Hello,I have been on 50 mg of azathioprine for nearly 29 years. I was placed on it by Dr. William Tremaine of Mayo. I had severe chronic pancolitis and was possibly looking a having to have a colectomy. He asked that we try one thing before moving on to life changing surgery. Every new GI doctor questions the dosage at 50 mg as it is the lowest dose available - this is what I started on and it has never changed. Many tests over the years to verify 50 mg is a therapeutic dose for me. Only within the last decade I have started to have some precancerous and recently cancerous skin conditions as a result of the azathioprine. All have been treated properly and I see a dermatologist annually. I would ask your prescribing doctor if you could back off for a bit and see if you improve. Azathioprine is an immunosuppressant and long term use does have its problems. It is not for everyone and it might be beneficial to really discuss options with your provider. I have had mild hair thinning due to the azathioprine but I am now 69 so this is expected. I do hope you find something workable because quality of life is very important as well. I wish you the best.