First, how old are you? Second, do you feel your inflammation is under control? Those answers will help me help you. If you' consider a biologic at any point (that's drugs like Humira and Xeljanz) don't settle for just the TB test to determine safety...also get a lung scan to rule out MAC (a non-tubercular lung infection that, like TB, worsens quickly with a suppressed immune system). Most Rheumies are completely I'll informed about it.

Julie,

I haven't had side effects from medication in 10 years. I did have fatigue, but my rheumatologist offered a stimulant, which I declined as it just masks fatigue. Then she offered a sleep aid, and I selected Lunesta, which has been very helpful to me. The rheum added in prednisone for an entire year in addition to my methotrexate of 20 mg. I now realize this was a poor choice. She had me on prednisone again for another 6 months. Prednisone is not a good drug because of the side effects of making your tissues paper thin, osteoporosis (I'm osteopenic right now), etc. I will not take it anymore. She should have put me on a biologic. Hindsight. It's a learning curve for us. You'll be on methotrexate for awhile. I'm on a low dose injection because my liver tests went up 2.5 and 3x the norm at one time. I think the injection of methotrexate is best as you get an accurate amount of drug, and it avoids the first pass on the liver (easier on the liver). Try not to go to far into the future with RA as we don't know what medications will come out or new findings that will help us. RA didn't affect my hands until the last 3 years. I don't have disfigured hands, but I notice some changes. My xrays show changes. My feet were first affected, but they don't really bother me now. Thank God. We really have to learn as much as we can to help ourselves. I am now at the point where I'm having a baseline echocardiogram, so that I'm on top of my cardiovascular health. My pulmonologist had me to do a diffusion capacity test for my lungs every 6 months to make sure the methotrexate wasn't causing any damage as well as a chest x-ray once a year. My rheumatologist told me she thought that was overkill, however, if I had damage, is it overkill then? I've had several rheumatologists, but I believe the one I have now is the best. She actually doesn't think that all biologics are the same! Of course they're not. She's concerned about safety. First time I've ever heard of that. Anyway, if I can be of help, feel free to private message me. It helps if you know someone to help guide you. One day at a time.

Arla