Anyone correct me if I'm wrong here. RA attacks our joints along with other body organs causing inflammation. It's the inflammation that then causes the pain. We need to do what we can to protect our joints and organs. You can certainly go without drugs. The Paddison Program (Google it) is a great example of people with RA that have changed their eating and never need meds. Perhaps you are able to keep the inflammation and pain controlled with diet and exercise.
Methotrexate is the first drug doctors usually start a client with. Diet and exercise were not enough for me. So I chose to start Methotrexate as a way to prevent any damage while I still eat right and exercise.
If you're on Hydroxychloroquine and do Ok, why would your doctor want to move you to Methotrexate?

Doctors now realize that they should hit RA fast and hard to prevent joint damage. Read about "treat to target" on the American College of Rheumatology and many other sites. Helps to see the big picture.

Just diagnosed this June, my rheumatologist put me on hydroxychloroquine. I was high dosed for a month and then went to a standard 200 mg/day. I was pain free and I considered this to be remission. Unfortunately about day 35, I broke out in an all body rash that was a drug reaction to the hydroxy. My rheumy wanted to see the rash and we talked about other alternatives after I got rid of the rash. I am very disappointed that I can't go back on the hydroxy. So, not taking any meds for my RA but will see my rheumy in 2 weeks. His philosophy is that without meds, your RA continues to work on erosion of joints and organs. (just like Desert Rose said) For other reasons, he said I am not a candidate for methotrexate and is considering sulfasalazine or a biologic. I know the biologics are very expensive but from what I am learning there are ways to minimize costs. I feel like a guinna pig trying drugs.
Good luck figuring out what drugs work for you.

Hi Rose, thank you for your reply. I need to know because I have been on hydroxychloroquine for about 2 years and seem to be ok with it. Yes, my hair thinned a bit but no stomach sickness the way I felt last week. I need to know how bad a person has to be before going onto MTX. What are the symptoms for a doctor to put you onto this? if I am already on hydroxy would I still need MTX? Unfortunately I can't ask my original specialist because he got Covid and had to give up his practice.
So let me get this straight: what you are saying is that MTX is better than hydroxy? and once I am on MTX I could give up hydroxy? or would I have to be on both?

Methotrexate is almost always a first line treatment for RA It is considered the "gold standard." It boosts other medicines Even the maximum dose is quite low compared to that prescribed for cancer for example. I would keep it in the repertoire for sure.