i agree totally. i've been trying to attack this from all angles and since i do feel better between flares than i used to at least some of it must be doing something.

my TSH was a bit elevated. found an endocrinologist who said, "can't fix your problems as they are rheumatological, but can help you feel better by adjusting endocrine things. if one has an endocrine problem, kinda makes whatever our other problems are worse."

i've been on the synthroid the last few years. didn't notice anything when i went on it. but since my TSH and other values are now within normal, i figure it must be helping somehow.

I am in the same boat. I have been tested for almost everything. I asked for and got a blood draw for testosterone today, will find out results in about 5 days.I am tired all the time, but not really sleepy. I have constant AS, one long never ending episode of pain and being tired, not interested in most things anymore exept finding a way to feel better. I Like you am searching for answers. I fear that if I dont find anything soon I will be forced to apply for SS which is not something I would want to do due to the change of lifestyle I would have to have with a reduced income. Keep asking, maybe someday we will find help.

here are a few ideas, though for me its simply the inflammatory arthritis talking:

• vitamin B12 (mine was actually high, due most likely to my fatty liver disease)
• iron / anemia
• vitamin D (mine was borderline low (30) so i'm on D)
• candida
• thyroid (my TSH was high, so i'm on synthroid)
• sleep apnea
• hormones (testosterone, estrogen, progesterone)
• cortisol (mine is on the low side so we've talked about the adrenal gland)
• DHEA (mine is on the low side so we've talked about the adrenal gland)
• blood sugar (i'm prediabetic / insulin resistant, thus a low sugar, low starch diet does wonders, as does aerobic exercise especially after eating)
• food sensitivities / allergies
• allergies in general

Sue covered all my issues.
The realization that what I was eating was affecting me did not set well. But I now recognize that my highs and lows can be addressed by exercise and self control.
Let us know what you find to be true.
Sleep has never solved my problem of being exhausted.
But my mind sure likes the rest.

a pred taper last week took care of all my energy concerns

it was nice to have a week of boundless energy and happiness!

yes, not a long term solution. but if a 6 day pred taper were to help you with your energy levels as much as it helped me, that would be a piece of data to help figure out the potential cause.

Chronic inflammation is associated with abnormal autonomic functioning - usually in AS there is disfunctional parasympathetic activity. Loss of autonomic balance is implicated in disease-related fatigue at least in other inflammatory conditions.