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In some cases yes, and some no. I have been taking metho for over 11 years now, and some side effects you learn to work with...and others...you have to put up with...to an degree anyway. If its somthing you can try and deal with anyway! For instance...i get low blood sugar with metho-for one of my symtoms, and i have found that if i eat regurlarly-(often-including before i go to bed at night)-that helps that part-most of the time. But as for the fatique...that one i have to deal with, but it's better then my RA going baserk on me. I was off it here recently-first..b/c of changing from metho-to arava, b/c the metho pills were getting way too harsh for me-to where i was throwing them up. So i was put on the arava, and after a month of it..i got a severe infectious disease, and had to stop the RA meds totally for 5 months-and then my RA was very active..i was getting more nodules on top of the ones i have had forever, and bad flareups. Then i was put back on the metho, but the shots instead of the pills. It is a love hate relationship-with the metho-for me anyway-the other problems i have are severe fatique, but i have that with out the metho too. And i still have some nesuea even from the shots..just not as bad, so far anyway. And i get dizzy spells, and IBS. But everyone is different..and it may not effect you this same way. Good Luck to you