Ms.

[kaleidoscope357]

Hello, I am a 51 year old Caucasian female with rheumatoid arthritis and fibromyalgia. How long after stopping methotrexate (MTX), should I continue folinic acid (Leukovorin)?  I was on methotrexate  for ~1 1/2 years (last 6 month at 20 mg/ week). I had hair fall, then finally frank alopecia and discontinued the MTX one month ago. During the last month of treatment, I asked that my folic acid be changed to folinic acid (Leukovorin). Not sure if it helped the hair loss or not, but it helped my fingernails. I finally discontinued the MTX  ~1 month ago . About 1 week after stopping MTX, I stopped my folinic acid and my hair loss seems to be worse and also my nails are splitting and my tongue is sore. ( I also had 2 Remicaid infusions 2 months ago in August and 1 week of Arava in May and am on Plaquenil (past 4 months and for awhile in the past).

[kaleidoscope357]

Thanks for the advice. I will see my physician.

[Dr. Kokil Mathur]

Hi!
Hair fall, split nails and sore tongue can be due to iron deficiency anemia, pernicious anemia and other B-vitamin deficiencies. Hence taking only folinic acid will not help. You must get your blood tested for iron, vitamin B12 and folic acid deficiency. Depending on the test results you have to start appropriate supplements. You can discuss with your treating doctor. Take care!