Part 1: Should I Treat Rheumatoid Arthritis with Methotrexate?

Get the facts about methotrexate before you decide

Over and over, I read these warnings on message boards about methotrexate. One RA patient is telling another newly diagnosed patient: “Hey, watch out. Don’t take methotrexate if they try to give you that! It’s gonna really mess you up.”

I approach this topic with trepidation, wondering if it’s about as controversial as war or water boarding right now. Is methotrexate necessary to fight Rheumatoid Arthritis or more nasty than it’s worth?

I guess that depends on your point of view. Methotrexate does have side effects, which we’ll discuss, but do they outweigh its benefits? This is a decision which belongs to each individual Rheumatoid Arthritis patient. However, it ought to be an informed decision.

Risks and benefits

Weighing risks and benefits is one of the cool skills we as RA’ers get to perfect that others don’t spend much time developing. We learn about what a certain therapy can do for us in the short term and the long term. And then we consider: “What’s that gonna cost me?” in the short term and the long term.

Finally, we ask ourselves: “Is it worth it? Will my life either be improved or extended so that the unpleasant side effects are outweighed?” Perhaps deciding to take methotrexate is a bit like marrying a rich gorgeous-looking person who has perpetual bad breath. Not a charming thought.

RA is not a charming diagnosis either. Rheumatoid Arthritis is a formidable adversary. When I think of the things that it can steal from us, I am angry. If an intruder were in my house robbing me, and I had a weapon that would stop him, I would use it. Methotrexate is one powerful weapon in the arsenal against RA. An RA Warrior wants to have every possible weapon to fight this powerful disease.

In this series, we will explore some risks and benefits of methotrexate for Rheumatoid Arthritis in more detail because, for most RA patients, it remains a valuable treatment option. Everyone does not need to make the same choice, but we ought to all be able to make an informed choice.