alt=a woman with fatigue examines a bottle of medication.

What the Fatigue?!

If I am not writing about napping, I am writing about fatigue. If you’ve read some of my other articles, you will know fatigue is a favorite subject of mine. I wish it weren’t, but it is.

"Hate" is a strong word, but I HATE fatigue!

I hate fatigue because I find it more debilitating than the pain of my autoimmune itself. And, yes, I am using the word ‘hate’. My students, on and off, use the word hate to which I gently remind them that “we do not use that word in my classroom. It is a very strong, nasty word, and usually 'strongly dislike' serves our purposes.”

I usually live by the same rule, but in this instance, I have to say that I truly hate fatigue. Without it, I could do so much more. I would not have to nap as frequently (which eats up a good portion of the day), I would not have to rest after every activity, and I certainly would not have (as much) brain fog that makes every thought even more difficult.

What causes fatigue?

Fatigue sucks, but where does it come from? You can bet I ran to my rheumatologist and asked his opinion. As many of you know, I also moderate for this site, so I have read many comments on what doctors have told other community members.

What I have gathered is that fatigue is still very poorly understood. What my rheumatologist said makes the most sense, but then I wonder if there are other components because even when my RA is well managed, I still tire more quickly. My rheumatologist always wanted me to tell him when my fatigue got worse. He said fatigue was a good indicator that my condition was not well-managed, and if I had an increasing amount of constant fatigue, it was time to re-evaluate my disease management.

The connection to RA symptoms

I agree with him. When my RA is not well-managed, I experience increased stiffness, swelling, and ultimately pain which then translates to fatigue. However, I know that some of my medications also cause fatigue. For me, those are methotrexate (MTX) and prednisone.

It has recently been brought to my attention that the pain medications I am on are “downers” and can cause me to feel lethargic. I am a bit skeptical about their effects as I don’t take them all the time, and I don’t feel any difference in my fatigue. To be honest, I don’t notice a massive difference in fatigue levels except when I switch up the Prednisone.

This makes me think that my fatigue (at least) comes from my disease. Maybe it is not directly correlated to the chronic illness, but I experience it because of the direct symptoms caused by RA.

What’s even more frustrating is that there doesn’t seem to be an antidote. With any of my other symptoms, there is something I can take or do. With fatigue, I can only take so many naps (which don’t guarantee a battery recharges) before I start wasting time. It’s just the party crasher I didn’t invite and never left.

Do you deal with fatigue? What are your tips for minimizing it?

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