That is me who takes the higher dosage of Folic Acid on the day I inject - the double dosage is prescribed by my Rheumatologist to prevent the side effects that I was getting - my GI was the one that prescribed the MTX, but the Rheumy prescribed the Folic Acid as she deals with more people that take MTX for RA, Lupus, on a daily basis.
My Rheumy told me that the Folic Acid dosage that I am taking doesn't deplete or counteract the MTX if taken the same day. For me it was either the double dosage of Folic Acid that day (taken in the AM - shot in the PM) or else I had to take the form of "Rescue Folinic Acid" (Levoleucovorin) within 12-24 hours of taking my MTX - my insurance won't pay for the Folic Acid or even the "Rescue Folinic Acid", so the compramise was to take my 1.5 mg daily and 3mg day of injection.
I really think that it is different for each person in what their Dr. believes in prescribing for that patient and the conditions in which they are taking the medicine for (in my case both Lupus and Crohn's). I am also borderline anemic most of the time, which can come into being folic deficient so that may equal the higher dosage for me. My levels of folic acid are also checked bi-monthly with my liver and everything is just where it should be according to both my Rheumy & GI Dr.
I have been on MTX almost a year and it is definitely working for both my Lupus and Crohn's - for the first time in years I will be considered in "Remission" - so I don't think that the higher dosage of Folic Acid is making my MTX not work at all.
Just my thoughts
Diagnosed with Lupus - April 2002
Diagnosed with Crohn's Disease (and all the lovely things that come with it) - January 2003 (problems since early 1990)
Normal Meds: Ambian 10mg, Flexeril 10mg as needed, Plaquenil 400mg, MTX 25mg Injection weekly, 1000mg Canasa Supp. as needed, Probiotics