It's quite normal for an increase in medication to lead to an increase in symptoms like e.g., fatigue and usually, as your body gets acclimatized to the increased dosage, the side effects will lessen ( check out my post on managing side effects). You may want to talk to your doctor about increasing your dose more gradually, giving your body time to get used to an increased dose a little at a time. However, if you have significant symptoms, you clearly need to something that gives you more bang for your buck. You may want to consider asking your doctor to supplement your methotrexate with e.g., prednisone for a while to bridge the gap and help you get more energy. As well, it's common to have combination therapy where you take two or more drugs at the same time, as together they pack more punch than one single drug - speak to your doctor about possibly adding Enbrel to your medication down the road.

As you mentioned, you have increased your dose at a time when you have started with a higher teaching load and when your RA may be more active than it was (hence the increase in the medication). All of those factors on their own will make you more tired, combined, they can knock you for a loop. Make sure you get as much rest as you can, eat a healthy, well-balanced diet, take your vitamins and perhaps consider adding the odd overhead to ease the strain on yourself.

BerserkeRA

12/23/09 5:32pm

Lene, thank you very much! 

 

I am going to speak to my rheumie about the biologicals next visit -- I'm already on methylpred and am trying to titrate off, but am still symptomatic and feel a bit trapped at my current dose (10mg qd).  I'm leary of increasing the MXT again and getting all loopy for 3-4 weeks, so perhaps a partner drug is the answer.

Lene Andersen

12/23/09 7:29pm

Enbrel is the miracle drug for many - it was for me (Humira has replaced it) and I hope it's an option for you.

 

Let me know how it goes?

BerserkeRA

1/21/10 12:30pm

This's my story and I'm stickin' to it.