Rheumatoid Arthritis and fatigue | Arthritis Information

 

About 25 years ago I was told that I had psoriatic arthritis. My primary complaint at that time was overall fatigue and body aches. I later went into a couple of really bad flares of psoriasis. But, over the years, I have experienced less and less psoriasis and rarely needed more than NSAIDS.

Then, about 4 years ago, my fatigue and achiness began to worsen. As I hadn't been to a rheumatologist for a few years, I found a new one and he decided that I have rheumatoid arthritis.

I was started on NSAIDS and plaquenil initially. But, after twice having problems with vertigo with the plaquenil and no improvement in my symptoms or labs, he stopped the plaquenil and started me on methotrexate about a year ago.

And, all along, my main problem has been overwhelming fatigue. I have only started to develop joint involvement a few months ago... in the knuckles of my right hand. I do still have body aches, but after 25 years of living with this, it's hard to tell if there is any improvement or not in that regard.

About 4 months ago, I told him that I really didn't feel any improvement at all, despite taking 20 mg/week. So, the last couple of times I've seen him, we have been talking ever since then about putting me on Enbrel.

And then today, I went to see him and told him again (for probably the 50th time) about my overwhelming fatigue. He told me that this is not normal, even for an RA patient, although he later admitted that it was possible the fatigue was coming from my RA due to my increasing CRP level. He encouraged me to have a cardiac workup to make sure I don't have heart disease. Ok. I've been telling him about the fatigue for YEARS and NOW he finally thinks maybe it's not related to the RA?

That conversation put me into a tailspin. All these years I thought that the fatigue I've been experiencing is due to the RA and now my rheumatologist is telling me that he doubts that it is.

I am really thinking that it's time that I get a second opinion about my RA. But, I wanted to talk to some of you who have been diagnosed with RA to ask you.....

Is fatigue a major part of your symptoms? Or is it a lesser issue for you? In other words, what is your biggest problem... is it the joint pain? or the fatigue? Or are they equal?

I appreciate everyone's input.
I am finding fatigue to be an increasing problem with me and find it more debilitating then any pain I'm having.

Fatigue is my biggest problem.  It seems much worse when I am having pain/inflammation.  Rheumatologist says that when inflammation is high, so is fatigue.

Welcome, I also suffer with fatigue, my rd says the same, get ra controlled. I think that the meds have something to do with the fatique, my pain levels are really low. I'm on 17.5 Mtx & Remicade.

Yes, I also experience what I call the "RA flu", fatigue, general body ache, malaise...  I'm sure it's related to my overall inflammation because if I take a couple of advil it does a pretty good job of alleviating the flu-like symptoms for a while, though NSAIDS don't do much for the RA joint pain.  The symptoms usually disappear for at least a week after my Humira shot so it's pretty clearly RA related. I am fatiqued all the time. joint pain has gone on the increase. The inflamation is outrageouse and that will cause fatique and malaiseI think that fatigue is the absolute worst part of the disease -- yes, overwhelming fatigue. Your rheumy says this isn't normal? Wow, he should talk to some more patients, i think.Hi Klm and welcome to the forum.  I am only Dx with possible RA and we are slowly weeding other things out, but my chief complaint when I first went to the Dr was fatigue.  I'm so tired of feeling tired!!!!Welcome klm424!!
Glad you're here, and I think all of us relate to the fatigue you're feeling. In March of this year it got way too bad, but my vitamin D got boosted up to 2,000 IU a day and that helped a lot!
Have you had your iron checked?

If you feel that your RD isn't the right one for you, maybe you should find another one. It's important to have a doctor you're comfortable with.

Take care~
Audrey





I had alot of fatigue then when they finally put me on enbrel it has gotten so much better. I take my shot on Tuesday and by the weekend I start feeling tired and sore all over again. I do have several really good days so it evens itself out. I sometimes still fall asleep and take a mini (20 minutes or 30) around 4pm. It's just enough to keep me going for the evening. [QUOTE=CinDee]I had alot of fatigue then when they finally put me on enbrel it has gotten so much better. I take my shot on Tuesday and by the weekend I start feeling tired and sore all over again. I do have several really good days so it evens itself out. I sometimes still fall asleep and take a mini (20 minutes or 30) around 4pm. It's just enough to keep me going for the evening. Is your Dr kidding? I too agree, time for a Different DR!!!! rhm specialist!! asap.. From my experience fatigue goes hand in hand with Ra and the drugs one has to take..
I have to say that at almost two years into this, the fatigue is less now than for the first eighteen months.
I still have it but seem to be able to do a little more these days.

In the beginning fatigue was the most steady symptom.   The pain/swelling would come and go, but the never-ending fatigue hit me the worst.  There were days when I came home from work and went directly to bed, no changing clothes, etc. just had to sleep.   It's gradually gotten better, not gone, but better.  I noticed an improvement when Enbrel was added.  I have to believe that getting RA under control helped the fatigue, so there is a connection.  Not sure why your RD doesn't think so.  There are days that I don't nap at all, but if I over-extend, then naps are still the best thing.

I've had RA since age 14, was in remission for 20 years with recurrence about age 45.  I'm 62 now, and was recently diagnosed with Lupus in addition to RA.  It is my opinion that the almost unbearable fatigue I've experienced the past few years is more related to Lupus than RA, for me. 

Like Cat E Clysm.. I was Dx'ed at age 10 and had about 30 years of remission.. only to be hit really hard.. I'm 50. I feel 70 :( My big complaint was fatigue at my initial appt.  The Rheumy asked if I ever got my thyroid checked and that ended up being the culprit.  I am assuming it is also autoimmune.  Just started a week ago on Levothyroxine.i've had sero-negative RA for 25 years and fatigue is the worst symptom I've had.  Overwhelming is the exact word for it when I'm flaring.  I've been on all sorts of Nsaids as well as Gold shots over the years, Mtx didn't do a thing, and because of other issues I can't take the tnf drugs.  I am on Plaquenil now and after about 6 of 7 weeks it did kick in and the discomfort lessened.  I don't know how your doctor feels that fatigue is not part of RA though.  AnnHi,
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