Worsening fatigue - RA or Methotrexate side effect?

Hi, I was recently diagnosed with RA. I started on methotrexate 3 weeks ago at 15mg dose. I’ve had 3 weekly doses so far..

The nausea the day or so after is pretty bad, but also I am experiencing worsening fatigue.. and I’m not sure if it’s the RA or side effect of the MTX. It’s constant, so not just the days following my dose.. I literally can’t get past about 1-2pm without needing to sleep, and as I work this is really difficult to manage.

my inflammation itself I think is relatively low atm.. and pain tolerable most days, but it’s just the fatigue is becoming more and more debilitating.

Has anyone else had this starting MTX, or do you just think is the RA? Fatigue was actually how I first started on the path to diagnosis following covid in July.

thank you


  • Ellen
    Ellen Moderator Posts: 1,485

    Hi @Kate1701

    While you wait for some of our members to reply - have you read this?

    Hope it helps a little.

    Best wishes


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  • frogmorton
    frogmorton Member Posts: 29,023
    edited 22. Nov 2022, 11:29

    It's so so tough fatigue which for me is usually a sign that I am flaring nowadays.

    Initially until my meds were sorted it was pretty constant. The only other time I have felt that drained was post baby.

    It's very tough when you're working to cope with I was advised to nap, but now do you do that? I expect it's a case of getting through the days (I was part time luckily when this kicked off for me) and when you get home collapsing and resting before tea.

    The good news is the nausea with MTX often does wear off and your dose has leeway to be increased if it is helping, but not quite enough.

    Sending you some ((()))

    Toni x