Tired of Methotrexate Nausea? Do This Instead

Introduction to Methotrexate Side Effects 0:00

If you have rheumatoid arthritis and you've visited your rheumeatologist, they handed you a pill of methotrexate. And you went to the internet and was worried about all those side effects that is listed. Today in the video, I'll tell you 7 proven strategies that will help you manage and prevent those methodrexit side-effects. Please stick around. Hello Rheumatoid Arthritis Warrior, this is Dr. Anta Subedi, your rheumatid arthritis coach at The Room Doc, as well as a practicing rheumeatologist helping a lot of patients with rheuma arthritis.

In the video today, I'll give you some proven strategy that I use every day in my clinic to help my patients. Before I go further, don't forget to like and subscribe to our videos so that you can get this content in the future. Also, accept our gifts, the holistic RA guidebook, as well as a smoothie recipe that you can use to prepare anti-inflammatory smoothie in the mornings.

Why Methotrexate Causes Side Effects 0:54

Let me start with a story of one of my patients, let's name her Rosa. She came to me with the diagnosis of rheumatoid arthritis for the last few years, and she was on methotrexate. But she is suffering from the side effect every single week. And she called this miserable Friday. where she typically take methotrexate and she had this methtrexit hangover with fatigue and was not able to enjoy her weekend. I met with her and we created some strategy on how we can minimize those side effects and eventually she was able handle those.

She was also able minimize and manage those very well using these strategies. And I meet her after a couple of months and came happier than before. She was able to manage the side effect of methotrexate as well as also control rheumatoid arthritis, keeping it in remission. And one of the first questions that you will have is why do we get side effects from metho trexite? Now, let me use an example of this copying machine. On your right side, you can see a normal cell replicating like a machine making copies of paper.

on the right hand, You can't see the machine that is under the effect the metotrexxate. So what the methotrexate does, it prevents copying of the cells. In your body, the immune cells are rapidly copying if you have rheumatoid arthritis. And those rapidly dividing cells, are immune, cells and they cause inflammation. So metotrexit quiet down or slows down the multiplication of those immune. Cells and it helps decrease inflammation, but Normally, our body is dividing constantly.

Common Methotrexate Side Effects 2:34

There are a lot of cells in our gut, in your mouth, and in the hair they are constantly replicating. That is normal development of those tissues. In those tissue too, the methotrexate also blocks the use of folic acid. Thats why you get those side effects. The diarrhea, mouth sores, hair loss. Due to the slowing down of the replication of normal cells into those organs. But the good news is we can minimize and manage these side effects with some strategies. And here is a quick recap of the most common side-effects and I've highlighted five of them that includes nausea, the stomach upset, fatigue, hair thinning, mouth ulcers and elevated liver markers.

All of these five major side effect are all manageable and even sometimes preventable with the right strategies And this is a very interesting side effects

Strategy 1: Folic Acid Supplementation 3:24

you may not have heard and it's called Anticipatory Nausea. If you have taken Methotrexate, you can remember the nausea that Methatrixate cause. And sometimes, even without taking the Methetrextate just having a thought of taking Methutreixate can bring that nauseam and that is what we call Anticipertory Nausia. Many of our patients, they do have that side effect. up to 10 percent, they can get this anticipatory nausea from methotrexid even without taking the medication. Now we reviewed the common side effects.

Let's work on understanding how we can minimize and manage those side-effects. So the strategy number one is our friend, the folic acid.

Strategy 2: Take Methotrexate at Bedtime 4:07

So folate acid is the best defense against all of those side effects that I have listed earlier. And studies have shown that if you are taking methotrexate with folac acid regularly, we can significantly reduce your nausea, your liver issues, as well as it also improve the retention of taking Methotraxite. So typically you use from one to five milligrams of folic acid based on your need and based your side effects. So check with your rheumatologist. The strategy number two to help you manage methotrexid is to take methetrexit at bedtime.

Strategy 3: Split the Weekly Dose 4:39

So as we discussed earlier, methotrexate can cause nausea and the fatigue. So why should we get those side effects if we can manage those sides during your sleep? So if you take metotrexit in the evening time, that can minimize some of your symptoms of fatigue and nauseas. You can also take it with crackers and water that also minimizes some discomfort you can get in your tummy due to methoxy. So the strategy number three is splitting your dose. What does it mean by splitting? So you can divide your methotrexate into two doses and take it every week.

For example, if you are taking metotrexit every Friday, take half of them your Friday morning and a half them in the Friday evening. And if split those doses, it will minimize your side effects and there's a bonus tip.

Strategy 5: Switch to Injection Form 5:29

The tip is it can also increase the effectiveness of metho trexite. You can see in this picture, so if we split your doses your stomach will be happier than taking all of them together. So the strategy number five is ask your rheumatologist if you can switch your oral methotrexate to injection form. The injection for methotrexit might give you less nausea and you might have less side effects. In clinical studies, up to 83% of the patients have reported less site effects if they have taken a method by injections.

and the injection methotrexate could come in different forms, including auto-injector or even injections. Check with your rheumatologist and your pharmacist on how to use those injections, and here are a few other strategies. One is aggressive hydration. At least drink enough water and pay particular attention on the day when you are taking methtrexxate. So dehydration can make you more fatigue and it can increase nausea. Adequate hydration on that day you take methetrexit, minimize that side effect.

Hydration, Ginger, and Doctor Communication 6:29

and also another pro tip. You can also use ginger to minimize the nausea that can come with methotrexate and you can prepare either ginger tea or you also can use the ginger itself. That can help you minimize that nauseam. Strategy number seven is having an open communication with your rheumatologist. Communicate effectively on how you are feeling, are you able to tolerate or not if we need to make any dose adjustment or splitting the dose or even taking injection form of methotrexate. So have those discussions with your rheumatologist.

Now, even with those all the strategy, if you are not able to tolerate the metotrexit, let your doctor know so that we can move on to the next level of medications. So a clear communication with your rheumatologist helps prevent, manage your side effects as well as find some other better options that may not give you all of these side-effects. And here is my checklist. This is a checklist that will help you minimize and manage you methotrexate side effect. That includes taking folic acid, taking methotrexate at bedtime and splitting the dose, moving to injection form of metho trexite, hydration, using ginger either tea or the capsule to minimize nausea and open communication with your doctor so that you can effectively communicate how you feel and what are the options you have if you are having those side effects.

Thank you all of you rheumatoid oxide warrior for watching the video. If you like the videos, please like and subscribe and let us know in the comments how you are handling and managing your methotrexate side effects. I'll see you in next video, bye bye.