Hello does anyone have any pointers about fatigue? I am tired most days. I do try get enough rest and sleep well most times. I can feel great in the mornings however by the afternoons I can hardly function. My understanding is that it is part of this condition and meds can contribute to it as well.

Fatigue is a huge part of PsA, and many of the drugs used to treat it. For some, finding a balance between rest and activity is key. There are things you might want to get checked before assuming that your fatigue is totally PsA related - low iron, vitamin D, vitamin B6 and,or vitamin B12 can contribute to fatigue in a big way. Many people with autoimmune disorders also have thyroid issues, so getting your thyroid levels and TSH levels tested could be beneficial. Diet can play a big role as well. Most people feel less fatigued eating healthy, natural foods and staying away from processed foods as much as possible. Some people with PsA find a gluten-free diet to be helpful.

I hope you find something that increases your energy levels - fatigue can be the worst part of the disease, mentally and emotionally.

Thanks I find that quite useful

Ahh, fatigue, brain fog & generally feeling crappy! Thought it was just me until I found this site! I echo ALL of Nyms comments. Some of the drugs I've trialled have exacerbated it but really, once other medical things have been ruled out, it's just part of the whole PSA journey. We don't hev to accept it, we need to manage it.

Like you, I mostly have more energy in the a.m and usually now get out of bed pretty early too. I have restructured my day (having the 'luxury'' of not having children at home anymore, a husband who works out of town & is only home a few days a week, and NO job as I had to quit due to PSA) so that I do my tasks in the a.m and plan to do little or nothing from early to late afternoon. i then get a small spurt of energy enough to prepare some dinner, shower & bed early.

I make sure to have a nap if I have to do anything in the evenings but generally avoid after dark social activities. used to love going out for dinner but now I make it breakfast or lunch.

At first I strongly resented having to change my life routines around but now it's OK. Slowly, other people in my life are accepting it.

I also take a lot of different supplements, don't know if they are really helping, but makes me feel better even if it's just that I'm having a modicum of control over what I'm putting in my body!

Thanks so much I already take iron tablets as well as calcium and magnesium. I have also had my thyroid checked a while back. Everything seemed to be fine. Will check again when I visit my rhuemy


I had terrible brain fog and my rheumatologist suggested swimming & gentle exercise. Reluctantly I tried it as was in too much pain/ too tired really. It worked! The brain fog cleared instantly (I googled it and a uk survey said that the endorphins caused by exercise clear the chemicals that cause the brain fog) and I felt much more mobile and in slightly less pain after 30 mins gentle swimming. Even the fatigue lifted somewhat. It wasn’t a cure by any stretch of the imagination but it certainly helped. Give it a try, it’s not expensive (well not here anyway as we have subsidised exercise facilities) and it may just help a bit.

Honestly, the fatigue is the hardest part for me. I can handle the pain, I can handle the meds, but the fatigue wipes me out and makes me feel useless. I have had all my levels checked and everything is fine (that was part of the tons of preliminary testing done prior to dx). I admit, there are days in which I start off the day with a Mountain Dew when I know I am going to have problems but since I am not a coffee drinker and I limit my caffiene intake, I think it is ok.

Swimming is wonderful for people with PsA. It helps me tremendously but recently I had to stop as my local pool only has a ladder to get in and out and my hands cant handle it anymore. Meanwhile, I am impatiently waiting for it to warm up so I can start up again at the outdoor pool which has steps. Swimming also helps me sleep better.

The fatigue is really difficult for me too. Add on a bunch of pain meds on top of this condition and how can you not be foggy and tired.....I find that I have to have at least one 2 hour nap during the day to make it through, sometimes 2. I really should try the swimming thing, it sounds like a good idea, although I am not a strong swimmer. It is funny, we just sold our old house 2 years ago, which had an outdoor pool which I could swim all the time from May to September (weather permitting of course...in Calgary), but that was before I was diagnosed so I didn't really swim alot. We do have a place nearby but the pool is really cold. I don't know what else helps with the fatigue, other than I try to walk everyday with the dogs, when I am able...I find that a bit of exercise helps.

I suffer from this also. The time I hate fatigue at most is during my hour long commute home from work. Nothing is more scary then not remembering the last few hundred meters while driving. I have my own techniques for this which include turning up the music and making stops along the way. Any other time taking a 10 minute nap here and there is quite refreshing, although it would be better to have a couple hours.

Most of my family live 5-6 hours away from me and many times I have to take the trip myself. When the fatigue hits, I have been known to open my window in the middle of the winter and let the cold air wake me up. I also have been known to take a mini nap on the side of the highway if needed. Thank God for hands free phones, sometimes that is how I stay awake and get caught up on news from my Mom. Of course I also take quite a few stops to wake me up and to stretch out the legs.

I am finding the fatigue the worst thing to cope with.
I have two small kids who are like the energizer bunny on speed
and there are many days I can not stay awake. The closer I get to my
next remicade treatment the more tired I get. It is like hitting a wall.
I already feel tired and worn out then bam! The three week wall hits
and I can not stay awake to save my soul. I just slept for an entire weekend essentially.
Thank God my Husband tries anx kept the kids busy. I could not stay awake
despite coffee, activity or, the fear of not being ready for Monday. I have do
many open cracks in my skin due to the psoarasis that I am
Terrified the pool will burn!!! Is there no hope? Small kids, a job and PsA? Am
I setting myself up to fail? I do not know anymore what my body is saying and
what my brain is saying. How much is reasonable? My friend with RA seems to have way more energy.

That’s awful Kirsten I don’t know how people with families cope. I’m on my own and even just keeping the house clean is an effort. They say eating well and excercise is important but even then its not enough. Have you tried methotrexate for your psoriasis? Even though I had awful side effects my psoriasis cleared up completely for the first time in 20 years although now struggling with Psa. Been on treatment for a year but don’t feel any better. I have 70% bad days and 30% good days. Anyway just have to take each day as it comes

So sorry Kristen. I know when I worked full time, had three teenagers, and my mom to care for that I often slept the weekend away. I used to wonder how in the world did I sleep for an entire weekend something is wrong with me. I see other people have so much more energy. Now I know what was wrong. The fatigue of PSA. Due to my husband's job change we had to move so I resigned, and we are still not fully done relocating. Waiting for our house to sale. I often wonder how much of a new job I should take on. I want to contribute more to my kids college, but I am not sure how much I can handle.

I agree, the fatigue is the most difficult part of this.

Jackson, and others, as to the driving, I used to gig with bands, and coming home at 3 in the morning after gigging all night was fraught with danger of falling asleep at the wheel. Opening the windows for fresh air and playing loud music was only marginally helpful, but what kept me awake was doing that, and singing along with the music, as loud as I could. Because of the physical activity of singing and taking in lots of oxygen, it worked.

Keep it in mind and try it next time you get sleepy... :-)


I try to explain to my family that its not just normal "I'm tired". Its more like I've hit a brick wall & been totally stopped.I HAVE to lay down & take a nap. To me the fatigue is also the hardest part. Just lay down when you have to.

It is a major part of the PsA and the meds are a large part too yes.....My rhumey told me to start taking B 12 or B complex (which has my folic acid in it for the stomach upset do to mtx) so i have been taking b complex and its only been about a week and ive already noticed some improvements with the fatigue hope this helps!

Just took the folic acid blood test earlier this week and will be starting to add B-12this weekend. It seems the neuropathy in my feet is worse since I started the meds for PsA so we are going to try this route and see what happens.

Something I read a while back is that you should take a B complex if you are going to take one of the B's, as you can cause an imbalance otherwise. it's worth looking into.

If you haven't read "The Spoon Theory" on butyoudontlooksick.com, I highly suggest it. Fatigue is one of the major indicators of autoimmune disorders, and nails things on the head. Extremely helpful in explaining things to others, too.