I'm not sure about
MTX causing low RBC counts but I take Imuran and it has caused me to have low RBCs and too many immature, malformed RBCs. My GI tells me it is from the Imuran. Low B12 and/or floic acid can cause the same problem so it's good they are testing that. Also, if a person has chronic illnesses, there is an anemia that desplays low RBCs called "anemia of chronic illness."
While on MTX, it is recommended that people take at least 1 mg folic acid daily. Because imuran can also effect folic acid, my doctor prescribed prescript
ion strength folic acid - 1 mg per day. The pill is tiny. My B12 is low from my Crohn's and I take a supplement for that too - 1000mg daily. It is a sublingual tablet that tastes good and just desolves under the tongue. I was taking a daily multivitamin and my doctors said it was just not enough for my needs. I continue with the multivitamin and the supplements. My RBCs are still low but not as bad as before.
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CD, Ankylosing Spondylitis, lupus, small fiber peripheral neuropathy, avascular necrosis, peripheral artery disease, degenerative disc disease, and a host of other medical problems.