Hi . Like Daniel, my wife, Kelly Mack (also a contributor here), was diagnosed as a child many years ago. Several years ago she started a treatment that brought her inflammation numbers into the normal range for the first time. She said she believes this medication does not make her tired, but, also like Daniel, notes that it is really impossible to tell because there is fatigue that comes from the disease, the existing damage, etc... The difference is that most previous medications, such as methotrexate, left no doubt that they were causing fatigue. Finding the right medication makes so much difference that even fatigue may not seem as bad. That said, fatigue is often the last symptom for people to notice an improvement and often even a normalization in the disease blood test numbers doesn't always help the fatigue. Best, Richard (RheumatoidArthritis.net Team)