Suggestions for reducing fatigue

Even when I'm not in a flare, I deal with significant fatigue that I control in part by taking Nuvigil (I've been taking it daily for 2.5 years now). Last year when I came out of a long flare, I was able to start drinking coffee again, which was awesome because I *love* coffee and had to stop drinking it in 2006 when I first was diagnosed. I also drink a lot of tea (several cups a day of black tea), but I never drink soda. So I probably have a pretty high caffeine consumption.

I've been sliding into a flare since August and my fatigue is much worse. If I don't take the Nuvigil, I can't function. But even with it, most days it's a struggle. I work a demanding job (uni faculty) and am finding myself really struggling. Currently, I probably have 2-3 cups of tea and day and 1-2 cups of coffee a day (often decaf). I can't really exercise beyond walking because even low exertion has become a migraine trigger. I'm not sure what else to do to get more energy, but I don't want to increase my caffeine consumption that much.

Note that I had my bloodwork done 10 days ago and none of my markers/vitamin levels are off except CRP, which will hopefully be addressed once I can start Entyvio.

Anyone have suggestions for other things to try?

Naps. ;)

Sorry, just being a bit cheeky.

Thanks all. I realize I answered a somewhat impossible-to-answer question that if any of us knew the answer to, we'd be rich. Part of this is that my flare has been getting worse so the fatigue is just one of many layers of my feeling unwell.

To answer your questions:

lamb: my GI ran bloodwork when I saw her two weeks ago but I haven't seen her since. Since August, my B12 went from 634 to 382 pg/mL; my Vitamin D went from 50 to 34; and my hemoglobin (closest I have to iron in these tests) stayed steady around 13g/mL. So there have been pretty significant decreases in two fatigue-related levels, although both are still in the "normal" range.

scifigal: naps are awesome. I have a futon in my office that I nap on whenever possible.

NCOT: I agree this is somewhat unavoidable in my situation. I've already cut back hours (most other faculty tend to work 55-65 hours/week; I'm working 40-45 now). I've had sleep problems for 20 years, had a sleep study done two years ago in 2015 and the only abnormality was I spent a very small amount of time in REM (8%). I took Trazadone for many years before trying a number of other things; last summer/fall, I stopped with prescription meds and just take melatonin. Based on my fitness tracker, my sleep quality is horrible (I take that with a grain of salt). Based on how I feel when I wake up, my sleep quality is not great, but it's not worse than it was before.

seems like i recall that fatigue was one of the more common side effects of botox - could be wrong tho -