MTX/pineapple/side effects?

[mb2]

I've been taking Enbrel since May '05 for PA, no P, and added 10 mg MTX in the fall and upped it to 12.5 mg at the beginning of this yr. I started getting some sore places in my mouth and on my lips.

I told the Dr about them and he lowered the dose again to 10 mg last wk.

I've been really really tired for weeks--no energy and I have to force myself to do things. I feel drained.
Yesterday I ate some fresh pineapple and my mouth felt even sorer all over and I've had no appetite today.
Are these the normal side effects? Does pineapple make MTX mouth sores worse? What is happening? I still have sort of a bad taste in my mouth today.
Any comments, advice, help? I am so struggling to keep doing things as I'm so tired. I'd love to just sit around all day curled in a blanket and watch the Olympics, but I drink caffeine drinks and get some energy.

Thanks,
Mary

[patti2957]

Hi:
You didn't mention folic acid but your doc should have prescribed it with the mtx. I take Folgard, which is 2 mg. of folic acid and b vitamins, I think. I've been on 12.5 mg of mtx since last May and several times right after taking it I've noticed that my mouth is a lot more sensitive, though I haven't had actual sores. Even after 10 months, I'm still really tired most all the time, especially the day after mtx. Fatigue has been a big issue for me, which is why my rheum chose Humira, rather than Enbrel. I've only had one shot so I haven't noticed any benefit yet.
I hope this helps, I sure know how hard it is to slog through tired days - instead of curled up the sofa, it's like trying to run while wrapped in wet blankets lol.
Good luck,
Patti

[JesseLou]

The sores are from the MTX, and you can get rid of them literally overnight with a prescription of oral kenalog from your dentist. It's a thick salve you place on the sore before you go to bed.

Pineapple has the highest acidic content of any food we eat - eat enough of i day after day (like I did in Hawaii once) - and you will get sores in your mouth. In your case, since you already have MTX sores, which act like canker sores, but aren't, pineapple would most likely send you straight through the ceiling. Avoid it until you get rid of the sores!

[mb2]

Thanks for the advice and comments. Most helpful. I'm taking 1 mg of folic acid every day and I also have been taking B vitamins since before all this started.
Patti, I know what you mean--in the winter it's REALLY hard not to just curl up in the sofa with a soft blanket and watch the winter Olympics. In the last 1.5 yrs I've had to give up most of my activities due to allergies as well as arthritis. I don't see my friends much right now, but we have lots of family to get together with.
Jesse Lou, the Dr's office offered to call in a prescription for a cream, but I decided to pass on yet another Rx. Then I ate the pineapple! So nice to know what happened. We rarely eat fresh pineapple and it tasted so good until it didn't.
If it's not one thing, it's another.
This can all be so discouraging, it's good to have people you can reach out to who can help with it.
I keep hoping the fatigue is caused by low thyroid. I have a thyroid nodule that is going to be biopsied on Thursday and I worry that I might have yet another chronic problem. Enough already!

Thanks for being there-
Mary

[jojocat]

I include pineapple in my lunch quite a bit. I usually buy the smallish cans of crushed with the pop up lids. I have noticed that the skin the the inside of my lip area is kind of roughed up, almost like a minor burn, but without the burn part. I take 20 mg mtx a week along with folic acid. It is very acidic, but also cheap and yum. I don't think I will quit eating it, but I am going to watch.

[Sunnysideup]

I just started taking mtx, I got some pills at the Health food store that contain Bromalain the thing in fresh pinneapples that helps fight inflamation. I don't know now if these will be safe to take with the mtx, or if they will cause mouth sores quicker. Any advice?

[GMOM]

MB2,
Sorry to hear about the mouth sores. I've always had cancer sores, and the mtx made it even worse. My dentist had me try a couple of things that seemed to help. In case you haven't heard of these:
For sores in full bloom, rinse your mouth a couple of times a day (especially just before bed) with milk of magnesia. Rinse and spit, don't swallow. The m of m will neutralize the acid in your mouth and help start the healing process.
When you feel sores coming on, try Biotene toothpaste and mouthwash. These are also acid neutral and have helped me. Biotene is designed for use with dry mouth, so it helps with that "cotton" feeling as well. I also use the Biotene gum to keep my mouth moist. (Biotene is otc, not rx)
I hope some of these suggestions help. Mouth sores just add to the misery of pa.
Blessings,
Gmom

[screech]

I just started taking mtx, I got some pills at the Health food store that contain Bromalain the thing in fresh pinneapples that helps fight inflamation. I don't know now if these will be safe to take with the mtx, or if they will cause mouth sores quicker. Any advice?


Bromalain is actually an enzyme from pineapple that works like a meat tenderizer. If you have a tough piece of meat, soak it in pineapple juice for 12 hours and see what happens - it turns to mush. Bromalain might be the key agent in what is causing trouble mentioned in this thread. There is a similar enzyme in Papaya. I think heating pinapple destroys the effect of the enzyme so products that are canned might have less of an effect but I am not a chemist so try it out for yourself. I personally don't like pineapple by itself.