Methotrexate is a commonly prescribed medication for various conditions, including autoimmune diseases like rheumatoid arthritis, psoriasis, and certain cancers. Many individuals taking this medication report experiencing tiredness or fatigue as a side effect. This article explores why methotrexate can cause tiredness and offers practical strategies to manage this symptom.
Why Methotrexate Causes Tiredness
Methotrexate, a folate antagonist, primarily works by interfering with the body’s use of folic acid, a B vitamin. This action is crucial for its therapeutic effects, as it slows the rapid growth of certain cells, such as those involved in autoimmune responses or cancer. However, this mechanism can also affect healthy cells, leading to various side effects, including fatigue.
The exact way methotrexate causes fatigue is complex. One contributing element is its impact on cell division and metabolism, which can lead to a general feeling of weariness. Additionally, methotrexate works as an immunosuppressant, meaning it dampens the immune system to reduce inflammation in autoimmune conditions. This immune suppression can sometimes result in reduced energy levels.
Fatigue experienced with methotrexate is often described as a profound exhaustion that interferes with daily activities, sometimes referred to as “methotrexate fog.” This tiredness can be particularly noticeable on the day of or the day following a dose. Furthermore, the underlying condition being treated, such as rheumatoid arthritis, also contributes to fatigue due to ongoing inflammation and pain, making it difficult to discern the sole cause of tiredness.
Managing Methotrexate-Related Tiredness
Several lifestyle adjustments can help manage methotrexate-related tiredness. Establishing consistent sleep hygiene, which includes maintaining a regular sleep schedule, ensuring the bedroom is dark and cool, and avoiding electronic devices before bedtime, is beneficial.
Prioritizing balanced nutrition also plays a role in sustaining energy levels. Consuming regular, nutrient-rich meals, particularly those with plenty of fruits and vegetables, can help individuals feel more energized throughout the day. Staying well-hydrated by drinking sufficient fluids, such as water, can help reduce feelings of fatigue.
Engaging in light to moderate physical activity, if approved by a doctor, can also alleviate tiredness. Even low-impact exercises like walking or swimming have been shown to boost energy levels and reduce fatigue symptoms. Pacing activities throughout the day and allowing for short rest breaks can prevent overexertion and help conserve energy. Some patients find that taking their weekly methotrexate dose closer to bedtime can help mitigate daytime fatigue and drowsiness.
When to Talk to Your Doctor About Tiredness
It is important to communicate with your healthcare provider about any tiredness experienced while taking methotrexate, discussing its severity and impact on daily life. Your doctor needs to understand the symptom’s extent to determine the best course of action.
Contact your doctor if tiredness is accompanied by new or worsening symptoms. These could include a fever, chills, persistent cough, shortness of breath, unexplained pain, or signs of infection. These additional symptoms might indicate more serious side effects that require immediate medical attention.
Never adjust your methotrexate dosage or stop taking the medication without consulting your healthcare provider. Suddenly discontinuing the drug can lead to a flare-up of the underlying condition. Your doctor can evaluate whether the fatigue is solely due to methotrexate or if other factors, such as anemia or other health conditions, are contributing to your exhaustion. They can then discuss potential adjustments, such as folic acid supplementation, or explore other treatment options.