The lovely Lene Anderson (author of the amazing book Your Life with Rheumatoid Arthritis), shared a link today to an article from The Rheumatologist, entitled “EULAR 2015: The Biology of Fatigue”
EULAR 2015 is the annual congress of the European League Against Rheumatism (EULAR)
My first thought was wow, fatigue has biology? From my own experience and from speaking with other RA patients across 3 continents fatigue seems to be almost the phantom symptom. We all as patients know it exists, we feel it’s debilitating effects, some of us daily. But it’s not really talked about, it’s almost like it’s RA’s dirty secret, the unsavoury cousin no one invites to the party.
Look at diagnostic criteria, posters covering symptoms, medical reports on clinical assessment. They talk about joint damage, inflammation, morning stiffness, they mention lungs, heart, eyes and blood vessels. And they might mention feeling ‘tired’.
The difference between feeling tired and feeling fatigued is enormous. In simplistic terms, if you sleep, tiredness is cured. Fatigue is a thief that steals, hours, days, motivation, energy, and can quite literally leave you unable to move. It is not affected by sleep, the two have no connection.
So, back to this article. Fatigue has a biology! I’ve gotten used over the past few months to reading ‘medicalese’ and I’ve linked to the article in full if you’d like to read it. But the sentence that has me excited (geek alert!) is this one…
“Roald Omdal, MD, professor of medicine at the University of Bergen in Norway, said studies have shown that there is a biological basis for fatigue, that fatigue is gene regulated and that there may be several pathways that bring about fatigue in patients.”
Oh and this one….
“In my opinion, interleukin 1 beta signaling is the fatigue cytokine,” he said. “There is convincing evidence from animal studies—and also, lately, in humans—that this plays an important role.”
Now I don’t pretend for a minute to understand the science behind this. I know that cytokines are small proteins that affect the behaviour of cells, and are involved in RA inflammation. The hows and whys are beyond me, I’ve never been accused of being a scientific mind!
What I do know is this, that once the cytokine that causes fatigue can be definitively identified, research can continue to the next logical step of trying to find a ‘fix’. Anything that brings us one step closer to being able to treat what many, and certainly I, describe as the most debilitating symptom of Rheumatoid Disease is a reason for this girl to smile today!