Thanks Seenie and yes I’ve had swollen and achy joints before. I’ve had mornings in the past when my whole body was stiff when I got out of bed. When I was diagnosed, my feet were causing so much pain that I could barely walk and had a handicap placard.
Excerpt from Psoriasis Foundation article:
https://www.psoriasis.org/advance/fatigue-and-psoriatic-arthritis
Wipeout’ fatigue
Fatigue from PsA and other types of inflammatory arthritis, which patients have described in research study interviews as “wipeout,” “overwhelming” and “like having stones on my back,” is often ranked among the most troublesome symptoms of PsA, along with pain, skin problems and physical disability.
Some studies show that as many as 50 percent of patients with PsA have moderate-to-severe fatigue, while 29 percent have severe fatigue, said Dr. Souyma Reddy, co-director of the Psoriasis and Psoriatic Arthritis Center at NYU Langone Medical Center in New York City. There’s rarely just one factor causing fatigue in PsA, she said.
“The inflammation that’s part of the disease process can play a role,” Reddy said. “Proteins called cytokines that are released during inflammatory reactions can cause fatigue, but also contributing can be conditions that are common among people with psoriatic arthritis, including anemia, obesity, diabetes, depression and sleep problems.”
Hey Frances, did you get anywhere with the fatigue? My Rheumy has sent me off looking for a sleep study. To be honest I’m not sure if that’s good or bad!
Do biologics ‘officially’ tackle fatigue? I mean, Mtx helped me stay awake and good energy / stamina levels coincided with the first 2+ years of Humira but is it something they are known to help with?
At the moment I’m going back to basics. Things I thought I knew I’m not so sure about anymore.
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Biologics do help my debilitating fatigue by suppressing my PsA. For some reason my main PsA symptom is fatigue, not pain or stiffness, so when a biologic is working my energy level increases. When Cimzia was working for me, I didn’t need narcolepsy medicine function as I do now.
Hi Jen,
Please reach out to me anytime, by private message or otherwise if you need support or advice on how to get help with your fatigue. I’m always here to help.
Here are two articles that may help you: How to Talk So Your Doctor Will Listen
Talking About Fatigue - orginally posted by Dandylons (an angel !)
Here’s my fatigue story . . .
I think that all rheumys/docs try to rule out other causes of fatigue. Also fatigue is an intangible symptom that they can’t measure. I honestly feel docs just don’t know how to address it, so often they do nothing or say something else must be causing the fatigue.
Over a 1 1/2 years ago I was also sent for a sleep study - I was 100% confident, that I didn’t have a sleep issue, but went ahead with the sleep study as a means to an end - to get my rheumy and docs to focus on PsA as the cause of my fatigue. So, after a sleep study, and lots of lab work they found nothing to support my fatigue.
I researched and found two narcolepsy medicines manufactured by the same drug company, Provigil and Nuvigil. You can get the generic of Nuvigil called Armodafinil.
Then some angel on this site posted an article about how to talk to your doctor about fatigue. I read the article 3-4 times and wrote a briefing paper following the advice in the article. I also brought my 79 year-old Mother to my appointment and she described how her once vibrant and energetic daughter needed help and care due to debilitating fatigue. Then I read my brief which FINALLY lead to a productive conversation on how to address my fatigue and increase my quality of life.
Alas, I was successful in getting a prescription for Nuvigil ! It was a little tricky to get Blue Cross/Blue Shield to approve it and I give all the credit to my GP’s nurse who persisted it getting the drug approved for me.
At this point, I’m not on a biologic and even with the narcolepsy med, I’m having debilitating fatigue some days. I’m getting an appointment with a PsA Specialist at John Hopkins Arthritis Center. Just waiting for the rheumy to review my lab work, medical history and other documents. I’m hopeful the PsA specialist will prescribe a biologic that I know will help with my fatigue as it has proven to do so many other times.
Frances
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Update: The “emergency” rheumy I saw who blew off my fatigue symptoms, had a “change of heart” after she read my lab work. Her nurse called to say my lab work showed systemic inflammation while I was taking 5 mg prednisone/day and that the inflammation was probably causing my fatigue - duh?
This rheumy during my exam didn’t believe I had any inflammation because, I had no stiffness and no pain in any of my joints, tendons etc. For me, the inflammation presents itself as extreme fatigue. Yeah, I’m different, we all are, get use to it 
Hi Frances, thanks so much for your succinct summary of your story and giving me some other avenues to research.
Nothing more empowering (particularly when you are exhausted all the time) than feeling like you can do something about it yourself 
I have a couple of questions I’ll PM you so I don’t hijack the thread, but I am so pleased that the other Rheumy at least recognized to some degree what is going on!
Hoping for biologics for you soon - for me life is not perfect on them but it is a whole lot more manageable 
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Well duuuuuuhhhhhh … this kind of thing makes me so mad. You know your body. You knew where that fatigue was coming from. And now she’s had a change of heart. OK, I guess that’s better than sticking to her guns, but sheeessshhhh…
My first rheumy thought my disease was mild because I didn’t scream when she checked my joints. She wouldn’t treat me with anything aggressive. Later, another rheumy found a whole mess of inflamed joints, but she realized that I had such a high tolerance for pain that made the other doctor think there wasn’t much wrong with me. But I knew that I was really unwell. And as I said before, the relief from wipeout fatigue was the best thing that treatment did for me.
So Frances, let’s hope that you find something that will pour water on your inflammation. It’s high time you started feeling better. Fingers crossed!
Thanks for your kind words and support Seenie ! I’m confident the PsA Specialist at John Hopkins will help me get back on a biologic or offer some other option for relief of the fatigue. Remaining positive!