Feeling tired after physical exertion, a busy day, or a night of too little sleep is normal. Having fatigue, however, is different from simply being tired. Fatigue is a constant, overwhelming exhaustion that doesn’t improve with rest. It can affect both your body and mind. Many people with psoriasis and psoriatic arthritis experience fatigue as a symptom.

Along with other psoriasis symptoms, extreme tiredness can take a toll on your well-being and daily life. Understanding how low energy affects your physical and emotional state can help you manage it and minimize its effects. Here’s what you need to know about fatigue in psoriasis, including how to manage it.

Fatigue Affects Quality of Life for People With Psoriasis

Feeling constantly worn out is common for people with psoriasis. For many, it’s one of the most troubling symptoms of psoriasis, as well as other long-term diseases.

Everyone experiences fatigue differently. Psoriasis-related fatigue can range from mild to extreme and debilitating. Most people with fatigue find that it affects their daily lives. One MyPsoriasisTeam member wrote that fatigue is their “worst symptom.” Another member shared, “This disease can make you exhausted. It’s more than just tired — sometimes, the fatigue can be so great it feels like your last day on earth.”

This exhaustion can drain the energy you need to manage daily tasks and responsibilities. As one member wrote, “The fatigue and pain are draining what little energy I had.” Another member explained that their spouse “gets so sleepy driving to work (an eight-minute drive) that he will doze off at his daily office meeting.”

Other members have shared how they feel when their fatigue is most extreme. “I get to the shutdown point,” one member wrote, “and I tell my family I have got to go. I have to rest!”

“The fatigue is the worst when it hits hard,” another member wrote. “I have fallen asleep at the table before. It’s like my body just says, ‘Stop now!’”

Some members find it challenging to determine what’s contributing to their low energy levels. As one wrote, “I have been feeling kinda low energy or a little fatigued. I am not sure if this is a psoriasis issue or an age issue. Maybe the expectations I have for myself are unrealistic. It could be a combination of factors.”

Fatigue in Psoriasis Can Have Many Causes

Psoriasis is an autoimmune disease — a condition where the immune system mistakenly targets healthy skin cells. This leads to inflammation of the skin.

Fatigue in psoriatic disease is triggered through two inflammatory pathways. Inflammatory cytokines — proteins made by the immune system — cause direct inflammation. Stress, mood, and other health factors create inflammation as well. These inflammatory processes can use up much of the body’s energy. Certain psoriasis medications and complications can also cause low stamina.

Medications for Psoriasis

Medications that work by changing how the immune system responds, such as those used to treat psoriasis, can cause tiredness and fatigue. These drugs include methotrexate for psoriasis (sold as Otrexup, Rasuvo, and Trexall) and cyclosporine. Other medications, such as antidepressants and those for anxiety and pain, may cause extreme tiredness in some people with psoriasis.

Biologic treatments — medicines made from living cells — can also lead to feeling rundown. One Dutch study found that around 8 percent of people with immune-mediated inflammatory disease taking biologics experienced fatigue. Fatigue was the most common side effect of infliximab (Remicade), rituximab, and vedolizumab. On the other hand, people who took etanercept (Enbrel) reported fatigue less often than other adverse reactions.

Depression

Depression and other mental health conditions are major factors in low energy for people with chronic inflammatory diseases like psoriasis. Depression and psoriasis can make each other worse. This can lead to a vicious cycle of more symptoms, such as fatigue, becoming more severe.

Low energy and depression in psoriasis may share the same root cause — chronic inflammation driven by the immune system. Both symptoms are associated with inflammatory cytokines. These proteins worsen symptoms of inflammatory diseases. Specific cytokines such as interleukin-1 (IL-1) and tumor necrosis factor-alpha (TNF-alpha) are thought to play a role in sleep.

Painsomnia

Poor sleep quality is common in people living with psoriasis. Nearly 90 percent of people diagnosed with psoriatic disease have trouble sleeping. In many cases, this difficulty is due to “painsomnia” — insomnia (difficulty sleeping) caused by long-term pain or discomfort. Itching, burning, and soreness can interrupt sleep and lower overall sleep quality, leaving you feeling more tired during the day.

Not getting a good night’s sleep can make you feel fatigued. Research has suggested that losing sleep can make psoriasis worse. This is an unfortunate cycle where discomfort from psoriatic symptoms makes it difficult to fall asleep. Poor-quality sleep worsens stress levels and quality of life. Extreme stress then worsens the inflammatory skin condition, disrupting sleep even more.

There may also be a link between psoriasis and obstructive sleep apnea (OSA). In OSA, a person’s airways become blocked while they sleep. Although the link is not clear, you should discuss any potential symptoms of sleep apnea you experience — such as snoring or waking up frequently during the night — with your doctor.

Iron-Deficiency Anemia

Iron is a mineral that our bodies need but can’t make on their own. Humans get iron through a wide range of plant- and animal-based foods. Iron-deficiency anemia occurs when the blood lacks enough healthy red blood cells. Without iron, the body produces too little hemoglobin (a protein) within red blood cells. Hemoglobin is responsible for carrying oxygen throughout the body.

People with psoriasis may be more likely to develop iron deficiency. Extreme tiredness, weakness, and a feeling of lightheadedness are a few common symptoms of iron deficiency. This condition can be diagnosed by a simple blood test.

Other Health Conditions

Living with other health conditions — including psoriatic arthritis, fibromyalgia, or chronic fatigue syndrome — can affect your sleep quality and contribute to fatigue.

6 Strategies for Managing Fatigue With Psoriasis

If fatigue is interfering with your daily activities, talk to your dermatologist or healthcare provider. Your doctor may need to run tests to figure out if another issue is causing your fatigue. After determining the cause, your doctor may recommend certain changes to help get your fatigue under control. These may include adjusting your psoriasis treatment plan or making lifestyle changes. Talk with a healthcare professional before trying any new therapies.

1. Talk to Your Doctor About Medications

If your doctor thinks your fatigue is caused by psoriasis medication, they may recommend changing your treatment. Let your doctor know if you notice any changes in your fatigue levels after changing medications, adjusting your dosage, or starting a new psoriasis treatment. Work with your doctor to find a medication or treatment option that keeps your psoriasis under control while reducing exhaustion.

2. Get Active

Although fatigue may make physical activity seem impossible, getting regular exercise can boost your energy levels. A 15-minute walk can have a positive impact on your energy levels. The most important thing is to stick to it — rather than aiming for intense physical activity, start slowly and work toward building a consistent exercise routine. Exercise can help you maintain a healthy weight, which may help lower inflammation.

3. Modify Your Diet

Eating a balanced diet may help keep fatigue at bay. Try to avoid fatty foods as much as you can. For a healthy psoriasis-friendly diet, opt for lean protein, whole grains, and fresh fruits and vegetables. Some foods — like tomatoes, olive oil, leafy green vegetables, almonds, salmon, and strawberries — have anti-inflammatory properties.

Eating fresh, homemade food instead of prepackaged food is also a healthier option. Try not to eat late at night, especially foods that are particularly heavy or rich.

If dietary issues are contributing to your fatigue, your doctor may refer you to a licensed dietitian. This specialist can create a diet plan with the right nutrients for your needs.

4. Ask About Dietary Supplements

Your doctor may recommend taking dietary supplements, like vitamin D, B vitamins, minerals, or multivitamins, to help manage fatigue. Some people with psoriasis have said that omega-3 fish oil supplements help them with severe fatigue.

5. Let Yourself Rest

Allow yourself to rest and take breaks when you’re feeling fatigued. It may be helpful to spread out your daily chores and activities with planned rests in between.

One MyPsoriasisTeam member shared how they handle life when fatigue hits: “When I’m fatigued, I try to keep my daily routine but just go through the motions and get the basics done. I still go to Pilates but put very little effort in.”

6. Keep a Fatigue Diary

Keeping a fatigue diary can help you identify what factors or situations may be contributing to your fatigue. In this journal, you can record the days and times when you’re fatigued and how long the fatigue lasts. Also, record what you were doing at the time, how you slept, if you worked or exercised, what you ate and drank, and if you had a psoriasis flare-up.

These notes can help you and your doctor find patterns in your fatigue and figure out how to prevent it.

The Bottom Line

The good news is that there are many steps you can take to help manage and reduce fatigue related to psoriasis and psoriatic arthritis. As always, check with your doctor before starting a new exercise program, making changes to your diet, or adding supplements.

Find Your Team

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, more than 134,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Have you experienced fatigue with psoriasis? How have you managed it? Share your experiences in the comments below, or start a conversation by posting on your Activities page.