Fatigue in patients with rheumatoid arthritis (RA) is very common. Studies done on RA patients show that fatigue is more frequently found in those patients who also have sleep problems, depression, greater disability, and more pain. In addition, patients who are anemic, which can occur in RA, have more fatigue.
Fatigue is also a very common side effect of methotrexate. Methotrexate causes folate deficiency. Folate deficiency is responsible for many of the side effects of long term methotrexate use such as mouth sores, gastrointestinal problems, anemia, and abnormal liver function tests. For RA patients on low-dose methotrexate, taking folic acid (a synthetic form of folate) can help you feel better and does not lessen the effect of methotrexate on your RA.
Talk with your doctor about your problems with fatigue. Ask your doctor about whether you have anemia or folate deficiency. You may want to discuss with your doctor whether it is appropriate for you to use medications to help the fatigue of chronic illness.
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