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The Link Between Rheumatoid Arthritis and Anemia

Why are RA patients already struggling with fatigue more susceptible to this energy-sapping condition?

The Link Between Rheumatoid Arthritis and Anemia

If you have rheumatoid arthritis (RA), you’re all too familiar with the symptoms of this inflammatory disease in which the immune system attacks and damages the lining of the joints. The end result? Stiff, inflamed, painful, tender-to-the-touch joints—often in the wrists and fingers—that interfere with carrying out the tasks of everyday life. Experts estimate that some 1.5 million adults in the US have rheumatoid arthritis.

While pain is the most obvious symptom, there are a host of other RA symptoms, notably fatigue. And it’s not the kind of tiredness that comes from binge-watching Netflix. Instead, it’s a persistent lack of energy that can make it challenging to do things as simple as taking a shower or making a quick run to the grocery store.

Extreme fatigue
What contributes to RA fatigue?  According the Arthritis Foundation, the inflammation caused by RA puts an enormous amount of stress on your body. This is especially the case during flare-ups, or for those who live with constant, low-grade inflammation. Simply coping with chronic pain on a daily basis can wear you out. And the inability to get a good night’s sleep can leave you dragging day after day.

One international study of 6,120 patients with rheumatic diseases, including rheumatoid arthritis, were asked to use a standardized rating scale to track their levels of fatigue. The researchers found that 41 percent of patients with RA reported severe fatigue. The researchers further reported that a variety of factors could be contributing to patients’ lack of energy.

In a study at the University of California, San Francisco, one researcher concluded that a mix of physiological, psychological and lifestyle factors, such as lack of physical activity and obesity also impact energy levels for people with RA. Medication side effects for treatment of other conditions, such as depression and high blood pressure, can also cause drowsiness.

RA and anemia
But there’s another culprit that could sap you of your energy. According to the Arthritis Foundation, nearly two-thirds of people with RA also have a condition called anemia of chronic disease (ACD). The condition is common among people with autoimmune disorders, since chemicals causing the inflammation hinder the production of red blood cells. If you have anemia, your body lacks enough healthy red blood cells to carry oxygen throughout your body—and without enough oxygen-rich red blood cells, your muscles tire quickly—yet another cause of RA-related fatigue. 

Be sure to speak with your healthcare provider if you notice an additional drop in your energy levels. With ACD, a common approach is to continue to treat the underlying cause of your fatigue. But your healthcare provider may also treat you with medication to increase your hemoglobin levels and correct any iron deficiency.  If you suspect that you may be anemic, do not take supplements or any other medication without speaking with your healthcare provider.

Medically reviewed in January 2019.

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