Right now the only medication I'm on is meloxicam. It seems to help with the inflammation but not enough to make any sort of difference. The pain I can live with as I have done for many years. The fatigue however is a drag.

Is there any common treatment for the fatigue, medication or otherwise? I'm well aware of the benefits of exercise but I'm looking for other fatigue treatments.

The only thing that helped my fatigue was Humira. And even with Humira, if I eat junk food or a high carb meal I will have major fatigue.

Yeah, same for me. NSAIDs weren't enough to treat my fatigue. It only dissipated when I started Enbrel.

I am working really hard on no carb diet for a few weeks now and it does seem to be helping, along with going to bed on time. Also taking a hot bath before bed, installed black out curtains, and trying to get better quality sleep. I generally eat low carb but have been so tired lately. Vitamins and exercise help of course. NSAIDs make me more tired. When I first started taking them I would go straight to bed after work. I take tramadol sometimes for fatigue. Doesn’t help with my pain anymore, but when I was on it noticed I couldn’t sleep. If I am having a bad week, I set my alarm an hr early and take two. Generally I wake up ready to go before th hour is up. My pain dr said it is fine for me to do that. Still have an afternoon crash and I don’t like to take too many pills. Seeing a new rheum today so hoping for some ideas from her. Other symptoms are under control. When I switched to weekly humira instead of biweekly I did notice better quality of sleep, but have had some ups and downs since then.

For fatigue, check out: Low Dose Naltrexone. Naltrexone was approved in the 80's for overdoses. Some pioneering docs came along many years later & now use it in very small doses 4.5 mg & under for many conditions (autoimmune). I have been on it for a year & a half. It did not help my pain as much as I had hoped, but has helped my debilitating fatigue.

It is typically given by a functional medicine doctor or you can go to the following site & find a doc near you: www.ldnscience.org LDN is typically taken at night. It turns off the endorphin production for 3 or 4 hours. This in turn sends the message to the brain that it needs to produce more endorphins. So when the person's endorphins kick in, they are much stronger. As a result, it can help pain, mood and fatigue in addition to many conditions.

SjoDry

The biologicals are the only thing that helped fatique. That was the first symptom that left when I started Humira. Fatique is a symptom of the disease, it means you are not getting enough treatment.

Anna

I'm trying to avoid biologics as much as possible.

Is there a specific reason why you are trying to avoid biologics as much as possible? Many people who post here have been on biologics for years and can perhaps speak to your concerns.

There are medications that take the fatigue away. I forget the name but they are prescription medications that turn off the fatigue in your brain.

Anything that gets the inflammation reduced. Most people say NSAIDs, biologics, some swear by the NSD diet. I've also had a bit of success with strong coffee and lots of resting through the day. I'm in the same boat, looking for a solution, and planning to experiment with SNRIs as some are known to boost energy in some people.

Modafinil/Provigil? I recently started taking this (prescribed by my pulmonologist for excessive daytime sleepiness). It was great the first week then it's effectiveness lessened dramatically, but it's still enough that I can function more effectively at work than before. My new rheumy seemed surprised I was taking it; she didn't tell me to stop but it sounds like I'll be starting a biologic sometime this fall (after recovering from surgery) so perhaps then she'll suggest I cease and see if the biologic helps with the fatigue/sleepiness.

From what I read seems tnf blocker further lowers levels of serotonin.
Would be interesting to know if people with AS like people with fibromyalgia have lower levels of dopamine in substantia nigra, I recently read documented research that great way, beside drugs which eventually wane off and can cause other problems, to increase dopamine would be walking minimum 3 times a week for several miles. This was in relation to patient with Parkinson disease. But what was even more interesting is they say people with low dopamine level have decreased motivation to make a first step, as the cost benefit ratio is higher. All in relation to neurotransmitters. Seems that the sedentary ways of modern life are killing our 🧠 . I a very active male 39 and beside AS I am looking way younger than most of my peers.