Anyone have any experience with taking methotrexate and doing an Ironman/or marathons? Problems, side-effects?
No, but it’s a pretty strong drug with a lot of negative side effects. I was on Plaquinel (nothing like Methotrexate from what I hear as far as side effects) and my times were never slower. I took it for about a year and a lot of my autoimmune symptoms went away so I felt better in some ways, but I was SO weak, and I just kept getting weaker. I decided to get off of it and just take a lot of fish oil, vitamins, eat well (Paleo diet most of the time) and just deal with my remaining symptoms. My times imediately got faster when I quit taking it. Do you have an autoimmune condition? Cancer?
Autoimmune. I will be on a “low dosage” of once a week for about 6 weeks.
Good luck, I have a friend who did it and it helped her a lot. Don’t know about training for an IM though. I would think it is a bad idea. When I was on Plaquinel I was only training for sprints as my body could no longer handle the long training. I have made a decision to stick with sprints and Olys because my recovery from longer workouts just doesn’t happen and I am chronically tired.
Wife takes it weekly and has been for 15+ years. Trained/completed 25K USMS open water swim and won her AG. Not a doctor. Talk to one.
Best of luck!
have some autoimmune issues and was on prednisone for a long time. was just about to switch to methotrexate, but instead tapered of the 'roids and am in a ‘wait and see’ instead. main thing w/r/t training (to say nothing of all the other crazy side effects and indications!) is your liver, i think. m’trex is hard on the liver, and so are 6-hour bike rides fueled by sports drink. make sure your doc knows you’re an endurance athlete and they’re watching your liver function!
-mike
p.s - i’m not an MD
I was on it about 3-4 years ago for rheumatoid arthritis (47 yo) … got off it for a couple of years, but nothing else seems to be working so I’m back on it (+ embrel).
I’m expecting fatigue and hair loss again … and (as iron_mike said) liver function has to be monitored while on methotrexate (regular blood draws).
I suggest trying to stay away from prednisone … it works to alleviate symptoms … but side effects are inevitable.
Make sure you work with your doc to find the right med(s) … hopefully, your doc understands your athletic/exercise goals if he/she doesn’t, you might want to search for one that does.
biggest side effects are lung and liver toxicity… but most people who get these side effects have been on it for a very long time…
i say what i do about the liver because endurance exercise has a real impact on things like ALT and bilirubin. throw a couple of headache tablets and a beer or two (and any other prescriptions!) into the mix and you’re actually pushing things pretty hard. when you tell most docs that you exercise, they’re thinking you’re on the nordic trak for 20 minutes 3 times/week. and you’d better believe there isn’t too much peer-reviewed clinical research on drug interactions and exercise at triathlon-style volume or intensity! so just make sure you spell out your training, diet and supplements clearly to your doc.
also:what he said about prednisone - that was possibly the worst year of my life. acne, hair loss, muscle wasting, huge mood swings, appetite swings, sleeping swings . . . and eventually my liver got so angry i started turning yellow. it’s a miracle drug for a million different conditions, but it’s also a very blunt instrument!
lastly: all that immuno-suppression (trexate AND ironman training!) means you’ll be more vulnerable to niggling infections. so be extra careful about washing your hands, and bet very fastidious with papercuts, blisters, etc. my cuts used to take AGES to heal!
-mike
This is a good place to get a short synopsis on risks and side-effects:
http://www.orthop.washington.edu/PatientCare/OurServices/Arthritis/Articles/Methotrexate.aspx
It is your body.
hey gj,
i’m on methotrexate (and humira weekly) for rheumatoid arthritis. i’ve been on methotrexate for about 7 yrs. did ironman wisconsin in 2009. no issues with training or the race. when i first started taking it, i noticed fatigue the day i took the dose (25mg), but afterwards was fine. i’m down to 7.5mg a week now, and have no issues whatsoever. at the higher dosage, when i did get a cold or other infection, it would hang on a bit longer than normal, but i wouldn’t say that i was sick a lot.
for me, being on methotrexate and having it keep my symptoms at bay is far better than the alternative. the only real downside is a serious drop in my alcohol consumption!
I like my doctor but as others have said, usually they don’t take into account how rough I’M is. They were rather “I don’t see why there would be a problem” and they have been somewhat flippant about how heavy the drug is. They would rather put me on enbrel…which I think is both ridiculous and ridiculously expensive.
My isssue is that my condition, which while annoying and increasingly hard to treat after 28 years, it is not life threatening and nonpainful. It just seems like the treatment carries far more risk than the disease.
hey madz,
Your post has given me some hope! I am 29 yrs of age and last year (2010) I completed a 70.3 ironman and I had signed up for a full IM in Coeur d’Alene for this June. Was just diagnosed in beginning of February this year after having symptoms since last October 2010 that doctors couldn’t figure out. I just started taking methotrexate and enbrel for RA this past week. Would you happened to have talked to or know anyone else besides yourself who has been able to compete in the full IM races without any significant problems? I’ve read so many different posts about how sports drinks are bad for your liver, or how people with RA shouldn’t be doing these races. I have my heart set on doing this race, I just want to be reasonably sure that doing this race won’t make my condition even worse off. Would you happen to have a training regimen in terms of what you eat and what your training schedule is? Any advice would be greatly appreciated.
One IM race won’t kill you.
Years of this drug plus IM will get you on dialysis 3x a week just a little bit more early (probably 5-10 years)… and then it is just a question of time.
My mom took it for 10 years and she didn’t do an Ironman.
She made it till 70.
May she rest in peace.
i’m glad you’re receiving treatment so soon. i went almost 6mos before starting methotrexate and by then my right wrist was pretty much shot. from my experience and research, i disagree with the previous poster’s statement that you will be on dialysis because of the drug and IM’s. i have been on my “drug cocktail” for about 7 years now, and my liver/blood counts remain unaffected. occasionally, after a particularly hard race my enzyme counts will be off, but my doc and i finally figured out that it was due to the enzyme release from muscle breakdown. a week later the counts were back to normal.
i try and incorporate as many anti-inflammatory foods and supplements as i can in my diet. fish and foods high in omega 3, i.e. ground flax seed, salmon, omega 3 fish oil supplements, etc. my doc has said it is ok for me at my weight (6’ 2" and 175 now and 162 IM weight) to have 2-3 beers a week. regular blood labs confirm no change in liver counts.
after discussion and research, my doc’s only concern about doing IM was to make sure that i was not under trained at all. concern was that i would push too hard and suffer critical dehydration and impact the liver. i had a bit of dehydration, but to no effect. my doc is actually very happy that i am doing tri’s, as i feel much better overall when i am training. much less stiff and sore.
everyone is different and reacts different to physical stress. my symptoms are primarily in my wrist and hand. if they were in my ankles or knees, i might have a totally different point of view.
don’t give up and keep pushing! good luck.
Hey Madz,
Thanks again for your insight. To anyone else who is out there, I can definitely provide more tips now that I have gone through a full tri-season fighting rheumatoid arthritis. If anyone out there has any questions, let me know. This year I was able to finish the Ironman Coeur d’Alene race, the Rev3 Quassy, the Toughman Half, the 70.3 Ironman Poconos and several other sprint tris and training camps. I am signed up to race Ironman New York next year 2012 and still have the New York Marathon left for this year!
I remain dedicated to taking my methotrexate and Enbrel and still do feel some pain on my longer runs, albeit on a much smaller scale. I have completely cut out all alcohol in my diet as I don’t want to risk anything else in my body. I take a multivitamin, a fish oil capsule, an echinacea supplement and a folic acid tablet every single day in addition to eating milled/ground flaxseed w/ greek yogurt every day. My symptoms remain in my hands, wrists, shoulders and both feet.
I wish the best to everyone out there and good luck in your races.
hopefully folic acid as well b/c of methotrexate use.
hopefully folic acid as well b/c of methotrexate use.
My wife’s doctor did not prescribe that initially. Big difference when another doctor caught that.
The wife can handle up to half distance but when trying to get to the load needed to do a full she just had to miss too many days. She is on weekly injections plus a host of other drugs for Behcet’s Disease and the affects fo the disease plus drugs runs her down quite a bit.
To the OP, congratulations. Doing long course is tough. Working through the drug and disease issues while doing long course successfuly is pretty cool.
Best of luck to all. My wife, 37 years old, already has total knee and hip replacement. Still swims like a fish. No way she will ever run again. Best fan/coach I could ever hope for. 25k USMS open water AG champ a few years back to boot. RA is a very, very dismal disease.
Jamie
One IM race won’t kill you.
**Years of this drug plus IM will get you on dialysis 3x a week just a little bit more early (probably 5-10 years)… **and then it is just a question of time.
My mom took it for 10 years and she didn’t do an Ironman.
She made it till 70.
May she rest in peace.
Evidence?