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Rheumatoid arthritis involves autoimmune-driven inflammation that affects the whole body, not just the joints. Early systemic signs come from this widespread inflammatory state, with fatigue being the most common. Cytokines such as IL-6, TNF-alpha, and IL-1 disrupt energy metabolism and sleep and contribute to the anemia of chronic disease, all of which make a person feel unusually tired even before joint symptoms are dramatic. Increased appetite isn’t typical in RA and can even be reduced with inflammation. High blood pressure and visual disturbances aren’t characteristic early signs of RA itself; they may occur with other conditions or complications but don’t reflect the usual initial systemic involvement. So fatigue best fits as the early systemic sign accompanying joint inflammation in RA.