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Re: MTX and folic acid

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Some docs feel that it's a purely theoretical risk that the folic acid will

offset the effect of the mtx. I dunno! - Patty

<< I wonder why doctor's differ on this? I had never been

told to NOT take it the day of my metho, but when I saw you saying that, I

asked the doc. She said no, that I AM to take it everyday, even the day of

>>

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I had been wondering about folic acid earlier since I had noticed that

whenever I eat acidic foods, my pain is worse. Also, someone, perhaps

Harry, said that he had a list of foods that turn the pH in the body more

acidic. I would like to have that list and I would like to know more

about whether or not to take folic acid. I know that folic acid is very

important to the body and that there is some indication that taking it

will prevent heart attacks and conditions such as spina bifida. It is

now being added to all sorts of foods, so we are getting more of it

automatically.

Thanks,

Gloria

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Your not saying you want to turn your body more acidic are you?

If you are then you are backwards, you want to become more alkaline.

Re: rheumatic MTX and folic acid

> From: Gloria M Tate <missgloria@...>

>

> I had been wondering about folic acid earlier since I had noticed that

> whenever I eat acidic foods, my pain is worse. Also, someone, perhaps

> Harry, said that he had a list of foods that turn the pH in the body more

> acidic. I would like to have that list and I would like to know more

> about whether or not to take folic acid. I know that folic acid is very

> important to the body and that there is some indication that taking it

> will prevent heart attacks and conditions such as spina bifida. It is

> now being added to all sorts of foods, so we are getting more of it

> automatically.

> Thanks,

> Gloria

> ________________________________________________________________

> YOU'RE PAYING TOO MUCH FOR THE INTERNET!

> Juno now offers FREE Internet Access!

> Try it today - there's no risk! For your FREE software, visit:

> http://dl.www.juno.com/get/tagj.

>

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>

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I initially began MTX without any folic acid...I complained to my RD about

feeling " sick " and " fluish " most of the time and he asked if I was taking any

folate....I told him I wasn't and he immediately prescribed some...the

" fluish " feeling disappeared shortly after that.

What I've read is that MTX depletes the body of folic acid and so it is

necessary to take some in order to replace what the MTX takes away...

------------------------------------------------------------------------------

--

Blessings and Health

Tony (Diagnosed Sero-Neg. RA Apr 99; on AP since 5 Oct 99)

Meds (DR Prescribed): Methotrexate 10MG per week; Folic Acid 2MG per day;

Prednisone 10 mg daily; Sulfasalazine 4G daily; Plaquinil 400 mg daily;

Minocycline 100 mg 2X daily; Prilosec 20-40mg daily

Alternative Meds/Herbs: Flax Seed Oil (Omega 3, 6, 9) 6 g daily; MSM 2 g

daily; Pantothenic Acid (B5) 2 g daily; Niacin (B6) 1 g Daily;

Echinacea/Goldenseal 420 mg daily; Milk Thistle 350 mg daily; Ginseng 840 mg

daily; Chitosan 2 g Daily; Lactobacillis Acidopholis 2 capsules daily

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Hi Christy,

I had a quesion for you. You said your child is taking multi-vitamin plus iron

and also a calcium supplement. I want so badly to give my son at the very least

an iron supplement and a calcium supplement. My doctor told me that he has a

bone loss and I keep asking her what I we can do to stop this. Her reply is

always that we can't work on that until we get his inflammation down. My doctor

has a very good reputation and is very much in demand. She is a UCLA ( a good

hospital) and so I am thinking that I have to just trust her, but I am also

worried that she isn't giving me the best advice for my child. What do you or

any one reading this think about her reply that we can't work on my son's bone

loss until after his inflammation goes down? Thanks, Robin

On Fri, 08 June 2001, gazelle34@... wrote:

>

> Robin,

>

> I am confused as to why your doctor is concerned about folic acid. He should

> be taking folic acid when on mtx. My daughter is on 25 mg mtx injected as

> well as 300 mg celebrex and prednisone. She takes a daily multivitamin plus

> iron as well as 1200 mg of calcium. I think you should quiz your doctor as to

> his reasoning. It goes against everything I have read and been told by our

> doctors.

>

> Christy

>

>

>

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Hi Robin,

Although inflammation does play large part in the course of treatment,

I'd never heard of prolonging the treatment of rebuilding bone loss.

I'm quite sure the Dr. is highly respected and well knowledgeable in her

field, But I don't believe anyone should take the opinion, of just any

one Dr..

Seek out a second opinion, with out mentioning your sons' Doctors' name.

I say this because, if she is extremely well known, other Doctor's are

going to follow in line, with her opinion.

I know it may sound as though, I'm down on Doctor's, but isn't the case.

I just know from 33 years of experience, you don't go with just one .

Hope that is of some assistance to you, and that little guy of yours'.

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Hi Robbin,

My son has had systemic JRA for the past 6 years. He's had some bone

density loss as well. Part of his daily medicine regime is taking

calcium supplements along with a prescription nasal spray called

miacalcin, which supposedly works to help the body better absorb

calcium. Sort of like the fosamax that a lot of menopausal women are

taking these days to help with their bone density issues. You may want

to visit the RxList website and look up miacalcin, print out this info,

show it to your doctor at your next visit ... and let them know that you

feel it might be better to try to work on this issue concurrently while

you try to deal with the inflammation issues. Others are doing it. Let

them know your concerns, again, as far as wanting the very best

treatment available for your child. You know, in our case it was an

endocrinologist who prescribed the miacalcin. We were referred to him by

our rheumatologist. He was also the person who ordered our bone

dexascans so we could have a better idea of the state of 's bones.

He was more at risk for this kind of problem because he's taken steroids

for a long time.

Hope this helps a little,

Georgina

Robin DiGiacomo wrote:

>

> Hi Christy,

> I had a quesion for you. You said your child is taking multi-vitamin plus

iron and also a calcium supplement. I want so badly to give my son at the very

least an iron supplement and a calcium supplement. My doctor told me that he

has a bone loss and I keep asking her what I we can do to stop this. Her reply

is always that we can't work on that until we get his inflammation down. My

doctor has a very good reputation and is very much in demand. She is a UCLA (

a good hospital) and so I am thinking that I have to just trust her, but I am

also worried that she isn't giving me the best advice for my child. What do you

or any one reading this think about her reply that we can't work on my son's

bone loss until after his inflammation goes down? Thanks, Robin

>

> On Fri, 08 June 2001, gazelle34@... wrote:

>

> >

> > Robin,

> >

> > I am confused as to why your doctor is concerned about folic acid. He should

> > be taking folic acid when on mtx. My daughter is on 25 mg mtx injected as

> > well as 300 mg celebrex and prednisone. She takes a daily multivitamin plus

> > iron as well as 1200 mg of calcium. I think you should quiz your doctor as

to

> > his reasoning. It goes against everything I have read and been told by our

> > doctors.

> >

> > Christy

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In a message dated 5/21/2003 3:28:08 PM Eastern Daylight Time,

robinanne53@... writes:

> have heard so much about not taking folic acid on the same day as MTX, but

> then I have heard that that only matters as far as chemotherapy is

> concerned. I'm confused. Does anyone know what to do for sure? Thanks

> alot! I sure want to do this right

My doctor prescribed the mtx for me and the folic acid daily. he never siad

not to take it the day of the mtx. He gave me the option of the mtx or

enbrel and I decided on the enbel. I never took the mtx but he never said

not to take the folic acid the same day. Now I'm wondering if I do start the

mtx, which way is right??

Janet

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Now I'm wondering if I do start the

> mtx, which way is right??

> Janet

Hi Janet,

I'm not a doctor, just a PA sufferer and MTX user.

My Doc also didn't mention anything about not taking the folic acid

on the day of my MTX dose. So I took it anyway. I then asked about

it and he said " It really doesn't matter " . The way he sees it the

folic acid is only to counter act any side effects of the MTX. I have

forgotten to take my folic acid on long weekend trips, and when going

without, I do not notice any difference. So, make a choice. Take it,

don't take it. It's not life threatening either way. See what works

for you.

Stay well

****Editors Note: The methotrexate is not for the side effects of methotrexate,

although it may lessen them. It is a methotrexate-agonist. It completely

stops the action of the methotrexate!! That is why timing can be critical--you

want to get as much as possible out of your shot/pills for the week before you

go taking your folic acid. It does matter. My doctor at Columbia Presbyterian

Medical Center is Adament that you should skip it on the day of your dosing. It

makes sense to me perfectly, now that I understand the rationale.

S.

group founder

Medi

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One more time, with documentary references this time;

Until recently, it was believed that methotrexate helped people with <A

HREF= " http://www.hollandandbarrett.com/Concern/Rheumatoid_Arthritis.htm " >

rheumatoid arthritis</A> also by interfering with folic acid metabolism.

However, recent

research has shown that this is not so. In fact, it now appears that people

with rheumatoid arthritis taking methotrexate should supplement large amounts of

folic acid. 

In separate double-blind studies, 5,000 mcg per day of folic acid and 2.5–5

mg per day of folinic acid (an activated form of folic acid) have substantially

reduced side effects of methotrexate without interfering with the therapeutic

action in rheumatoid patients.2 3 Folic or folinic acid were taken at a

different time from methotrexate and sometimes only five days per week.

Similarly,

recent evidence suggests that people who are prescribed methotrexate to treat

severe <A

HREF= " http://www.hollandandbarrett.com/Concern/Psoriasis.htm " >psoriasis</A>

experience fewer side effects if they also supplement high

amounts (5 mg per day) of folic acid.4 As is the case with methotrexate and

rheumatoid arthritis, supplementing folic acid did not interfere with the

activity

of methotrexate. Such high levels of folic acid should not be taken without

clinical supervision.

2. SL, Baggott JE, Vaughn WH, et al. Supplementation with folic acid

during methotrexate therapy for rheumatoid arthritis. A double-blind,

placebo-controlled trial. Ann Intern Med 1994;121:833–41.

3. Shiroky JB, Neville C, Esdaile JM, et al. Low-dose methotrexate with

leucovorin (folinic acid) in the management of rheumatoid arthritis. Results of

a

multicenter randomized, double-blind, placebo-controlled trial. Arthrit Rheum

1993;36:795.

4. Duhra P. Treatment of gastrointestinal symptoms associated with

methotrexate therapy for psoriasis. J Am Acad Dermatol 1993;28:466–9

<A

HREF= " www.bad.org.uk/doctors/guidelines/psoriasis/metho.htm " >www.bad.org.uk/doct\

ors/guidelines/psoriasis/metho.htm</A>

~~~

Patients will normally be advised to take folic acid 5mg daily for as long as

methotrexate is continued. If the MCV (mean corpuscular volume) rises above

106 fl, despite folate replacement, then further methotrexate therapy is

probably contraindicated26. It is important to note that folate therapy does not

appear to reduce the therapeutic effect of methotrexate in psoriasis24. ~~~

24. Duhra P. Treatment of gastrointestinal symptoms associated with

methotrexate therapy for psoriasis. J Am Acad Dermatol 1993; 28: 466-9

26. Dodd HE, Kirby JDT, Munro DD. Megaloblastic anaemia in psoriatic patients

treated with methotrexate. Br J Dermatol 1985; 112: 630-1.

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In a message dated 5/23/2003 10:34:59 AM Eastern Daylight Time,

david@... writes:

> . My doctor at Columbia Presbyterian

> Medical Center is Adament that you should skip it on the day of your dosing.

> It makes sense to me perfectly, now that I understand the rationale

Thanks . Would you mind giving me the name and phone number of your

doctor. I am on Long Island.

Janet

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In a message dated 5/31/2003 6:18:55 PM Eastern Daylight Time,

robinanne53@... writes:

> ****Editors Note: The methotrexate is not for the side effects of

> methotrexate,

> although it may lessen them. It is a methotrexate-agonist. It completely

> stops the action of the methotrexate!! That is why timing can be

> critical--you want to get as much as possible out of your shot/pills for the

week before

> you

> go taking your folic acid. It does matter. My doctor at Columbia

> Presbyterian

> Medical Center is Adament that you should skip it on the day of your dosing.

> It makes sense to me perfectly, now that I understand the rationale.

>

Okay, that's the complete opposite of what my rheumy said. She explained it

to me that the MTX leached the folic acid out of your system to kill the

faulty cells that create the white blood cells that attack the joints and that

they

can't absorb the folic acid form you get from pills. Only the cells that are

" normal " and functioning properly can absorb it. I had severe problems with

folic acid deficiency...my hair was falling out in handfuls and my mouth was

so sore my gums bled every time I brushed my teeth. I'm currently taking 3 mg

of folic acid every day and 5mg of lukovorin calcium (folenic acid..what your

liver turns folic acid into to make it useable) once a week.

Smile,

Becky

+++++++++++Editors Note: Leucovorin is used as a rescue- it stops the action of

the methotrexate. That is why you take it once a week, several hours after your

metho dosing. Normally you would not need the folic acid if you were being

given the leucovorin, but it sounds like you have an unusual folic acid

deficiency. Why I don't know. Sometimes pregnancy can really deplete your

stores,etc... It sounds like yours is a special case and I would do exactly

what the doc recommended unless you don't feel comfortable, in which case you

can see another doc for another opinion on treating your PA

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Welcome

I take 1mg daily except the MTX shot day. 12 hours after the injection (the next

morning) I take a 10 mg Lukevorin. So really that is 5 1mg Folic Acid and 1

10mg Lukevorin.

gmcconnell53 <onewiselady@...> wrote:

Hi! I never posted before today and now I am posting twice in one

day. I take MTX 15 mg orally once per week. (have been on it for 6+

years) I also take folic acid once daily 400 mcgs. Is that enough

to compensate for whatever bad the mtx does?

Thanks again!

Gail

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Hi Gail,

I take 1 mg of folic acid a day. This has been the same dose since I

started the MTX in May. I started at 7.5 mg of MTX and now am up to

20mg. It seems to be working and I don't have any side effects from

it so I'm happy.

Eileen

> Hi! I never posted before today and now I am posting twice in one

> day. I take MTX 15 mg orally once per week. (have been on it for

6+

> years) I also take folic acid once daily 400 mcgs. Is that enough

> to compensate for whatever bad the mtx does?

>

> Thanks again!

>

> Gail

>

> [Editor's Note: Gail, Welcome! We look forward to your

contributions. My doc has me taking a little higher dose of folic

acid, but then I'm also higher, at 25 mg./week, on the methotrexate.

I'm sure others will have thoughts on this as well.

>

> D.]

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I take Folic Acid and Folinic Acid with the Meth because of side effects. I was

fatigued, losing my hair, having sores appear in my mouth and my appetite was

affected, so I take the folic acid. I just started taking it at a higher dose

hoping it'll help, otherwise I'll have to go off the Meth and start something

else.

<HomeBuilders@...> wrote:Hi ,

What is the reason for givin Folic Acid with MTX? I was started on 15 mg./wk 3

weeks ago, but no Folic Acid. I have notice no change in my pain, but have had

no side effects either. Thanks in advance for you help.

Aloha,

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Hi, the reason for giving Folic Acid with Methotrexate is that Methotrexate

destroys folic acid. That is what I have been told by my Doctor. Take care,

Geraldine from U>K>

========================================

Message Received: Oct 27 2005, 11:28 AM

From: " " <HomeBuilders@...>

Cc:

Subject: [ ] MTX and Folic Acid

<html><body>

<tt>

Hi ,<BR>

<BR>

What is the reason for givin Folic Acid with MTX? I was started on 15 mg./wk 3

weeks ago, but no Folic Acid. I have notice no change in my pain, but have had

no side effects either. Thanks in advance for you help.<BR>

<BR>

Aloha, <BR>

<BR>

_____________________________________________________________<BR>

Netscape. Just the Net You Need.<BR>

<BR>

<BR>

</tt>

<!-- |**|begin egp html banner|**| -->

<br><br>

<tt>

Please visit our Psoriatic Arthritis Group's informational web page at:<BR>

<a href= " http://www.wpunj.edu/pa/ " >http://www.wpunj.edu/pa/</a> -- created and

edited by list member aka(raharris@...). <BR>

<BR>

Also,in August 2001,list member Jack aka Cornishpro@... began to

conduct extensive research which he publishes as the " Psoriatic Arthritis

Research Newsletter " , monthly in our email and digest format. Many thanks to

Jack. Back issues of the newsletter are stored on our PA webpage as well as the

archives of the list. <BR>

<BR>

Don't forget that the list archives comprise a tremendous amount of information

(Over three years of messages and answers).Feel free to browse them at your

convenience.<BR>

<BR>

LET'S HEAR FROM SOME OF YOU LURKERS out there! If you have a comment or

question, chances are there is a person who has been around a while who can help

you out with AT LEAST an educated guess for an answer! If not,we can steer you

in the right direction with a good website to go to,<BR>

<BR>

Blessings and Peace, <BR>

<BR>

Atwood-Stack, Founder<BR>

Alan , Web & List Editor<BR>

Jack , Newsletter Editor<BR>

Pat Bias, List Editor<BR>

Ron Dotson, List Editor<BR>

Orin, List Editor<BR>

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and any others who help in any way (thank you!)<BR>

</tt>

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, pending anyone else more 'learned' than I responding, this is

what my rheumatolgist told me - Folic Acid can alleviate any nausea

that results from using methotrexate and it replaces the folic acid

antagonised by use of methotrexate. I also understand that some

doctors only give a low dose or no dose at all because fundamentally

the Folic Acid interferes with the methotrexate. I also ramped up my

intake of naturally occuting foodstuffs that contain Folic to, but I

don't know if thats of any actual benefit. XX C.

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,

Methotrexate is a folic acid antagonist meaning it blocks an

essential step in DNA synthesis which causes a reduction in cell

reproductive abilities.

Folic Acid is sort of an anitdote to methotrexate. Thus, folic acid

reduces the side effects of MTX- hair loss, mouth sores, and nausea.

From what I understand 1 MG is the typical dose. Therefore, do not

take your MTX and folic acid at or near the same time b/c they

counter act one another. It is best to take MTX at night right before

you go to bed on a day of the week that is not that stressful- if

possible.

I took MTX for about 4 months and I had horrible nausea, some mouth

sores, and a little hair loss (I really loved not having to shave my

legs as often!) I stopped the MTX and went on Enbrel but in many ways

I wish I were still on it. In hindsight, I do think it was helping a

little even though at the time it didn't seem to have helped at all.

I certainly had one hell of a flare when I went off of MTX.

If the folic acid does not control the side effects, they will put

you on Leucovorin Calcium (Folinic Acid). I understand the typical

dose is 15 mg. This drug really helped control my nausea. Ask about

it if you are having significant side effects.

OH and for women of child bearing age- I have read that it takes

about 3 months for MTX to get out of your system and it is safe to

concieve after that period of time.

Trisha

>

> Hi ,

>

> What is the reason for givin Folic Acid with MTX? I was started on

15 mg./wk 3 weeks ago, but no Folic Acid. I have notice no change in

my pain, but have had no side effects either. Thanks in advance for

you help.

>

> Aloha,

>

> _____________________________________________________________

> Netscape. Just the Net You Need.

>

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In a message dated 10/27/05 11:28:39 AM GMT Daylight Time,

HomeBuilders@... writes:

What is the reason for givin Folic Acid with MTX? I was started on 15

mg./wk 3 weeks ago, but no Folic Acid. I have notice no change in my pain, but

have had no side effects either. Thanks in advance for you help.

Hi ,

Sorry that I have taken so long to get back to you. Usual story. Still way

behind. I hope in the meantime that someone answered your question. As far as I

know it is to counteract possible side effects. There seems to be differing

opinions among our various Rheumy's about how it should be taken. I was told

to take it three days after my MTX dose. Others were told to take it daily.

So who knows? I guess it probably doesn't matter. As far as I know we are all

still alive no matter what way we have taken it. lol One thing though. Most

of us have been told to take it one way or the other so maybe it is something

you should ask your Rheumy about.

I hope you are doing well on the MTX.

Take care,

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>

>

> In a message dated 10/27/05 11:28:39 AM GMT Daylight Time,

> HomeBuilders@n... writes:

>

> What is the reason for givin Folic Acid with MTX? I was started on 15

> mg./wk 3 weeks ago, but no Folic Acid. I have notice no change in my pain,

but

> have had no side effects either. Thanks in advance for you help.

>

Folic acid is given to prevent mouth sores.

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What kind of mouth sores, I get sores in the corners of my

mouth/lips but not on MXT. Starts out as really chapped lips then

eventually gets worse turnes more to scabbed sores that hurts to

open my mouth. Just curious, it gets better then comes back. Not

currently on folic acid but have been for previous years. Something

to think about I guess.

Keli

> >

> >

> > In a message dated 10/27/05 11:28:39 AM GMT Daylight Time,

> > HomeBuilders@n... writes:

> >

> > What is the reason for givin Folic Acid with MTX? I was

started on 15

> > mg./wk 3 weeks ago, but no Folic Acid. I have notice no change

in my pain, but

> > have had no side effects either. Thanks in advance for you

help.

> >

>

> Folic acid is given to prevent mouth sores.

>

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http://arthritis.about.com/od/arthqa/f/folicacidmtx.htm

This link with tell you why you should

take Folic Acid along with Methotrexate. God bless.

From: Rheumatoid Arthritis [mailto:Rheumatoid Arthritis ] On Behalf Of prathiba n

Sent: Tuesday, February 21, 2006

10:16 PM

Rheumatoid Arthritis

Subject:

MTX and folic acid

Hi All,

I have to take MTX injections 15ml ones in every week. But i dont take

Folic Acid. is this alrite if i dont take ?

need your suggestions

cheers

Prathiba

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MTX depletes the body of folic acid in major way. (I'm guessing you

are feeling tired most of the time?) They are almost always

prescribed together. Ask your doctor.

Sierra

> You can continue you meds through drug assistance programs

offered by the drug companies. MTX and folic acid are really cheap.

I was on the MTX injections and a 3 month supply cost me less than

$10. Folic acid pills can be bought OTC in the non prescription

strength...talk to your doc about how many pills to take to bring you

back up to an acceptable amount for him.

>

> See if your doc will work with you on fees...most docs have cash

pay fees as well as the labs do too.

>

> Also check and see if you have a medicaid program,state run

disability program or medical insurance program. Also look for any

free clinics or drug studies you may be able to enroll in to get free

meds and care.

>

> Good luck

>

> Toni

>

>

> In a message dated 11/30/2005 3:38:14 P.M. Central Standard Time,

Rheumatoid Arthritis writes:

> Date: Tue, 29 Nov 2005 18:28:17 -0000

> From: " ramyst66 " <ramyst66@...>

> Subject: first time joining any on-line group

>

> Hi, this is the first time I have ever been a part of any group, on-

> line or otherwise. I am 39 years old and was diagnosed with RA

August

> of 2002.(My dad was diagnosed around the time he hit 40 years old.)

I

> had health insurance so was able to go through the process of the

> elimination of the " harmful " drugs with the end result of Humira

> being the one that worked.(Although self injections were very hard

to

> emotionally learn to do as I hate needles.) The first time I tried

to

> refill my prescription, the co-pay went from $6o to $250. I

stopped

> taking anything until August of this year, when a company change in

> our health insurance, provided me with NO COST home delivery of

> Humira. Since I didn't take anything for 2 years, my

Rheumatologists

> (excellent doctor who deals with RA himself) also prescribed

> methatrexate and folic acid as the Humira didn't seem to work as

well

> as it did the first time around. Guess what, the company I worked

for

> closed, filed bankruptcy, and now I am faced with no health

insurance

> and can't afford to pay for Cobra insurance out of my unemployment.

> I'm not sure where to go from here. Any suggestions? Are there

> any " alternative " medicines/suppliments that have actually worked

for

> anyone? Thanks for listening to my " story " and any suggestions

would

> be greatly appreciated.

>

> Sincerely,

> Renita

>

>

>

>

>

>

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