Ouch. Last Wednesday or Thursday, I noticed that I must have burned the roof of my mouth. I didn't remember eating anything so hot that it could singe the skin, but the tenderness in one spot let me know that I must have.
Friday it still hadn't really healed over. In fact, it seemed to be worse. Saturday afternoon, I realized that I had another tender spot in my mouth and a slight metallic taste was developing. Sometime in the afternoon, I realized what was really going on.
I have developed some mouth sores. Ouch and yuck. Why are these showing up now?
Last month when I visited with my rheumatologist, she asked if I had ever developed mouth sores before. No, I haven't. Why did she ask this? I take methotrexate.
Methotrexate is used to treat different types of cancer, but it is also used to treat rheumatoid arthritis. Methotrexate is an antimetabolite and antifolate drug which inhibits unusal rapid cell growth.
One of the many possible side effects of methotrexate is mouth ulcers, or mouth sores. To help prevent this and other side effects, it is customary to take supplementary folic acid which comes in 400mcg (otc) or 1mg (prescription). I had been taking 1.2mg daily for the past three years.
Based on research published in the Journal of the American Medical Association last fall (and other research studies), my rheumatologist suggested that I stop taking folic acid. Why, do you ask?
High doses of folic acid have been associated with an increased risk of developing lung cancer. The risk remains small, but an increase is an increase. Since I had not experienced many of the nasty side effects of methotrexate, my doctor simply wanted me to stop the folic acid, which may or may not have been helping to alleviate those potential side effects.
Well, one month off of the daily supplementation and I am beginning to develop mouth problems. So on the way home from a busy day accompanying several students at solo festival, I stopped at the grocery store.
My shopping list was short: Folic Acid!!
I immediately took four tablets as soon as I got home and will do so daily until my mouth feels good again. Hopefully at that point I can decrease the amount I need to keep the sores away without increasing the risk of cancer, especially since cancer has run in my family.
Hopefully, it won't be too long before my mouth is in tip top shape once again. :)