I’ve been on MTX for 2.5 years without any noticeable side effects. This week I’ve been nauseous every morning to the point of vomiting a few times. Not nice as I’ve started a new job with morning hours.
Can you start getting side effects after years on this medication?? I continue to take 5mg folic acid everyday but injection day. I tried increasing my pred for a few days in case it was adrenal symptoms…no change. I also have diverticulitis and have noted a few chills and the odd headache but no other symptoms except a bit of bloating/gas. Diet hasn’t changed, no constipation.
Don’t think it’s the stomach flu because only nauseous in the morning. And of course, no way I’m pregnant. I have been napping the odd afternoon when I get home as I adjust to work (which is somewhat stressful as I learn the position).
Any suggestions for relief?? Should I skip a week of MTX to see if there is any difference?
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PMRCanada
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I would say that the Stress of changing to mornings and learning a new job is the main contributing factor.It could mean that stopping the MTX wouldn't make any difference or could make you feel worse.
Did you feel an improvement by increasing the Pred dose by a small amount?
Stressful events can require a temporary increase in steroids dose in the same way as sick days can.
Your adrenal response will still be suppressed and this affects your " fight or flight" response from your autonomic nervous system to new stress stimuli. Causing more nausea and even vomiting in those people who also suffer from IBS and Digestive Health issues. This could be what has happened to you.
You probably just require a little extra cushion from the steroids as well as more short rests during working hours and mindfulness and breathing techniques until you adjust to your new role over the next week.
If it continues, or gets worse, you might need to reconsider whether the change in working hours or time that you work is going to be right for you long term whilst you are still tapering steroids.
You should probably discuss the situation with your doctor or specialist if you feel you require a Pred increase after 7-10 days and things aren't improving in your case before making any big decisions about stopping MTX or deciding to increase Prednisolone any higher or longer because your combined health issues mean your needs are more complex and would require professional advice.
Also consider whether the work change has meant you have made a slight change in the times you take any of your daily medications , or in the time and food choices you are making. This could have also caused a temporary disruption in your digestive symptoms while your body adjusts to the new chemical regime.
You may also find you will require a lighter diet and smaller portions more regularly through the day , as well as more hydration to help keep your stomach settled , to reduce inflammation in general and to help reduce the stress responses during activity.
Hope things settle down for you soon, take care , Bee
Yep, on 5mg for a few months now but felt I was right on the edge of controlling inflammation. I tried 6.5 today and things are better. May taper back down to 5.5mg over the next few days and stay there. Also MTX 15mg weekly.
Think it’s diverticulitis. More chills today, combined with the stress of starting a new job and the accompanying learning curve and earlier morning hours (although only 9am-noon daily, so lots of time for rest while at home).
My next appt with rheumy isn’t till mid Dec so I’ll talk to her then. Honestly don’t think I can taper lower than 5mg at this stage (tried to start a .5mg taper to 4.5 and had to abandon it at week 3 due to returning pain in neck, shoulders, and buttocks).
And 5mg is likely to be at the border of adrenal function coping too. I'd really dial back on tapering and any more activity - and even stay at the slightly higher dose a bit longer until you are settled at work.
Yes, sounds like a plan. My trying 6.5 was just in the form of a pred burst so I’ll likely do 6.5, 6, 6, 6, 5.5 and stay on 5.5 for awhile. For the 3+ months I was on 5 I felt niggles and it seemed it was barely doing the job.
Sounds more like a bug to me. Treat yourself to rest, lots of fluids, and wear a mask when you are in public just in case you have something contagious and want to protect others.
I often feel nauseous and have episodes of vomiting. I put it down to Diverticular Disease. Stress can trigger an episode of weeks in duration. A new job is stressful as is a change in routine.
yes in my case, I was on 25mg for many years and then it really made me ill with vomiting and diarrhea, so my rheumy and me decided to take me off it x
Your immune system might be fighting off a common bug. Give it 1 to 2 weeks and see if things return to equilibrium. Changing meds might just confuse matters. Rest.
Yes, trying one thing at a time and giving it time before making the next change. Trying a short pred burst first and noted much improvement at 6.5 (up from 5), now on second day of 6mg (everything still ok). As I replied to PMRPro, I’ll drop down to 5.5 in another day and observe for symptoms. So part of my issue was definitely that 5mg was too low while dealing with the stresses associated with a new job 3 weeks ago as adrenals are trying to start working again. .5mg can make all the difference.
Still have minor bloating and chills (diverticulitis symptoms) but nothing like the nausea, vomiting and fatigue I experienced last week.
Kept up with MTX at same dose, so no changes there. It’s just that my symptoms could be chalked up to adrenals not keeping up at lower dose pred, or diverticulitis or common MTX side effects.
I was forced to rest last week when I came home after work. No fatigue at all last 3 days at higher dose.
Missed you at the meeting last Friday. Hope this settles soon as you were doing so well. As you know I'm a GCA person so no advice and got bad news Friday so back to 60 Pred & Actemra. All the best Lil
Sosorry to hear your news….frustrating I’m sure! My work schedule conflicts with our Friday meetings unfortunately, but I’ll try and join again when I can.
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