PsA flare and weight gain

I have PsA in my hands and have been having a painful flare for the past month. Usually, I’ve noticed that the

fewer carbs I eat, the better my hands feel. Not this time. I’ve been following a low carb diet (under 50g) for the past month and cannot lose weight (up 4 pounds in 1 week) and my hands are swollen and painful. And even ugggglllyyyier than usual. I’ve gained 25 pounds over the past year even though I exercise hard (strength training and metabolic conditioning) 3x/week and follow a healthy diet. I take 20mg MTX and 10mg Leukovorin weekly. Can this flare be keeping me from losing weight?

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Hi @Goodjaz! I can’t help you much with the question of weight gain. But one look at your hands and I couldn’t help but think “Ouch!”

Are those bone spurs there? It’s not uncommon for osteoarthritis to settle where joints have already been damaged. That said, they are also very red and angry looking. I would definitely check in with your rheumy if this is a new development.


Hello there.

Yep, agree with Stoney in that your hands do look painful and best to check with your rheumy. My top finger joints (one day I’ll remember the proper name for them!) are swollen too, though not quite to the same extent and it is the one area that I am resigned to seeing as predominantly OA-related. But I’m sure PsA plays its part.

I reckon PsA does influence metabolism and therefore weight. My weight is more stable now that the disease is controlled but when it was full-on I lost weight rapidly. Could be that it can have the opposite effect too. I’ve been told that inflammatory arthritis effects the thyroid, which might explain my tendency to weight loss and your current tendency to gain weight. Might be worth asking about a thyroid test.

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I can’t help re the weight issue, it’s not something I’ve found makes a huge lot of difference to me PsA wise. Although I’m sure it does to loads of people. What makes me feel better is simply the meds workng better. But when was the last time your rheumy saw those fingers? And when did you last have a meds review? And is your rheumy aware of your present flare?

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I messaged my rheumatologist about the pain I’m having and sent photos. She’ll see me at my next scheduled appt in May. My diagnosis is complicated because I don’t have psoriasis and never have (although it runs in my mother’s side of the family - my mom died of complications of lupus so auto-immune disease runs in the family). There’s been the question of whether I have inflammatory erosive osteoarthritis (a rare subset of hand osteo), but xrays and physical exam led my rheum to treat me for PsA. A few months ago she also had me go off MTX to see if it was having a positive effect since it’s not effective for the erosive osteo. Within 2 weeks, I was back on MTX so have now settled on the PsA diagnosis. But my hands hurt pretty much every day for most of the day, my toes are starting to show signs of arthritis, and I’m in general just bummed out. And tired all the time.

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My dr had me on Dexamethasone and I gained 15 lbs in 2 weeks. After I went off it I lost 13 of those pounds in 3 weeks, just water I guess.
I am about to start mtx 20 mg weekly injections, plus folic acid and sulfasalazine. Has anyone experienced hair loss on mtx? Any other major side effects, weight gain, loss of taste?? Thx

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