Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group fatigue without pain or inflammation?

Is it possible to have chronic fatigue without any AS pain or discernible inflammation? Lately I seem to be in a sort of remission pain-wise, which is nice while it lasts. But I am also very tired. I thought fatigue only happened as a result of a flare?

Didier

Fatigue can be due to anemia, low B12 or thyroid issues too. You should get your iron checked.

Mono also causes fatigue. Do you have any swollen glands?

If you were a non AS sufferer these would be the first thing a doc would check for.

Maybe this is non-AS related.

I think you can I know there are times when I'm not in a flare but I'm so fatigued I stay in bed...there have been times I get upset and think quit being lazy but not every day is like that some days I have good non fatigued days
Lisa

In addition to the things Katy mentioned, also if male, testosterone levels another thing to have checked.

I will feel fatigued first when starting a flare, needing to sleep like 10-12 hours a night or more, and still tired. Then other symptoms slowly come on. But fatigue is the first symptom. Kind of like when coming down with some viral illness. Only time tells me if I'm getting sick or starting a flare.

I get fatigued from an immune response from food mainly(doesn't really happen from drugs) or if I am carrying around a lot of inflammation but kind of getting rid of it. Then I will feel a lil fatigued/a lil tired and a lil lethargic. Exercise tends to help me with these things. Medication not so much... that does help with that 2nd one though and the resulting fatigue you could say.

Also a bowel movement reduces my fatigue too.

Fatigue comes from active disease progression. So even without pain you can still have debilitating fatigue.

Hello Didier,

How old are you? I am 25, and I have had bad fatigue and low inflammation ever since being diagnosed in November 2011. I was 23 then, so my diagnosis is consistent with the median age of onset, although my problems with hip pain go way back to when I was 19-20 during my first university years. The disease has progressed into my lower back (night pains), but still nothing really serious. I take 120mg of Arcoxia daily, which helps some with the pain, but not with the fatigue.

It's strange that my blood tests have always come back completely clear, yet I feel sickly tired and occasionally look the part as well (pallor, dark rings under eyes). I've been trying real hard to find relief for my fatigue issue, because I have this demanding job, but my successes have been few. Observations that I've made: the fatigue is relieved by really long periods of sleep, eating less and mild, mild exercise. Even slightly overdoing exercise can lead to some kind of hellish cycle where the body cannot recover and becomes more and more fatigued. The fatigue comes and goes in flares, and currently I'm in one. It may be that there is some connection to my allergies, because I'm highly allergic to pollen (according to tests), but I do not exhibit any of the symptoms usually associated with pollen allergy, with perhaps the exception of occasionally itchy, puffy eyes.

My fatigue is also associated with bad dreams and nightmares. I conclude that the bad dreams and nightmares are caused by the fatigue and not vice versa. This is because the "fatigue feeling" often comes on unexpectedly during the day even after an undisturbed night of sleep and then nightmares come the next night. Although it may be that these issues both reinforce each other. My mind and body seem to be unable to get enough sleep, no matter what. This is made worse by the fact that I cannot sleep more than ca 7 hours straight, although I know and feel that my body would gladly sleep for 10-11 straight hours if it only could.

Another thing that I can associate with the fatigue is feeling breathless, like I cannot get enough air. I have had a sleep study done, which ruled out sleep apnea though. The daytime tiredness/sleepiness is caused by the low inflammation, I know it. The feeling is like something was clawing at my attention, forcing it to conserve its energy (which, in my case, tends to result in a lot of procrastination and doing anything else but the hard attention-demanding task at hand).

I have read on these forums that for many, the biologics have helped with the fatigue, but for me these are out of the question at the moment because I have such low inflammation and no visible disease activity even when MRI is used that I do not meet the treatment criteria, which apply where I live. So I am left with this fatigue, which in my opinion is even worse than the pain. Pain can be managed, but the fatigue, in my experience, not so much. Anyway, I hope that you'll find some new energy soon, as I myself am trying to do.

Is fatigue related to AS a CFS (chronic fatigue syndrome)?

Hello lool,

I think the answer to your question is no. Chronic fatigue syndrome or CFS is a separate medical condition. I suppose it cannot be ruled out that a person suffering from AS mistakenly attributes his or her fatigue to AS while actually suffering from CFS, but my guess is that in most cases the chronic fatigue in AS is caused by the AS itself. That is to say, if the AS were cured, the fatigue would be gone as well.

Didier, for years my main symptom was incredible fatigue and lack of energy. I had pain, but since I'd had pain for so long (starting when I was 15), I never actually realised it was abnormal to have pain. If you know what I mean. This delayed my diagnosis by decades.

I would encourage you to have a sleep study to ascertain what is going on while you sleep. Fatigue is considered a symptom of arthritis by The Arthritis Society in Canada, and by The Arthritis Foundation in the States. As someone pointed out Chronic Fatigue is a different disorder, but not necessarily uneelated to AS. Lack of sleep, good quality restorative sleep, has a direct impact on our pain levels and ability to cope. We can think we're sleeping 7 hours a night, only to find out that our brains are coming to partial or full consciousness many many times a night. When I had mine, I woke up about 45 times, but would never have known it. Others I know find that they are awakened over 200 times. Please do get checked out at a sleep clinic. There might be something you can do to help with this.

Exercise, by the way, is one thing you can do for both your AS and your sleep.

Warm hugs,