Methotrexate and Hypothyroidism

[sklitch]

Hi all. I have Psoriatic Arthritis along with Hashi/Hypothyroidism. My Rheumatologist has just put me on Methotrexate (with Folic Acid on non-Meth days).

Anyone else on the same? What should I expect.

Any supplements I need to be wary of? I'm taking D3 (3000iu), B complex, Magnesium Glycinate, Selenium, Zinc, Ashwagandha, L-Threonine, CBD Oil. I've already stopped caffeine 6 months ago. And I know alcohol should be kept to a minimum.

Also, would the methothrexate have any effect on the Hashis antibodies given that it is intended to reduce inflammation?

I'm currently on 125mcg Levo and seeing an Endo for the first time next week (TSH is bottom of range, T4 & T3 middling but not optimal, still very symptomatic - vertigo, hair loss etc).

Any input from anyone in a similar situation would be great.

TIA

[Sue-b]

I’m sorry I don’t have any advice but interested in answers as I have hashimotos and have recently been diagnosed with spondyloarthritis as well. Hoping that someone comes along with help!

[Marz]

I am sure you have read about healing the gut to help with auto-immune conditions - not sure your Endo will be on board with gut healing. I see from your earlier posts that you had low vitamins and minerals. Have you been re-tested for VitD especially ? Low nutrients can often point to gut issues and mal-absorption ... Low VitD is implicated in auto-immune conditions - in fact loads of conditions.

Am afraid I am not sure about the anti-bodies being affected by Methotrexate. I have Crohns - Hashimotos - and a B12 issue due to surgery.

Surely there is Folic Acid in your B Copmplex ?

Also read on your previous post that reducing your T4 would not be good

[jgelliss in reply to Marz]

Marz you are so very right how *Important* it is to heal the guts to make our thyroid meds and nutrients work so much better for us . Most problems come from the *Guts* our second brain .

[sklitch in reply to Marz]

Hi Marz

Thanks for your comment. I know I need to be healing my gut. I take pro-biotic and am dairy free (well, lactose but minimal lactose free dairy). Just reluctant to take the final step of Gluten-free.

I asked the Dr to re-check my Vit D and she said she will test it in 12 months! How do I know if I am supplementing enough? No idea.

There isn't enough Folic Acid in a B Complex. I have been prescribed 5mg a day. My B only has 400mcg. It helps with the nausea and hair loss (!) apparently.

Oh, and my GP reduced my Levo from 125 to 112.5 based on the previous TSH (0.22, range 0.27 - 4.2) and I relapsed so badly. I told her I didn't need a blood test to tell me that was a mistake. Back up to 125 currently.

[Marz in reply to sklitch]

City Assays Birmingham - website of the same name - send out postal kits for D Testing. Also several companies on the Thyroid UK website - see link below ...

thyroiduk.org

Glad you were able to return to the dose that makes you feel well. What a shame your Doc wrongly follows the TSH result ... sounds as if you are doing lots of good things. 😊

[kaylala68]

Hi sklitch,

I am in a very similar situation. I have psoriatic arthritis and hashimoto's to, I am on methotrexate injections and folic acid to help with sickness caused by injections. I am also on etanercept injections weekly for psoriatic arthritis and aim is to reduce inflammation.

I feel awful most of the time. I am currently taking 100mg of Eltroxin as gp pharmacy was struggling to get my Mercury pharma levo.

I to would be grateful for any help or information anyone has to give.

Thank you in advance.

Kayla

[Marymary7]

A family member was on Humera injections and Methotrexate for rheumatoid arthritis and given massive doses of folic acid tablets or her hair fell out and obviously for other reasons. I worried about these strong drugs. She stopped all because of pregnancy and now only on Humera. I read about needing such massive doses of folic acid was something to do with various pathways being blocked. I wonder if a less manufactured folate would be better as a Methylfolate if you asked the specialist.

Sorry that's not much help.

[tangolil]

My sympathies. I have Hashi and was recently diagnosed with Rheumatoid Arthritis and prescribed Methotrexate (six tablets taken standing up(!) on one day followed by 5mg Folic acid the following day. On the third day I experienced severe rigor and was admitted to hospital - treated with steroids and anti-biotics. Rigor ceased but I was left utterly depleted. Please be aware that Methotrexate can cause these nasty side-effects. I refused further treatment with this drug and take

Sulfasalazine (Igr. twice daily) which I can tolerate. I take folic acid daily anyway. Hair loss and weight gain from mixture of drugs, lethargy and loss of appetite.... Hope you improve.

[Polly91 in reply to tangolil]

Sorry to hear this Tangolil.

I too think I have developed RA. Can you tell me how yours started? I’ve had swollen fingers for 3 months - one side is worse than the other but they are getting sore. I don’t want to take methotrexate either but don’t want it getting worse.

Thank you

P

[tangolil in reply to Polly91]

Mine started with a very swollen knee which I thought was septic arthritis but, when the joint was aspirated in hospital, no bacteria was found but my rheumatoid factor was extremely high. I take Prednisolone (decreasing dose now) and Sulfasalazine (which has been around for ages and less 'dangerous' than Methotrexate in my opinion). Do, please, get your swollen fingers looked at by a Rheumatologist - RA usually affects both sides of the body at once so it is a fairly good indication if both hands are swollen that you need a diagnosis. Do not leave RA untreated because it affects all the organs in the body.

[Polly91 in reply to tangolil]

Thanks v much. It does sound like RA. Was one side much worse than the other? Can you think of what might have triggered it?

How long before you started treatment. I've had the symptoms for over 3 months now.

Thanks again

P

[tangolil in reply to Polly91]

I had my first symptoms in November last year. Yes, one side was worse than the other. It was suggested that I had an infection - certainly a urine infection showed up when I was first hospitalised. Treatment and cure of the urine infection did nothing to alleviate my symptoms though and, after another two admittances to hospital it was decided that my disorder was, in fact, RA. I had no temperature raise due to the infection but I did feel unwell and not 'myself'.

RA is quite difficult to diagnose and blood tests only give a possible clue. Other factors need to be considered and I urge you to seek advice asap. My dose of thuyroxine has been increased from 75mcg to 100mcg since diagnosis. I hope you get some help. Best wishes.

[Polly91 in reply to tangolil]

Thank you v much. I am seeing my GP next week. I should have gone sooner.

Which blood tests did you have rheumatoid factor?

Thanks

[tangolil in reply to Polly91]

Here is the list: Anti-nuclear antibody (hep.2) CCP antibody.

Erythrocyte sedimentation Rate. Full blood count.

C-reactive protein serum. Liver function. Urea and Electrolytes WITH potassium.

But these tests are done to monitor my RA while on Sulfasalazine and you may need others to determine and diagnose. Sadly I do not have a record of these because they were done during my stay(s) in hospital.

Best wishes.

[Polly91 in reply to tangolil]

Thank you. Did you start any hormone therapy around the time you got symptomatic or diagnosed by any chance?

[tangolil in reply to Polly91]

I have a weekly Vagifem insertion (very low dose) which, I am advised by my GP, does not enter the blood stream.

Hope this helps.

[sklitch in reply to tangolil]

Wow, that sound terrible. I will keep a close eye on myself when I take my first dose on Sunday. I tried Suplhsalazine a few years ago and it did nothing except turn my pee orange.

[Astridnova]

Do you think there is a relationship between your Psoriatic Arthritis and your thyroid problem? Given that you say your ratios are not optimum, have you tried natural dessicated pork thyroid? Methyltrexate can bring on a heap of problems. pdr.net/drug-summary/Rheuma... Not saying you should not take it, but think it through. This site gives info about diseases associated with thyroid disease and psoriatic arthritis is one of them. You probably know this... mythyroid.com/diseaseassoci...

[sklitch in reply to Astridnova]

All auto-immune disorders are connected. if you have one, you will likely develop more (though I didn't realise the relationship between PA and Thyroid was so close). I had the arthritis first when I was a teenager, my thyroid only started giving up 5 years ago.

NDT isn't an option at the moment. I will see what the Endo says next week but I know how difficult is to even get T3, let alone NDT in the UK. I'm fairly certain all I need is a small increase of my Levo and my GP not to freak out over a suppressed TSH.

[JumpJiving]

sklitch - are you taking methotrexate in tablet form or injecting it? If injecting, severe nausea can be a problem. In tablet form, mouth ulcers. Vitamin C can help, as does the folic acid. Be strict about sensible diet (lots of fruit & veg, no alcohol, no caffeine, limited sugar, minimal processed foods). I cannot comment on interactions with thyroid problems - I have the thyroid problem in this household, my wife takes the methotrexate for RA.

[sklitch in reply to JumpJiving]

I've been prescribed tablets at the moment. Dr said to start there and change to injections if the tablets don't suit. I'm trying with my diet but it's not easy. I guess I should start supplementing Vit C along with the Folic acid (and everything else).

[sklitch]

Thanks all for your comments. We will see what happens with my first methotrexate dose on Sunday.