RA, methotrexate and Anemia recently diagnosed

Hi @juj, Methotrexate can cause low levels of red blood cells. I've expanded the title of your discussion and am tagging fellow RA-ers who have experience with methotrexate like @sheilaray @sueinmn @suzannesparks @virgo1952 @kimberlynitz66 @oregongirl @ellens among others. They may also have experience with anemia.

Juj, how has your doctor suggested managing the anemia while on methotrexate?

Methotrexate maybe lowering your immune system to fight infection. Treat the anemia to strengthen your suppress immune system then the RA. Your White blood cells may soon elevated and lymphocytes. Then you could develop Sjorgens syndrome, or lymphoma.
My symptoms were weakness in both legs after COVID . I developed pain in right ankle like a sprain. My doctor told me I have RA. I took methotrexate for 10 months and kept feeling worse. Then my WBC elevated and B lymphocytes. I developed sjorogens syndrome. I went to a Rheumatologist I told him I could not take methotrexate anymore. He put me on Hydroxychloroquin (anti malaria drug). Another doctor told me my iron level was low and put me on iron supplements. I then started feel strength back in my legs. I can stand from a sitting position without holding on. I can now climb stairs. I went back to work after 10 months. The hydroxychloroquin bothers my eyes now so I only take 1/2 the dose. Your body RA maybe mild to moderate and not need such powerful drugs with all the side effects.

We are in a TOUGH spot w/ my husband's RA (77 years old) which was awakened by the Covid Vaccines. First on Cimzia for 9 months and developed severe antibodies due to it. Switched to Methotrexate 2-3 years ago. NOW, had a TAVR 9/25, 2 stents put into his Circumflex Artery 8/2025. NOW has severe Anemia and had a pacemaker put in 3/2025. He is headed back into Anemia right now after 1 transfusion and 6 units of iron over a 8 day period 4/2025. Today is 5/4/2025. What are we supposed to do, NOW?

Hematologist called today. She said she is almost 100% certain that it is the TAVR (Aortic Valve Replacement) and NOT the RA nor Methotrexate. There is a balloon procedure to fix it. Will know more after Thursday (May 8, 2025) when we meet with the surgeon.

@ginsus

Hugs prayers for a good outcome.

@hendripl69 Welcome to Mayo Clinic Connect! I’m really glad that you found this site. Are you on this particular support group because you have an autoimmune disease? What can we help you with?

After my left hip replacement in fall 2024 and some severe nosebleeds in winter 2025, I developed persistent anemia. It caused the delay of my right hip replacement surgery. So, then many layers of investigation began - lots of lab work, upper endoscopy to check for GI bleeds, referral to hematology to check for bone marrow or cancer issues (I am a two-time cancer survivor) - nothing showed a reason. My rheumatologist suggested stopping methotrexate. I had been on it for decades. I have been off it for about 10 weeks now and my hemoglobin, hematocrit, and RBC are slowly climbing back up - not quite in the normal range yet but encouraging. All this while still having frequent nosebleeds! My ferritin is still quite low, so an iron infusion is not ruled out yet, as I cannot tolerate oral iron. But the main thing is I have been able to reschedule my surgery. so far, my RA has not flared terribly, as I am still on Xeljanz and a small dose of prednisone. I am still taking my daily folic acid and my weekly leucovorin to help clear the methotrexate.

@becsbuddy

Well, not completely diagnosed as of yet as everything is taking time.
Taking Methtrexate, Retinal Vasculitis, Low hemoglobin and hematocrit, and very serious vertebrae damage throughout back.

I also believe my esophagus is involved developing Barretts and having 2 radiation treatments last year.

Going thru the second opinion Spine Specialist because my Rheumatologist recommended.

Still suffering 5 months on Methotrexate