Barbara, What have your labs been like lately, such as a CBC?

Methotrexate is given to some patients, but it's not very common. I'd be interested to know why they went that route, too. Do you have any inflammatory conditions, such as lupus or arthritis?

Have you had a peripheral blood smear, so that they look at what your cells are up to?

What about a B12 test, or thyroid ones? Do you get enough folic acid?

Have you had a morning, fasting cortisol test?

Fatigue has a lot of causes and might take some time to figure out, but it should be figured out! Some are simple to fix (B12) and others aren't (anemia), especially while on Methotrexate.

If you have a good internist, go see them and ask for their advice.

Fatigue isn't normal, no matter what the cause.

Annie