• Amy Suto

How to Holistically Reduce Methotrexate Side Effects for Rheumatoid Arthritis Patients



If you've been diagnosed with rheumatoid arthritis, you've probably been put on methotrexate, one of the most commonly prescribed drugs for our condition.


My brother, who is studying to be a doctor, warned me about Googling up a storm before I had my first appointment with a rheumatologist.


"If you do Google it," he warned, "you'll see that it's a drug that might look a little scary. It's commonly used to treat cancer patients, and it can have a lot of side effects. But there's a lot of options for medications for RA, so you may want to wait until you have your appointment."


As a natural hypochondriac, I did my best to stay away from my usual panic-Google-search. But I eventually did tiptoe down the rabbit hole, and my anxiety was pretty intense when I started on the drug.



My Experience with Methotrexate Side Effects


I was in Nashville, Tennessee when I took my first dose of methotrexate. We're currently on a quarantine roadtrip, as my home in Los Angeles was a COVID hotbed and my friends and I wanted to escape the city and live better. (This was also a great choice because I could struggle through all of my new health challenges with lovely people by my side, rather than be isolated alone in my place in LA.)


Anyways, after starting on methotrexate in February at 10mg, each week I upped the dosage until I was at 20mg.


At 10mg, I didn't really feel anything.


At around 15mg, I started to feel nauseous right after taking my dose at night. Even though I was taking the dose in the evening so that I wouldn't really feel much and would drift off to sleep, I was being kept awake by the nausea.


And then, I hit my 20mg dose of methotrexate.


Instead of being nauseous just at night, I was nauseous all day. During that time period, we were on the road driving to our next stop in Banner Elk, NC, and I just remember feeling sick the entire six hour drive.


Not only that, but my hair started to fall out.


As a woman, that's probably the most terrifying side effect. As a twenty-six year old, I never really contemplated the thought that I'd be losing any of my hair (even temporarily) anytime soon.


To wake up one morning and realizing my usually thick hair was quite thin in some areas and seeing more hair on my brush than usual -- I just broke down in tears.


Something had to change, so I called my doctor and we started to rearrange my medical protocol for treating my rheumatoid arthritis.



Supplements and Holistic, Homeopathic Remedies for Methotrexate Side Effects


Before starting methotrexate, there are things you can do to help reduce side effects so that you can lessen the impact of the medication before you even begin!


Here are some of my top tips for reducing methotrexate side effects, holistically:

  • I'd recommend working with a nutritionist who specializes in a holistic, food-forward approach to reducing side effects. Your nutritionist can design a meal plan for you to help support your liver, which is where methotrexate is processed through.


  • Get a serious nettle tea habit. Get organic nettle tea bags like this one, and drink Nettle tea every day. This helps to improve overall well-being as well as support your liver. Nettle tea can be a bit earthy, so I recommend drinking with a bit of Manuka honey, which has its own antiviral, anti-inflammatory benefits.


  • Do castor oil packs. I'll do a separate blog post on this soon, but castor oil packs literally ~changed my life~ when it came to reducing my symptoms and completely improving my energy and state of being. I highly recommend everyone to try these -- even if you don't suffer from RA! Make sure to get organic castor oil that is in a glass bottle like this brand, not plastic. You don't want chemicals from plastic near your body.


  • Try dry brushing and gua sha. These practices help you stimulate your lymphatic system, which helps your overall health. Gua sha is rooted in ancient Chinese medicine, and you use a tool like this one to massage your chest, neck, and face with upwards movement with face oil (like this amazing organic face oil from True Botanicals I swear by.) If you can, please support a local Ayurvedic medicine practitioner and buy your gua sha tool from them, and learn from someone who has experience in the practice. For dry brushing, find an organic bristle brush and brush in upwards movements towards your heart, starting at your feet and moving up. Dry brush before showers, and do gua sha after (or in the mornings after your skincare routine.)


  • Drink a ton of water the day after your methotrexate dose. This will help wash your system of the drug, and help your organs function better. You should be drinking a ton of water per day and staying super hydrated just as a rule, but ESPECIALLY if you're on methotrexate.


  • Do yoga and meditate. I'm a certified yoga teacher, and I know firsthand the importance of a regular yoga practice. Yoga helps with circulation, stress reduction, activating the lymphatic system, and building strength and flexibility.


  • Find supplements that support your overall health. I created this supplement list specific to RA, but be sure to talk to your doctor and nutritionist before starting anything so you can craft a plan unique to you and your needs.


The healthier your lifestyle, the better positioned you'll be to have less side effects from methotrexate and be able to heal from rheumatoid arthritis more naturally and holistically.



Rheumatoid Arthritis Medication Options: More than Methotrexate


Currently, I'm on a weekly 10mg dose of methotrexate and will be starting Xeljanz soon in addition to my methotrexate.


I turned down my doctor's offer of trying methotrexate as an injectable form -- I hate needles and would not be able to self-administer, no way -- and my symptoms aren't too bad after my healthy lifestyle overhaul, so I'm hoping that this new combination can get me to a place where I can get off my medication and bring my rheumatoid arthritis completely into remission.


If you're dealing with a lot of side effects, be sure to talk to your doctor about your options -- you have more than you think, and your daily quality of life is important!



Methotrexate Has Different Side Effects for Everyone


Even though I had a rough time with higher doses of methotrexate, it doesn't mean you will. Everyone's body is different and we all respond to drugs differently, too.


Try and take this period of trial and error in stride, and lean on your support systems. This is a hard drug to withstand, but healing takes time.


Are you on methotrexate? Dealing with side effects? I'd love to hear from you in the comments.



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