Methotrexate with obese patients

Hi Amy, I completely understand your concerns, I’m also a psychiatric nurse and I had lost 8 stone. My Psoriatic arthritis is causing me to have lots of time off work. I’ve been on Methotrexate for 2 years now and although I initially had some bad side effects my body soon got used to it. I am also on Humira which I’m not finding very good at all. I’ve had so much time off due to flares and fatigue. I had a hysterectomy 18 months ago and I have put 4 stone back on. I put this down to the hysterectomy but now I’m wondering if the Methotrexate is partly to blame, I’m going to see my Rheumatologist in a couple of weeks so will post with what she says.

Hi Cat, Thanks for taking to read & reply. Firstly, congratulations on your weight loss-that is amazing. I had an endometrial ablation 18 months ago which sorted my gynae issues out. I’m on meds for recurrent depression, and I am certain they have helped my weight, nor has my under active thyroid or insomnia. I accept that I need to remain on the meds I am on at the moment; it’s so silly but I didn’t appreciate my well-being until I was unwell, and didn’t realise how disruptive it would be to my daughter and my husband It sounds really encouraging that your doing well on the methotrexate now, I have toyed with asking to request injections as I have read a lot of people say that it is better for side effects. Are your work understanding with your sickness? It’s such a massive worry being off sick.. I’m not familiar with the other drug that you are on, when did you start that? What is it for? Fatigue always feels like I’m opting out of self help, I think there are cross overs to psoriatic arthritis & symptoms of depression, which makes it tough to try and figure out how best to address things! Thanks so much for your time Amy

Hi Amy, Thank you for your reply, I can’t believe how much alike we are. I too had the endometrial ablation 3 years prior to hysterectomy! When I started Methotrexate I had tablets but they made me really ill, my Rheumatologist changed me over to injections which I tolerated much better. They used to knock me out for a couple of days at first though. Humira is one of the newer biologics, I was tried on Leflunomide and Sulfasalazine alongside the Methotrexate but unfortunately nothing helped the Joint swelling and pain, so I’m now on Humira which is the brand name for Adlabimumab, and Methotrexate together. I think it’s just trial and error to find the right medication as we are all different. I really hope you get sorted as flare ups are horrendous. I’m lucky as my employers are really supportive now, but I’ve had employers who haven’t been very understanding. xx

It’s crazy how alike our stories are! How strange, but reassuring somehow. I have been good so far With the ablation, but I guess I’m hoping it continues to remain effective 🤞 It’s such a minefield hearing all of these medications, I naively thought methotrexate was the be-all-and-end-all type thing. I have looked at it so much, I’m going to try and wait and see when I have my appointment what they suggest. I have been off for 7 weeks, still choosing not to drive as my knee won’t tolerate the repeat clutch movement, and my grip abs swelling in my hands leave me worried.; I think I will go on a sickness stage when I go back, but I’m Staying off until I’m well enough to go back so I can avoid another episode; it is scary and All this really came on to this extent within 72 hours. I dong know what to expel with flares, I suppose I have all that to learn. Let me know how you get on with your review? Thanks for sharing your story xx

Hi cat, After a really bad day, tears and needed full help with dressing & bathing, I called the helpline & was very lucky to be squeezed into clinic NYE. As expected I had the inflammatory diagnosis confirmed with elements of mechanical also. I start sulfalasine tomorrow & had IM steroid jab. I’m luck that this has been an early diagnosis & he doesn’t think there is any significant joint damage to worry about. It’s been a quiet & subdued day, but I’ve kicked myself and feel lucky that it could be much worse. Happy new year

Hi Amy, Sorry to hear about how bad you’ve been suffering, but good news that you was seen quickly. I started on sulfasalazine when I was first diagnosed and it worked really well, unfortunately once it started working I stopped taking it and my joints then deteriorated really quickly. The steroid injection takes a few days to start working but they are quite effective. I found they gave me hot flushes but other than that they are really good. I’m so glad you’ve been started on medication and hopefully it’s no already caused too much deterioration. The only advice I would give anyone is not to stop taking the medication when you feel you are recovered. Good luck with it all and please keep me updated xx