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Living with Psoriatic Arthritis (PsA)

How can I battle fatigue?


#1

I started humira 8 weeks ago. It is the first medicine that I didn’t have a bad reaction to. I have been taking 5mg of prednisone a day for the past month. I am feeling very tired, but often am unable to sleep. I get about 5 to 6 hours at night, then I’m up for about an hour and a half, sleep another hour or so, then have a little energy for about 2 hours. By mid afternoon I’m super fatigued but am unable to take a nap. My body is very tired but my brain won’t shut off. I’m take b complex supplements as well as a some other vitamins. I eat a decent diet but don’t get much exercise. Psoriasis has improved slightly.

My recent blood work was bad. Sed rate was 37. Liver enzymes in the 140’s.

Does anyone have any suggestions? I really need to be able to function better without being so wiped out all the time.


#2

I’m assuming you take the pred first thing in the morning? If not do. My further thoughts are first see if you can do without the pred entirely as that can you make ‘wired’ like that, exhaustedly wired. You might find without it you sleep much better. Don’t forget also that B vitamins can ‘gee’ you up too. So potentially ease back on them too.


#3

Interesting. I have been taking the pred in the early afternoon. That coincides with my afternoon tired spell. I cant go without it yet, about 4 more weeks. Ive been taking the b vitamins for a long time. I will try easing back to every other day. I’ve been taking them because I’ve heard they give you energy. You are probably right that they are making me too awake to get proper rest. Thank you so much!


#4

This should make you smile. When I was on pred the only way I could get up and dressed in the morning was to wake myself at 4am to take them and then by about 7am I could function.

But honestly taking them early afternoon as you’ve been doing would have had me still wandering around my house at 2 or 3am looking for something to do. I’d start taking them at 7am and see how different you feel at bed time. You might find the fatigue in the afternoon disappears too. It’s sounding like the previous afternoon’s dose had run out by then so your energy levels just dropped.

Hope it improves for you.


#5

In fact I did this only last week :joy:

You will definitely find things much easier if you take the Pred first thing in the morning (though the 4am wake up is not required, unless you absolutely have to!).

Our natural cortisol peaks about when we get up, so as Poo says, the morning is the best time to take it to feel “in sync” - you probably feel like you have chemical jet lag every day at the moment, you poor thing!


#6

Thanks Jen. I took my prednisone right in the morning today. Feeling lagged now, but I just did all my shopping for the week. Usually I have to make two or more trips. So that is good. Hoping that in a week or so of taking it in the morning I will adjust and go back to normal energy levels.


#7

A lot of fatigue can be managed with behavior. I tend to wake up many times during the night. When I do awaken, I lie there quietly and consciously relax all my muscles, from finger to eyelids. I schedule nine hours in bed every night to compensate for lost sleep time. I recognize that I have less energy than the average healthy person, so I use the image of a cup full of marbles to organize my day. Each marble represents a unit of energy. Some days I will have more and some days less. But I carefully budget their use so I can get the most important tasks accomplished each day. If I spend them too freely, I will be out of energy and have no recourse but to go to bed. So I try to avoid using up all of the marbles. I find that lying down fully reclined with my eyes closed for ten minutes does a lot to recharge my energy. I may do this one or two times a day. I break tasks into small manageable parts, only working for a few minutes and then taking a rest. If I am anticipating a tiring event such as a social occasion, I take it easier for the few days leading up to that event, and I plan to take it easy for the few days afterwards. I have been living with fibromyalgia (now a psoriatic arthritis diagnosis) for decades, and I have found these strategies to be very useful.


#8

Why thank you for the insightful and heartfelt comment. I appreciate it. I am actually feeling better since beginning toI take the pred earlier - with food - in the morning. It was hurting my stomach to take it before I had anything in my stomach.


#9

I love the cup full of marbles analogy NancyJ. My husband has been away a few days so my cup is empty after work, running after my two children and keeping house on my own. A Migraine in the week knocked me out too. I’m tired to the bone so will be recharging from now up to Wednesdays trick or treat. Everywhere hurts but I need to try to keep positive and hope this will pass and my marble cup will refill with time and rest and hope not succumb to the downward spiral