medscape.com/s/viewarticle/...
A study in RA patients who had had to discontinue MTX because of gastric intolerance found that it was associated with an increased incidence of Helicobacter pylori, the underlying cause of stomach inflammation and peptic ulcers. It is recommended you request screening for H,pylori and treatment if it is identified.
No I had no problem been on it weekly now for about 6+ months.
I had no such side effects but I was also taking folic acid and omeprazole to prevent stomach problems.
Does this relate to oral medication? I have requested injecting Methotrexate because of dodgy stomach and history of naproxen induced stomach ulcers but haven’t started yet 🤞
I was injecting but was stopped after about five months because of high liver enzyme blood results. However, these could also have been caused by tocilizumab which I was also injecting.
Hello… I was on methotrexate for a couple of years, it was stopped when I started TCZ, nearly a year ago… I can’t say I noticed any gastric/stomach problems at all…. if that’s anecdotally helpful.
Thanks for posting the medscape article. I'll use it as a guide now in case of future problems and show it to my doc. I've only had 2 minor bouts of diverticulitis in the 12 months since taking oral MTX but the diverticulitis was already an underlying issue prior to taking MTX .
Same here except I take injectable MTX each week.
I inject MTX (20mg). Sometimes I have a couple of days of fluctuating nausea afterwards, sometimes I don't. It's there and a bit annoying but does not interfere too much with my functioning. It also does seem to decrease when I take folic acid on more days during the week, but this could be placebo. I always get an 'loose stomach' the day after my injection, but again, I've just got used to it
I've been taking oral methotrexate for about 18 months & have had no gastric side effects. The only one I've had is my hair falling out a bit quicker, but since folicacid was increased to 6 days a week, that has slowed.
It just made me feel 'ill' & my hair started falling out so stopped after 2 wks. I'm about to try which is a another steroid sparing drug, Mycophenolate so we will see where that goes.
I am still on 3 mg of Prednisolone. I was referred to a rheumatologist, who thought I should come off it (because of diabetes and bone density) and go onto methotrexate. He wanted me to have a syncathen test which came back normal but borderline.
I have normal bone density and blood glucose and I have been diagnosed with H pylorus, which has not responded to 2 courses of antibiotics. I’m still waiting to see a consultant, who apparently is The only person who can prescribe for antibiotic resistant H. pyloris.
To be honest, the Rheumatologist at Kingston hospital was rude and abrupt and not interested in what I had to say. I’m grateful for your post, as it means that methotrexate would definitely be a bad idea.
I’m going to ask to be referred to St. George’s for a second opinion.
If it is already a problem the last thing you need is MTX isn't it! But any doctor who wants a patient on 3mg pred to switch to MTX is nuts - it isn't guaranteed to work and now you know - might make you a lot worse!!!!
Worrying about what didn't happen at high doses now you are at 3mg seems a bit late!!
Thank you for your response.
I agree completely, and even more so now that I’ve heard about the adverse effects of methotrexate. Do you know if I would be entitled to ask for another Rheumatologist on the NHS I certainly have absolutely zero faith in this one. I’ve
In parenthesis, I would be interested in finding the report to show it to my GP
The title is the paper with all the authors listed and the journal reference is right at the end.
Feeling rather confused.
My GP wanted me to see a rheumatologist as I’ve been on Pred for seven years; Recently have been on 3 mg for the last few years as the last Rheumatologist told me to stay on it. Rheumatologist at Kingston Hospital wanted to take me off 3 mg and put me on Methotrexate which I felt uncomfortable about.
Syncathen test came back normal although borderline.
I’ve asked for a referral to St. Georges Hospital, but will have to wait a long time to see a rheumatologist. My GP is concerned, because my DEXA scan showed slight, deterioration in my spine, although I’m happy to report, I’m still in the normal range for bone density (aged 75).
I think your doctors both need a reality check!
If you are on 3mg then adding MTX is adding potential side effects for no guaranteed benefit. Have you ever tried to get any lower using a REALLY slow taper? Sometimes, if you take a couple of months for 1/2mg you can get lower. Professor Dasgupta told us a few years ago that he leaves some patients on 2-3mg long term as it aboids relapses.
Although some damage can still be done at low levels, if you are still in normal range for bone density after 7 years of pred, it is unlikely to get worse now. What were your t-scores?
Is a single private appointment an option? I'm pretty sure that a session with Rod Hughes in Chertsey would result in a letter to your GP saying that remaining at 3mg would be perfectly acceptable and MTX is not required.
Because I already had stomach problems my rheumatologist put me on injectable methotrexate.
~Sadly I join this queue - horrendous side effects & only after 1 week.
Onwards & upwards to the next DMARD with fingers & toes doubly crossed ~
My stomach problems began when I began Prednisolone. They didn't get worse when I started taking Methotrexate. I now only take 20mg Omeprazole rather than 40mg per day (when I had higher doses of pred. )
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