Approximately 1.3 million people in the United States live with rheumatoid arthritis (RA), meaning they also are living with constant inflammation, which can be described as painful swelling throughout their body. (Source)

When we think of inflammation, we often think about the visual side of it, such as a swollen lymph node or an inflamed joint. However, RA causes inflammation all over the body, including in places we can’t always see.

For most people, inflammation isn’t always bad. It’s the body’s way of responding to and healing an injury, infection, or something “not normal” such as a mosquito bite. However, for people with an autoimmune condition such as RA, the immune system attacks healthy cells in the body that it shouldn’t. The result can be painful chronic inflammation as well as other symptoms including extreme feelings of tiredness, or fatigue.

While there are many reasons why you might feel fatigued, it’s important to know if RA is the cause. Lifestyle changes could help combat RA fatigue and keep inflammation under control, alleviating that debilitating feeling of being overly tired, preventing more serious complications, and helping improve your quality of life.

What is RA?

Rheumatoid arthritis, often referred to as RA, is a chronic inflammatory autoimmune disease in which the body’s immune system mistakenly attacks healthy cells around the joints, causing painful swelling. Although RA mainly attacks the joints, usually many at one time, it can also affect the skin, eyes, heart, kidneys, and lungs. Without treatment it can lead to permanent joint damage and other potentially serious complications. (Source, Source)

As with many autoimmune diseases, it can be difficult to diagnose RA in the early stages. This is because the disease develops over time, symptoms can differ from person to person, and there is no one single test to confirm RA. Symptoms also mimic other conditions, including different types of arthritis that are not autoimmune in nature.

The specific cause of RA is unknown, but there are both genetic and environmental characteristics that can increase or decrease your risk. These include age, genetics, and weight, and exposure to environmental toxins. As with many autoimmune diseases, RA tends to affect women more often than men. (Source)

How Is RA Treated?

While there are many types of arthritis, each is treated differently. Because RA is an autoimmune condition, symptoms often are systemic, or affecting the whole body, as opposed to just certain joints. This can change the approach to treatment.

Rheumatoid arthritis can be treated with both medication and self-management strategies. As with other chronic illnesses, there is no cure for RA. Therefore treatment is intended to reduce the pain and stop or slow further disease progression and damage. Some medications for autoimmune diseases such as RA help stop the body from attacking healthy tissues, slow disease progression, and treat symptoms such as pain and inflammation. Diet and lifestyle changes may also help you manage RA and its symptoms. (Source)  

What Are the Symptoms of RA?

Symptoms of rheumatoid arthritis are similar to other conditions and can vary from person to person. This is what makes it a difficult and frustrating condition to diagnose, especially in the early stages. Some people develop symptoms slowly over time, while others develop symptoms rapidly or all at once.

For most, RA mainly affects the joints in the body. It can happen in any joint, but is most common in the wrists, hands, and feet. Unlike other types of arthritis, symptoms often happen on both sides of the body. For example, if you have RA in one hand, you may also develop it in the other. Symptoms tend to flare, or become worse at certain times, because of factors including stress and weather. (Source)

Common joint-related symptoms include:

• swelling
• pain and stiffness
• decreased range of motion
• painful nodules near the joints

There are other symptoms associated with RA that are not joint related. These include:

• fatigue
• weight loss
• digestive issues
• eye and ear issues
• gum disease
• skin problems
• sleep issues

Fatigue, which is considered extreme tiredness that doesn’t resolve with rest, is one of the earliest signs of RA and one of its most common symptoms. In fact, studies have found that people with RA often experience more fatigue than pain. Fatigue can be caused by the increased inflammation in the body that results from RA. Despite this, many may not realize that their RA is actually responsible for their extreme exhaustion. (Source)

What Is the Difference between Rheumatoid Arthritis Fatigue and Regular Fatigue?

Occasional fatigue is a normal part of life. It can be a response to physical activity, being stressed out or bored, or not getting enough sleep. However, when fatigue is ongoing and not relieved by rest, sleep, eating better, or a reducing stress, it could be a sign of something more.

Rheumatoid arthritis fatigue is caused by increased inflammation in the body. This kind of fatigue is different from the normal feeling of being tired, and can be described as  overwhelming and uncontrollable exhaustion. If you have fatigue that is debilitating and starting to decrease your quality of life despite typical interventions, it may be a sign of RA fatigue. (Source) (Source)  

You may face disruptions in your day-to-day life from RA fatigue. You may find you have no energy for simple everyday activities, and it can affect your performance at work. This can lead to feelings of being out of control, which can cause anxiety, depression, and loss of interest in activities you usually enjoy. Other symptoms of RA fatigue include an increased need for sleep and a hard time concentrating. (Source, Source)

You may experience RA fatigue if pain or anxiety over being diagnosed with a chronic illness interferes with your sleep. Medications to treat RA, including steroids, also can cause insomnia in some users. (Source)

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What Triggers RA Fatigue?

Rheumatoid arthritis flares, including RA fatigue, can happen at any time and are usually a sign of uncontrolled disease and increased inflammation in the body. In the case of RA fatigue, there are many factors that could cause a flare.

Common changes in weather, such as pressure or temperature changes, have been shown to trigger RA joint pain, which can then trigger fatigue. Similarly, many foods, such as low quality red meat and sugar, are naturally prone to causing inflammation that can be exacerbated if you have RA. For tips on sourcing high quality, grass fed meat, check out this article. Please note: even the slightest allergy to a food, such as gluten, can cause increased inflammation as well. Stress also sets off the body’s inflammatory response. (Source, Source, Source)

If you have RA, it’s important to take care of your body. Eating well, drinking enough water, and engaging in activities that promote relaxation all help keep symptoms of fatigue under control.

What to Do If You Think You Have RA Fatigue

If you have rheumatoid arthritis and think you may have RA fatigue, it’s important to speak with your health care provider as soon as possible. Addressing RA flares and getting your RA under control is important for preventing joint damage and other potentially serious complications.

A big part of managing RA fatigue is getting your inflammation under control. Health coaches at WellTheory are experienced in helping people with autoimmune diseases make nutrition and lifestyle changes to aid in their healing. For many, these changes are enough to control RA. A survey of WellTheory members found 75% of those with RA saw an improvement in their quality of life after 8 weeks working with a WellTheory health coach.

Other ways to manage the symptom of RA fatigue include:

• getting enough sleep each night
• eating a health and well-balanced diet
• drinking plenty of water
• exercising regularly
• prioritizing activities that help you relax, such as yoga
• avoiding activities that cause high stress
• avoiding alcohol, tobacco, and other drugs

Sometimes RA fatigue continues to be a problem, despite attempts at managing it. If you find this to be the case, consider talking to your health care provider about whether you should consider medication, or making changes to medications you’re taking. Studies also show that cognitive behavioral therapy can help people with RA fatigue find relief. (Source)

The Bottom Line on RA Fatigue

RA fatigue is a debilitating symptom of rheumatoid arthritis. It is different from normal fatigue, and can cause extreme disruption in your daily life. While there is no one-size-fits-all treatment for RA fatigue, it’s possible to reduce symptoms with nutrition and lifestyle changes. If you’re experiencing RA fatigue, It’s important to begin addressing symptoms and getting your inflammation under control to avoid complications. WellTheory offers personalized nutrition and lifestyle coaching to help you sustainably manage RA fatigue.