Methotrexate (Rheumatoid Arthritis Drug)

In the previous tutorial we introduced antirheumatic drugs called DMARDs. Now let's discuss in greater detail a particular small molecule DMARD called methotrexate. This was originally designed to be an anti-cancer drug, but it was fortuitously found to be effective against rheumatoid arthritis, among other inflammatory diseases. How does this drug work? Let's find out!

Script by Chris Hofmann

Check out "Is This Wi-Fi Organic?", my book on disarming pseudoscience!

[davidmurphy]

A friend of mine suffered from this at the age of 35, it took about a year to get the diagnosis. You could always see he was in permanent pain and then they have him this treatment and it was like night and day - you could see him just relax. The difference was incredible.

[thevincimotivates]

Having this at 24 really sucks… praying for all of yall to feel better.

[thecockroach]

This video has hardly been out an hour and friends are already sending this to me. Thank you for explaining one of the drugs I take, it feels better to have a stronger understanding of what it is and does.

[catboyedgeworth]

i just went to the doctor yesterday because of arthritis symptoms, swelling, crooked fingers, & weak joints. thank you so much for posting this, it really helps me understand the condition and not be so afraid.

[mmmsunshine]

My rheumatologist FINALLY convinced me to start this last year at 50 after decades of RA pain - I cannot believe the difference. When I was prescribed it, I had a few people and the pharmacist recommend that I not take it since it is deadly 😒....glad I didn't listen.

[marylynne]

My partner was on Methotrexate, it nearly killed him. Our GP was quick to get him into hospital when his blood test results suddenly went haywire. Meds were changed and his rheumatoid arthritis is much worse now, but at least he’s still alive.

[TheRuddy]

As a nurse this makes for an amazing review and helps me daily to care for my patients. Thanks professor Dave

[elyshebbachristele]

I was diagnosed with RA at the age of four and I started methotrexate at 6 up until 14. Although methotrexate helped me, the side effects were hell. I’m 26 now and it’s interesting to see and understand the science behind this drug that I used to take soo often. Although I don’t see myself ever going back on this drug, I love to see how much it has helped people because this condition is no joke. I wouldn’t wish an RA flare up on no one!

[jrojala]

Very interesting video!! I had methotrexate therapy when I was 28 and again when I was 34 to help manage my autoimmune disease (granulomatosis with polyangiitis). I’m very grateful for the science that made this possible.

[DuchessandDori]

I am a 31 year old RA patient. I have been taking methotraxate and folic acid for years now. I wish I found this explanation earlier as nobody explained how essential taking folic acid is.

[mickeyfilmer]

This was an extremely useful video for us as my wife is currently on methotrexate -one tablet once a week, for a very rare skin rash, that did not respond to any other treatments. Many thanks for this explanation of the drug- it is a big help, and far better than the doctor's "Erm take this anti cancer drug for a year, it will cure you but you need blood tests every week and mri scans every six months !"

[ractoon]

I just want to say thank you so much for these videos, I have ADD and it makes it really hard for me to concentrate on subjects like these, but somehow you've made it easy enough for me to understand. Thank you again, love this channel!

[SlunkyBoi]

For anyone who is about to go on mtx or even currently on it:

I was diagnosed with RA I think at 22, and it was so bad I could not walk or even hold a tissue. I’ve been self injecting MTX once a week for years now and straight up forget that i even have arthritis. I highly suggest injecting it over taking it orally. Some will tolerate it but for me it made me borderline suicidal. I passed out the first times I took the injection, I hate needles, but trust me when I say the injection will save your life. Highly highly recommend. Always listen to your own body & take frequent blood tests tho, everyone responds differently to different drugs. Also try other less harmful drugs first if your dr suggests it, and definitely take folic acid as well. Also no binge drinking!

I felt extremely hopeless with my RA but self injecting mtx is only a few $ a month (it is a generic drug, if it costs too much or has a name they’re likely charging you extra for the packaging, no joke) and can be extremely worth it. I’m not a dr! Always listen to your dr first.

[studentaccount]

A relative of mine took methotrexate and wound up passing in their 50s from RA complications. It does not work for everyone. She was racked with pain and the RA effected her vital organs. It might work for mild arthritis for a while. She told me the methotrexate caused her to be very tired.

[TheWuschi]

Some years ago, I lost my mother to Methotrexate. Due to an error in anamnesis at the beginning of what was planned to be a minor short-term stay in a renowned Austrian hospital, her weekly arthritis-stabilizing dose of MTX was given to her as daily dose. The OD led to effects like an uncontrolled chemotherapy (which it actually was); her bone-marrow was completely destroyed, her immune-system broke down, she had to be reanimated and for the remaining horrible months of her life she had to be tube-fed and most of the time artificially respirated. Even though I know, that her death was not the "fault" of this drug, but the consequence of medical malpractice, I was triggered by this praise of Methotrexate as an antiarthriticum beyond my limits...

[catrest]

This was so helpful! I was diagnosed with psoriatic arthritis a few weeks ago, and started on methotrexate. I've been trying to learn as much as I can about how it works.

[KatiCleo]

Thank you for explaining how this works, I've been curious about its specifics for a long time, especially since when you get properly sick by something else you are allowed to skip a week of methotrexate to bounce back more easily. I've been taking both methotrexate and hydroxichloroquine for 4 years now since I was diagnosed with RA in early 2020. Whenever the doctors try to wean me off either my symptoms come back unfortunately. But for now I'm not complaining. I'm still young and at least I have my mobility.

For the fellow users in the comments: another typical methotrexate side effect (especially if you take more than let's say 20mg per week) is mouth ulcers. They can be a real pain. Also not sure if it's an RA side effect or a methotrexate side effect but you might become more prone to yeast infections as well.

[kingspud]

I take this drug. It took a long time to build up enough to begin feeling the therapeutic effects (approximately 6 to 8 weeks) but it has really helped a lot.

Thank you for helping me understand this better. I'm going to review this with some of my science interested buddies to see if I can explore this a little further.

[GS-ucyl]

I have had RA for 22 years. Initially was diagnosed with lupus and found out in March of 2023 that I actually have rheumatoid arthritis…long story. My new doctor wants to take me off of hydroxychloroquine (which has never given me any issues) and put me on methotrexate. She gave me 90 days to decide. During that time, I decided to eliminate gluten, watch sugar, do intermittent fasting and increase my Vitamin D. I’m taking 4000 iu of Vitamin D plus I take a multivitamin which has 1000 iu. I noticed an immediate difference after increasing my vitamin D. My biggest complaint is having one or two stiff fingers when I wake up, and I refuse to take methotrexate for those symptoms.

[shannonjhanlen]

As someone who suffers from RA. I am on Methotrexate, the Folic acid supplement and Prednisone.

Before I was on these drugs, I was in Chronic pain and barely able to move let alone do anything like, Work, Walk, Cook, Clean etc etc.

Just 3 days after I started treatment I was able to live a full life again. These drugs are a "miracle" (If there is such things) and it made my love and confidence in proper scientific medicine so much deeper and profound.