Its been 2 weeks so far & no change. 10mg. I was able to convince the rheumatologist for the prescription because of the rheumatic like symptoms in my fingers, but as we know joint soreness is common with ME. I already had an MRI of my right hand a year ago, that didn't suggest rheumatoid arthritis. It barely suggested osteoarthritis either. He has referred me to get MRIs of both hands, since my left is now worse than my right. Methotrexate typically takes at least 12 weeks for noticeable effect & the dosage is often upped around 8 weeks. You take a baseline blood test at the start & then another in 4 weeks, to check proper kidney & liver function while on MTX Other tested physical symptoms I have of ME/CFS are Postural Orthostatic Tachycardia Syndrome (20 minute standing test of pulse pressure & heart rate) & hypoglycaemia (1 hour glucose consumption blood test).