How Long Will Methotrexate Fatigue Last?

Question

Asked by AmyAria

How Long Will Methotrexate Fatigue Last?

I've taken methotrexate for two weeks and it wipes me out!! I can handle a day or two a week of this for the "greater good" and all, but then I just got stuff I have to do!! I'm not completely incapacitated, but I am getting really tired of my husband's cooking...God bless him! I even find myself pining to do the stuff I used to complain about doing! Will the fatigue gradually get better as my body acclimates?

Answer

Oh the fatigue.   I deal with it too on a weekly basis.  Methotrexate can cause severe fatigue, but there are good news. Slowly but surely the methotrexate will build up in your body and your side effects will become less severe. I can't promise you that the fatigue will go away. It does for some, but others can be on methotrexate for years and still experience fatigue.  That said, one of the first signs of a medication working can be having more energy. This means that although you may experience a fatigue for a few days after you take your medication, you may end up having more energy the rest of the time.

RA and fatigue go hand in hand. In fact, people with RA have a higher need for sleep and when your disease is more active, it's common to be more tired. Have you heard of the Spoon Theory? It's a way of explaining how people with chronic illness often have to be more cautious about how they use their energy. You may want to read our tips on managing energy levels with RA.

There are ways of managing side effects from medication, including fatigue. You may want to talk to your rheumatologist about your fatigue. Sometimes getting a prescription of folic acid can help reduce it. Other tips include scheduling your meds for the day before the weekend allows you to take it easy and give your body the rest of needs. Sleep in, try to have low-key days, nap when you need it. When you and your husband cook, make more than you need for one day, put it in the freezer, so you have food to warm up when you're not up for doing much.

I completely understand the anxiety of not being able to get up and do what needs to be done.  I've developed some tricks that can help, even on your tired days. I make a list of things that need to be done throughout the week.  Instead of overdoing it before I take my methotrexate (which makes the fatigue even more severe), I try to distribute the chores out throughout the week. Say there are 5 important chores that need to be done throughout the weekdays.   Instead of doing two or three of them the days before you take you methotrexate (as we tend to do because we know the fatigue will knock us out) do one chore a day, even on the day you take your methotrexate.  If you can't accomplish it, then put it on the list for either the weekend or the next week.  You will find that it you don't overdo it before and after you take the methotrexate the fatigue won't be near as bad.

I hope this helps.   Good luck and best wishes!