feeling tired all the time

Hi all,

For the last 2 to 3 weeks I've been feeling tired constantly - it's a fairly low level of tiredness so it's not really stopping me doing things. In addition, I'm also waking up early so not feeling rested when I get up. I'm usually in bed shortly after 10pm and usually manage to fall asleep ok. My joints aren't particularly being grumbly at the moment either!

I'm on methotrexate for rheumatoid arthritis which I started in March and in June went upto 25mg weekly.

Can anyone advise?


  • stickywicket
    stickywicket Member Posts: 27,608

    I've been on meth for years. The one thing that comes to mind is that, during that time, I've had low haemoglobin about three times. My GP, being thorough, sent me for endoscopies and colonoscopies but there wasn't a problem so I was just given a course of iron tablets. My rheumatologist, when I told him, said he'd just have done that at the start as both RA and meth can lower iron levels. Maybe worth a bloods check? But, do ask them to check your inflammatory levels too as it could maybe be the first sign of a flare.

    If at first you don't succeed, then skydiving definitely isn't for you.
    Steven Wright
  • jamieA
    jamieA Member Posts: 611

    Hi @JenHB

    Since PsA appeared about 2 years ago my sleep has been disturbed most nights - I usually wake around 4am - whereas I was previously a sound sleeper. I think it's a low level pain and stiffness in my hands at this time that's responsible for waking me. I raised this with a rheumatologist I saw who said the body naturally produces steroids during the day but doesn't during sleeping hours - particularly between 4am-7am and this may be the cause. I thought this was a bit odd at the time but it does kind of explain things.

    As well as that I take bouts of extreme tiredness either the day after or two days after my MTX day. It literally feels like someone has pulled my energy plug out and I usually end up going for a lie down for the afternoon. Again I raised that with my rheumatology nurse and she said that's a common side effect. I take folate the 6 days of the week I don't take MTX. I've also had to take vitamin B12 as I became anaemic and I've been prescribed vitamin D3 as my levels were low - again the medics said this wasn't uncommon with people with inflammatory arthritis.

  • frogmorton
    frogmorton Member Posts: 29,035

    There is nothing like inflammatory arthritis fatigue (except maybe post baby birth tiredness which I remember being very similar) it really is unique. You can't fight it so I give into it. Someone here advised taking timed naps if needs be using my alarm so that's what i do when flaring.

    BTW is 10pm early enough to be dependent on what time you are up in the morning?

    Best of luck

    Toni xx

  • Baloo
    Baloo Member Posts: 359

    If you not had it for long yet maybe it's just a virus.

  • JenHB
    JenHB Member Posts: 130

    When will I learn it's not a good idea to google stuff? I spoke to the rheumatology nurse last week who sent me more blood forms but advised also speaking to my GP. Spoke to my GP today and although rheumatology did their blood tests on Tuesday evening they are going to do their own next week - suspect a lot of them will be the same but she also said that they will be checking for vitamin deficiencies and my thyroid. Googled about the thyroid and underactive thyroid doesn't sound good - also based on it saying it may be a result of the immune system attacking it.

  • Lilymary
    Lilymary Member Posts: 1,733

    There are so many causes of persistent fatigue Ike suggest starting with the blood tests. If you’re lucky, they’ll find the cause and start treating it. If not, they will at least have ruled out the obvious causes and start looking at something else. I sympathise, I don’t have RA but have spent years battling fatigue, in and off, and it’s wretched, but it’s been multiple causes over the years, including the various medications and treatments I’ve been on. Do persist with the tests, but meanwhile be kind to yourself.

  • JenHB
    JenHB Member Posts: 130

    Just to give an update - doctor said that my blood tests were clear apart from being borderline vitamin D deficient. So advised taking an over-the-counter supplement considering my medical history.

    Initially was surprised as I had been outside a lot in August but then remembered that I had been very conscientious about applying suncream as I had been told the skin may be more sensitive to the sun when on MTX (I was also then with a friend and 2 toddlers so helping to set a good example).

    Just thought that this may be useful for others!