PsA fatigue, flu like symtoms



I was diagnosed with PsA three years ago and over the last 3 years have had various joints swell as well as enthesitis in various places and sacroiliac joint inflammation. I also have OA in my spine and my hips and am hoping for a hip replacement later this year. My PsA symptoms can be quite sporadic with some periods when symptoms are minimal.

As well as the joint inflammation I suffer regularly with fatigue, flu like symptoms and headaches. I also feel tender around the glands in my neck. The thing is these episodes, they occur every couple of months and last a couple of weeks, don't necessarily tie in with any joint inflammation. I am just gettng over the latest bout and managed to get a blood test whilst I was unwell. Every other time the symptoms have resolved before I could get a test. Anyway my ESR was raised at 27mm/hr. Not really high but I was starting to feel better so expect it might have been a little higher if I'd had the test when I was feeling at my worst.

I recently saw the GP who picked up on the neck pain and suggested it might be polymyalgia rheumatica. She didn't seem to think the PsA was a cause. I am not sure its polymyalgia. I don't really have those symptoms and the episodes have been coming and going for getting on for 3 years now so similar timescales to PsA.

I jsut wondered if others with PsA have similar episodes and whether they tie in with joint inflammation. I only see the rheumatology every 6 months or so but am going to try and call them to discuss. Am not in medication at the moment but MTX has been suggested. I have been holding off and trying to manage the joint pain with naproxen.

Thanks for any comments or advice?


  • jamieA
    jamieA Member Posts: 765
    edited 1. Mar 2024, 18:16

    Hi @jeb68

    I'm not a medic so can only relate what I've experienced. When my PsA was at it's worst I had swelling on either side of my neck. The medics thought I might have had a problem with my thyroid but after tests ruled that out. Apparently there is a known connection between psoriasis/psoriatic arthritis and an under active thyroid as they both show increased levels of the cytokines IL-17 and TNF alpha. I've been on Amgevita an adalimumab biosimilar - it's an anti-TNF drug - since July 2021 and haven't experienced any swelling in my neck since it kicked in.

    I think many of us with inflammatory arthritis suffer fatigue as it takes so much energy out of you. I don't know about you but I don't sleep well and almost nightly waken around 3-4am. When I wake my forearms and wrists are swollen due to enthesitis according to my rheumatologist. A rheumatologist I saw when I was admitted to hospital said that the body generates it's own steroid - cortisol - but that generation stops during the hours of sleep.

    I hope you get stabilised soon.

  • jeb68
    jeb68 Member Posts: 2

    Hi @jamieA thanks for your comments. I had my TSH levels checked and they were OK. I do get other symptoms of underactive thyroid though so wondered if it could be related.

  • noddingtonpete
    noddingtonpete Moderator Posts: 1,144

    Hello @jeb68 and welcome to the Community.

    Glad to see you are getting some good support already. If you need any specific information just ask a question on here or pop over to the Versus Arthritis and try searching. We have a lot of information on arthritis and treatments as well as hints and tips.

    Best wishes


    Need more help? - call our Helpline on0800 5200 520Monday to Friday 9am to 6pm

  • KPez09
    KPez09 Member Posts: 23

    I have PsA and now 3 months into taking methotrexate. When I have a flare it does feel similar to the flu, low grade fever, fatigue, increase in scaled patches, more stiff and more swollen joints. I managed to catch a cold so I've been out of sorts for the last 10 days anyway but the fatigue is so bad

  • Mindful
    Mindful Member Posts: 7

    I feel your pain @KPez09 I've been fatigued all day today and I couldn't understand why. My pain levels aren't as high so was thinking Th8s must be how things are with PsA? I'm newly diagnosed, so navigating new ground here too. X I tend to feel flu like the day after Methotrexate

  • KPez09
    KPez09 Member Posts: 23

    MTX just makes me feel a little dizzy the day after. The fatigue is odd for me but usually indicates a flare. Stress, weather and food all make a difference to me.