Starting a new game I was struck by the huge penalty I got from Realistic Fatigue (perhaps in conjunction with Realistic Leveling as I'm using it as well) during the tutorial dungeon, before having the char set. Basically, my char could only walk, fight one enemy at a time etc., otherwise she would be close to collapse or collapsing. Anyway, it was a bit over the top but I liked the additional difficulty/enforced strategy. The problem is that if I edit the Realistic Fatigue ini to make it more "hard core", it will affect all actors globally - and I don't want that. So I wonder if Realistic Fatigue can be combined with, say, Vim and Vigor Advanced to make fatigue matter even more for the PC? Or is there some other mod that works fine combined with RF?

I have never used V&VA, so I cannot comment on that, but I have another suggestion.

I LOVE Realistic Fatigue, this is one of the mods I think is absolutely necessary in my load order - but I have never upgraded past version 1.13. The reason for this is that until 1.13, the fatigue effects only affected the player, not other actors, and I don't want other actors (who don't have any idea of saving their fatigue) to be affected. 2.x is of course better in many ways, but I'm very happy with 1.13, and also completely avoids the problem with enemies stumbling and collapsing too easily.

I see your point and have in fact tweaked down some effects in Realistic Fatigue to deal with "asthmatic" enemies. This has the upside of having RF affecting NPC's, which I really like - together with the wounding system in MMM it makes for "more realistic" and varied fights. The downside is of course that the PC also has this "light" version of RF. So ideally I'd like to have separate ini settings for the PC and NPC's/creatures I'd guess. Meanwhile, I'll experiment around a bit with different combinations and see how it goes.

EDIT: Checking the V&V readme it seems to be obviously incompatible with Realistic Fatigue as it changes the fatigue system in a completely different way. I wonder if one could use Realistic Fatigue and Fatigue Effects together as the latter lets you configure fatigue settings in its ini?