Could the immense fatigue be due to Sulfasalazine or Methotrexate? Would love to hear of others' experience

I think you've sort of answered your own question, as sounds as if your RA is not yet fully controlled so you're still getting the RA fatigue. But having said that, it can take really quite a long time for your body to get used to taking strong meds and adapt, so there's probably an element of drug fatigue too. When I started Sulpha it did take me about 3 months to get used to it (and same with MTX and Hydroxy so all in all it's as about a year before I felt human again after diagnosis). And last year I did start to feel as if the drug burden was just getting too much for me, so talked to my rheumy about tapering down a bit as my RA was really under control. And that was a big mistake! I'll take a woozy drug head rather than active RA any day. Needless to say I'm now back on full doses of all 3 DMARDS again, and just make sure I do eat, exercise and sleep well to counter their effects.

Fatigue is just part and parcel of active rheumatoid disease I'm afraid. I had time off DMARDs and it only worsened so I'm less inclined to blame the drugs now and more inclined to blame the inflammatory process. For some people anti-tnfs have been life changing and I think that possibly includes a lessening of fatigue as the disease process is well controlled - but I haven't been offered them yet so really can't say.

I really hope you feel better soon I know that the fatigue is terrible for me just now.

Thank you both, Helixhelix and Twitchytoes. That's very helpful. I am probably not being patient enough! I suppose I should factor in age as well, being 70 next month. I am thankful I don't have to travel to work. In theory, I'm an artist, but such painful hands and fatigue have suppressed my creativity, at least for now.

So glad to have found this forum.

Hi Jora, I am in U.S. and some things are done differently here, so I can only tell you my experience with Methatrexate and Pred. The highest dose I could ever tolerate of Pred was 15 mg. I was on 20mg for a week or so and was completely crazy. I am presently at 3.75 a day and tapering off. I was on MTX , 15mg at first. My doctor increased MTX to 20 mg a week. I inject and do not take it orally. I could not even get out of bed after injecting 20mg the day after; complete exhaustion. Doctor suggested injecting half one night and half the next, 10 and 10. The difference was remarkable! The fatigue is tolerable now, I pace myself. I do know when I was taking same dosage of MTX .along with a higher steroid dose I was much more tired and out of it. I suspect the combination of MTX and Pred is contributing to your tiredness. The sulfa drug I have had no experience with. I've been on the MTX 20 mg since January 2014 and for me the divided dosage seems to have helped with the fatigue more than anything. Don't mean to ramble- hope this helps!

I too had to split my MTX, which really helped that drug wiped me out as , also helps is the 5mg folate each day except MTX days. (know rheumatologists vary quite a bit on folate dosage). Sadly the fatigue is as others have pointed out often a component of the active disease. Hope you get back to your easel (or equivalent) soon.

I would say that it is RA and possibly methotrexate. I had to stop methotrexate because it made me so tired that I was unable to hold a job for 2 years. It's difficult to know exactly unless you eliminate and try. I would speak to your rheumy nurse or rheumy he I were you.

Fatigue can be a side effect of RA. So easy to blame the drugs for everything when there can be other causes.

I have more energy when my RA is well controlled. Anti-TNF treatment has helped me a lot, much more energy and RA better controlled.

Cecil

Hi I have ra and fatique that comes and goes seemingly for no reason. It is very dif to plan to do things. I am not on any drugs, was offered mtx but I'm not good on tabs,my body just doesn't like it. So for now I'm going it alone. Had steriod jab ended up in hospital for 2 days made me very ill. I find the ra is enough to put up with. I wish you well . Hope you can work again art is close to my heart.

I think it could be. When I took sulfasalazine, I was so I'll. I had no appetite.lethargic and just sick, sick sick. My rheumatoid took me off and immediately I felt better. Now I'm only on plaquinil. Hope you feel better and speak to your doctor.

I have been on mtx injections for a year or so and due to bad flares, have just started anti TNF injections (Cimzia). I suffer cronic pain and cronic fatigue. My reumy has told me that the fatigue is due to the RA and cannot be relieved with drugs it is a "side effect" of the disease. Something we have to learn to live with, but very hard when previously so active. Damn RA !!

Just found this conversation from three years ago and I am having the same fatigue problems with methotrexate and sulfasalazine. Just wondered if three years on how you are doing? Paul.