If you are living with lupus, your doctor may have prescribed methotrexate (Rheumatrex) for relief from chronic inflammation and improved movement in your joints. Methotrexate is used to treat autoimmune diseases like lupus and can calm down the overactive immune response linked to certain conditions. An autoimmune disease is a condition in which the body’s immune system mistakenly attacks its own healthy cells and tissues, leading to inflammation.

Methotrexate, like any medication, can potentially cause side effects that may prompt your doctor to discontinue its use in your treatment plan. Sometimes, individuals with lupus who are prescribed methotrexate may also be recommended to take a multivitamin supplement called Rheumate. This supplement aims to reduce the side effects of methotrexate and enhance a person's overall well-being, ultimately improving their quality of life. Read on to learn more about how taking Rheumate may help manage the side effects of methotrexate.

What Is Methotrexate?

Methotrexate is a disease-modifying antirheumatic drug (DMARD) prescribed to treat lupus. It is also used to treat other autoimmune disorders like psoriasis or rheumatoid arthritis.

Methotrexate works by preventing the cells in your body from using folate (folic acid). Folate is an important nutrient used by cells to carry out basic functions like making DNA. To use folate, your body uses an enzyme to convert folate into methyltetrahydrofolate, the active form of folate. By preventing your body from using folate, methotrexate helps calm your overactive immune system and decreases lupus symptoms.

Side Effects of Methotrexate

Although methotrexate is mostly used to treat lupus, it can cause side effects that may negatively affect your well-being. These include:

• Gastrointestinal symptoms like nausea, vomiting, upset stomach, diarrhea, loss of appetite, and mouth sores
• Fatigue and weakness
• Liver problems
• Blood cell changes including anemia (low red blood cells), increased infection risk, and a tendency to bleed more easily
• Skin problems including rash, itching, or sensitivity to sunlight
• Lung problems such as coughing and shortness of breath
• Alopecia (hair loss)
• Weakened immune system

Methotrexate Can Cause Folate Deficiency or Make Folate Deficiency Worse

Folate deficiency happens when your body has less active folate than normal. Some people have a problem with the gene responsible for making the methylenetetrahydrofolate reductase (MTHFR) enzyme. The MTHFR enzyme transforms folate into a form that the body can use. This process is important because folate is needed for tasks like building DNA and fixing damaged cells. Because they are unable to convert folate into its active form, these people often have a folate deficiency. This deficiency can be made worse by methotrexate treatment.

Some of the side effects caused by methotrexate result from folate deficiency. For some people, such as those with problems in their MTHFR gene, these side effects are bad enough that they have to stop taking methotrexate. One way to treat folate deficiency (whether or not it is caused by methotrexate) is to take folate supplements. Taking these supplements may help lessen your side effects so you can continue taking methotrexate to treat your lupus.

What Is Rheumate?

Rheumate is a multivitamin supplement used to decrease the side effects of methotrexate and improve lupus symptoms. It is only available by prescription and cannot be purchased over the counter like other supplements. Rheumate is classified by the US Food and Drug Administration (FDA) as a “medical food” and not a drug.

Medical foods are not meant to treat a disease — they are designed to supplement your diet to help manage symptoms of a condition. Medical foods must be safe to eat but do not have to go through clinical trials to get FDA approval. For this reason, Rheumate was not tested in clinical trials to see if it actually helps lessen methotrexate side effects. Despite this fact, there is research supporting the use of the ingredients in Rheumate to help manage both the side effects of methotrexate and the symptoms of lupus.

Ingredients in Rheumate

Rheumate comes in a tablet that contains the chemicals methyltetrahydrofolate, vitamin B12, and curcumin. These chemicals are added to Rheumate tablets to help the body process folate better, keep the nerves healthy, and reduce inflammation.

Methyltetrahydrofolate

Rheumate contains methyltetrahydrofolate (the active form of folate) so your body doesn’t need the MTHFR enzyme to convert folate into the active form. This helps to restore folate levels that have been lowered by methotrexate treatment or due to a problem with your MTHFR gene. Some of the potential side effects of taking a folate supplement include a loss of appetite, nausea, a bad taste in your mouth, irritability, and problems sleeping.

Taking folate can interfere with how some drugs work. Your doctor may have you stop taking Rheumate while you are on these drugs or have you take your medication a few hours after taking Rheumate. Finally, some people are allergic to folate. Be sure to talk with your doctor immediately if you experience difficulty breathing, swelling, or itchiness after taking folate.

Vitamin B12

Taking folate supplements can make it hard for your doctor to tell if you have a vitamin B12 deficiency. Too little vitamin B12 in your body is dangerous and can potentially cause neurological (brain and nerves) problems. Rheumate contains vitamin B12 to help prevent this from happening. At high doses, vitamin B12 may cause headaches, nausea, diarrhea, tiredness, or a tingling sensation in your hands or feet.

Curcumin

Curcumin is an antioxidant that is made by the turmeric plant that may help decrease the inflammation caused by lupus. Curcumin is safe to take, but some people have reported nausea, diarrhea, headaches, skin rashes, and yellow-colored stool after taking curcumin.

What MyLupusTeam Members Are Saying

Rheumate has helped several MyLupusTeam members with their lupus symptoms. One member shared, “Rheumate has been extremely successful with alleviating joint aches and the tingling and numbness occurring in my fingers and toes. My headaches have also subsided.”

Another member expressed, “I started taking Rheumate to increase my energy and help with my muscle pain. I feel so much better! Everything is CLEAR. The brain fog is gone too. Turns out, I have problems in both MTHFR genes so, my body really needed the folate. I’m so pleased!”

Your Doctors Are Your Best Resource

Talk to your rheumatologist or other health care provider if you’re considering incorporating Rheumate into your treatment plan. Remember that individual responses to supplements can vary, and seeking medical advice before adding any new supplement to your regimen is highly recommended. Your health care provider can provide personalized guidance based on your specific health needs and circumstances.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Have you tried Rheumate to treat the side effects of methotrexate? Has it helped? Share your experience in the comments below, or start a conversation by posting on your Activities page.