If you have lupus, you may have received a methotrexate prescription from your doctor to relieve inflammation and improve joint mobility. But like any medication, methotrexate comes with potential side effects.

To help avoid some of methotrexate’s unwanted side effects, doctors sometimes recommend a prescription supplement called Rheumate. Here’s how it works and why it could be an important part of your treatment plan.

What Is Methotrexate?

Methotrexate is a disease-modifying antirheumatic drug (DMARD) that is often prescribed to treat lupus and other autoimmune disorders like psoriasis or rheumatoid arthritis. Higher doses of methotrexate are also prescribed to treat cancer.

Methotrexate helps control lupus by calming certain parts of your immune system that cause swelling. It also blocks your cells from using folate (folic acid) — a type of B vitamin that supports basic functions like making red blood cells. Normally, your body changes folate into its active form so it can use it, but methotrexate interferes with this process. Together, these effects help lower inflammation and relieve lupus symptoms.

Side Effects of Methotrexate

Methotrexate is often helpful for lupus, but it can have some negative effects, too. Possible side effects can include:

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

Methotrexate and Folate Deficiency

Folate deficiency happens when your body has less active folate than normal. Taking methotrexate increases the risk of a folate deficiency. Your healthcare provider can check for signs that you’re low in folate and help you find the right balance for your body.

To help prevent a folate deficiency, healthcare providers usually recommend that people with lupus take a folate supplement while taking methotrexate. Folic acid is a synthetic form of folate. It’s sold without a prescription and often included in multivitamin supplements. Taking folic acid has been shown to greatly reduce methotrexate side effects, such as stomach problems.

What Is Rheumate?

Rheumate is a prescription supplement that contains folate along with a few other active ingredients. The U.S. Food and Drug Administration (FDA) classifies it as a “medical food,” not a medication.

Medical foods aren’t used to treat a disease. They’re designed to supplement your diet to help manage symptoms of a condition. Medical foods must be safe to eat but don’t need to go through clinical trials to get approved by the FDA. Because of that, Rheumate hasn’t been tested in large studies to show how well it works or whether it provides all the benefits listed on its label.

Does Rheumate Help With Lupus?

Rheumate hasn’t been studied in clinical trials for lupus or methotrexate treatment. However, some of the ingredients in Rheumate have been researched on their own.

Each Rheumate tablet contains methyltetrahydrofolate, vitamin B12, and curcumin. These ingredients are meant to help the body use folate more effectively, keep nerves healthy, and reduce inflammation. Here’s what the research says about those claims.

Methyltetrahydrofolate

Rheumate contains methyltetrahydrofolate, which is the active form of folate. It helps restore folate levels in people who have trouble processing folate, such as those taking methotrexate. Possible side effects of folate supplements include loss of appetite, nausea, a bad taste in your mouth, irritability, and trouble sleeping.

Folate can affect how some medications work. Your doctor may ask you to stop taking Rheumate while you are taking certain drugs or to take your medicine a few hours after taking Rheumate. Some people are also allergic to folate. Call your doctor right away if you notice swelling, itchiness, or trouble breathing after taking folate.

Vitamin B12

Taking folate supplements can make it harder for your doctor to tell if you have a vitamin B12 deficiency. A lack of vitamin B12 in your body can be dangerous and may cause neurological problems (problems with your brain and nerves). If you’re taking folate, it’s usually a good idea to take B12 to avoid a B12 deficiency. Because Rheumate contains both folate and B12, it helps lower the risk.

Like other B vitamins, B12 is water soluble. This means your body gets rid of any extra B12 through urine. As a result, it’s very rare to have any toxic effects from taking too much B12.

Curcumin

Curcumin is a chemical that comes from the turmeric plant. This natural antioxidant may help reduce the inflammation caused by lupus. In one small study of 62 people with lupus, curcumin supplements were found to lower autoimmune activity and inflammation. However, evidence for its role in lupus is still in its early stages and not based on large clinical trials.

Although curcumin is generally considered safe, scientists haven’t yet been able to recommend a specific dose or guidelines for taking it. Curcumin doesn’t absorb well in the body unless it’s made with special ingredients to help absorption. It can also affect how some medicines work, especially blood thinners and drugs that weaken the immune system. Always talk to your doctor before trying it.

What MyLupusTeam Members Are Saying

Many members of MyLupusTeam have said that Rheumate has helped with their lupus symptoms and improved their quality of life. 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 shared that Rheumate has helped with their overall well-being: “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 my body really needed the folate. I’m so pleased!”

Remember, whether you take prescription Rheumate or an over-the-counter folate supplement will depend on medical advice from your rheumatologist.

Your Doctors Are Your Best Resource

If you want to take Rheumate, you’ll need a prescription from your doctor. Talk to them about the pros and cons of taking Rheumate instead of a regular folate supplement to help them guide you toward the best treatment for you.

Your healthcare team knows you best. They can track how you’re doing on methotrexate and watch for any side effects that need attention. Together, you can make the most out of your lupus treatment and use all the resources available to you.

Join the Conversation

On MyLupusTeam, people share their experiences with different types of lupus, get advice, and find support from others who understand.

Have you tried Rheumate? How did it work for you? Let others know in the comments below.