I'm wondering if I added MTX or some other drug to Enbrel would help my fatigue? I am taking Plaquenil and doesn't seem to help much. I couldn't handle oral MTX but thought I might be able to handle injecting MTX.
Any and all thoughts welcome and appreciated !
Frances
It did for me definitely. But it made me sick enough to quit twice. Now I am thinking about going back on it again for a third time. I did inject it so I don’t know how the pills would work. Everyone is different though. Each time I went all fit my pain was significantly worse as well as my fatigue.
Thanks for responding TigerGirl. I'm going to discuss with my rheumy. I took the MTX and they made me too sick, but I've heard that injecting has less side effects.
TigerGirl said:
It did for me definitely. But it made me sick enough to quit twice. Now I am thinking about going back on it again for a third time. I did inject it so I don't know how the pills would work. Everyone is different though. Each time I went all fit my pain was significantly worse as well as my fatigue.
MTX actually made me really fatigued, however when we added sulfasalazine I noticed an improvement in my energy level. When I went off the MTX I noticed a huge increase in my energy level! Now I am on Sulfa and Leflunomide and have had a decrease in energy again, not nearly as bad as when I was on the MTX. It seems everyone's experiences with meds vary.
I had a problem with the oral MTX making me tired. I'll ask about sulfasalazine also.
TaraLynn said:
MTX actually made me really fatigued, however when we added sulfasalazine I noticed an improvement in my energy level. When I went off the MTX I noticed a huge increase in my energy level! Now I am on Sulfa and Leflunomide and have had a decrease in energy again, not nearly as bad as when I was on the MTX. It seems everyone's experiences with meds vary.
Another option is leflunomide (Arava). Similar to MTX, but I tolerated it much much better than MTX. It gives my biologic a boost, on its own it only helps about 10-20%. With a biologic, it helps cut down on those extraneous symptoms.
Frances, IMHO, any drug that comes with a discussion about a "hangover", as does MTX, is not going to help much with fighting fatigue. I was on MTX pills for about a year and when my liver function tests showed problems, my rheumy started me on injections. I thought I had fatigue when I was on the pills. Seriously? I would sleep 30 hours after the injections. Had absolutely zero energy. But, it did help with the PsA symptoms.
Thanks for the response Lar. 30 hours wow - you sound like me !
Lar837 said:
Frances, IMHO, any drug that comes with a discussion about a "hangover", as does MTX, is not going to help much with fighting fatigue. I was on MTX pills for about a year and when my liver function tests showed problems, my rheumy started me on injections. I thought I had fatigue when I was on the pills. Seriously? I would sleep 30 hours after the injections. Had absolutely zero energy. But, it did help with the PsA symptoms.
Great question…featuring this discussion.
Thanks ! I'm desperate for help with my fatigue.
GrumpyCat said:
Great question....featuring this discussion.
If someone comes up with the answer for fatigue, let me know. My arthritis pain is well managed, but the fatigue! It has changed my life. I had to leave my job because if it, among other things, and it doesn't seem to matter if I'm on Enbrel or Humira. I have stopped making excuses for it, it is just the way it is I guess. But I also have to take into account my age and the rest of my medical history. Being fatigued is easy compared to some of the rest of it. But it would be nice......
Jenny, I'm committed to finding something that will help.
From what I have read and my doctors have told me fatigue is multifactorial, or we have many things that contribute to the fatigue, so there are many parts that help if not cure it. Here is what I know in a nutshell:
Getting the disease under control. My PsA is poorly controlled so I deal with fatigue a lot. About every year I have to change bios and the increase in fatigue along with pain and stiffness and inability to fully extend some joints is the signal for me. I have to take a daily NSAID, weekly DMARD and monthly Bio to have any control over PsA at all.
I exercise every day. I try to go to the pool or grocery store or something 3-4 times a week. The rest of the time it is house work, a walk up my driveway, smaller more frequent bursts of activity.
I try to get outside everyday. This isn't always possible in -30 but I aim for it on other days. Light on the back of our retinas really helps fatigue. I also take D3 and a multi vit everyday.
Keeping a regular sleep/wake cycle. Again this is what I aim for. When I am in a flare I can sleep 16 hours out of 24. But by and large I try to go to bed by midnight and get up by 10. I find if I nap then I end up "needing" a nap.
I try to eat a largely clean diet. But again this is what I aim for.....I have a serious doughnut problem. I tell my husband I married him so I could stay in doughnuts (he's a cop) he doesn't like doughnuts, nor my humor for that matter! I do make sure I have a daily iron rich and Vit C rich food daily. Both help anemia which is common in PsA and Iron rich foods help and Vit C rich foods allow our bodies to absorb more iron.
I try to plan something to look foreword to. This is tricky as I hate canceling due to a flare on someone. So I build "treats" into my day to reach my goals. If I finish my exercises I can have a walk through a garden center or a doughnut! And if I keep doing my exercises I can walk at the Botanical Garden (Montreal) this summer.
And last but not least sometimes I have to just keep putting one foot in front of the other despite the fatigue. When I feel comatose with fatigue, neither awake nor asleep I know it is the meds that need adjustment for all other fatigue I use my bag of tricks.
I hope this helps as fatigue can be almost as disabling in PsA as pain and stiffness.
I just lost my reply..............anyway, thank you Michael in Vermont.
I am sorry jennyb. Aren't computers wonderful except when they are not. I don't know if it helps but when I lose something on the computer I usually find it under "drafts". Except for 2 goats I lost playing Farmville 2. I am not sure where they went.
The other biggie I forgot is I had my depression treated. I take an anti-depressant and at bedtime I take another anti-depressant to help me sleep. And I get therapy. I figure if I didn't need it before PsA I sure as hell do after it. I hate burdening family or friends with my woes so I pay a therapist to be my friend. Best money I ever spent. I am learning to live a meaningful life with PsA and most of my relationships intact!
Good idea! about the therapy. I once mentioned depression to my doctor and he gave me prednisone, and truly, it did the trick. I have always been the steady-eddy person, but this arthritis has put a major chink in my plans for my older age. (I also have a lot of other medical issues, past and present, that contribute, and Enbrel and Humira and methotrexate will not fix) I sleep pretty well, except lately....if I take some nuprin I do better, like last night. I slept till almost 5, with no waking up, which is almost a miracle!
I will look in the "drafts" but I will probably just dump it anyway, at this point.
Being in eastern Washington, we usually have a lot of sun but not this year......a lot of fog, and clouds, and not much snow and sun. It has to make a difference!!! take care, and thanks again.
I take 5mg prednisone daily and it doesn't help with my fatigue;
This was a prednisone rescue type....a pretty big blast then tapering off for a week or so. I don't take it but 3-4 times a year. That is what the doctor's office calls it. They prescribe too much so I have some just in case. I can start some without waiting if I need it.
I don't know what your interactions and all are. I only take Humira and Celebrex, until the last month it was Enbrel and Celebrex.
I noticed early on that I could barely get my head off the pillow if I wasn't taking a 200 Celebrex twice a day. It's too high a dose and my Dr. wants me to try to get back to 1 a day.
Every time I try to go down to 1 a day it's like I have been up for 4 days and no matter how much sleep I get, I am down. Too tired to drive safely or do anything dangerous, just out of it.
Back on two a day, I am up till midnight, on time to work and chatty.
Cytokines!, they are the thing that make flu sufferers wore out. That's what I think mine is.
Shame that Celebrex makes the blood so thin and Prednisone isn't something you can take every day.
It does seem it's just about anti-inflammatories for me. I am wanting to find the right one.
I loved being on Celebrex, I felt so well. Within a week or so I started having stomach pains, so I did a little experimenting and sure enough, that stuff was giving me a stomach ache, so I had to quit taking it. I had a ninety day supply that I couldn't use, so I gave it to my doctor's office, and they will use it.
I don't hardly drive at all; I find myself sleepy and inattentive, and I fear having a Menier's attack while driving, so I don't drive very far or very much. This is right up there with the biggest problem of having the disease.