Extremely tired before PMR diagnosis

Hi @maryjanecowell - I think there is a correlation with fatigue prior to PMR showing up. Here's an older research paper on the topic.
-- Fatigue as a precursor to polymyalgia rheumatica: an explorative retrospective cohort study
https://pubmed.ncbi.nlm.nih.gov/25366389/
There are actually quite a few discussions on fatigue and PMR if you want to scan through them and learn what others have shared - https://connect.mayoclinic.org/search/.

@johnbishop thank you for this research. Doctors first wanted to explore heart problems and do a sleep study that both proved not to be the cause of the fatigue. I appreciate their efforts but now I want to just concentrate on the PMR. No distractors now. Thanks.

Fatigue during infection or inflammation is largely driven by the immune system. Immune cells release signaling molecules (cytokines like IL-1, IL-6, and TNF-α) that act on the brain and trigger "sickness behavior": tiredness, low motivation, reduced appetite, and a desire to rest.

Thanks for posting your question. I was diagnosed with PMR on July 31, 2026. But starting in mid June I noticed being fatigued after activities. My rheumatologist says fatigue isn’t generally an issue for her PMR patients. But, your post resulted in others posting studies suggesting fatigue may well be an early symptom of PMR. I find the knowledge helpful because, although I’m pain free due to prednisone, I remain fatigued and it’s been worrying me.

I am very fatigued since diagnoses in March 2026. I can only do half or less of what I used to do. Surprised that the rheumatologist says fatigue isn't generally an issue. I read a lot from others about this on Facebook support groups who complain about fatigue. Good luck with managing your symptoms.

Absolutely -- so much good information here. I thought I had covid because that's the only time I'd felt that tired with muscle pain. I didn't go to doctor until I could not lift my arms (granted, that made diagnosis easier because the sx were super clear)

@queenmlb my rheumatologist said fatigue is common, but I suspect people complain about the pain a lot more, so maybe fatigue gets lost in the mix of inflammation sx.

I have always wanted to ask my rheumatologist exactly how many pmr patients he sees but thinking he may perceive my question as insulting, I don't ask. This disease/condition, whatever it is, can take so many different paths and day to day you experience different and varying degrees of 'symptoms'. Dr appointments are so spaced out and explaining/discussing months of symptoms/problems you've had in an at most a 20 or 30 minute appointment can be frustrating not only for you but also the Dr. In my Dr notes, he always makes a point of stating that I have returned with questions. I have become the pmr question queen. How am I different from his other pmr patients? Probably a lot different.
How do you treat pmr fatigue? Is it from poor sleep, lack of sleep, depression, lack of motivation, inadequate diet, or some unexplainable phenomenon?

If my experience is indicative, fatigue might indeed mark the earliest stages of PMR.

While on a vacation trip to Hawaii with family, one January, I became overwhelmed by fatigue and spent most of each day in bed sleeping and resting while the family were at the beach. By February I felt acute pain in my hips and shoulders and had trouble putting on a shirt. In March/April I was diagnosed with PMR. I had never thought that the extraordinary fatigue I experienced in January might have been a precursor to PMR but now it seems possible, if not likely. Thank you for your excellent question.

@pmrsuzie
It's probably a perfect storm of all you mentioned. PMR impacts all facets of life.