2 conditions taking their toll

I was wondering if anyone had any ideas on ways to help me feel better.  I have more than one chronic health conditions, but the two that seem to be at different ends of my conundrum now are RA and CFIDS.

The medication I am on for RA, Methotrexate and prednisone, is suppressing my immune system like it is supposed to.  However, in doing this it has caused the EBV to go wild and the fatigue is so severe.  I have been to an infectious disease doctor who told me there is nothing he can do until I would get off the immune suppressing drugs.    

I take good quality vitamins in addition to the different medication I am on.  I was hoping that someone out there may have the same comorbid conditions and have found some help.  Any input would be appreciated!

Thanks all, Karen

[carolanivey]

Hi Karen,

I'm sorry you're having so much trouble. I also have RA, for which my main medications are methotrexate and Enbrel. If mtx isn't working for you, I would urge you to look into adding a biologic like Enbrel or Humira to the mix. It's very important that you get off the prednisone if at all possible. It can give you short-term relief but trust me, the long-term effects of prednisone are not worth it.

I don't have your chronic fatigue issues, but I can see where mtx can contribute to that problem! I assume you are taking a prescription folic acid tablet 24 hours after your mtx dose? This can help alleviate some of the unpleasant side effects like mouth sores and hair thinning. It's important that you do NOT take anything containing folic acid on your mtx-dose day, because both substances compete for the same chemical receptors in your body. Let the mtx do its thing for a full 24 hours before taking your folic acid and vitamins.

Something I might suggest is switching from oral mtx to injectible. I switched to injectible a couple years ago and my nausea and mtx-induced fatigue have pretty much disappeared. Maybe if you switch, at least the mtx won't be contributing to your EBV.

RA in itself is a drag on your energy reserves - I can't imagine what it must be like to have both RA and EB! Since you have RA, getting off immune suppressants isn't much of an option. Find a rheumatologist who is willing to consult with your other specialists in order to come up with a treatment plan that will work for you.

Good luck!
Carolan

[kmil1999]

Thank you so much for your reply.  I am taking th Folic Acid.  Am I not supposed to take the Folic Acid on the MTX day?  Also, should I also hold all my vitamins and other supplements on that day too?

Thanks for the help.  Luckily, I take the MTX at night and haven't had any of the side effects.

Thanks again,
Karen