can

[MrsNails in reply to Abbey17]

I had my Rheumy Team & My Pharmacist check BUT you need to check with your Prescriber which is what l did - l’m going to do the same re Glucosamine/Chondroitin before l take it….

[PMRpro Ambassador in reply to Nightingales]

labtestsonline.org/articles...

explains it. Probably most relevant to people with thyroid problems or if you have a heart attack.

[Nightingales in reply to PMRpro]

Thank you so much PMRpro. You are brilliant in tracking down relevant information. I think this is important information that is not well known. I was thinking of going on Biotin but with regular immunoassays and THS plus others I twill have to reconsider. Thank you again Sherlock Holmes 😊👏👏

[Skysey]

Hi Abbey. I was on Methotrexate for a few months but had to stop as it was affecting my liver. My hair thinned badly and I had it cut short to try to thicken it. I had straight mousey hair and now have wavy hair which actually looks better! Once off the methotrexate, my hair recovered well. I use a thick and full shampoo and conditioner which has also helped. Some people don’t seem to lose much hair. I think it is individual as people respond differently to medications.

[castingcollectives]

I lost nearly all my hair on methotrexate after 3- 4 months fell out in lumps.Good news when I was taken off it all grew back thicker and curly! ...Straight before still grey though so have it coloured.

[MrsNails]

Abbey, my hair loss is compounded by Chemo but prior to that l did some research & found Biotin can help - l had the Rheumy Team & My Pharmacist check it out & there were No Contraindications - it’s a water soluble vitamin (so you’ll wee out any excess) but don’t take more than you should - so that’s worth a shot too!

Buy it as Vitamin B7 rather than an expensive ‘Biotin Supplement’ for Hair n Nails

[Abbey17 in reply to MrsNails]

Thanks for this I will definitely check it out today. x

[MrsNails in reply to Abbey17]

I’ve just amended my Post to say Biotin is B7 & it’s cheaper to buy than a specific Hair n Nails Supplement.

[Abbey17 in reply to MrsNails]

Ah right thanks

[MrsNails in reply to Abbey17]

labtestsonline.org/articles...

[Abbey17 in reply to MrsNails]

This is really important information, I think it can be so easy to assume that health supplements won’t be an issue.

[MrsNails in reply to Abbey17]

That’s why it’s very important not to be tempted to exceed the RDD thinking more will be better as it’s not necessarily so. I recommend a Chat/Appointment with your Pharmacist & l always recommend to get your Medication from the same Pharmacy as then ALL your Meds are recorded.

[Betty_H]

I've been on MTX since January and have not noticed any hair loss at all. I'm on 7.5/week, and 1 mg folic acid per day. My rheumatologist did not tell me not to take the FA on MTX day. I'll have to check this out.

[Abbey17 in reply to Betty_H]

Yes do, I was told to leave 3 days after taking MTX as it interfere with it. But it seems most people just avoid the day

[MrsNails in reply to Betty_H]

MTX depletes the body of FA but also FA on the same day prevents the MTX working properly! I’m a Six Day a week FA 5mg l just don’t take it on MTX Day

[Frewen1]

Hello, I’ve been on Methotrexate for some months, can’t honestly say it’s made the slight hair thinning I’ve noticed from Pred any worse. I am lucky, I have quite a lot of hair, but it’s definitely become more a bit thinner, and more coarse, but not noticeably worse. Good luck

[GreyBike]

Hi. I take methotrexate (and prednisolone). I started getting hair loss when I increased from 15mg tablets to 20mg tablets but this stopped when I increased my 5mg folic acid from one day a week to 6 days a week. I m now on 25mg (injections) with no hair loss at all. I have also seen posts from people who say that taking biotin really helped their hair loss.

[Leymay24]

I was wondering if ladies like me who are taking Letrozole tablets and have poor thin hair as a result would benefit from taking vitamin B7 or Collagen. The Letrozole tablet is to stop Breast Cancer coming back.

[Sutta]

Hi, I have been on methotrexate for over 20 years now. At first, my hair loss was worrying but it settled down and my hair is just a little thinner. If you use good products and minimize drying you may well find it improves. It can take our bodies a while to cope with new medications. I would stick with it if you can.

[Sharitone]

I've been on MTX for 4 months. My hair is falling about at approx twice the normal rate 19 months ago when I started on pred, and I think it has accelerated with MTX. Every morning I crawl round the bedroom floor picking up the tangles! However, Reading the other posts, it occurs to me that the rate of loss may have slowed down since folic acid was increased from 1 day a week to four. I was told to leave 48 hours between MTX and FA. so you have a range to choose from!

[izzyart]

Yes, i had some hair loss but not noticeable by others...it was always straight, now curly (which i like)...still on 7.5 mg methotrexate each week, i think it helps me reduce pred...went from 10 mg pred 2 years ago to 3 1/2 today, it also helps erase my arthritis.

[Abbey17 in reply to izzyart]

Great to hear also that you’ve gone down to 3.5 mg Well done.

[Gail10US]

I hesitate to jump in here because I have only been on prednisone, and not MTX. That said, I had a bad flare of PMR that went on for 3 months and caused actual bald spots called alopecia. The dermatologist gave me steroid injections at the bald spots and Rogaine. The Rogaine regrew my hair overall. The doctor had me use the Rogaine For Men formula even though I am a woman. It really helped.

[Poshcards]

hi, you need folic acid 6 days a week not on day of metho trexate, it certainly helps xx