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    Methotrexate and Liver
    An_248434 posted:
    I have had sero-negative RA for over 10 years (I am 35). I started 15 mg of methotrexate once a week (on Monday) 3 months ago. At first, the side effects were terrible (flu-like pains, fatigue, nausea). But then my doctor added in 6 mg of folic acid every Friday and had me split the methotrexate into 2 equal does 12 hours apart on Mondays with a little food each time. This made a considerable difference and now my hands don't hurt nearly as bad and I can even make a fist. However, I have recently been diagnosed with a fatty liver and inflammation (with very bad right upper quadrant pain). I have read that the methotrexate can cause this, however my rheumatologist says I have not been on it long enough to cause any liver problems. I am going to see my gastroenterologist next week for more testing. Has any else been diagnosed with liver problems so soon after starting methotrexate (I have not had any issues in the past with my liver).
    Scott Zashin, MD responded:
    It is best to avoid MTX in patients with liver issues and I suspect the MTX was not the cause of this problem. Glad you are getting checked out with your GI doctor. They will be able to give you more information.

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