Is Methotrexate Safe? 5 Evidence-Based Truths You Need

Introduction to Methotrexate Side Effects 0:00

If you are on methotrexate or about to start metotrexxate, you deserve the truth about the side effects. Not the sugar-coated version, not the horror stories from the internet, the actual, evidence-based truth. I'm a rheumatologist. And today, I am sharing you 5 truths about methoxy side-effects. Every patient needs to hear about those important side effect. Some of these will reassure you, some might surprise you but all of them will help you take the medication safely and confidently. If you are new to our channel, welcome to The Room Doc.

This channel has one mission, to help live better with rheumatoid arthritis with less pain, more mobility and long lasting joy in your life. There's a lot of misinformation out there about rheumatoid arthritis and the medications. If you go to social media, if you got to YouTube, you will see a lotta misinformation. This channel exists to fight that misinformation with real science explained and simple language explanation so that you can take the best decision for your health. Every video that we create gives you practical, evidence-based tips you can use today.

So if that sounds like something you need it, hit that subscribe button and join the community. Before I go further, a quick question. Are you currently on methotrexate? Drop a yes in the comments and tell me your experience. Now let's go to those five important truths about metotrexxate.

Five Key Truths About Methotrexate 1:35

Before we dive in, let me give you the roadmap and I'll summarize those five important truths that we'll be covering today. The truth number one, most side effects are mild and fixable. I'm going to show you actual data. and it is far more reassuring than what you have read online. The truth number two, the methotrexid hangover is real, but it's temporary. And there are some simple ways to plan around it. Number three, your liver test monitoring is for prevention, not to panic you. I will explain why the fear around liver damage has been dramatically overestimated.

Truth number four, infection risk is small actually smaller than prednisone and most other biologics that one catches a lot of people off guard truth number five this is the one nobody talks about methotrexid may actually save your life We are talking a 41% reduction in mortality. That is not a small number.

Most Side Effects Are Mild and Fixable 2:44

So let's get to number one. Most side effects are mild and fixable. Yes, side-effects happen. but the vast majority are mild and manageable. When I look at these particular side effects, I did some deep digging into the literature and there was a study which looked at 20,000 RA patients and they found that up to 24% experienced nausea. That means 76% of you who are taking methotrexate, you will not have nauseas. While 20% report abdominal pain, 80% had some stomach pain but ultimately only 8.5% have to stop the medication.

Now here is a key fact side effects are fixable if you do experience nausea or stomach upset there is proven strategy before giving up on methotrexate that is taking your folic acid. Now, let's go to the truth number two. The methotrexid hangover is real, but it is temporary. Let's talk about something your doctor, your rheumatologist may not have warned you about, the methtrexit hang over. Many patients describe feeling tired, foggy, or slightly off to one to two days after taking methoxy at your weekly dose.

When you read about the packets insert, it will list fatigue, malaise, and dizziness as commonly reported side effects. Some patients also report difficulty concentrating and mood changes. I'm not going to tell you that this does not happen. It does. And to some of our patients, it could be harder to tolerate. But here is what you need to know. The pattern is predictable. Day one is when you take your methotrexate. day two to day three is, when your feel that fatigue, the fogginess and the mild nausea.

but by the day four through day seven, you feel normal again.

The Methotrexate Hangover and How to Manage It 4:38

And I have a practical tool that you can use. You can plan around it. And here is my strategy. Take methotrexate on a day when you rest the next day. Either Friday evening is a popular one for many of my patients. So that, you have time to recover over the weekend. Stay well hydrated when taking methoxacate. Increase your folic acid. Ask your doctor about how much methotsate you are taking and how folate acid you need to take. If fatigue is severe, switching to subcutaneous injection might sometimes help you.

But remember, the hangover usually improves over time as your body adjusts to the new dose of methotrexate. Here's something important to consider. RA itself causes crossing fatigue. Many patients find that once methotrexate control the disease, their overall energy actually improves, even with mild hangover days with metho trexite. Trading one tired day for six good days is a good trade most patients are willing to make. That's why listen to your body and also communicate to you doctors if in case it becomes more severe that you are not able to manage.

The truth number three is your liver needs monitoring, not a panic attack. This is the truth that requires nuance. Methotrexate can affect your livers, that is real, but the risk has been dramatically overestimated. What actually happens is about 15% of the patient experience mild temporary liver enzyme elevation. This usually resolves in its own or with the dose adjustment of your methotrexate or the folic acid. Only around 4% percent of patients need to stop metotrexxate permanently due to liver issues.

And the most dreaded complication, the significant fibrosis or cirrhosis is very rare when we close the monitor. If you have a healthy liver and no major risk factors, methotrexate is very unlikely to cause significant liver damage. Your absence steps are simple.

Liver Monitoring Without Panic 6:49

Never skip your blood test, limit alcohol use, maintain a health weight, and tell your doctor if you've got diabetes or history of liver problems, even before you go on metho. Now the truth number four, infection risk is small, smaller than what you think. This is the true that got amplified during COVID-19 infection. But let me give you the honest picture. When we look at the bigger studies, I found a big study looking at 12 clinical trial, looking the risk of methotrexate. And that study found that there is a 25% increased risk overall infection in rheumatoid arthritis.

most common things like cold, bronchitis or upper respiratory tract infection, but there was no increased risk of serious infection. That's why methotrexate is actually one of the safest options from an infection standpoint. However, Rear serious infection can happen. Your protection plan is to get vaccinated, wash your hand regularly, and call your doctor if you develop any fever. And never stop your methotrexate on your own without talking with your doctors first. They will help you guide when to stop and when not to.

Now the truth number 5. Methotrexate may actually save your life. This is one of the truth that you may not have heard in the internet. While everyone focuses on the risk, they miss the biggest truth of all, methotrexit reduces your risk of dying. Now, you might ask how methoxy could increase your longevity. It primarily through cardiovascular protection. rheumatoid arthritis patients have a significantly higher risk of having heart attacks and stroke because of that chronic inflammation that damages your

Infection Risk and Safety Precautions 8:34

blood vessels. Multiple studies have shown that methotrexate reduce those cardiovascular risk by almost 18 to 28 percent. This is the truth that should be in every online discussion about metho trexac, but instead the internet is full of fear about the side effects while ignoring the fact that this medication may literally save your life if you have rheumatoid arthritis. Now let me also weigh the benefit and the risk. When you weigh risk against the benefits, the picture is very clear. The risks of methotrexate are manageable, mild nausea, monitoring the liver enzyme elevation and slight increased risk of infection.

But the benefits are life-changing, control joint inflammation, preventing long-term joint damage and a 41% reduction in overall mortality and 24% overall decrease in heart attack risk and strokes. Now, we need to be honest, no medication is free of side effects, but untreated rheumatoid arthritis is far more dangerous than methotrexate itself uncontrolled inflammation destroys your joint damage your heart and shorten your lifespan now let me summarize what we talked today your five truth action checklists truth number one side effects are mild and fixable.

By taking your folic acid daily and try the proven fix it that we have discussed, we can minimize those side-effects.

Methotrexate Benefits and Mortality Reduction 10:03

Number two, the hangover of methotrexid is real but manageable. Plan your doses on a rest day and stay hydrated. Truth number three, your liver need to be monitored closely but not the panic. Keep your blood test appointment and maintain a healthy weight. That could minimize this side effect. Number four, infection risk is small but real. Stay current on your vaccines and call your doctor if you have any concern of infection. And number five, methotrexid may save your life. Don't stop it without talking to your rheumatologist.

Here is what I want you to remember. The truth about methtrexit isn't scary. It is empowering. Yes, Side effects exist, but they are mostly mild, mostly fixable and mostly manageable with the right strategies. And the benefit? Protecting your joint, your heart and your life. You now know more about methotrexate side effects than most patients ever will. Use that knowledge. Take your folic acid, keep your blood test appointment and don't let fear rob you from a medication that could transform your life despite rheumatoid arthritis.

And remember, what we stand here at The Room Doc is less pain, more mobility, and long lasting joy in your live despite your diagnosis of rheuma to arthritis that is not just a slogan, that's a promise. Let me leave you with this question. What truth surprised you the most today? Drop in the comment below and share this video with someone who need to hear the real story about methotrexate. And I'll see you in next video. Bye bye.