Neither my father nor I (he has PMR; I have a different inflammatory arthritis) has tried this long term. His PCP prescribed B vitamins at one point for fatigue before PMR diagnosis and it had no effect.

I took electrolyte supplements (for a medical reason) that happened to have excessive amounts of B vitamins and it ended up causing neuropathy because of the extreme amount of B6. It’s a common side effect, so just something to be aware of.

One of my father’s main PMR symptoms is fatigue, which could be a symptom of adrenal fatigue but it’s hard to pick it apart, and he takes LDN (low dose naltrexone) for fatigue, as do I and it’s very effective with very few if any side effects. I’ve thought about bringing it up in this space but worried about opening up a potential can of worms since it flies very much under the radar.

It’s a micro dose of naltrexone, prescribed off label from a compounding pharmacy for various chronic pain and inflammatory conditions. At such low doses it’s being researched for and is thought to increase endorphins and modulate glial cells (which when overactive are believed to cause chronic pain).

It’s been used for fibromyalgia, chronic fatigue and central sensitivity for years and now is becoming more well-known because people are trying it (including at Mayo) for long COVID.

I don’t want to make it sound like a magic pill or anything but it has been helpful, it’s safe and has very few side effects. It just can be difficult to obtain because many physicians aren’t aware of it or aren’t comfortable with compounding pharmacies, and it requires a prescription.