Spondylitis Association of America
Posted By: laurru21 Methotrexate and Folic Acid - 12/08/15 05:09 PM
Hi all,

While I am feeling better on MTX, am noticing hair loss. I currently take 12.5mg by injection. My doctor is increasing the folic acid from 1mg to 3mg daily EXCEPT for the day of the Methotrexate injection.

Anyone know about this? I am afraid 3mg (3,000) is too high a dose? But, I don't want to get off the MTX and I also don't want my hair to continue to come out.

Any thoughts or what dosage of folic acid anyone takes would be helpful...thanks!
Posted By: Shirley Re: Methotrexate and Folic Acid - 12/09/15 06:58 PM
Hi, my rheumatologist increased my folic acid from 5mg once a week, to 10mg once a week to prevent it upsetting my gut. It was later increased to 5mg six times a week after my hairdresser commented on more than usual hair falling out when she washed it (after the mtx was increased from 15mg to 20mg each week). So 3mg six times a week doesn't sound problematic to me and there is scope to increase it further if needed. It's just a vitamin that gets depleted by the mtx, and the deficiency causes symptoms, so replacing the vitamin seems logical.
Posted By: Sheep1 Re: Methotrexate and Folic Acid - 12/09/15 08:28 PM
Here is a link at Web MD about folic acid and dosage recommendations. Women who have high risk of neural tube defective pregnancy take 4 mg per day, for other conditions, people take up to 5 mg a day.


Also note that folic acid is a water soluble B vitamin, which means that it won't be readily stored in your body (like fat soluble vitamins such as vitamin A), and whatever you body doesn't use, you'll pee out.

And here is a study at PubMed that concludes that up to 30 mg per week can be used in rheumatoid arthritis patients on MTX without harm (I didn't read the paper though, just the abstract and conclusions). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4483203/
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