Tips for avoiding hair loss on Methotrexate

RE: Folic Acid.  It is always required when taking mtx but ask to be tested  to see if your body uses that kind.  I was tested by a naturopath and found that my body doesn't use the folic acid (been taking for most of 10 years) but needs the methylfolate. Just FYI

I'm taking Biotin.  Lots of ladies in another support group swear by it. Its a B vitamin supplement and MTX decreases Folic Acid and B Vitamins.  I take B12 also.

My hair very thin take healthy air skin nails by Andrew less an has helped but like you regrowth not same hair just started orencia infusions does anyone have info on this pretty scared taking this I'm 68 had ra 9 years

The biologic I have infused is Remicade so I am not familiar with your drug. I do not have RA, I have Ankylosing Spondylitis . When I started Remicade 15 months ago I stopped Methotrexate and my hair grew back much thicker than it had been. Plus I feel much better. Methotrexate had made me nauseous every week for 2 to 3 days. The infusion process at the hospital I go to is good. They make everyone very comfortable with  heated recliners , blankets  etc. I wish you good luck. If your infusion is like mine it is almost like going to the spa- well not quite, but nothing to dread. Plus the Remicade works very well for me. I hope your drug works for you and that your hair thickens as well.

I too have RA late in life diagnosis on Methotrexate -Folic acid  about 6 months .  Oh my god the clumps of hair - am taking Hair skin and nails as a supplement.  What else may I do?  Or is there another medication to take that doesn’t cause this?

I’d appreciate advice from anyone experiencing the same .  

Thank you !

It is such a difficult problem.  I was on Methotrexate for 7 years and it became increasingly toxic over time. I don’t know what dose of methotrexate you are on but if it is effective in controlling the RA maybe cutting  back on the  methotrexate would help. The methotrexate pills are 2.5 mg  each – I think most  people take 3 or 4   once a week  initially. I was up to 9 of the 2.5 tabs each week for quite a while.  Other  people may know of other alternatives, and others may have  alternatives to Folic acid ( I think  Folates I have heard some people  say can be a supplement that works better for some people than Folic Acid. Also some people have luck with Leucovorin instead of Folic Acid—for me Leucovorin  did not work with hair loss at all but everything is so individual  and some people say it helps a lot ) Make  sure  you  take a lot of Folic Acid ( like  1,000 mg per day) , and take lots of  Biotin- that helps with regrowth. Also  don’t brush your hair  when it is wet- that exacerbates the loss.  I have taken lots of different  vitamins that  helped a lot over the years.

After  about  7 years on Methotrexate I  was switched from Methotrexate to Remicade  which is a  biologic that is the  infusion version of Humira. It works well with no hair loss side effects- and lots of people have effective treatment with Humira and Enbrel too, but the cost can be high depending on your insurance. Even on Medicare  it costs @ $6,000  a year out of pocket. The great thing about Methotrexate is it is so low cost. All of the newer drugs are very costly.

Other drugs I have heard of are  Xeljanz and Leflunomide. I do not know their cost or effectiveness. Maybe others have had experience with them and can let you know about them.

I know how discouraging and  debilitating the massive hair loss is. What is so difficult is that it takes @ 3 months to see results so you don’t know if what you  are doing is working for a long time. The good news is once you go off Methotrexate any hair loss recovers. The trick is managing the loss while you are on Methotrexate. Good luck with trying to find the best alternative for you. It is just so individual  there is just not one solution. Also make sure you talk to your Doctor about  side effects  ( nausea,  hair loss, headaches  etc.) . Most Doctors are very helpful in trying to come up with alternatives that don’t cause hair loss or other side effects.

Steph G

Hi everyone, i was on 15 ml MTX for controling Psoriasis arthritis for two weeks and i quit becasuse it caused extreme hair falling although i used folic acid with it as well. Now it has been three months that i quit but the hairfalling keeps going. I havw tried diffrent hair vitamines Biotine,B complex but no results . Please share ur experience !!!

Ive only been on Metho for 6 weeks 7.5 mgs every Tuesday . ive doubled my folic acid, biotin, collagen and tonight doing my hair i noticed a big spot that is so thin and balding . i have chronic lyme with bad psoriatic arthritis. I get so sick the day i take them . only positive no shaving . i dont know what else to do to save my hair.

I might be very late and slightly gatecrashing here, but this may be helpful. I lost a huge amount of my long, thick, straight hair while taking prednisone for 2 years for PMR. It thinned, it snapped, it fell out ..I was beside myself. The ladies on the PMR forum recommended BIOTIN capsules and my hairdresser, who also had long, blond, thick straight hair and whose hair fell out after anaesthetic, recommended NIOXIN shampoo and conditioner with a weekly NIOXIN treatment. (her hair is now absolutley lustrous and long). My hair recovered, stopped falling out and began to grow back, albeit curly, which is a shock, but 12 months after starting the Biotin and Nioxin, and while still taking prednisosne , my hair is now quite thick and healthy, and getting longer. A regular trim keeps the ends tidy as it grows.

The kicker for me is that I finished tapering off the prednisone about 4 weeks ago, but have now been diagnosed with RA, and my rheumatologist wants me to start methotrexate. And so, I fear, it will all fall out again........

hi so I've only been on methotrexate for a couple years when it started causing me significant hair loss within a span of three to four weeks due to some onset extreme stress in my life but my rheumatologist noticed it at the end of the appointment and she recommended me taking two of my folic acid but then didn't send me a prescription into the pharmacy to meet that requirement. so when I looked into it more folic acid is the least bioavailable form of the folate so you either want to actually take folate or methylfolate which is even more bioavailable in our bodies because it skips certain processes but also for folate to work appropriately it also needs to be in combination to b12. but also there is nothing wrong with taking large amounts of this vitamin because it's what you call water soluble which means anything our body is not using we will just pee out so it's not dangerous and I've confirmed this with several pharmacists. so currently I'm taking b complex with a combination of this methylfolate and B12 on top of the folic acid that I get prescribed one tablet a day but it's all so new for me that I haven't seen any results yet just because I've been doing it for like 3 weeks. I've been on 20 mg of methotrexate which I inject once a week so that it skips my digestive tract I was having really bad acid reflux and I would rather just inject it anyways I'm also on a biologic injection too but that one does not cause hair loss I've already spoke to the specialty pharmacist about that as well so I'll keep you all updated on my little front but I'm really mad because it took 3 years for this to start killing my hair and some stress who knew.