I don't know much about Stelara but I think you are probably right on most of your thoughts. It seems like all of the DMARDS I have tried take months to take effect so I wouldn't be surprised if Stelara was the same. When I switched from Enbrel, which worked but caused some nerve system side effects, to Orencia, I also went through a period of over a month as Enbrel wore off until Orencia took over. For that time I had more pain and fatigue even though I was taking MTX all along.

Are you taking MTX or another drug in combination? or possibly Prednisone? It might help you through the transition. But in any case, all you can do is wait it out to see if Stelara works for you. Call you Rheumatologist if it gets too bad.

Thanks for your input! Yes, still taking methotrexate faithfully.

It seems logical to me that there'd be a rough period during the time that the Humira is wearing off but before the Stelara kicks in. We'll see what the doctor says on Tuesday.

Except for the lethargy, did the Humira work well?

Here's the thing: many drugs get blamed for lethargy when in fact the disease itself causes lethargy.

Yes, that complicates things, doesn't it? In my case, the lethargy pre-dated the Humira; I never thought of it as a side effect. But it certainly could be. I'm also carrying some extra weight, and that certainly doesn't help the lethargy situation. And there's other stressors in my life which are not within my ability to regulate at the moment; that certainly isn't helping.

So, my lethargy could be caused by the disease, or by the meds I'm taking to combat the disease. Or it could be caused by the disease and exacerbated by the meds. Or the meds might not be helping the lethargy in a noticeable way, but perhaps without those meds, the lethargy would be much worse - they may in fact be working. Or maybe it has nothing to do with RA and is a symptom of mild depression caused by the stressors I mentioned above. I don't think the last one is the case, but let's face it, it's not something you can easily self-diagnose.

I have no idea if the Humira was working, because I'm not sure what 'working' even means. The Humira might have been working beautifully, because without it perhaps I'd be worse.

The stiffness in my hands lately might be caused by having stopped the Humira, or by the change in the weather, or by the disease really ramping up and overriding the benefits of the various meds. Or maybe I didn't realize I was overdoing something and I'm just tired.

Sorry. I know there are no answers. Just feeling frustrated. I hate this disease.

Hi Katie. Here is my two cents.

Lethargy is a way of life for me. I have found no med but prednisone that helps. Prednisone can't be a solution, so I rest when I need it. I have that luxury. Everybody doesn't. If you find something that cures lethargy, PLEASE LET ME KNOW ASAP!

Switching meds - for me, one didn't really fully wear off until the other kicked in. It took about 3 months for MTX to go in to full effect for me, so I can miss 3 weeks before I really start to feel it. The same when I switched between biologics. It may not be the same for you.

Stress totally changes EVERYTHING for me. It is the fastest way to a flare. If you can't do anything about the stress right now, all I can say is to get plenty of rest.

I hope you land on the right med combo soon and your stress is soon mitigated.

My definition of "working" [as related to a drug's use] is when you've achieved a level where the inflammation is controlled and the pain has, for the most part, stopped.

In my case, Humira + MTX are "working." I still have some lethargy. I don't think, in my case, that the lethargy is caused by the drugs [my MTX dose is 7.5mg]. I think it's just caused by the disease itself and .....ahem....old age.

What I'm saying is that I personally wouldn't change my drug program if it got rid of most of the pain and inflammation and only left me with lethargy.