I’ve been on Enbrel since the end of July. I’ve dealt with fatigue issues from the onset of my PsA, but over the last 2 months it has gotten much worse, to the point I can barely make it through the day. I can sleep 8 hours and I wake up and feel like I haven’t slept at all. It’s lunch time now and if I laid my head down, I could be asleep within minutes. Is this just the progression of the PsA or have others had experience with major fatigue with Enbrel?
Also, my WBC was mid 7’s (it was 7-8 the whole time on MTX) the end of June and the end of Aug (after 1 month of Enbrel) it had dropped to 3.5. Could this be contributing to the fatigue?
Not likley. They usually don’t get concerned about a white count until its 1,5. #.5 is only slightly lower than average (being above or below average doesn’t mean its “abnormal”) A temporary increase in fatigue with Enbrel (or most other Biologics is not unusual and is usually a sign the medication is starting to do its job as.changing inflammation levels (either up or down often result in fatigue. It usually passes in a time. But to put your mind at ease call the Enbrel nurse line:. You can schedule it here: https://www.enbrel.com/support/schedule-a-call/
As much as I advise folks to stay in touch with their docs, Its important to first start with the nurse line with any biologic for questions. You will get better answers and more importantly, in most Rhemie practice there are gate keepers who in an abundance of caution (more appropriately CYA mode) will have you skip a dose or two or even DC a med until your next appointment. This often leads to difficulties you need not have.
Enbrel had the opposite effect on me. My fatigue was totally wiped out within days of starting Enbrel. It did lower my WBCs–my most recent count was 2.9–if it goes down to 2 I’ll get nervous!
I hope your sleepiness symptom goes away, Rob3–and your WBCs go up!
fatigue has been an ongoing issue for me. I was knackered for years before PsA was diagnosed, completely wiped out for two years or so before and after diagnosis / treatment and intermittently exhausted since.
Methotrexate took me out of the twilight zone. And that’s not a bad description, I was definitely not in the world as we know it beforehand. Given my experience, I’m wondering if you’re still on Mtx? Despite the ‘Mtx hangover’ that so many go through, I think it might help me with fatigue as I’m still on it alongside Humira and intermittent fatigue is infinitely preferable to the wall to wall variety.
I haven’t had any fatigue for a couple of months. I hardly know myself! I wish I could identify something that may have contributed to this happy state of affairs but I can’t. As with just about everything though I’d recommend regular exercise to help combat fatigue.
Incidentally, my neutrophils occasionally dip to 2.5 without any noticeable change in how I feel.
I’m only taking Enbrel and Duexis right now, my dr took me off mtx when I started Enbrel. When I was taking MTX though, I’d be wiped out the entire day after I took it.
Do you take mtx shots or pills? I tried both and neither worked, but my dr never mentioned taking them both together.
Hi Rob, I take Mtx pills. It’s a funny old drug, in my experience it initially delivers very slowly, little by little, and is more a steady workhorse than amazing. I suspect it may be underrated, especially as like any old workhorse it can deliver a bit of a kick.
Many of us take it on the basis that it can boost the performance of biologics and help prevent us developing antibodies to them. Plus tntlamb here often says it helps with peripheral issues, i.e. anything other than the spine (I think!).
I got my blood work back over the weekend and my D and B12 levels were very low, so maybe that is contributing to my increased fatigue levels lately. My dr wants me to add supplements for both…fingered crossed it will help!
Well thats what a doc prescribe and certainly is a lot. Normally its only done for 8 weeks and then reduced to 2000/day. What they often overlook though is magnesium which makes the D work levels are also often low or need to be increased to get the full benefit of the D. That might be worth looking into. About the worst that will happen if you increase your magnesium is some loose bowels. Be sure they check your liver enzymes while on D therapy as D3 can increase your liver enzymes. Instead of adjusting that, they tend to look at other meds including MTX. Vitamin Supplementation is not for the feint of heart…