The fatigue from rheumatoid arthritis (RA) is not the normal feeling of being tired. Fatigue from RA is mind-numbing. There’s no way to fight against it, and for me, I have no other choice but to go to sleep. Unfortunately, no matter how much I rest, that rest might not do much to touch my fatigue. This means that I am constantly tired, and that no matter how much sleep I get, it is never enough.
Experts in rheumatology do not agree on the definition of fatigue. However, rates of RA-related fatigue have been hypothesized to occur in between 42 and 80 percent of patients, which acknowledges that it is a significant symptom.
According to the Arthritis Foundation, there are a variety of causes of fatigue in RA, which include pain, depression, medication side effects, inflammation, anemia and other deficiencies, such as low levels of vitamin D and B12.
How fatigue affects my life
Fatigue has been a problem since I was first diagnosed with RA. Luckily, when I was in graduate school I had a bit of flexibility in my schedule, which at times allowed me to take an afternoon nap. However, once I started working a stressful, 9-5 job, my fatigue really took a toll on my life.
Impact of fatigue
Fatigue can impact so many aspects of your life, such as:
- Social life. I couldn’t be as social as I wanted to be. After work, I did not have the energy to do much other than eating dinner and going to bed. When I was working, I usually crashed around 9:00 p.m. I just could not keep my eyes open.
- Physical health. I have near-constant heartburn. I believe it’s due to me going to bed right after dinner, which doesn’t give my body time to digest. This affected my metabolism.
- Sex life. Another thing that fatigue really impacted was my sex life with my now ex-boyfriend. When you can be poked with a stick and not react that does not necessarily make getting intimate easy or fun.
- Quality of sleep. When I would fall asleep on the couch at 9:00 p.m., I would then wake up later in the night, at around 11:00 p.m. or 12:00 a.m., to go to bed. I would not sleep as good the rest of the night, as I had when I crashed at 9:00 p.m. I suspect this is because I was able to get a sounder sleep when sleep came spontaneously rather than forcing myself to go to bed.
There are some medications that can treat fatigue, such as antidepressants and psychostimulants. Psychostimulants reduce fatigue and contribute to alertness. They are often used to treat Attention Deficit Hyperactivity Disorder and narcolepsy. But the use of psychostimulants has not been studied closely in treating fatigue from RA. If you have a vitamin or iron deficiency, supplements can be used to help battle fatigue. Lastly, if pain, anxiety, and insomnia are what is preventing you from getting sleep, sleeping medications may help improve sleep quality.
After talking to people in the community for whom stimulants had been effective, I asked my rheumatologist about it at my last appointment. I explained that fatigue was my worst symptom and that it was negatively impacting my quality of life to a significant degree. Unfortunately my doctor didn’t want to prescribe a stimulant. She was more inclined to provide a sleep aid that would help me get a better overall quality of sleep, than she was to add a stimulant to my already long list of medications.
Aside from taking medications to combat fatigue, exercise and eating well may also work to improve fatigue.
While fatigue is a common symptom in RA, it is also one of the most difficult symptoms to treat. Most of us do not want to sleep our lives away, but it can certainly feel that way when so many parts of our lives are substantially limited due to fatigue. Unfortunately, I do not have any easy answers or tips on how to combat fatigue, as it is something I am still struggling with myself. If your fatigue is negatively impacting your quality of life, be sure to discuss it with your doctor.
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