Has anybody heard of Prednisone induced extreme fatigue after 35 years of constant use for RA?

It's hard to be a family member of someone with a chronic illness - it can make you feel very helpless and I'm sorry you and your mom have to go through this.

All medications have side effects, more serious medications have more serious side effects and long-term use of a serious medication may make the side effects worse. The person with RA and her/his doctor has to discuss the pros and cons of long-term use of any medication and sometimes, the benefits outweigh the possible cost. According to the research I did in order to answer your question, long-term use of prednisone may indeed cause weakness and weight loss, especially weight-loss in arms and legs. As well, in my experience, if the medication that you're on is not quite working and your RA is flaring, the fatigue can be quite significant, so that may be a factor, as well. However, keep in mind that I'm not a doctor and for more accurate information on this, you should speak to your mother's rheumatologist - perhaps it would be a good idea if you went with her for the next appointment, for support and discussion with the doctor.

And this is where I go out on a limb, despite knowing very little about your mother's case. I don't quite understand why she is only taking prednisone. There has been tremendous progress in the medication used to treat RA and there are numerous alternatives to prednisone. There is methotrexate, which is a drug commonly used to treat RA and as we move up the ladder of medications, there's Plaquenil, Arava and the Biologics, such as Humira, Enbrel and Remicade. Many people with RA are treated with a combination of two or several of these and I'm surprised that your mother isn't. Of course, I don't know if she's tried any of these and prednisone works better for her, but if she hasn't, maybe it's time to have a discussion about medication alternatives with your mother's rheumatologist. Please be aware that these medications also quite "serious" and therefore have side effects, but often, the benefits vastly outweigh the risks. Also keep in mind that doctors are just people, which means that some doctors are more comfortable with a more aggressive approach than others. If your mother finds that she and her doctor have reached a point where they idea of treatment differ, she has the option of a second opinion.

Should you wish to try one of the Biologics, be prepared that they are quite expensive. However, the drug companies offer programs for people who can't afford the meds, so money doesn't have to stand between you and effective treatment. If you'll forgive me for being self-referential, in my latest post discussing side effects of medications, I linked to a list of these programs offering support for people who can't afford the expense of medications - you can read more here.