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Fatigue with 6MP?

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Ulcerative Colitis
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Posted 4/4/2013 4:32 PM (GMT 0)
I've been taking 6MP (50 mg/day) for about a month and a half. My doctor had me start taking it as a way to boost the effectiveness of Remicade, which I started a couple of weeks later. He also explained that 6MP takes between 8 and 12 weeks to work, and that I might start experiencing some of the side effects before I got the benefits. That warning was with regards to the nausea I was dealing with, which has gone away since I started Remicade (and was much more likely a symptom of UC, not a side effect of 6MP).

However, over the past couple of weeks, I've noticed that even if I sleep 10-12 hours a night, I'm still tired, and I'll feel sleepy somewhat earlier in the evening than expected. For example, if I sleep from midnight until 11am, by 10pm, I'm ready to fall asleep. Given that I'm in a PhD program, I can't devote that much time to sleep, especially since I still feel tired afterwards!

Today, I've noticed a more physical fatigue. Not only am I sleepy, but I also feel like my whole body is tired from some sort of physical activity. My legs feel wobbly even when I just go to the bathroom and then lie back down on the couch!

Has anyone had this sort of experience with 6MP? I'm improving, but not in remission, with Remicade, 4.8g/day Asacol, and the 6MP, but I'm worried that my doctor will want me to stay on 6MP, even though I'm pretty sure it's the Remi that's been working (given that I improved immediately after my first infusion, when the 6MP hadn't kicked in yet).

And does anyone have advice for how to manage this fatigue?
Posted 4/4/2013 4:58 PM (GMT 0)
I think fatigue is common while on 6mp. I was fatigued before starting 6mp so I can't say whether the 6mp has contributed to my fatigue, it doesn't seem like I am any worse than I was before 6mp. I am tired all the time, it's exhausting.
Posted 4/4/2013 5:03 PM (GMT 0)
I'm on 6mp and I have not noticed any out of the ordinary fatigue. Uc in general can certainly cause fatigue depending on how good or bad it currently is (I remember lots of fatigue early in this flare before I got on either pred or 6mp). ScienceGirl, what are your current symptoms?
Posted 4/4/2013 5:21 PM (GMT 0)
Before 6MP/Remi: 10-15+ BMs a day, liquid stool with blood and mucous, extreme pain, urgency and cramping. Nausea, no appetite, fatigue.

Since first Remi infusion (but before last week): 4-6 BMs a day, soft or solid stool, no liquid stool, mucous or blood. Urgency is still there, but less severe or frequent. Nausea is gone, appetite is mostly back, although I'm sticking to mostly low-residue/roughage diet.

Now: Same, but with fatigue worsening.

I know that fatigue tends to be more noticeable (at least for me) as I move from "still symptomatic" to "near remission," but it's usually not this pronounced, nor does it come so long after my other symptoms improve.

I'm not convinced that this is the 6MP, but since I didn't improve after my second infusion, my doctor wants to consider upping my 6MP dosage. If this is what's causing the fatigue, I'd rather not!
Posted 4/4/2013 8:11 PM (GMT 0)
I started on the 6mp about 9 weeks ago when I was suffering from bad flareup symptoms. I was even hospitalised one month afterwards with a terrible re-occurrence of symptoms (I had a massive CRP of 189). Fatigue was a big problem - sleeping at least 10 hours a day, etc, but whether it was caused by the UC or the 6mp, I am not sure. The last few weeks I have been feeling a lot better and my blood work is a lot better. Maybe the 6mp is finally kicking in. I would think about staying on 6mp for the 8-12 weeks to see how you feel if you can stand it. A problem with increasing the 6mp is that you are already on a high Asacol dose which is not always compatible - there are other posts about this problem.
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