Yes I have been taking folic acid since I started taking MTX. I am also on Plaquenil 100mg twice a day and prednisone 5mg daily along with Humira every other week.My rheumatologist isn’t sure if any of these meds are causing me to be anemic or if it’s just RA itself. She is trying me without the MTX until after I have the bloodwork tomorrow and see what the results are. She told me not to take it until I heard back from her. I will know the results in about 2 hours. I have my bloodwork done at quest and they send me an email when the results are final and a link to see results. Guess we will know tomorrow. Thanks for all the info you have given me.

MTX deletes the folic acid in your body and then patients will get sores in their mouths and on their lips. There are so many options now to use for RA. Rebecca if the MTX has put you in remission great. Then it takes more than a few days to get out of remission and the RA takes over. Were you taking folic acid with the MTX? Also iron deficient anemia is from more than one isolated drug for RA. We have a chronic autoimmune disease that depletes our nutrients. I have always taken a MVI with Iron it’s a little constipating but I can handle that. If your HCt and Hgb were severely low like 8 that is alarming. I only go that low after I had major surgery which I had twice. Had to amp up my iron which there are brands that are more gentle on your digestive system.
I want to get this across. The benefits of taking DMARDS for RA outweigh the risks

I tried to take methotrexate years ago. It gave me severe diarrhea. I lost 10 pounds in one week. Well due to insurance we had to change from orencia back to the old try and true. I took methotrexate for five days and ended up with severe mouth sores. It has been two weeks since I quit taking it (the five days) and I still have sores under my tongue and back of my throat. The side effect is not worth it Once you find a medicine that you can take without side effects stick to it. Some of the RA meds are worse than having RA .
I had steroids injected in my fingers yesterday. The pain was definitely worth it. I can bend my fingers today with minimal amount of pain. I will see how long it last but right now I can make a fist. I can’t pick up something heavy just yet but I am thinking positive.

It’s a shame that we take all these meds to keep us moving and help with the pain and in the process of it all it hurts other parts of our body. Having RA in itself causes so much fatigue and now being anemic on top of it makes me feel even more exhausted. My rheumatologist has my methotrexate on hold for now. Having another H & H drawn tomorrow so I guess we will see if being off of it has made any difference. My rheumatologist told me not to take it until I heard back from her. So far I can’t tell any difference in how I feel.

Also they did a study about the use of prednisone. MTX and prednisone is the standard of initial care. Guidelines differ on the early treatment of RA – ACR suggests not to use glucocorticoids (GC) and EULAR updated recommendations for RA treatment presented at #EULAR2025 continued to suggest early treatment with MTX and glucocorticoids (1). We do know that it is not easy to get a significant minority of RA patients off of prednisone.
This is from a website that I learn about RA because I was a nurse practitioner. It has medical terminology but it’s a great look for the best information it’s rheumnow.com and ACR is the American College of Rheumatology another great place for all the latest research.