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Date: 03.01.2016
From: Abbe Gallacher

Subject: Symptoms of methotrexate and low WBC

Hi I'm new to this but really hoping someone can help me! I'm 21 years old and have had rheumatoid arthritis for around nine years. Last year I began taking methotrexate on top of sulphasalazine. I take 15mg methotrexate weekly and 1500-3000mg sulpha daily. I have my bloods monitored every two weeks, last bloods were taken 16th Dec and I was quite low. On the 19th Dec I woke with headache feeling very weak and shaky for most of the day. I thought it was from working a lot but today I've woken with the same symptoms. I feel like it's my WBC count being low making me feel under the weather, and unsure what to do. Having more bloods taken on Wednesday so can speak to the nurse. Was just wondering if anyone else has had the same symptoms and can maybe offer any home remedies or advice! Thanks in advance, Abbe.
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Date: 03.01.2016
From: lucy

Subject: Re: Symptoms of methotrexate and low WBC

Hi Abbe, When the white cells get too low they can make us more prone to infection. I usually get a mouth ulcer or two when mine go low. Taking folic acid can help with the side effects. I don't really think it would be a symptom of them being low but it is worth checking with the nurse about this. If you have been on methotrexate for around a year I would have thought monthly blood tests would have been enough unless there is another reason they like to do them more often. At least it's not too long to your appointment. Good luck and let us know how you get on. xx
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Date: 04.01.2016
From: Abbe Gallacher

Subject: Re: Symptoms of methotrexate and low WBC

I do take folic acid daily, forgot to mention this. I have been taking methotrexate for roughly a year and my doctor wants to increase the dose asap, which i've not been able to as my WBC count is too low. My nurse called me a few months ago when my counts were low asking me to come in if I felt ill at all, I'd not felt ill at all until the last few weeks I've had shaky and weak days. I don't know a single person who has arthritis or who takes either of these meds so it's just impossible to share stories! I have read that sulphasalazine being an antibiotic can make us more prone to thrush, since taking methotrexate I have halved the amount of sulfa I take which I'm happy about. Was really scared to start methotrexate, I worry about losing hair! My hair is awfully weak at the moment and I'm not sure if it's just me being paranoid. Do you take either of these meds? Sorry for so many questions, I'm so keen to hear other people's experiences. Thanks for replying xx
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Date: 04.01.2016
From: sleek fox

Subject: Re: Symptoms of methotrexate and low WBC

I've taken both of them but have had to stop due to side effects. Personally, I wouldn't continue with a drug that makes me feel so ill and you must tell your nurse.
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Date: 04.01.2016
From: lucy

Subject: Re: Symptoms of methotrexate and low WBC

Hi Abbe, I do take sulpha. and Mtx along with a couple of other drugs. I have been on them for around fifteen years now and up until now I haven't had thrush with them. Do you know what your white cell count is? I was told if they went below 4 then to stop the methotrexate until they come back up again, I had a look at my card and I see mine have been 3.6 before. Is it the rheumatology nurse that you have to see about getting your bloods checked. I think you should give the rheumy nurse a call and see what she thinks about the way you are feeling. Oh and ask as many questions as you like, we are happy to answer if we can. Take care xx
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Date: 13.01.2016
From: Abbe Gallacher

Subject: Re: Symptoms of methotrexate and low WBC

Thanks for all the help! My consultant told me that around 2(WBC) is low and mine 2 around the time I wrote the first post. I have arranged to see a doctor on Monday as my consultant is way too busy to see (he is rheumatology). I haven't felt the same as I did when I first wrote so maybe they are rising again but who knows. I haven't increased anything and some days I even decrease the amount of sulfa I take. I think eventually I will completely come off the sulfa which I'm hoping, as it makes my wee luminous and I blame it for getting repeated cases of thrush! xxx
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Date: 14.01.2016
From: lucy

Subject: Re: Symptoms of methotrexate and low WBC

Hi Abbe, yes, the sulpha does make your pee orange but seemingly this is harmless. I think it's more likely to be the methotrexate that is making the white cells low. If your white cell count is only 2 then I certainly wouldn't be increasing the methotrexate, in fact, I think I would be stopping it until they come up to normal again. I hope you feel better soon. Take care xx
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