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Managing Psoriatic Arthritis and Flu-Like Symptoms

Managing PsA

July 28, 2023

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Photography by Carol Yepes/Getty Images

Photography by Carol Yepes/Getty Images

by Stephanie Orford


Medically Reviewed by:

Nancy Carteron, M.D., FACR


by Stephanie Orford


Medically Reviewed by:

Nancy Carteron, M.D., FACR


Can psoriatic arthritis make you feel like you have the flu? Some symptoms, like fever, can be present in both conditions. Here’s how to tell them apart.

Have you been getting colds and the flu more frequently since you started getting psoriatic arthritis (PsA) flare-ups?

You’re not imagining things. When PsA attacks your own tissues during flares, your body may pay less attention to protecting you from germs than it would in someone without PsA.

Although some people with PsA and other autoimmune conditions may be less susceptible to viral infections due to an overly activated immune system, others are more prone to catching colds and the flu.

The flu can have some of the same symptoms as you might experience in a PsA flare. So you may find yourself asking: Is it a PsA flare, the flu… or both?

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Symptoms and triggers of psoriatic arthritis flare-ups

Psoriatic arthritis can cause flu-like symptoms.

You might get a low grade fever when you’re having a flare. And flare-ups can cause many people to feel fatigued, a symptom that also happens when you have the flu.

You may not experience flu-like symptoms all the time with a flare — they tend to come and go.

The length of a flare-up can really vary with PsA. According to the Arthritis Foundation, a flare in one person can last for just a few days, while in someone else, it might last months.

Many factors can trigger a PsA flare, including stressful events, eating certain foods, or getting a sunburn. And sometimes, the trigger is unknown.

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Symptoms of flu

If you have PsA and you’re experiencing flu-like symptoms, you may be curious whether it’s the flu, a PsA flare-up, or both.

If you have a cough, sore throat, or runny nose, it may be due to a cold or the flu.

Two less common symptoms — eye inflammation and diarrhea — may happen if you have the flu but could be mistaken for symptoms related to PsA.

That’s because the flu virus can sometimes cause some symptoms of inflammatory bowel diseases, like diarrhea.

And if the flu virus gets in contact with your eye, such as by rubbing your eye with a hand you just coughed on, you may develop eye inflammation (conjunctivitis).

See the table below for common symptoms of PsA and the flu, and where they overlap.

SymptomPsoriatic arthritisFlu
body aches
eye inflammation
sore throat
runny or stuffy nose
psoriasis flares on the skin
joint stiffness, swelling, and pain
back and neck stiffness
tenderness in entheses, like at the heel and bottom of the foot
painful “sausage” swelling of a finger or toe
nail pitting or crumbling
nails separating from the nail bed

Why people with psoriatic arthritis may be more prone to getting the flu

When you have an autoimmune condition, including PsA, you can have a higher chance of getting the flu and other illnesses than people without your condition.

That’s because PsA changes the way your immune system works, leaving you more vulnerable to infections. Experts think that, though the immune system is overactive in PsA, it may focus on attacking the body instead of blocking pathogens.

With PsA, you may also take longer to recover and be at greater risk of flu complications, including pneumonia.

On top of that, some medications for treating PsA suppress the immune system. These include corticosteroids, certain DMARDs, and biologics.

That means that you may be less able to fight off invading germs while you’re taking these medications. That’s why doctors sometimes recommend going off your PsA medication for a few days while your body recovers from the flu.

Other DMARDs don’t have the same immune-suppressing effect. These include Plaquenil and sulfasalazine.

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How the flu may affect psoriatic arthritis

When you get the flu, it can affect your body a bit differently than it would typically affect people without PsA.

The infection may last longer, and you have a higher risk of complications, such as:

  • pneumonia
  • bronchitis
  • other respiratory infections

Many potential complications of the flu can affect organs throughout the body, including the heart, lungs, brain, ears, and muscles.

Another way getting the flu may affect you is if your doctor recommends you go off your PsA medication to treat the flu. During that time, even though the flu will probably get better, your PsA symptoms may get worse.

For all these reasons, it’s important to take steps to prevent yourself from catching the flu.

How to avoid getting a cold or the flu

If you have PsA or another type of autoimmune condition, getting an annual flu shot (or nasal spray) is one of the most effective things you can do to prevent getting the flu, according to the Arthritis Foundation.

Experts also recommend getting vaccinated for pneumonia and COVID-19.

Note that an observational study from 2015 found that getting a flu shot was associated with psoriasis flares in some people. However, more research is needed to confirm this.

You may need to go off your medication for a few days after you get vaccinated so that the vaccine can become more effective. You should speak with your doctor if this is true for you.

If you’re concerned about getting vaccinated or want recommendations tailored to your specific needs, speak with your doctor.

Other flu prevention methods include:

  • Wash your hand frequently: Do this especially after being out in public.
  • Exercise: Any form of exercise will help strengthen your immune system and deliver a host of other health benefits.
  • Eat a healthy, well-balanced diet: This includes legumes, whole grains, and lots of fruits and veggies.
  • Consider supplements: Speak with your doctor about supplements that may help you the most, such as fish oil, vitamin D, or a multivitamin.
  • Reduce stress levels: Chronic stress can dampen your immune system and open the door for infections.
  • Sleep well: Getting enough sleep can support immune function and overall well-being.
  • Quit smoking: If you can, quitting or cutting back on smoking will benefit your immune system, energy levels, and overall health.

You can also ask your doctor for your prescription medications to be the lowest dose, if possible.

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What to do if you get the flu

If you think you might have the flu, you should speak with your doctor as soon as possible.

Your doctor may recommend you take an antiviral medication. The earlier you start taking it, the better.

Consult your doctor on whether it’s necessary to stop using your PsA medication for a few days until you recover.

Beyond that, home treatments for the flu include:

  • getting lots of rest and sleep
  • reducing commitments and stress
  • taking over-the-counter pain relief medication, like ibuprofen and acetaminophen

And if you’re experiencing flu-like symptoms of PsA, but not the flu, your treatments are quite similar:

  • get lots of rest and sleep
  • reduce stress when possible
  • take OTC anti-inflammatory medications, like ibuprofen
  • put a warming pack or heating pad on stiff joints


Having flu-like symptoms when you have PsA can be confusing and uncomfortable.

You might wonder which condition is causing your symptoms — and if you have both conditions, how one affects the other.

They can both share common symptoms, including fatigue and fever. They may even share a few less common symptoms, like inflamed eyes and diarrhea. But PsA typically doesn’t cause sore throat, coughing, or a runny nose.

When you have PsA, you’re also at greater risk of complications from the flu, so taking steps to prevent coming down with the flu is a good idea. In particular, experts recommend people with PsA get an annual flu shot.

Medically reviewed on July 28, 2023

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