Calling All Chemists

Craig Cooper · 11-07-2006, 11:00 AM

So I have a client with Rheumatoid Arthritis who's doctor put her on an experimental drug a couple of years ago called MEHTATREXATE. She was on an ungodly dose, which caused her to gain weight, rapidly. She's been off the drug for about a year and a half now, but is unable to lose the weight she gained, despite exercise and diet intervention. I was wondering if anyone has heard of the drug and what it's specific action is that would cause weight gain.

Robb Wolf · 11-07-2006, 01:14 PM

It is usually used as a cancer drug. Blocks folate metabolism. Nasty stuff but I have no idea why the weight gain unless it messes with insulin sens due to folate deficiency. It's also interesting to note that folate is integral in apoptosis, the process whereby our body disposes of abnormal cells via programmed cell death. Methotrexate is "trying" to kill cancer by removing folate from the equation while preventing some of our best machinery from dealing with abnormal cells. Odd approach to killing something.

Actually, Methotrexate may improve insulin resistance:
http://www.pubmedcentral.nih.gov/art...i?artid=153842

Brad Hirakawa · 11-07-2006, 01:50 PM

Craig,

Methotrexate has been around for quite a while, since well before I was born anyway.

I believe the doses used for treating arthritis are relatively low compared to the dose used for cancer, and it's often co-administered with another drug (I forget which one). Although it may still affect folate metabolism at these relatively low doses, I don't think that is what the doctors are shooting for in the case of arthritis. Methotrexate appears to knock down certain components of the immune system, and that is what is believed to alleviate some of the arthitic symptoms... but I'm digging way back in my education on this one.

Thumbing through the literature.... I don't see any common side effects related to weight gain. But, there are always idiosyncratic toxicities out there.

Sorry I could not help more.
Brad

Craig Cooper · 11-07-2006, 02:28 PM

So I need to get the exact dosage from my client, but she said that cancer patients usually take 6 pills/week, where as she was taking 10! Again, will have to find out dosage before that makes any sense.

Robb Wolf · 11-08-2006, 01:51 PM

I think you may just need to approach the whole situation with caution. Get a DETAILED food log for 3-7days. Sleep patterns etc. Delving deeply into the pharmacology of a chemotherapeutic she took 2 eyars ago is dicey ground.

Quote:

Originally Posted by Craig Cooper

So I need to get the exact dosage from my client, but she said that cancer patients usually take 6 pills/week, where as she was taking 10! Again, will have to find out dosage before that makes any sense.

Craig Cooper · 11-08-2006, 03:09 PM

Robb - thanks, I know. I'm drawing at straws, but I can't figure out what else it might be. She gained 40lbs while on the drug, and hasn't been able to lose ANY weight since. I've had her give me a 7 day food log, which was decent. She's scared of saturated fat, there are traces of wheat in her diet, and she's a cottage cheese/yogourt fan. My first intervention will be trying to eliminate dairy from her diet, see if that works. She's doing 3 Metcon workouts/week + 2 30-45min cardio sessions. I'm just frustrated, I'm sure you can relate.

Robb Wolf · 11-09-2006, 11:27 AM

Fer-shizzle...I feel like instituting a metabolic ward as part of our training. One month of what we feed you, lights out at 20:00 and daily fanny kicking. Hmmm...

Yael Grauer · 11-09-2006, 01:16 PM

Quote:

Originally Posted by Robb Wolf

Fer-shizzle...I feel like instituting a metabolic ward as part of our training. One month of what we feed you, lights out at 20:00 and daily fanny kicking. Hmmm...

OMG, you should do it! You can call it Paleo Boot Camp! You'd make bank, too--they charge over six THOUSAND bucks a week for that at the place one of my friends works at...and Fitness Vacation charges 13,000 a month...and this one is 2500 for eight days... http://www.swatfitness.com/vacations.htm

Scott Kustes · 11-09-2006, 01:22 PM

Robb, that's actually a good idea. 6 weeks of Paleo eating (have Scotty cook up some of his recipes), completely darkened rooms for 10 hours/day. I'd come work there. We'd have "Robb Wolf - Chief Science Guy, Assistant A$$ Kicker", "Greg Everett - Chief A$$ Kicker", "Scotty Hagnas - The Paleo Cooker Guy", and me..."Chief Turn Off The Lights Guy". Anyone else wanna volunteer for a position?

We'll make you rich before it's over! Then you can quit training people and just buy a private island, kick back, drink mai-tais and smoke cigars.

Ken Urakawa · 11-09-2006, 02:15 PM

I'll be the "shout slogans at you while you sweat" guy...Oh, and the "I think he's down at the Sierra Nevada brewpub again" guy...