RA, methotrexate and Anemia recently diagnosed

Posted by juj @juj, Feb 25, 2023

I have rheumatoid arthritis and have been taking methotrexate since July 2022 with 2 infusions of Rituximab in January. I have blood drawn every two weeks with my baseline established June 2022. My RBC, hemoglobin and hematocrit have been declining with each blood test and all three results are out of range. I recently had bloodwork for Iron TIBC, folate, serum, vitamin B12 and ferritin and all results are in range. Does anyone have experience with this or something similar?

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Colleen Young, Connect Director | @colleenyoung | Mar 3, 2023

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?

angellav | @angellav | Mar 4, 2023

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.