Drug & supplement interaction

Macrobiotic Diet + Methotrexate

Methotrexate brand names: Rheumatrex, Otrexup, Rasuvo, Reditrex.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Macrobiotic Diet and Methotrexate in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Macrobiotic Diet and Methotrexate

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Methotrexate and Macrobiotic Diet in our sources. This does not guarantee that the combination is completely free of risk — research on Macrobiotic Diet alongside specific medications may be limited.

Worth understanding: our licensed dataset holds no drug-interaction record for Macrobiotic Diet at all — not against Methotrexate, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

Macrobiotic Diet is an eating pattern rather than something you take. Ask your pharmacist or doctor before changing how you eat while on a prescribed medicine: some medicines are dosed around meals, and a change in diet can change how they work. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Macrobiotic Diet safety at a glance

Macrobiotic Diet overall Use caution Balanced versions can be healthy, but strict versions may cause nutrient deficiencies.
Pregnancy Use caution Strict versions may not provide enough protein, calories, or key nutrients; medical supervision is advised.
Breastfeeding Use caution Nursing parents need adequate calories and nutrients, so strict versions should be supervised by a clinician.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Methotrexate and Macrobiotic Diet? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Macrobiotic Diet and Methotrexate May Share a Side Effect

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so following Macrobiotic Diet while taking the medicine can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • Bone thinning Worth acting on Additional detail

    Macrobiotic Diet

    “The macrobiotic diet has been associated with increased risk of rickets and osteoporosis, likely due to calcium and vitamin D deficiency. Following a strict macrobiotic diet that does not include additional intake of fish and fat has also been associated with reduced height for age in children less than 8-years-old.”

    Macrobiotic Diet · Natural Medicines adverse-effect record, reported in bone loss.

    1 source cited
    1. 27952. Dagnelie PC, Van Dusseldorp M, Van Staveren WA, Hautvast JG. Effects of macrobiotic diets on linear growth in infants and children until 10 years of age. Eur J Clin Nutr 1994;48 Suppl 1:S103-S111.

    Methotrexate

    Listed in the ADVERSE REACTIONS section of the FDA label for Methotrexate. Read the label on DailyMed ›

Effects for Methotrexate come from the ADVERSE REACTIONS section of its FDA label; effects for Macrobiotic Diet come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 489,806 voluntary FDA FAERS reports for Methotrexate that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Overlapping uses

What Methotrexate Is Prescribed For, and What Macrobiotic Diet Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Methotrexate is a prescription medicine with approved uses on its FDA label. Macrobiotic Diet is an eating pattern: what follows is what researchers have looked at it for, and how strong that evidence is.

Methotrexate is prescribed for: Methotrexate treats a wide range of serious conditions. In cancer care, it is used for acute lymphoblastic leukemia, non-Hodgkin lymphoma, osteosarcoma, breast cancer, head and neck cancer, and gestational trophoblastic neoplasia (a rare tumor related to pregnancy). It is also used to prevent and treat meningeal leukemia (cancer affecting the lining of the brain and spinal cord). Outside of cancer, methotrexate is prescribed for adults with rheumatoid arthritis (RA), children with polyarticular juvenile idiopathic arthritis (a form of childhood arthritis), and adults with severe psoriasis that hasn't responded well to other treatments.

Macrobiotic Diet has been studied for:

  • Cancer studied, not established Macrobiotic Diet has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Macrobiotic Diet for cancer

    Although there has been interest in using the macrobiotic diet for various cancers, including colon cancer, there is insufficient reliable information about the clinical effects of the macrobiotic diet for these conditions.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Methotrexate on your own; if you are taking Macrobiotic Diet for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Macrobiotic Diet or Methotrexate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Macrobiotic Diet or Methotrexate, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Methotrexate

This page covers Macrobiotic Diet only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Methotrexate page lists 82 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Apple (major), Beer (major), Grapefruit (major) and Siberian Cocklebur (major).

By severity: 7 major · 60 moderate · 15 minor.

From our pharmacist’s overview on the Methotrexate page

“The liver is where methotrexate and supplements clash most. Methotrexate (Rheumatrex, Otrexup, Rasuvo), used for rheumatoid arthritis, psoriasis, and certain cancers, can strain the liver on its own, and 38 of the 82 interacting ingredients on this list add liver risk of their own, alcohol included, which makes this a list to approach…”

Reviewed by 2 · Jul 18, 2026

Open the Methotrexate interaction page

How much people look this up

Where Macrobiotic Diet and Methotrexate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Macrobiotic Diet
Steady interest

#794 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Methotrexate
Top 5%

#49 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Macrobiotic Diet reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Macrobiotic Diet and Methotrexate records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Eating pattern

About Macrobiotic Diet

What is Macrobiotic Diet?

  • General wellness and longevity
  • Cancer prevention and support (popular belief)
  • Heart health
  • Weight management
  • Digestive health

The macrobiotic diet is a plant-based eating pattern centered on whole grains, vegetables, and beans, with limited animal products and processed foods. Some versions can be healthy, but strict versions risk nutrient shortfalls, and there is no strong proof it treats or cures diseases like cancer. Talk to your doctor or a dietitian before starting, especially if you have a health condition.

Whole-food eating plan based on whole grains, vegetables, and legumes

An interaction check asks whether these two react with each other — it does not ask whether Macrobiotic Diet is a good idea for someone in your situation. Here is what our Macrobiotic Diet record says about it on its own.

Macrobiotic Diet: dosing

There is no standard dose for a diet. Instead, macrobiotic eating is about food choices and proportions, often with grains making up a large share of meals and vegetables and beans filling the rest.If you want to try this way of eating, choose a balanced version, include a variety of foods, and avoid the most restrictive forms. Many people on plant-based diets need a vitamin B12 supplement, and possibly vitamin D, calcium, iron, or omega-3s. A registered dietitian can help you plan meals and decide which supplements you may need.

From our Macrobiotic Diet monograph — the full record covers uses, side effects and every documented interaction.

Read the full Macrobiotic Diet monograph & all interactions
Medication

About Methotrexate

What Is Methotrexate Used For?

Brand names: Rheumatrex, Otrexup, Rasuvo, Reditrex

Methotrexate treats a wide range of serious conditions. In cancer care, it is used for acute lymphoblastic leukemia, non-Hodgkin lymphoma, osteosarcoma, breast cancer, head and neck cancer, and gestational trophoblastic neoplasia (a rare tumor related to pregnancy). It is also used to prevent and treat meningeal leukemia (cancer affecting the lining of the brain and spinal cord).

Outside of cancer, methotrexate is prescribed for adults with rheumatoid arthritis (RA), children with polyarticular juvenile idiopathic arthritis (a form of childhood arthritis), and adults with severe psoriasis that hasn't responded well to other treatments.

Most-Reported Side Effects for Methotrexate

From FAERS, the FDA’s public side-effect reporting system (489,806 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Rheumatoid arthritis 42,798 reports
Arthralgia 40,830 reports
Fatigue 33,049 reports
Nausea 28,999 reports
Joint swelling 25,026 reports
See full Methotrexate drug information
Keep checking

Other Drugs & Macrobiotic Diet

Browse every other medication we’ve checked against Macrobiotic Diet — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
0Minor
2,829No known interaction
No interaction 2,829 drugs checked — show the list
Evidence & sources

Macrobiotic Diet References

The 3 references that drive our Macrobiotic Diet monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Van Staveren WA, Dagnelie PC. Food consumption, growth, and development of Dutch children fed on alternative diets. Am J Clin Nutr 1988;48(3 Suppl):819-21. PubMed
  2. Louwman MW, Van Dusseldorp M, van de Vijver FJ, et al. Signs of impaired cognitive function in adolescents with marginal cobalamin status. Am J Clin Nutr 2000;72(3):762-9. PubMed
  3. Dagnelie PC, Van Dusseldorp M, Van Staveren WA, Hautvast JG. Effects of macrobiotic diets on linear growth in infants and children until 10 years of age. Eur J Clin Nutr 1994;48 Suppl 1:S103-S111.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Following Macrobiotic Diet While Taking Methotrexate: Common Questions

Is it safe to follow Macrobiotic Diet while taking Methotrexate?
We do not list a known interaction between Macrobiotic Diet and Methotrexate. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Macrobiotic Diet and Methotrexate have any of the same side effects?
Yes — our sources link each of them separately to one of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Are Macrobiotic Diet and Methotrexate used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Macrobiotic Diet in each. That is a conversation for your prescriber, especially if Methotrexate is being adjusted to a target.
Does Methotrexate interact with any supplements?
Yes. Methotrexate has documented interactions with 82 supplements in our database — Macrobiotic Diet is not one of them. The Methotrexate interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Methotrexate and Macrobiotic Diet?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.