Methotrexate & severe fatigue

Hi @Lindjemp

I hope what I’m about say helps.

The fatigue is the worst part of this disease (for me at least). Do you know what type of RA you’ve been diagnosed with?

Here is my list of fatigue busting things that may, or may not help.

- Oral steroids. prednisolone. I found these effective but they will usually give them for short term. Your inflammation may be raging and this might help. Talk to your GP or RA Nursing Team.

I am of the view that my gut is linked to inflammation. So I have been following a very different diet to help manage the inflammation which in turn causes my fatigue.

- no gluten, artificial sweetener, reducing sugars ending in “ose” as much as possible, I.e no honey, glucose etc. No deadly night shade veg, so no white potatoes, tomatoes, aubergine, peppers etc. lately no red meat - not sure about this one.

I spent lots of time and money trying to find a supplement or quick fix for fatigue. It was only when I bought an RA cookbook that I tried excluding things from my diet. This worked a treat.

Microbiome. I do try and look after my microbiome. I do this through pre and probiotics. E.g lots of fibre through varied veg, and fermented foods like kefir sauerkraut and things.

Emotional stress. I definitely attribute emotional stress to an inflammatory reaction and fatigue. So try and distance yourself that causes worry or emotional stress.

Finally an easy thing to say, but hard to do - is staying hydrated. Water doesn’t cut it for me and since I don’t consume artificial sweetener it’s hard to know what to drink. So I go for sparkling water or those flavoured sparkling waters that claim to have no sugar or artificial sweetener.

Basically I had a classic Mediterranean diet (ex Jamie Oliver fan) that consisted of: French pastries and bread (gluten), pasta (gluten), potatoes and tomatoes (deadly nightshade), Diet Coke (sweetener), Guiness (gluten) etc Since making these changes I do feel like it’s [fatigue] in check, although I do still experience fatigue flares.

This all comes with the caveat that I do take a biologic medication which will likely be contributing. However, I made the changes to my diet about two months into my biologic medication and definitely felt better as a result.

I hope this helps. The fatigue will get better but it might be a long road. There is a fabulous poem by Stephen Fry that tries to describe what you might be feeling like the weather. It’s very real and may not improve tomorrow but the season will change for you.

hope this helps