I suspect we're only beginning to understand how many autoimmune manifestations there are. This is of course just anecdotal, but my Facebook feed is full of men and women both who are struggling with intense, unexplainable fatigue. As a farmer with a lot of friends in the same line of work, I've been aware of the tick-borne illnesses for a long time, and I have an unfortunate number of friends dealing with a Lyme diagnosis. But my world has other people in it, too, and I have been noticing more and more people from different walks of life dealing with fatigue as well. I won't be surprised if other factors (other than the tick-borne diseases already on the radar) are eventually discovered.

Re the depression: I've just made an appointment with my family doctor to start the discussion. Yesterday I came home from buying groceries and sat int he car for a full ten minutes before I got out and brought everything in. It was 9 degrees Fahrenheit here; I wasn't sitting out there because I was enjoying the view, or listening on the interview on the radio. I just.....didn't feel like moving. My first assumption was that I was just tired, But I've caught myself doing that a lot lately, and not just delaying a job that isn't necessarily enjoyable. It's hard to put into words, but something's just off lately. Good luck to you, let us know how it goes.

Same here. I suffer a LOT from INERTIA! Just can't get up and get going. Is it RA? is it age (I'm 74 in two days), or depression...or a combination of all....

I fall asleep at the drop of a hat, but when it's bedtime, then inertia strikes and I am too tired to get up out of my chair to get to bed!! I wind up staying up too late. Vicious, defeating cycle.

Oh, and just to add to the joy here: my doctor's office just called back; my most recent bloodwork for my rheumatologist shows high blood sugar, and they wanted to doublecheck, was that in fact a fasting blood test? Well, yes, it was. Not only, that, but my last routine bloodwork, three months ago, was also fasting, although they marked it otherwise because they hadn't asked. It was just a tick or two above the normal range. I knew that, and knew what it meant, and thought I'd make some dietary changes and see if it made any difference. Apparently, it did not.

They're going to run a different test that checks the average blood sugar levels over the last three months, and they'll have that information when I go in on Monday. the nurse practitioner, who phoned to ask me about this, said that this could very well be the cause of my fatigue/lethargy (and of course the RA itself, or the RA meds, can cause that, too.) She said that while we cannot rule out depression, we will probably want to follow this particular trail and try to get my blood sugar settled down before making any other decisions.

So, just a thought that you may also wish to investigate as you look for answers.

I agree about the inertia. It's partly but not totally a physical tiredness. there's an element of just not caring. I think that part is actually more worrisome to me than the physical tiredness.

And as a person who was always ridiculously healthy until the RA, I'm finding myself baffled and angry and all the feels about this. I just made an appointment for my regular mammogram, and for the first time ever, I'm actually apprehensive about that, because it's like I no longer trust my own body, you know? Bah.

I did read that Type 2 diabetes could be a cause. My sugar was high last time it was tested but borderline.

GOOD LUCK!!!

an A1C is more useful as they move the tests along the conveyor belt - it is a reading of your sugar over the past 3 months as opposed to your fasting number overnight.

between that test and a sleep apnea test maybe they will find another issue that can be treated and get that crazy exhaustion behind you I hope. Hang in there.

while you are at it don't forget the thyroid. I can't think of anything else except cut out all napping for 2 days and force yourself awake awake awake and see if that helps?

Had more than one thyroid test

This really underscores how important it is for us to not blame everything on the RA. A bit of a challenge, since RA can present itself in so many guises, and none of want to be that person who's whining about every little thing, either. I'm just so glad I don't have a doctor who shrugs and says 'well, at your age it's probably just menopause'. I've got some friends who have wasted a lot of time because of attitudes like that. Be an advocate for yourself!