Morgan, I've not had any side effects from the MTX and my blood work is still normal, so I've had a great response with it. It is possible that it will be suggested to you, but you have to be sure about your future plans for babies too as you cannot fall pg while on it because it will cause birth defects (not might, but will). But I would recommend to anyone to try all other alternatives first before heading down that path because even if you don't get side effects, it does put a heavy burden on your liver and kidneys and it robs your body of folate too