Your Hair Doesn’t Have to Fall Out on Methotrexate

Introduction: Methotrexate and Hair Loss 0:00

You are in your sour and you look down. There are more hair in the drain than usual. You're on methotrexate for your rheumatoid arthritis and now you are terrified. Is methtrexit making your hair fall out? Are you going to be bald? So do you stop taking your metho trexite? Please take a deep breath. Here is the truth. Methotrexate can cause hair thinning but it happens fewer than one in every 20 patients. It's almost always mild and most importantly it is fixable. Today in this video I'm going to explain you exactly why it happened and I'll give you five most important practical steps to stop the hair-thinning due to methotrexit.

Before we start, have you noticed any hair changes since starting Methotrexate? Please drop a yes or no in the comments below. I did every single one and your experience might help someone else watching this video and who is terrified. Before I go further, don't forget to like and subscribe to our videos and also accept our gift, the free copy of the book as well as the recipe for the smoothie. And let me also start with a story of one of the patients. Let's give her the name Claudia. She is 50 years old, a hair stylist.

I know, she's a hairstylist and was diagnosed with rheumatoid arthritis two years back.

Patient Story: Claudiau2019s Hair Thinning 1:24

Methotrexate was working beautifully for her joints. Her swelling was gone, her pain was done, and she was able to function. But about three months into the methotrexxate, She started noticing more hair in her breasts. For someone whose entire career is about here, this was devastating for her. She came to my office in tears, she said. I would rather have the joint pain than the loss of here. Now I understand her fear, but I also knew something she did not understand. that the hair loss due to methotrexate is fixable.

And we made some few changes. Within three months, her hair lost was back to normal. She got her back. But she's still a metho-trex-ate without any major hair-loss. Now you might wonder, what did we do? I will tell you exactly. First, let's understand what is happening in your body when you take methotre-xates and why it causes hair losses. When you are in methotrexate and you're having hair loss, you go to the internet and start searching. And there's a lot of myths out there about methtrexit and hair-loss.

Let me bust the biggest myth right now. When people hear methetrexxate, and they think of chemotherapy in the same sentence, they picture complete baldness, like what happens during cancer treatment. But this is not what happens with methotrexate in rheumatoid arthritis. According to available literature, one in five patients present with hair loss on metho trexite.

Why Methotrexate Can Cause Hair Thinning 2:57

And when it does happen, it is diffuse, mild thinning and not complete baldness. You might ask, Why does that 1 to 5% of the patient experience hair thinning? It comes down to how the medication works, how methotrexed works. Methotrexit is a folate antagonist. It works by slowing down rapidly dividing cells to reduce inflammation. If you go back to here, Your hair follicles also happen to contain some of these fast-growing, fast dividing cells in your body. When methotrexate temporarily depletes your cellular folate, it can disrupt the growth of the hair folicle, and that we call anagen phase.

It affects that phase of hair growth. And this is the active growth phase for your hair cycle. The hair-folicles essentially decide to take a break. sifting prematurely into the next resting phase, which leads to setting a few months after taking methotrexate. And you can think of this as a mechanical interruption, not a permanent damage to your hair follicles. Because we know exactly why it happens, we now exactly how to fix this problem. Let me walk you through the 5 strategies to protect your hair while you are taking methotrexate.

Strategy number 1 is the most powerful tool we have and that is taking your folic acid. As we discussed earlier, methotrexate depletes the folic acid or folate to control inflammation. We have to strategically replace it to protect your healthy cells, such as the hair. Folic acid is a shield for your hair follicles. If you are experiencing thinning the very first step is to look at your folic acid prescription. The standard dose is often one milligram daily but for some patients who are Experiencing side effects like your hair loss.

Strategy 1: Optimize Folic Acid 4:54

We frequently do increase this to higher dose up to five milligram. Some of your rheumatoid arthritis might need 2 mg daily or you might go up to 5 mg to protect your hair. Folic acid replacement is the medication that helps protect hair loss and it is one of the single effective interventions we have to help protect those hair due to methotrexate. The strategy number two is optimizing the dose of methotrexate. More medication does not always mean equally better results. In rheumatology, our goal is always the lowest effective dose that keeps your inflammation under control.

If you are on 25 mg of methotrexate and you're experiencing hair loss, your rheumatologist might find that dropping the dose up to 20 mg or even 15 mg might maintain your joint into remission. It might control your arthritis. but it can minimize the hair loss. It's always a delicate balance but some small adjustment can make a huge difference on the side effects. So next time when you go see your rheumatologist if you are struggling with the here loss but your joints are doing well ask them can we decrease the dose of methotrexate so that you don't have this side effect.

The strategy number three is one of my favorite and it can help minimize your side effects. And that is to switch your methotrexate from pill to the injection.

Strategy 2: Adjust the Methotrexate Dose 6:27

When you swallow the pill, it has to be processed through your digestive tract and your liver also metabolize the metotrexxate and then it goes to bloodstream. this systemic processing is often what trigger many of the side effects including the hair thinning and the nausea. By switching to a small once daily subcutaneous injection the medication bypass the gut entirely. It is absorbed more efficiently meaning you can often use lower dose and it can frequently reduce your risk of side effect with the air thining.

That's why the other the third strategy is to ask a rheumatologist can we switch from pill to the injection so that the even the lower dose of methotrexate might be able to help control the inflammation due to rheubertor arthritis and not cause the hair thinning so ask your rheumeatologists now the fourth

Strategy 3: Switch from Pills to Injection 7:27

one that is one of my favorite because i'm so passionate about this and this is following our NASCAR framework and the N is what I'm talking about the nutrition. Medications control the inflammation but your daily habits build your resilience. If your hair follicles are under stress from the medication you must provide them with the absolute best building blocks to recover. This means an anti-inflammatory diet rich in protein, iron, zinc and omega-3 fatty acids. When biotin supplements are popular, true hair recovery comes from a whole food approach that supports your cellular health from the inside out.

Feed your body what needs it the most. That is the building block with a lot of protein. And that will also help support your hair. So don't forget the end of our NASCAR framework, the nutrition. Now, strategy number five is knowing when to pivot. If we have optimized your folic acid, adjusted your dose, tried the injectable form and support your body with a nutritious diet and you are still having

Strategy 4: Nutrition and Hair Support 8:39

the air thinning, then you need to talk with your rheumatologist. You need that honest conversation with the rheumeatologists. Methotrexate is an incredible medication, but it is not the only option. We have an entire arsenal of other disease-modifying anti-rheumatic drugs and biologic therapies that is available to you. You never have to choose between saving your joints and keeping your hair, so have that honest discussion with your rheumatologist. If you are still struggling with a lot of hair loss, even with those strategies that I talked today, have that honest discussion with your rheumatologist to switch you from methotrexate to other medication that may not have the same hair-loss side effects.

Now, let's bring this all together into a clear action plan you can use today. First, take your folic acid dose and ask your Rheumatolysis if it can be optimized. Second, Review your methotrexate dose to ensure you are on the lowest effective dose possible. Third, ask if switching to an injector form might make sense. Fourth, focus on your nutrition on anti-inflammatory protein-rich foods to support your follicles, your hair follicle recovery.

Strategy 5: When to Consider Other Medications 9:54

And finally, keep the communication open with your rheumatologist. Even following all the strategy you are having the side effects, let them know that you want to change to other medications. You are not just a patient taking a pill of that methotrexid, you're an informed advocate for your own health. The fear of hair loss is valid, but it does not have to dictate your treatment of rheumatoid arthritis. Methotrexate-induced hair thinning is uncommon, it is usually mild, and most importantly, reversible.

By using a structured evidence-based system that we talked today, we can protect your joints and also protect you hair. If this video brought you a clarity today please subscribe to our channel and share this with someone who might be struggling with the hair loss due to Betatrexate.

Action Plan and Final Takeaway 10:48

You have the power to optimize your health. And I'll see you in the next video. Bye bye.