Rheumatoid arthritis (RA) isn’t simply a disease of swollen and achy joints. In reality, RA is a systemic and inflammatory autoimmune condition that can affect everything from your brain to your heart and GI tract. And one very common symptom associated with RA is fatigue. But this isn’t just your average midday slump: RA fatigue can make it difficult to get out of bed in the morning, do basic tasks, or even enjoy life. The good news? There are ways to manage it. Click through for tried and true tips.
But First: WHY Does RA Zap Your Energy?
There isn’t one clear-cut reason that low energy so often piggy-backs RA, says Vinicius Domingues, M.D., an assistant professor of rheumatology at Florida State University College of Medicine in Tallahassee, FL. But there are some commonalities. In particular, “some patients with RA can become anemic, which is a major factor in fatigue,” says Dr. Domingues. Anemia reduces your body’s ability to absorb oxygen, which is needed to produce adenosine triphosphate (ATP), the main energy carrier in all living things. Also, not getting enough sleep is also a major energy issue for people with RA, says Dr. Domingues. “When you have pain, you can’t really have a restful night.”
Be Aggressive With Treatment
Tempting as it is to spend your limited energy on getting more energy, don't neglect your treatment. “Some of the disease itself can cause fatigue,” says Dr. Domingues. Kelly O’Neill Young, president of the Rheumatoid Patient Foundation, says that fatigue will improve alongside other symptoms if RA is well-controlled. Here’s the catch though: Treatments rarely work 100% of the time. Despite best efforts, there will be spells when the disease is more active–and when you feel like you’re moving in slow motion. “Those are the times we can use other tactics to help protect and improve our energy,” says O’Neill Young.
Catch All the Zzz’s
“Do whatever it takes to get enough sleep each night,” says O’Neil Young. Try following best practices like sticking to the same sleep schedule daily and limiting blue-light exposure before bed. O’Neill Young also recommends adding rest days following strenuous activity.
When the “painsomnia” interferes with your REM, consider keeping a bedside arsenal of tools—heat and ice, splints and extra joint-supporting pillows—to defeat pain on the spot.
Break a Sweat
Dr. Domingues recommends that all people diagnosed with RA ramp up their exercise. “It’s one thing that really works for energy,” he said. Regular exercise helps strengthen your mitochondria—the part of the cells in your body that produce energy. “I personally have tried it all,” writes Ashley Boynes-Shuck on her blog, Arthritis Ashley. “B12 injections, supplements, tea, coffee, chocolate, more sleep, and less sleep,” says the RA advocate based in Pittsburgh. “Regular exercise and a one-day juice cleanse here and there have been the only things that have steadily increased my energy levels.”
Eat the Rainbow
We’re not talking Skittles, here. Research shows that energizing nutrients such as zinc, calcium, selenium, and vitamin D found in lean meats, nuts, and leafy green vegetables–all important for hormone production–are in short supply with RA. So, if you’re struggling with rheumatic fatigue, your first real win could happen right on your dinner plate.
“Food will not heal this disease,” cautions O’Neill Young, “but you need to eat as healthy as possible to be as well as possible.” This includes adding vitamins and supplements at your doctor’s discretion.
Align to a Higher Purpose
Doing more might be the last thing you think of when you’re feeling worn down. But for Kelly Boyd, 39, of Hamilton, NJ, there’s more energy to be found in doing for others. Diagnosed with RA at two years old, Boyd now relies on a wheelchair to get around. “In spite of that, I work full-time and volunteer with several nonprofit organizations,” including the Arthritis National Research Foundation. According to Boyd, this volunteer work fills her with the jolt of energy that only purpose can bring.
Take a Moment to Meditate
You know those times when you feel like curling up in a ball because of your fatigue? Those can actually be great opportunities to drop where you are and replenish your mental energy with meditation. In a small study of adults with RA, Mindfulness-based Stress Reduction (MBSR) reduced psychological distress–a primary energy drain–by 35%. Participants did the program for 45 minutes a day for eight weeks. Only have a few moments to spare? Start by focusing on deep belly breaths for 5 to 10 minutes, or try an app like Headspace .
Delegate Small Tasks When You’re Feeling Overwhelmed
“Having RA fatigue isn’t like being tired after work,” says O’Neill Young. “It’s like being sick with the flu.” We don’t try to do everything when we’re in the throes of flu symptoms, so we shouldn’t feel the need to check off all the daily to-dos if we’re overwhelmed by fatigue. During these times delegation is key. Things like sweeping the floor, dropping off mail, and picking up the kids can all take away from energizing self-care like meditation, gentle exercise, and rest. Allow yourself to hand tasks off to a spouse, friend, or child (doing chores builds character!) when you need to.
Ask Your Doc About Medicinal Marijuana
Indica is a strain of medicinal marijuana commonly used for pain relief. Though the scientific research is still lacking, there are many anecdotes of Indica being useful for RA symptoms . “I’ve found (Indica) helps relax my muscles more in my body from the pain,” says RA patient Donna Brandt 52, of Port Angeles, WA. “This has led me to feeling more energy for things I actually enjoy,” she said. Laws and access to cannabis vary nationwide, but if you think you'd like to try it, bring it up at your next appointment. Repeat: Always proceed with doctor supervision on this one.