Reducing fatigue

Hi Catherine-that's great that the methotrexate has lessened your pain and increased your energy levels, and that the side-effects are generally mild. It sounds like you are on a highly effective treatment (let's hope it stays that way!).

The sulfasalazine took several months to become effective, and while I'm mostly okay on it, I still have mild inflammation that comes and goes in my feet, hands, and wrists, and lately, my right elbow has also felt stiff at times. It is nowhere near as bad as when I first switched to sulfasalazine, but noticeable enough that I think the rheumatologist may put me on methotrexate (my next appointment is on February 21st).

Yeah it is! Herbal medicine in general seems like a very interesting subject, something I would really like to learn more about.

That's really good you are on top of getting good sleep, it must make a major difference in terms of feeling less fatigued and helping your body heal. My habits are somewhat similar to yours, but probably not as disciplined. The thing that most makes me sleep like a baby--which I don't do enough lately--is a long day outside in the sun, preferrably in light physical activity (for example, kayak fishing). Caffeine definitely seems to affect my sleep, and over the past several months I have mostly avoided it, even though I am a tea lover. Are you a coffee or tea drinker?

Likewise Catherine, thank you for sharing your journey, and for listening. I hope you're having a good week. 😀

Ah, I’m sorry to hear that you’re still experiencing the inflammation, , and in quite a few places too. Glad to hear you have a rheumatology appointment coming up. I’d be interested to hear what your rheumatologist has to say at the appointment. I had quite a bad flare in my elbow last winter, and my rheumatologist said I will still get flares even on the mtx… Not sure how I feel about that !

You’ll have to let me know if you find any other interesting information about alternative remedies. I love learning about them!

That is really interesting about having a day out in the sun. I think I read somewhere that the sun has a lot to do with melatonin production and the natural sleep/wake cycle. I probably don’t get enough sunlight… I can blame some of that on living in the UK, but I should get out more. Speaking of being British – I actually hate tea! But I do enjoy a coffee. I should probably take a leaf out of your book and have some time off from it!

How are you feeling this week? Are you managing okay without the ginseng? –Catherine, Community Moderator

Hi Brian-I am somewhat new to this as well, having initially experienced pain and swelling in my feet about a year ago, which eventually spread to my hands. I have had issues with chronic inflammation and degenerative cartilage in my knees, as well as mild psoriasis on my knees, elbows, and scalp, since my late teens, which in hindsight were probably early warning signs (I am now 36). I can't pinpoint a cause for certain, but I strongly suspect that my family situation growing up had lasting psychological effects that manifested phyically.

I think the most critical thing for me has been finding a good rheumatologist. Other things that have probably helped include:

- Reducing stress levels (slowing down and doing things that calm your inflammation/pain when you're at your worst; doing things you enjoy, with people you love; journaling and meditation; exercising)
- Improving sleep (improving sleep hygene, adopt CBT techniques, e.g. from insomnia coach podcast)
-Experimenting with autoimmune diet and supplementation (for this I have relied heavily on a book called The Keystone Approach)

Hang in there, it can get better. From what I gather, there are some pretty good treatment options out there for psoriatic arthritis today, especially compared to 20 or 30 years ago. Find a good rheumatologist, develop an understanding of your condition and approaches for treating and managing it, and try out different things to see what works for you and what doesn't. You are your most important advocate.

Hey , appreciate you joining the discussion and sharing with us! I know just what you mean - it's really good to chat with others who understand and are going through similar things.

I am so happy to read that the methotrexate is having a positive impact on you. You’re actually the first person (as far as I can remember – brain fog!) who’s also mentioned this effect on energy levels. A lot of people seem to suffer with more fatigue on methotrexate. Do you mind sharing what dosage you are on, and how much folic acid? I am taking 15mg mtx and 10mg folic acid. How long did it take for you to notice an effect?

That’s a great question about the thyroid levels. I feel like at this point I have had every test under the sun, haha! We do keep an eye on my thyroid but so far the tests have always come back normal. My vitamin D is regularly low but correcting that doesn’t seem to have any noticeable impact (although we do still supplement as I’m sure it’s doing other good things for me that I can’t feel!). Have any of your tests come back as abnormal? I think it could be interesting to look at whether my mitochondria are functioning as they should…

I am curious, alongside the physical fatigue, have you suffered with the brain fog/cognitive fatigue? I’d love to hear your experiences with this too, if you have any. Sometimes I feel like my brain gets worn out quicker than my body does! –Catherine, Community Moderator

Hey Catherine, how have you been lately?