Dust mite, I'm sorry you're feeling this way. I'm right there with you right now and for the past several months. It's awful. But I have had many periods in the past 9 yrs that were so much better. Still trying to sort out whether this is just flare or advancement, or mild kidney issue or other problems. I'm 63 and leave next week traveling out of state when our daughter gives birth to her 3rd child. She has two boys already, 1.5yrs and 3.5yrs and I honestly do not know how I'm going to manage that level of activity and chaos.
It really is important to report specifics to your rheumy - "fatigue"has a wide range of meaning. So examples of how its impacting your life are relevant and important - especially with kidney involvement. Ask he/she for help.
Good luck and all the best!