Hello,

I'm male 32 years old with rheumatoid arthritis on 10mg methotrexate each week and folic acid supplements.

About 2 months ago i started to notice an itch across my torso when I was at the gym or went out for walks. Any time I raised my body temperature it seemed to flare up. At the start it was quite easy to ignore. The itch started waking me up randomly in the middle of the night and has since caused bad insomnia.

About two weeks ago I woke up with an intense burning all over my torso. It seemed to flare up quickly then settle back down but ever since then I have these seemingly random flares throughout the day or night that come out of nowhere and last for 15/20 seconds then settle back down. The burning, tingling pain is really intense and debilitating.

I have Rheumatoid Arthritis and take 10mg methotrexate each week. The nurses assured me that methotrexate doesn't cause this kind of neuropathy. I know stress makes it worse but it's hard to stay positive.

I've just ordered an active B12 test and my doctor has suggested putting me on a low dose of nortriptyline to see if it eases the symptoms.

I know these symptoms aren't typical but has anyone ever experienced anything similar and does anyone have any advice going forward?

Thanks.

Welcome, MRH321!

It's too bad that you have rheumatoid arthritis. It can cause quite a few problems. But so can the methotrexate. Have you tried omitting it for a while, just to see if the symptoms clear up? According to this, it can cause itching:

Methotrexate Side Effects: Common, Severe, Long Term - Drugs.com

If you're taking anything else--prescription drugs or OTC drugs or supplements--you might want to check into those as well if your doctor hasn't done this already. Some drugs interact with one another in odd ways too.

I hope that you can find a way to relieve your symptoms.

Hi, welcome to Neurotalk.
As Agate pointed out, your medication has the potential to cause itching and so does your type of arthritis. I would ask your Doctor again about this. Are you seeing a Rheumatologist? If the itch is accompanied by a rash, it needs to be looked at right away. I am on a pro-inflammatory medication. It causes "flares" as well and it also makes me itch. If it gets too bad I have been prescribed antihistamines. Ask Doctor about that.

The flares themselves could be a rheumatoid arthritis flare. In an autoimmune disease, flares can be brought on by many factors including stress, over heating, certain foods. You would know all this already I'm sure.

You could try to reduce inflammation by making a change in diet. The site below mentions triggering foods and other toxins even airborne. It's specifically related to the spine but it also gives suggestions on how to manage and prevent RA flare.

Spine Universe -Managing RA flares

I'm sorry you're in so much pain and the itching can be unbearable I know. Please talk to your RA specialist about treating that itch.

Welcome MRH321.

First thing that came to mind was B12. Good that you're getting it checked. Folic acid can mask a B12 deficiency. B12 serum testing alone may not be adequate to uncover a B12 deficiency. If you suspect B12 is an issue and B12 serum comes back in the normal range, then more conclusive testing would be warranted.

You may want to consider adding b12 followed by a B complex a week or two after.

It's ironic, as I was reading your post I started thinking of the nortriptyline I had been on, for nerve ending problems. Is the nortriptyline working for you?