Here was an interesting comment from someone on another message board. Unfortunately no links to studies so not sure how valid any of this is "Our best understanding is that autoimmune fatigue occurs as a somewhat separate process to inflammatory activity. It may even be the residual result of inflammatory damage, rather than an ongoing process, and consequently only symptomatically treated (ie - with dopamine agonists and stimulants ) Even biologics make only a slight difference to fatigue levels, that is most likely explained by better sleep and rest due to symptomatic relief."