What is the name of the biologic that you take? I didn’t know you could take the methotrexate & biologic at the same time. I’m glad you mentioned the foods to avoid because that’s my next mission, as I already know that the diet can make a big difference also. I’ve already reduced the amount of carbs I consume more protein and having plain Greek yogurt for breakfast & lunch
That’s typical me being more complicated. With regards to my knee, I’m getting a second opinion. I’m not happy with the orthopaedic doctor I chose, I will find one that will be willing to do more that just look at my x-rays then discharge me without doing anything.
You can most definitely take MTX and a biologic at the same time - in Australia it is mandated unless you have unacceptable side effects because as well as working synergistically for some people, it also reduces the likelihood you’ll develop antibodies to the biologic that make it ineffective.
1 Like
I’d say the majority of us on biologics take methotrexate alongside. Here’s an old post of mine: The Other Side of Planet Methotrexate.
Keep asking questions! The better you understand what’s happening, the better you will deal with it.
As for your knee, if you aren’t happy with the non-answers you are getting, it’s worth finding a new ortho. Your relationship with your rheumatologist and orthopaedic surgeon is probably going to be a long one, so you may as well find one who you are comfortable with.
If it takes a long time to get on the list of the one you really want, stay with the first until you’re on the second’s list. I’ve been seeing my orthopod since 2005, and my rheumatologist since 2014. I had to wait 2 years for the one I wanted. All worth it.
Other than low carb and more so reducing sugar, the research shows diet doesn’t make a whole lot of difference to PsA. Please don’t get overly caught up in diets to treat this disease. It distracts from so much in my view. If diets worked as well and some scammers say, (those who want to pay them) then the doctors will simply ask us to follow a specific diet.
2 Likes
That’s so true, thanks for this input, I’ve been trying to control everything I eat since 20 years or more for weight loss and failed dozens of times, so I was feeling a bit depressed about having to try again with a different goal in mind but still on that same depressing restrictive train of misery. I asked my doctor if I have Metabolic Syndrome and she agreed that I do and said this is common for PsA. So anyway knowing that a diet would not make a difference to reducing the pain makes me feel much better, so thanks for that. 
2 Likes
Glad to have helped. Obviously being the right weight (I’m not as I am overweight as so many people with PsA are sadly) helps everything but getting caught up in various exclusion diets (more so if you have to pay for them) to the point of virtually self harming isn’t good psychologically if nothing else. And it can cause more stress and given stress feeds PsA that’s silly too.
Do what works for you. @letizia has worked out for works for her very much so but for example that would not work for me personality wise. However something like the 5:2 diet has been shown to help not just us lot but lots of other things too. The western world does eat badly and is overly obsessed with food and far too many of us have eating disorders of some type be it over eating or under eating.
No diet should ever be a
PsA is bad enough without doing that yourself as well.
You find out yourself what might make things worse. For me it’s sugary stuff and thankfully I don’t have a sweet tooth but I do like savoury carbs. However if I eat a sugary dessert I know about it the next day. A few people (not half as many as they say either) find ‘nightshade’ foods such as peppers, tomatoes and potatoes aren’t that good for them. Other people sadly add in a gluten intolerance to their PsA so need to address that.
But please believe there is no ‘magic’ diet for PsA. First concentrate on settling on meds and then go from there. Methotrexate (mxt) didn’t like me at all. But sulfasalazine did and worked well for a time. So remember there is an array of meds to treat this disease and what works for one person doesn’t for another so it is very much try this one and see. Best of luck.
1 Like
PixelChick, Poo has hit the nail on the head for so many of us. I have metabolic syndrome too, and I lug extra weight around. Weight control (and even more so, loss) is very difficult when you are in pain, when movement hurts, and when you are also depressed (which is a very real and common co-condition of PsA). For now, get yourself feeling better and put the weight loss struggle aside for a bit.
I feel my best when I reduce my sugar and other carb intake. I’m not saying I’m doing a keto diet, not counting grams, but just tempering my intake. I noticed a big difference in appetite when my disease was finally starting to be controlled: my appetite moderated, and of course, I could move more easily so that helped too.
There is nothing simple about PsA. But at the same time, there’s lots of little things that we can do, all of which can make life a little easier. But the key thing, as far as I am concerned, is finding a rheumatologist who will not give up until your PsA is under the best control possible. Don’t settle for “less pain”. I want my rheum’s goal to be “minimal pain”. And as for your knees, I wouldn’t be making any big decisions about them until your PsA is under control. I’m guessing they might feel different when your PsA is under control.
2 Likes
I agree with poo and seenie regarding diets. My most effective one is that I no longer eat anything that doesn’t taste good. That way I get a wee shot of adrenaline when I do think of food and that helps me get out of the chair! Finding and developing an “off button” really helps as eating all things in moderation have kept me at a consistently ok weight. It sounds simple but it is a start…Try not to eat after 8 pm and drink a full glass of water 20 minutes before a meal to make my stomach feel “full” while eating. That’s about all I do and avoid food guilt altogether. Unfortunately, I find that many doctors are biased against people that are over weight. The thought and sometimes comments are, “If you don’t do what you can, I can’t (won’t) help you.” It is very unfair but all too real. Lack of mobility/pain, depression and frustration all contribute to our whole body and PsA treatment is a priority. Whatever our weight might be, PsA inflammation is most often hidden below all sorts of surfaces. Everyone is worthy of fair and proper treatment.
1 Like
Hello, have been put on Cosentyx in addition to Methotrexate. Have also on occasion resorted to intermittent fasting to help with pain and inflammation, with strong results.
1 Like
That’s interesting. And if it works for you, that’s fantastic! How long does the effect last, Letitia? If you do intermittent fasting for a long period, does the effect carry on too?
1 Like
How long do you fast for? I don’t go a day without food but I do feel happier in my tummy when I have very light meals. Even more so when I eat just once on any given day.
1 Like
I found benefit from all kinds of lengths of fasts. Not eating for even just three days resolved a baker cyst and pain on my arthritic knee a couple months ago, Fasting for a day and eating the next, in my case only carnivore has strong results also with blood test crp and ves, although cannot say to what degree methotrexate and cosentyx contribute. Losing weight has an overall beneficial effect, and even just eating once a day helps when not fasting. Results were had in lessenining of pain and inflammation with longer fasts from three to five days, even a week or two. Fasting with electrolytes and in my case with coffee as well as water, and eating only meat eggs fish and cheese (which must stop or limit) have strong results on my overall situation. Am at the moment embarking on a new series of fasts in addition to diet and medicines to knock down 6 or 7 kilos or so which have crept up over the winter also due to lack of movement from back pain which kept me bed ridden for months. Am not obsessing over speed of weight loss or even weight loss in particular, more that my body has a chance to recover and help itself. A series of fasting spells plus low carb no gluten no grains etc got me off a wheel chair a couple years ago when I was off methotrexate to heal a grafted femur, so I know it is a worth while health marathon. The thing is eating beef and other meat and fish eggs cheese is certainly not sacrifice, it is delicious, I do not miss carbohidrates and sugar two years on, fasting and carnivory feel like a beneficial routine, not an intermittent spell before returning to eating other diets.
Hi Seenie,
I thought it was interesting that I reminded you of yourself!
I was scheduled for a two parter spine surgery Dec 7 & 10 but got my first cold in over 2 years. Now it’s scheduled for Feb 1 & 4th. But w/ this uptick in covid, who knows? My 3 year old granddaughter & her little brother (6 months) were just both positive for covid this past weekend. Which means, my husband & I may not be far behind - even though we’ve had all 3 & my next booster is scheduled for next month. I’m only taking Humira once more before surgery because it’s stopped working. Hopefully after surgery I will be starting Remicade. Well gotta go!