Compared to the general population, people with rheumatoid arthritis are more susceptible to additional health problems. Certain medical conditions can cause fatigue if they are left undiagnosed and untreated. These conditions include but are not limited to:

See Lifestyle Factors and Fatigue Associated with Rheumatoid Arthritis (RA)

Anemia. Many people with rheumatoid arthritis have abnormally low levels of red blood cells, a condition called anemia. People with anemia may experience fatigue along with other symptoms, including but not limited to pale skin, dizziness, or irregular heartbeat.

Heart disease (cardiovascular disease). Those with RA are diagnosed with heart disease, particularly ischemic heart disease, at a higher rate than other people. 1 Arthritis: Rheumatoid Arthritis. Centers for Disease Control and Prevention. Updated November 6, 2014. Viewed December 22, 2014. Ischemic heart disease restricts the blood supply to the heart and other parts of the body, which can lead to fatigue. 2 Diseases and Conditions: Heart Disease: Symptoms. Mayo Clinic. July 29, 2014. Viewed December 22, 2014.

Infection. Fatigue is a common symptom of infection. It is not clear why people with rheumatoid arthritis are more susceptible to infection. Experts theorize that it could be directly relate to the RA activity, or the RA medications, or both.


Depression. There are high rates of depression among people with rheumatoid arthritis. People with depression are more prone to feelings of physical weakness and exhaustion.

Sleep Disorders. Approximately 35% of Americans get less than the recommended 7 to 8 hours of sleep per night, and 48% of Americans report snoring. 3 Insufficient Sleep Is a Public Health Epidemic. Centers for Disease Control and Prevention. Page last updated January 14, 2014. Page viewed January 27, 2015. Moreover, experts estimate sleep apnea affects 17% of adults between ages 30 and 67. 4 Young T, Peppard PE, Taheri S. Excess weight and sleep-disordered breathing. J Appl Physiol. 2005;99(4):1592–1599. [PubMed] Insomnia and other sleep disorders can cause significant amount of fatigue and daytime drowsiness.

See Coping with Chronic Pain and Insomnia


A person who suspects an underlying medical condition should talk to his or her health care provider so in-office screenings and/or recommend additional testing can be performed. For example, a patient who is suspected to have heart disease may be advised to undergo a stress test and electrocardiogram (ECG or EKG). Alternatively, a patient may be advised to undergo a sleep study to help determine if he or she has a sleep disorder.

See Getting the Sleep You Need With Fibromyalgia

Dr. Erich Widemark is a faculty member of the Nurse Practitioner program and the Director of Simulation Education for the University of Phoenix, College of Health Sciences and Nursing. He has held various roles with the University of Phoenix, including Director of Nursing, Lead Faculty Area chair, and Subject Matter Expert for Curriculum Development within the Nurse Practitioner Program.