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Constantly tired

I can almost (I say almost) put up with the pain but this constant tiredness is really getting me down. I was diagnosed 4 months ago. I am taking plaqunil, methatrexate injections 17.5mg soon to be 20mg, folic acid weekly and maloxicam 7.5mg twice daily as needed, started on sulfasalazine this week. I run a very busy 5 star B&B and have taken on more staff so that I can take on a more supervisory role. Sometimes I get up feeling tired and it goes on all day and sometimes it hits mid afternoon and I have go to bed. I know the drugs can take some months to work but will the tiredness get better as the drugs start to kick in?

10 Replies

Hiya Angela. Our paths have crossed before & I'm sorry to hear you're still struggling. In my experience deep fatigue is usually the result of my RD not being controlled well enough. You're reasonably newly diagnosed & I would think your RD is quite active starting you on HCQ, MTX, meloxicam & now the need for sulfasalazine so I think you need to help yourself by resting as much as possible in order to let these meds do their job. Taking more of a back seat will help but I would think the responsibility of your busy business is probably still there & I think most people on here would agree stress & RD don't make good bedfellows. Is there any way you could step back even further just until you get somewhere near properly controlled?

You're doing right taking yourself off to bed, you probably just have to else you'd topple over!

The fatigue will ease, it becomes more of a general weariness at times & you just need to learn to listen to your body, which you are doing to a degree, but your not yet having restful sleep as you're waking tired. The pain, again as you're not quite there yet, forms part of fatigue & maybe meloxicam isn't quite enough to cover it. I was taking 15mg daily when taking HCQ & MTX & my Consultant changed me to Arcoxia (etoricoxib) & that helped so much more. Eventually HCQ was dropped & it turned out that just MTX worked better for me, so it may be that tweaking your meds may be necessary for you too in the not too distant future.

If you haven't already I'd talk to your Rheumy about it, just as you have here.... & be honest! Without knowing exactly how you're feeling he only has blood tests & examinations to form an opinion & that doesn't give him the whole picture.

I hope it's just that the meds that aren't quite there yet but it will get better, it's just not a quick fix. x


Hi there thanks for your reply, I know that I work to hard my hubby is always telling me to rest more but I feel if I give in this awful disease will be winning ( this was never meant to happen to me!!) I have only just started on the sulfasalazine and know that it takes uptp 3 months to work. I was taking naproxen but had to stop that as it was causing bad indigestion so am a little afraid of anti inflammatories. Xx


Reading your other posts I'm not really surprised! It's just that what I've learnt is that RD needs to be listened to in the early days & once you do it's easier to work round, once you know just how far it can be pushed. Less pushing gives you a better chance of controlling it rather than it controlling you. I'm there now with the help of my meds but still need to listen from time to time otherwise it it shouts & there I am flaring!

Were you not you prescribed a ppi (omeprazole or similar) to take when you were on naproxen or now with meloxicam? As well as protecting the stomach they help with indigestion & heartburn too. DMARDs will work on reducing some pain but as you know anti inflammatories & pain relief are often also needed to reduce it further to an acceptable level. If you haven't had one ask your GP if he'll prescribe one for you. x


Good morning nomoreheels heels, feeling a bit better this morning although I didn't really sleep very well, partly because I am hot then cold had my hair cut short because of it. the other reason is because I lay thinking about what is going to hurt in the morning. I do take omeprizole so my tummy is a lot more settled now. Thanks for being there. Xxx


I can relate to that! Pleased you're feeling a little better though & just pop on whenever - or if you feel you need support or help, we're all either in the same boat or bailing out! x


I totally feel for you. I started on my meds: MTX and folic acid in May and by July I was still suffering from fatigue and my blood results showed no improvement. I was then put on steroids 12mg daily and since then I have never felt better. The dosis has now been reduced as my blood work has come back almost perfect! I honesty believe it's all about finding the right combination of meds for you that will make all the difference. Sending you a big hug xxx


Thank you, and big hugs to you too. I hope that my medication is now on the right road and within a few months I will start to improve. The good thins is that we are coming to the end of a very busy season and we have a month off over Christmas so this may help to allow the drugs to kick in. I don't really want too many steroids as I struggle with my weight already. I am only a stone overweight but I know more weight will make me even more tired and miserable. Xx


sorry to hear about your diagnosis ..when i was diagnosed with RA i was not in pain i had gone to docs with a swelling under my foot turned out many tests later it was RA .. ,, but until i was diagnosed i wasn,t in pain ..then sure enough i had a massive flare up ..put on methorexate after sulfasalazine failed to help

,i even went on a trial drug until i could stand the pain no more.. steroid injections ..while waiting for methotrexate to kick in .. that was 12 years ago my rheumy said i had severe RA that diagnosis did not help me. but luckily for me the methorexate has saved my life.. been on 10mg and no pain , i do get a bit wiped out sometimes when i do to much but still working ,,full time ..i have never told my work or friends i have it ,,no deformities in my hands ,,except my toes are bendy ..a bit their is light at the end of the tunnel... keep taking the methotrexate until you find the right dose for you..

i forget i have it now until someone mentions it ........i am 60 now just joined my local bowls club.......


Hi there thank goodness you had a positive out come and it's good to hear a good story about RA. I think a lot of people on this forum are struggling with it, so keep sending those positive messages because it does help sometimes xxx


read a book on how diagnosis is a killer to some people...

funny how i went into flare up and pain when he diagnosed me ... nothing before then ,,, so i just get on with it ,, i know a lot of people suffer badly with it

so not to put them down ,,but i know what works for me xxxx


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