Take Folic Acid To Help Prevent Hair Loss From Methotrexate
Methotrexate also affects the absorption of the B vitamin folic acid, or folate in its natural form, which impacts cell division as well as hair growth. Patients on methotrexate should be taking folic acid at the same time to help mitigate methotrexate side effects, such as nausea. We can increase the folic acid dose if hair loss is occurring, says Dr. Domingues. Your doctor may also recommend a different version of folic acid called folinic acid, which is available by prescription. Its a little stronger, says Dr. Domingues.
I have had hair loss directly as a result of taking methotrexate the hair loss was immediate but I added extra folic acid and biotin , and those helped, Christina A. told us. Studies have shown taking folic acid doesnt alter the effectiveness of MTX.
Two Drugs That Treat Rheumatoid Arthritis And Blood Cancers Shown To Promote Hair Growth
Two drugsone used to treat rheumatoid arthritis and another for different types of blood cancershave shown promise in reversing hair loss characteristic of alopecia areata and related disorders, according to a study in mice funded in part by the NIHs National Institute of Arthritis and Musculoskeletal and Skin Diseases . The study was published in Science Advances.
Alopecia areata is an autoimmune disease in which the immune system, designed to protect the body from foreign invaders such as viruses and bacteria, mistakenly attacks hair follicles, leading to hair loss on the scalp and elsewhere. There is neither a cure for alopecia areata nor drugs approved for its treatment, though some steroid-based medications may help promote new hair growth without treating the underlying disease.
Previous research led by Angela Christiano, Ph.D., of Columbia University, tested the effects of tofacitinib and ruxolitinib on hair regrowth in a mouse model of alopecia areata. Tofacitinib and ruxolitinib inhibit the Janus kinasesignal transducer and activator of transcription pathway, which classifies them as JAK inhibitors. The researchers found these drugs promoted rapid hair regrowth in both mice and humans with alopecia areata when given orally. Even more robust hair growth resulted when the drugs were applied topically to the mice, suggesting an effect on the hair follicle itself.
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When Should I Call The Doctor If I Have Sjgrens Syndrome
Severe mouth or gum pain could indicate infection or tooth decay. Itchy eyes, eye pain, or blurred or double vision can signal infections or other vision problems. You should also call your doctor if you notice swollen lymph nodes in your neck, armpits or groin. Enlarged lymph nodes could indicate lymphoma or another health condition.
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Why Does Methotrexate Cause Hair Loss
Indeed, when I was first diagnosed with RA and started on MTX, my initial search for patient stories resulted in several hits about people suffering hair loss from MTX. While folic acid is often prescribed to offset this side effect, MTX is designed to inhibit cell growth including cells causing inflammation but, unfortunately, also hair follicles.1
Can You Do Anything To Stop Or Minimize Hair Loss With Arthritis Drugs
Fortunately, if you experience hair loss from your arthritis medication, there is a lot that can be done to minimize or stop it completely. I have lowered the dose, stretched out the treatment cycle, made sure patients were taking folic acid and other B vitamins, and were eating a balanced anti-inflammatory diet, Dr. Carteron says. Here are some tips to prevent hair loss that you can try.
How To Stop Hair Loss Associated With Medication
If hair loss is affecting your appearance and self-confidence, your healthcare provider may try to lower your dosage or switch you to another medication to see if that solves the issue.
If the medication is effectively treating your arthritis, your practitioner may discuss with you the benefits and side effects before taking such measures.
When altering the dose or switching medications isnt possible, your practitioner may refer you to a dermatologist for other options.
What Is Alopecia Areata
Alopecia areata is a form of hair loss that occurs in children and adults. It is non-scarring, which means that the hair follicle is not destroyed and that it has the ability to regrow hair. It is considered an autoimmune condition that results in inflammation and loss of hair. While hair is lost most commonly on the scalp, hair anywhere on the body may be affected. Alopecia areata only affects the hair and nails and does not cause any other body-wide problems.
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Methotrexate Can Cause Hair Loss
Methotrexate is the most commonly prescribed disease-modifying antirheumatic drug for rheumatoid arthritis. It causes hair loss in about 1% to 3% of patients.
Methotrexate works by stopping the cells that cause inflammation from growing and, as a result, can stop hair follicles from growing too.
A folic acid supplement, commonly co-prescribed with methotrexate, can help keep your hair healthy, but does not encourage hair growth.
What Does The Research Say
Even though hair loss doesnt happen to everyone who takes methotrexate, it can occur whether youre on a low dose or a high dose. However, a higher dose could result in more hair loss.
Methotrexate can be taken as a regular prescription to treat certain conditions. There are also instances when you might receive a single dose of the drug, such as in the case of an ectopic pregnancy. In this situation, the medication can stop the growth of an egg that has implanted outside the uterus.
In single-dose uses like this, hair loss and other side effects are uncommon, but can occur. Side effects tend to develop when taking the medication regularly.
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Who Is At Risk
Alopecia areata has two peaks of onset one in childhood and one in adulthood though it has been reported in all ages. As with other autoimmune conditions, there is likely a genetic basis to alopecia areata with unknown triggers that result in the loss of hair. Associated conditions in the patient or family that might represent increased risk include Type 1 diabetes, celiac disease, rheumatoid arthritis, vitiligo, thyroid disease, multiple sclerosis and inflammatory bowel disease.
Low To Medium Settings For Hair Tools
Being careful with hair tools is important as well. If you use a hairdryer, curling iron, or flatiron, keeping the temperature at a low to medium setting will reduce that breakage that we often have to contend with thanks to RA.
My stylist recommended a hot air curling brush, combining the curling and drying into one operation, thus reducing the damaging effects of using both a dryer and a curling tool.
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Dandruff Or Scalp Psoriasis
When the skin on the scalp is inflamed and itchy, its obviously tempting to scratch it. But that may cause your hair to shed more than usual.
Dandruff is the most easily treated cause of hair loss, Dr. Fusco says, because you can treat it with over-the-counter products, like a shampoo containing zinc pyrithione or exfoliating ingredients such as the classic Head & Shoulders Classic or Oribe Serene Scalp Anti-Dandruff Shampoo . “Consistency is the trick,” Dr. Fusco says, so it’s important to find a shampoo and conditioner you like enough to use regularly.
But other conditions can also cause itchiness and scalp flaking, including seborrheic dermatitis and psoriasis . Treating these issues may take more time and effort than dandruff, so its important to check in with a dermatologist if you think you may be dealing with one of these conditions.
How Does Ra Link To Hair Loss
Rheumatoid arthritis can link to hair loss in two different ways. These include:
The good news is that it is rare to experience hair loss as a side effect of the disease. In the event it is caused by Rheumatoid arthritis, any hair loss tends to be mild. It is also much more likely to experience thinning hair, than for it to fall out completely.
Patients with genetic pattern baldness that are taking medications for the disease are more at risk of experiencing hair loss.
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Changes In Birth Control
Going off hormonal birth control or changing to a different type of hormonal contraception can also cause hormone-induced shedding. “Whether you’re just starting it, discontinuing it, or changing brands, your body can react by causing the hair to go into an increased shedding mode,” Dr. Fusco says.
This is another form of telogen effluvium, which means that its usually temporary. You can rely on volumizing products and styling tricks while you wait for your hair to regain its fullness.
Hope For Patients With Hair Loss: Arthritis Drug Spurs Regrowth
Researchers at Yale and Stanford have provided the most conclusive evidence to date that a rheumatoid arthritis drug can also be used to grow hair on patients with a disease that causes disfiguring hair loss.
Alopecia areata is a frequently devastating autoimmune disease causing patchy or complete hair loss across the body, including loss of eyebrows and eyelashes. Current therapies are not reliably effective.
In a clinical trial involving 66 adults with alopecia areata, more than half saw hair regrowth and one-third recovered more than 50% of their initial scalp hair loss after three months of taking the arthritis drug tofacitinib citrate 5 mg, twice daily.
The study was published Sept. 22 in JCI Insight.
This study demonstrates the drug is effective for treating alopecia areata, said Dr. Brett A. King of Yale School of Medicine, who designed the study with Dr. Brittany Craiglow.
In 2014, King showed that tofacitinib, marketed as Xeljanz, could be used to treat alopecia areata. The new study confirms the validity of that report and builds a case for pursuing treatment of the disease with this and similar drugs.
The only missing pieces are, one, the results of treatment over longer periods of time and, two, looking at treatment of the pediatric age group, where the disease frequently shows up first and can be particularly devastating, King said. Well have those results soon.
The study was limited by short duration side effects were mild, he said.
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What Is Folic Acid
Folic acid is a B vitamin that assists the body in making new cells.1 Folate occurs naturally in foods such as lentils, beans, asparagus, spinach, turnip greens, and broccoli.2 Folic acid is the synthetic version of folate that is available in supplement form. As folic acid has been shown to decrease neural birth defects such as spina bifida, it is not only recommended that pregnant women take the supplement, but it is mandated by the U.S. Food and Drug Administration that folic acid be added to enriched cereal products .3
Who Gets Alopecia Areata
While anyone can get alopecia areata, some people have a greater risk of developing it. Those most likely to get it have:
A close blood relative with alopecia areata: Its estimated that about 10% to 20% of people with alopecia areata have a family member who has it. Because many people try to hide hair loss, this percentage may be higher.
Asthma, hay fever, atopic dermatitis, thyroid disease, vitiligo, or Down syndrome: Research shows that people who have one of these diseases are more likely to get alopecia areata.
Been treating cancer with a drug called nivolumab: While its too early to say whether this greatly increases your risk, a few cancer patients who received a drug called nivolumab have developed alopecia areata. The drug is used to treat lung cancer and melanoma that has spread. Hair loss usually begins a few months after they start treatment. Its called nivolumab-induced alopecia areata, and the hair loss is considered a good sign. This type of hair loss usually means that the drug is working.You can treat this hair loss with a corticosteroid that you apply to the bald spots. It allows the hair to regrow without stopping cancer treatment.
Your race may also affect your risk of getting alopecia areata. In a large study, researchers found that black and Hispanic nurses were more likely than non-Hispanic white nurses to develop this disease.
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The Link Between Rheumatoid Arthritis And Hair Loss
Hair loss is a relatively rare complication of RA. When it does happen, it usually isnt severe enough to be a cause for alarm. It can cause your hair to thin out in places, rather than literally falling out in patches. However, if you are already under the effects of one systemic autoimmune disease, it could put you at risk of developing others. An example of this would be alopecia areata, which can cause loss of hair on the scalp or even all over the body.
Certain medications for RA also have the potential for causing hair loss as a side effect. The most common types prescribed by health practitioners to treat RA are disease-modifying anti-rheumatic drugs . They manage RA by suppressing your immune system, which, in turn, reduces chronic inflammation. There are also several types of DMARDs, the most common of which is methotrexate.
Initially used as an anti-cancer drug, methotrexate works by stopping the growth of skin cells in order to stop the formation of scales. Because of the way it works, however, the drug can also stop the growth of cells that support hair follicles. This causes the hair follicles to weaken, making it easier for hair to come loose. The drug also reduces the bodys levels of the B vitamin folate, which promotes healthy hair. Despite this, hair loss only happens to about one to three percent of people taking methotrexate.
Consider Other Causes Of Hair Loss
If youre experiencing hair loss and suspect it could be from arthritis medication, you should be evaluated by your doctor to figure out the root cause of your hair loss. The medication may be the one thing that you can identify as new or different, but that said, many other common things can cause hair loss, which may be misattributed to medications, Dr. Blazer says.
Thyroid problems, anemia, age-related hair loss or thinning, and hair loss associated with pregnancy can all play a role, Dr. Carteron says. I investigate other potential causes of hair loss for patients, and help manage them if indicated. Even stress itself, which not surprisingly can result from a chronic condition, can lead to hair loss.
Having other co-occurring autoimmune conditions, such as lupus and alopecia areata, can also cause hair loss.
Methotrexate helps my RA. I did stop it for a while when I was getting large bald spots, but it was determined that it wasnt caused by my meds and I was diagnosed with alopecia areata, Kris S. shared on FB.
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