Polyarthritis

Methotrexate (MTX) has liver toxicity as a major side effect, and some herbal ingredients may share the same liver metabolic pathway. While common medicinal herbs such as *Dokhwal* and *Bangpung* rarely cause problems at low doses, changes in liver enzyme levels may occur depending on the dosage and combination. It is safer to start taking herbal medicine in small amounts while undergoing regular liver function tests.

Perspective of a Korean Medicine Clinic

In Korean medicine, the liver governs tendons and is responsible for detoxification. During MTX use, treatment that reduces the burden on liver function is the priority. At Dongjedang, we carefully review the patient's medication history and coordinate treatment to focus on improving blood and Qi circulation while minimizing the burden on the liver. Starting with external therapies such as acupuncture and pharmacopuncture instead of oral medication is also a safe approach.