Hit the wall? Fatigue and Rheumatoid Arthritis

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For years I battled with extreme fatigue. Out of nowhere, I would become exhausted and I felt that I could not continue on. Think about the last time you had the flu and how exhausted you felt. Now, go about your day feeling good when all of a sudden you are overcome with that exhaustion, that fatigue. For me, it hit hard and fast. One minute I felt fine and the next I felt that I could not move. I would wish for a nap. I would sit in one place without the energy to move. It was so unlike me to loose energy that way. I could not find a reason for the fatigue such as lack of sleep or stress. It was not until I was diagnosed with Rheumatoid Arthritis that I started to understand the fatigue. My doctor suggested that I keep a log of how I feel during the day including how I slept the night before, food I was eating, type of exercise I was getting, when I felt especially good and when I felt fatigued. I am still working on the log book because I am terrible at remembering to document everything so I was rendering the log book useless. Once I have a completed log, I am to meet with my doctor to look at trends to see if we can come up with a plan to battle the fatigue. However, in the meantime, I did some research and the following is what I discovered. I share this with you not as a professional but simply as a person who is struggling to get a handle on her RA-my RA journey so to speak.
HEALTHMINDER Personal Wellness Journal Health Diary and Symptoms Log


SLEEP: Sleep is difficult if you are in pain or you cannot get into a comfortable sleeping position. When your joints are swollen or sore, your sleep is interrupted. I had a terrible time sleeping because I tossed and turned all night trying to feel comfortable. I would wake up throughout the night stiff and in pain. Some people say to avoid taking a nap during the day and to power through those periods of fatigue while others suggest that you allow yourself to nap when you are tired.

            DEPRESSION: People with Rheumatoid Arthritis are more likely to develop depression, according to my doctor. Depression can increase fatigue. Depression can also be a side effect of some medications commonly prescribed to people with RA. There was one report I read on the internet that suggested that chronic pain causes unstable levels of hormones and neurotransmitters, like serotonin, which can lead to depression. I can speak to this first hand. I am probably one of the most optimistic people you will ever meet. If there is a positive way of looking at something, I see it that way. I live in constant amazement of the world. That is until my RA kicked in. I felt depressed and helpless. I felt despair. These were uncommon (and uncomfortable) feelings for me. I did not know what to do with these feelings and how to handle them. With help from my doctor, I came to understand that for me, the depression was directly associated with fatigue. So, by dealing with the fatigue, I am fighting back the depression without medication.

            MEDICATION: Medications commonly prescribed for RA may contribute to fatigue.

INFLAMMATION: As stated above, with RA, your body’s immune system attacks your own body which leads to flu like fatigue.

           ANEMIA: Anemia reportedly affects up to two-thirds of RA patients and is common in people with severe joint disease. As a lay person, what this appears to mean is that your body doesn’t have enough iron which normally holds onto oxygen and distributes it around the body for energy. Because of this, a person with RA has to work harder than most to move resulting in fatigue.

Suggestions to beat your fatigue

Exercise regularly.

When my doctor first told me this, I dismissed it. The last thing I wanted to do was exercise. For years my mother has been nagging me to exercise. I did not feel well enough to even consider it. From firsthand experience, I can tell you that it works. Exercise increases your muscle mass and strength, which make movement easier. It also increases blood circulation and flexibility, which will help to reduce pain. And, can we talk about the endorphins? I always heard about exercise releasing or creating endorphins. I’m not really sure what they are, but I know they make you feel good. After working out, I am happy almost elated. I want to go again. I can’t want for my next workout. It works.

With exercise, don’t start off doing everything. Start off slow and take it easy. Combining activities has helped me because I get bored easy and by doing different work out programs, I am not stressing one area of my body. Swimming is my best option as I feel the best when I am in the water. I swim every chance I get. My husband and I started riding bikes again. We tried doing it on Saturday and Sunday but felt that it was too much. We agreed to ride once a week for as long as the weather is good.

Talk to your doctor before starting any type of activity. Remember to start off slow. It does work, just give it a chance.

Relax into Yoga for Seniors: A Six-Week Program for Strength, Balance, Flexibility, and Pain Relief

Healthy food:

Talk to your doctor about a diet plan that works for you. For me, I like the Mediterranean diet.   Eating nuts, fruits, vegetables, and more fish plus cooking with olive oil works for me. I allow some indulgences because I love experimenting with food.
The Complete Mediterranean Cookbook: 500 Vibrant, Kitchen-Tested Recipes for Living and Eating Well Every Day

Healthy sleeping habits:

Before I started exercising, I had difficulties sleeping. I was using a prescribed sleep medication at least twice a week to help me sleep. At night, I was not able to get comfortable. Since I started exercising, I have not had any difficulties sleeping. I do, however, try to be consistent with when I go to bed and when I get up. If you have difficulties falling asleep, try different things such as a warm bath, reading a book, or sipping on warm tea. Keeping a log book will help track what works and what does not. I talked earlier about napping. I work Monday through Friday, so I do not have the option of taking a nap during the week. I love my naps on the weekends. Simply laying down for an hour in the afternoon really helps.  I run errands, work around the house, and take a nap. I wake up refreshed and ready to go again. It works for me. Keep track of what works and what does not. Try different techniques to help you sleep. Try to keep to a routine, if possible.

Joint Support:

            I have a brace for almost every joint and I wear one, as needed. I even have them for each one of my finger joints. I don’t usually wear them for long, but taking the stress off my joints, even for a short amount of time, helps with the pain and to fight the fatigue that comes from fighting off the pain. Embrace the braces, don’t be embarrassed by them. I could care less what people think if the brace helps me feel better.
Compression Knee Brace Elbow Brace Support Set (2 Pairs) Men Women Knee and Elbow Sleeves for Running, Jogging, Walking, Workout, Joint Pain Relief, Arthritis and Injury Recovery (Medium Size)

Break time:

            This has absolutely been the most difficult thing for me to do. I work at my desk during my lunch hour. If I am at home, I always feel that I need to do something. I try to go home after work and read for just ten to fifteen minutes while I watch our chocolate lab run through the sprinkler. During my lunch hour, I try to put my feet up on my desk and read a book, even if it is only for fifteen minutes. I brought a yoga mat to work so that I could do some yoga exercises during lunch but the mat remains tucked away in my office. Maybe today will be the day that I take advantage of the yoga mat.


If you are like me, you want an easy fix. You feel tired and worn down. Take a pill and you will have energy again, right? There are no easy remedies for RA and fatigue. You can, however, know when you need to slow down, rest and take a break. Listen to your body and PAY ATTENTION TO IT. Keep a log book and start looking for a pattern of when you are feeling fatigued. Try different things to see if you can break that pattern of fatigue. If you take anything away from this, it would be the importance of adding exercise into your life. I really cannot tell you how much it has helped both with my RA symptoms and fatigue. I sleep better at night and I feel better. I had to laugh at myself today because I had to run up a flight of stairs as I was late to a meeting and the elevator was taking too long. A month ago, I would have been winded and would have walked into the meeting trying to catch my breath. I breezed into the meeting feeling great and ready to run up another flight of stairs. This is progress.

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