• Amy Suto

5 Tips to Handle Chronic Fatigue and Brain Fog with Rheumatoid Arthritis

Right before I started writing this blog post, I almost reached over and picked up my (vegan, soy, nontoxic) candle to drink instead of my cup of tea. Before that, I opened a new tab and then stared blankly at my screen, trying to figure out what I had meant to look up.

Brain fog and fatigue are real side effects plaguing those of us with rheumatoid arthritis, and even when I'm eating clean and exercising, I still feel it creep in.

As a freelance writer, it's not ideal to have my brain take a vacation when I'm working. So, I've developed my own system of dealing with and managing both chronic fatigue and brain fog that comes along with rheumatoid arthritis.

Here are my top 5 tips for reducing brain fog and fatigue:

Tip #1: Developing an RA-Friendly Workout Routine

Okay, okay, before you roll your eyes at me I want you to know that I FEEL YOU when you're reading my tip of "work out more!" and you just want to take a nap.

As someone who previously had an undiagnosed iron deficiency at the start of my holistic health journey, I get you with the whole "I'm too tired to exist" thing.

But working out cuts through my brain fog and fatigue like nothing else, so I'm going to recommend it to you anyways, and yes -- it's going to be quite a fight to set a routine and stick to it.

Here's the way to hack working out for RA: you need to have a mix of resistance training, low-impact cardio, and stretching/mobility in your week, and you need to do these things with someone who can help hold you accountable.

I'll do another post on my workout routine, but know the fastest route to more energy is getting your body moving.

Interestingly enough, high-intensity cardio might ~not~ be the answer for you. Strength training is really the ticket to lower your inflammation, but sometimes overexercising or doing too much insane cardio can give your body inflammation and trigger more exhaustion and fatigue.

I discovered this the hard way the other week when I was tired but pushed myself to go to a cardio barre class and felt like I was going to faint after.

Tip #2: Take Sleep Seriously and Go to Bed Before 10:30pm

I'm a chronic night owl, and yet going to bed before 10:30pm at night has really changed my life in a lot of ways, so I'm recommending this to you ~in full understanding~ that many of y'all are night owls, too.

When I go to bed early and wake up early-ish, I feel more energized, better rested, and have lower stress and higher productivity and happiness. I sleep 8-10 hours per night, every single night, but I notice that those hours leave me more rested if I'm going to bed earlier, not later.

There's some hormones that get secreted if you go to bed at 10:30pm that promote muscle growth and rest. I'm not a scientist or a doctor but you can Google it. Mostly, though, I feel the difference, and you may want to try it and see if you do, too.

Here are the tips that ~actually~ helped me to go to bed earlier:

  • Get sunshine first thing in the morning. Get outside, put your feet on some soil (if you can!) and get some sunshine. This is known as morning grounding and it helps get your circadian rhythm going. This is a must if you don't get a lot of natural sunlight in your home or office.

  • No caffeine after 3pm. I used to be a permanent 4pm coffee kinda gal. Now, I've drastically cut back on caffeine and stop drinking caffeinated tea around 2 or 3pm at the latest.

  • Yoga, stretching, and meditation before bed. Do some yoga poses to help you work out any tension or stress. You hold a lot of stress and trauma in your body, and by doing some yoga, stretching, foam rolling or whatever before bed will help you get it out. Meditation is also great to do in the evenings.

I would recommend avoiding sleep aids (even melatonin) as your body could become reliant on those things to sleep. Oh, and if you're working out, you'll also probably find it easier to catch some ZZZzzz's.

Tip #3: Reduce Your Coffee Intake

This sounds counter-intuitive, but it's actually not.

For the longest time, I used to rely on coffee as if it was a superpower. In reality, it was a crutch that was hiding my iron deficiency and harming my sleep quality.

Coffee that's not organic can also have a ton of pesticides and also have mold growing on it. So, get organic full-bean coffee that you grind yourself if you choose to indulge.

When I switched to drinking matcha tea first thing in the morning instead of coffee, all my anxiety disappeared. I got my caffeine buzz, but it was slower, more gradual, and more sustained.

If you rely too much on coffee, it can have negative effects on your overall energy levels, and tax your adrenal glands.

Adrenal fatigue is something that people with rheumatoid arthritis really need to care about. Controlling your cortisol levels and adrenal glands will help a LOT on your road to healing holistically. I'm not going to get into this a lot right now, but if you do a quick Google you can read more about it.

Basically, coffee and excess caffeine puts you in constant fight-or-flight mode, which drains your adrenal glands, pumps cortisol through your body, which makes your body hold onto fat (which can increase weight gain), and this increases inflammation.

I actually gave up coffee for the first ~four months~ of my healing journey, and oh boy did that suck. I had many a breakdown, but this was one of the best ways I found to uncover things like my iron deficiency that were ruining my quality of life. I recommend you take a break from coffee, too, and understand how to help your body generate energy naturally.

I'll still indulge in coffee, usually around 1 or 2pm and I only drink a small cup, or a little espresso. I try not to do this most days, and save it as a treat. This allows me to still get the buzz from coffee, but in a small, manageable dose. Trust me, you'll feel better on the other side of your coffee dependency.

Tip #4: Drink a Gallon of Water Per Day

Excessive? No. Drink your water.

In Dr. Brooke Goldner's book Goodbye Autoimmune, she talks about how everyone who comes to her to reverse their autoimmune disease, she makes them drink a gallon of water per day to help flush out toxins, get the digestive system going, and to reduce inflammation.

I've found huge improvements in my energy levels and brain fog when I'm properly hydrated, so try increasing your water intake and see if that helps!

Tip #5: Eat Clean and Try Targeted Supplements

Eating a clean, plant-based diet and taking the right supplements can help immensely when it comes to energy and brain fog.

Vitamin D3 in particular helps a lot with energy, but you can read more about rheumatoid arthritis supplements on this great Healthline article. Remember to consult with your doctor or nutritionist before starting any supplements.

Drinking green tea is a great way to get some anti-inflammatory action and a bit of caffeine into your day, so give that a try before turning to coffee.

Sometimes, Your Fatigue and Brain Fog Still Stick Around

If, after all of that, you're still dealing with chronic fatigue and brain fog, there are a few more changes you can make to troubleshoot:

  • Try therapy and journaling. Maybe your exhaustion is stemming from unhealed trauma. Therapy or exercises like journaling can help you work through things that might be coming up for you, both from your past and in the frustration that stems from constant brain fog and fatigue with rheumatoid arthritis.

  • Try meditation and deep belly breathing. Another potential source of your fatigue is that you're taking shallow breaths all day instead of longer, deeper inhales and exhales. Try meditating twice a day for 15 minutes each session, and really focus on breathwork. Try deep belly breathing: as you inhale, let your belly fill up with air, and then open your mouth and exhale. This is especially helpful for those of us who have stomach issues or hold stress in our stomach.

  • Reduce external stressors. Sometimes, it's an external stress that's draining you. Take a look at your life and see if there's a way you can reduce stress and make your life less chaotic.

  • Get serious about rest. Fatigue and brain fog might be the result of burnout, not just your rheumatoid arthritis. As a highly ambitious person dealing with RA, I've had to modulate my workload to recover from burnout and prioritize rest and mental peace. Those things have helped me ~so much~ and I can't recommend them enough.

  • Do the things that bring you joy. Go sketch in a park. Stroll down the beach. Hang out with people you love. Do the things that bring you joy, and let that fill you with energy. Rheumatoid arthritis and other autoimmune diseases can be tough because they make us feel tired to do the things that bring us happiness, but sometimes if you push yourself to do those things, paradoxically your energy increases.

I know how defeating it can be to feel like you can't get out of bed or you're lying on the couch and can't get yourself up to do work. I've been there.

Be kind to yourself in this process. When I started my healing journey, I thought I'd never get my brain fog or exhaustion to get down to a manageable level.

But I did. Here I am, working out 5-6 times per week (which was unfathomable before!) doing yoga, hiking, weight training, and enjoying life with more energy than ever most weeks.

Sometimes my fatigue and brain fog come back, and then I need to get serious about making sure I'm sticking to my clean diet and healthy habits. Even if you get into remission, you might still encounter brain fog and fatigue.

This stuff takes time, but hang in there. Unlocking the fatigue and brain fog puzzle is a tough one that can feel unsurmountable at times, but you've got this! Don't give up, and keep on your healing journey.

I promise you, it's worth it.