Boosting Immunity on Methotrexate Treatment: Diet, Lifestyle Tips

Understanding Methotrexate for Autoimmune Diseases

Methotrexate is a common disease-modifying antirheumatic drug (DMARD) used to treat severe autoimmune conditions like rheumatoid arthritis (RA) and psoriasis. It works by suppressing the overactive immune system responsible for painful joint inflammation and damage.

How Methotrexate Works

In autoimmune disease, the body's immune system mistakenly attacks healthy tissues and organs. Powerful drugs that broadly suppress immunity can help control this dysfunctional process.

As an immunosuppressant, methotrexate decreases the production of certain immune cells and inflammation-promoting proteins. This provides symptom relief and helps protect tissues in the long run.

Benefits of Methotrexate

Along with dampening an overactive immune response, benefits of low dose methotrexate may include:

• Reduced joint pain, swelling, stiffness
• Slowed disease progression and joint damage
• Improved physical function
• Better quality of life

For many RA patients, methotrexate can be an effective foundational treatment for managing this incurable condition long term.

Side Effects of Methotrexate

Immune suppression causes increased infection risk and other possible methotrexate side effects like:

• Nausea, fatigue, headaches
• Mouth sores
• Respiratory infections
• Low white blood cell counts
• Liver damage risk

Working closely with your rheumatologist to monitor bloodwork and overall health on methotrexate is crucial.

Methotrexate Effects on the Immune System

The whole point of methotrexate treatment is to restrain overactive immunity. But suppressing the immune system too far leaves patients vulnerable in other ways.

Increased Infection Susceptibility

One of the most common and dangerous side effects of methotrexate is an increased risk for infections. Everything from minor colds to serious pneumonias or sepsis become more likely with the immune-impairing effects of this and other DMARD medications.

Preventing and promptly treating any infections is paramount for people relying on immunosuppressants like methotrexate to manage their disease.

Delayed Injury Healing

The immune system plays an intricate role in proper wound healing and recovery after any injury or surgery. Dampening immunity can lead to very slow, poor, or complicated healing.

Minor cuts may take longer close up. And doctors will advise patients to temporarily stop immunosuppressants before and after any major surgery to avoid healing issues.

Weakened Vaccine Response

Vaccines help "teach" the immune system to recognize and mount a defense against specific germs. But with methotrexate suppressing normal immune function, vaccination efficacy is reduced.

After starting methotrexate, patients should discuss with their provider when they may need booster doses or additional vaccines beyond standard recommendations.

Should You Get the COVID Vaccine on Methotrexate?

Given its effects on infection risk and vaccine efficacy, methotrexate patients rightly wonder about getting the COVID-19 shot.

COVID Risks with Methotrexate Treatment

On one hand, methotrexate and other immunsuppressants raise the chance of contracting and having worse outcomes from COVID-19 or other illnesses.

But stopping crucial medications also carries dangers of disease flares, irreversible joint damage, and reduced quality of life.

Benefits of COVID Vaccination

All major health organizations strongly advise patients with autoimmune diseases, even on immunosuppressants, get fully vaccinated and boosted for COVID-19.

While vaccine efficacy may be slightly reduced, studies confirm methotrexate patients still produce significant immune response and antibody protection in most cases.

For the best shield against infection, experts emphasize continuing DMARD treatments while staying up to date with all recommended COVID shots.

5 Ways to Boost Immunity on Methotrexate

Is there anything you can do to help shore up immune defenses while on a medication like methotrexate?

While you should never stop prescribed treatment without your doctor's supervision, certain lifestyle measures may provide a beneficial boost alongside medications.

Emphasize Proper Nutrition

Consuming a nutritious, balanced diet focused on whole foods provides the building blocks for strong immunity. Be sure to take prescribed folic acid supplements to help mitigate methotrexate side effects.

Emphasize antioxidants like vitamins C, E, A, and nutrients such as zinc, iron, and protein at every meal and snack throughout the day.

Stay Hydrated

Dehydration takes a toll on the entire body, including immune defenses. Make a point to consume adequate non-caffeinated fluids every day while taking medications like methotrexate.

Women should aim for at least 11 cups (2.7 liters) and men 15+ cups (3.7+ liters) of water daily from beverages and food sources.

Prioritize Sleep

Quality sleep gives the body time to carry out critical immune functions and repair processes. Being chronically overtired weakens the entire system.

Try to get 7-9 hours of sound sleep per night. Maintaining consistent bedtime and wakeup routines can help optimize circadian rhythms and sleep performance.

Reduce Stress Levels

Anxiety, depression, and chronic stress take a toll on immunity by increasing inflammation and the key stress hormone cortisol long term.

Work to actively manage sources of stress through outlets like therapy, meditation, nature time, social connection, organization systems, and/or medication if prescribed.

Exercise Regularly

Along with supporting overall health, regular physical activity has been shown to enhance immune response on a cellular level.

Aim for 150+ minutes per week of moderate activity like walking, swimming, gentle yoga, etc. Listen to your body and back off immediately if joint pain increases post-exercise.

The Best Immune Boosting Diet with Methotrexate

Diet plays a central role in maintaining disease control and fortifying the immune system against infection risk while taking methotrexate.

Work closely with your healthcare team and registered dietitian to develop the right eating plan tailored to your needs and any other conditions like diabetes or obesity.

Anti-Inflammatory Foods

Inflammation drives autoimmune disease activity and damages joints and organs over time. An anti-inflammatory diet emphasizes produce, plant foods, fish, nuts, seeds, spices, tea, etc.

Key anti-inflammatory additions to boost immunity could include:

• Leafy greens like spinach, kale, chard
• Cruciferous veggies - broccoli, Brussels sprouts, cabbage, Bok choy, etc
• Strawberries, citrus fruits
• Fatty fish like salmon, mackerel, tuna
• Walnuts, almonds
• Spices - turmeric, ginger, rosemary, garlic, etc
• Green tea, herbal tea

Gut Supporting Foods

Around 80% of the immune system resides in the vast gut microbiome. Supporting healthy digestion protects the gut lining and feeds beneficial bacteria.

Include plenty of high fiber prebiotic foods like onions, garlic, bananas, oats, flax, artichokes, etc. Fermented items offer probiotic gut support too - yogurt, kefir, kimchi, sauerkraut, etc.

Micronutrient Rich Choices

The body requires sufficient vitamins, minerals, and antioxidants to carry out proper immune processes. Aim for colorful produce, eggs, nuts/seeds, citrus fruits, berries, whole grains, beans/lentils, mushrooms and organ meats like liver.

Healthy Proteins

Protein helps heal injuries, fight infection, and neutralize disease-causing autoantibodies. Fish, poultry, eggs, meat, dairy, legumes, nuts, seeds, and soy products offer methotrexate patients immune nourishing proteins.

Adequate Healthy Fats

Don't skimp on beneficial fats - especially omega 3s from fatty fish, nuts/seeds, avocado oil, etc. Fats fuel the body, absorb key nutrients, balance hormones, and support cell membranes and immunity.

The Best Lifestyle Habits to Complement Methotrexate Treatment

While medication adherence is paramount, certain lifestyle measures also benefit autoimmune patients on methotrexate therapy.

Commit to an Exercise Routine

Along with aiding weight management and cardiovascular fitness, regular exercise directly bolsters immune resilience. Aim for 30-60 minutes of moderate activity most days that doesn't aggravate joint inflammation.

Don't Smoke or Drink Excessively

Smoking and heavy alcohol intake negatively impact treatment efficacy and multiply infection risks. If you do smoke or drink, talk to your doctor about safely cutting back or quitting.

Protect Against Illness

Follow prevention basics - wash hands frequently, disinfect surfaces and devices, avoid crowds when infection rates are high locally, etc. Getting recommended vaccines, including annual flu shots and COVID boosters, is also key.

Stay Connected Socially

Loneliness and isolation increase cortisol, inflammation, depression and undermine immunity. Nurture social bonds however possible through community groups, video calls, volunteering, etc.

Manage Stress Wisely

Unchecked emotional stress chronically floods the body with cortisol and inflammatory cytokines. Prioritize stress relief through sufficient sleep, counseling, mindfulness practices, organization skills, etc.

The Takeaway Optimizing Immunity On Methotrexate

Methotrexate is a powerful medication for suppressing overactive autoimmune responses in diseases like RA. But immune impairment also raises infection vulnerability and reduces vaccine efficacy.

Closely monitor health with your rheumatology provider. Committing to methotrexate treatment while simultaneously supporting immunity through nutrition, hydration, restorative sleep, stress relief, exercise, and healthy lifestyle habits can help counterbalance increased infection susceptibility.

Placing high priority on preventing illness and staying up to date with COVID-19 plus annual flu vaccination also provides vital protection given methotrexates immune-dampening effects over the long run.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.