When does the tiredness end?!

kirstyeb

I’ve been recently diagnosed with PsA and prescribed methotrexate. I can’t believe the levels of fatigue!! Everything is such a humongous effort. Has anyone experienced this taking methotrexate and does it improve?

I’m also wondering if it’s just from sheer pain. I was advised to stop taking NSAIDs whilst taking methotrexate, however this has increased my pain tenfold. Walking has become a real struggle and taking it out of me. I have called the nurse line but no one called back :/

Any advice on pain management while waiting for methotrexate to work and the hideous fatigue - either would be amazing! Thanks in advance <3

annabanana

Hi @kirstyeb , I'm sorry to hear that you're struggling with fatigue and also your pain. I hope things improve for you, I know chronic fatigue can be a challenge for many people with arthritis and it's never an easy thing to deal with. I've attached a couple of links on managing fatigue and one on pain management which may be worth a look.

https://www.versusarthritis.org/about-arthritis/managing-symptoms/managing-fatigue/

https://www.versusarthritis.org/news/2022/april/5-ways-to-help-with-fatigue/

https://www.versusarthritis.org/about-arthritis/managing-symptoms/managing-your-pain/

You mention that walking has became quite difficult, is this due to foot pain? If so I would recommend seeing a podiatrist if you haven't already. Only due to PsA being linked with plantar fasciitis and Achilles tendinopathy, which cause pain along the back and underside of the heel (but of course, everyone is different).

Best wishes!

Arciere

hi there

sorry to hear this - I know how hard this can be. It will get better.

Ask for some Predisolene oral steroids from your GP. I found those with naproxen were really helpful.

I have also found that removing things from my diet and removing a source of stress helped.

things removed from my diet include gluten, artificial sweetener and deadly night shade veg. I drank loads of Diet Coke before and had wheat in every meal pretty much - despite having a healthy diet per se

The source of stress is still there but I guess am managing that better (a feeling of loss)

I started on methotrexate and found it didn’t work. So think about whether it’s making any difference and go back to your rheumatologist. I get the feeling they walk you up medication starting with the simplest. I now take an adalimubab medication. This may be the source of my wellness but I think it’s a mixture of the diet, stress management and the medication.

Good luck - keep talking about it

kirstyeb

https://community.versusarthritis.org/discussion/comment/729013#Comment_729013

thank you so much for taking the time to reply. Other people sharing their lived experience goes a long way in knowing I’m not alone!

I’ve had some contact today from rheumatology and they’re switching me to injections of methotrexate to try to reduce side effects, adding prednisolone and increasing my folic acid. The GP has given me an obscure pain killer, I’m not really sure how much it’s helping but has also come with some side effects.

Unfortunately I have quite a stressful job and to say this year has been disastrous would be an understatement! Managing stress is something I’m usually good at, but it feels much more difficult when feeling unwell to adding in other challenges. I have discussed with my partner the possibility of looking for a change in career in the new year, but a difficult decision to make, I love my job so much!

Arciere

That sounds like good progress. I think there is difference between healthy stress which can make us productive and motivated maybe and, the other type which can eat you alive. A specialist nurse I saw thought there was a link between psychological trauma and a physical inflammatory response. I am not an expert at all, but if I reflect on it, I think I had a cocktail of poison (the gluten), stressful thought processes, lots of artificial sweeteners (thus a poor gut health) and a body that was technically on fire from an inflammatory perspective.

Good luck with it. It’s trivial but I do think being fully hydrated helps too. There is an excellent Netflix documentary about gut health and inflammation which you may find interesting - it’s called hack your health.

I would happily swap the fatigue for physical pain, it’s the worst and I found others find it hard to empathise and support. A completely invisible illness.

Take care

creAte

@kirstyeb ... taking daily B12 vitamin really helped me with fatigue...

hevver7

I’ve had fatigue badly for a year since the RA started. The pain is still very bad but on dropping down on prednisolone to 3.5 mg daily I’ve woken up! Either that or the B1, B3 or Boron I introduced recently. I’m not taking B12