How To Treat It
If youre experiencing fatigue, make an appointment with your doctor to discuss possible treatment options. A doctor will likely want to run some tests to find out more about what may be causing your fatigue.
Based on the results of these tests, your doctor may prescribe medications or recommend counseling, physical therapy, and occupational therapy.
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Tip : Examine Medications
There are medicines that are used very frequently in MS for bladder dysfunction, for mood, for pain which make you super tired, Boster said. So if youre trying to live your best life and not be exhausted, look at your medicines and ask the doctors which ones are contributing to fatigue and which can be removed or cut in half.
In addition, physicians might be able to prescribe medications to help boost energy levels, which can work well in conjunction with lifestyle changes.
Axonal Loss And Altered Cerebral Activation
As conventional measures of T2 lesion volume and atrophy have fallen short in providing a basis for fatigue in MS,20 many investigators have relied on non-conventional neuroimaging techniques to shed further insight. The demonstration on positron emission tomography of decreased regional glucose metabolism in the frontal cortex and basal ganglia of fatigued MS patients has suggested that neuronal dysfunction in these regions may play a role.21 Magnetic resonance spectroscopy studies have shown significant reductions in N-acetylaspartate/creatine ratios in multiple brain regions among fatigued MS patients in comparison to non-fatigued MS patients, suggesting axonal loss as a contributing factor.22,23 MS-related fatigue also may arise at least in part from compensatory reorganization and increased brain recruitment, as functional MRI studies that have demonstrated increased volumes and patterns of activation in the cingulate gyri and left primary sensory cortex in fatigued MS patients compared to non-fatigued patients.24
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The Modified Fatigue Impact Scale
The Modified Fatigue Impact Scale, proposed by the Multiple Sclerosis Council for Clinical Practice Guidelines, has gained recognition among MS specialists as a reliable tool. Originally derived from the 40-item Fatigue Impact Scale ,59 the MFIS contains only 21 items and offers a more multidimensional assessment: physical , cognitive , and psychosocial functioning . The total score is the sum of the 21 items. An abbreviated version that contains 5 items also exists. Besides its multidimensional features, other advantages of the MFIS include ease of use, good reproducibility, and strong correlation with FSS results .51
Tip : Conserve Your Energy
Energy conservation isnt just important for the environment. Its also a key principle for those with MS.
Whats your best time of day to get things done ?
If you notice that you feel less fatigue in the morning, take advantage of your extra energy to complete tasks such as shopping and cleaning. You can then conserve your energy later when you feel more fatigued, knowing youve already accomplished key tasks for the day.
People with MS may be especially sensitive to heat. As a result, they may experience more fatigue when they become overheated or are in a warmer environment. Try these techniques to cool down:
- Use air conditioning as needed, especially in the summer months.
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Recognize And Manage Depression
Depression can be a major problem in MS. And depression often contributes to fatigue. Symptoms include changes in appetite or sleep, irritability, and a feeling of hopelessness or guilt.
Make sure to discuss your depression with your healthcare provider because it is treatable. Counseling and medication can help your depression and may alleviate your depression-induced fatigue as well.
Fatigue Cause No : Sleep Apnea
Some people think theyre sleeping enough, but sleep apnea gets in the way. It briefly stops your breathing throughout the night. Each interruption wakes you for a moment, but you may not be aware of it. The result: youâre sleep-deprived despite spending eight hours in bed. Your doctor may order a sleep study to check for this.
Fix: Lose weight if youre overweight, quit smoking, and you may need a CPAP device to help keep your airway passages open while you sleep.
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What Is Chronic Fatigue
Chronic Fatigue is the constant feeling of weariness or overwhelming tiredness that doesnt seem to improve or change regardless of the amount of rest or sleep received. Patients may receive an adequate amount of sleep each night and still feel fatigued during the day.
Fatigue affects people physically, mentally and emotionally. When people experience fatigue they feel as though their energy has been depleted and they dont have the strength to perform daily activities.
Fatigue may come and go or worsen during certain times. The onset of the fatigue may be unpredictable and occur without warning signs or symptoms. Fatigue may not be preceded by physical activity or exertion, and it may occur in between or during flare-up episodes of RA.
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Make Sure To Get Good Sleep
Practicing good sleep habits like keeping to regular bedtimes and cooling down your bedroom can help with sleep problems. Alcohol, caffeine, and some foods might interfere with your sleep. Avoid these and any other triggers that can interfere with your sleep.1
For MS symptoms that make it hard to sleep, like urinary problems or spasticity, ask your doctor what to do.1
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Ms Subtype And Disability
MS subtype and disease severity can affect the risk of fatigue. The Expanded Disability Status Score correlates with fatigue scores,48,50,51 though less strongly, perhaps, after adjusting for depression.51,52 A review of The New York State Multiple Sclerosis Consortium Database showed that fatigue consistently correlated with Expanded Disability Status Score.47 Fatigue appears to be more severe in patients with progressive subtypes of MS,3,49 but this observation may in part be confounded by differences in disability levels.49
How To Get Started
Donât worry if youâre out of shape, stiff, or struggle with balance. A physical therapist can design a routine that suits your needs and your fitness level. Itâs also important to find exercises you enjoy and will stick with. Maybe you like to work out by yourself. Exercise is a form of meditation for some people. Or you might do better with group workouts or team sports. Once you figure out what you love, you can make exercise part of your everyday life.
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Finding Help And Taking Help That’s Offered
People might say to you ‘If theres anything you need…’ or ‘If there’s anything I can do…’, but it is not always easy to ask for help, even when it is offered.
It can be useful to prepare a list of tasks that youd like help with. That way, if someone does offer to help, you can easily tell them how they could help.
If you find it hard to take, or ask for help, our fatigue management course could help you!
Work Closely With Your Ms Healthcare Providers
Make and keep regular appointments with your doctor to assess whether your disease is under the best control possible and youre receiving optimal MS treatment.
In many cases, when MS is well-controlled, it can help in terms of fatigue levels, says Devon Conway, MD, a neurologist at Cleveland Clinic’s Mellen Center for Multiple Sclerosis Treatment and Research in Ohio.
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Factors That Contribute To Your Fatigue
The fatigue thats unique to MS is called lassitude.
80 percent of people with MS experience this overpowering feeling of tiredness in body and mind.
We dont know the exact cause of lassitude, but we have identified many factors that can add to your feeling of fatigue.
- Insufficient sleep, which can be related to other MS symptoms like bladder urgency, muscle spasms, or pain. You might also be getting too much screen time before bed, or facing an underlying sleep problem like sleep apnea or restless leg syndrome.
- Depression or anxiety, which are common in people with MS. These mental health challenges can be draining for anyone, but they may lead to a vicious cycle for someone with MS. Your depression leads to feelings of fatigue, which amplifies your feelings of depression, and so on.
- Muscle stiffness or weakness, which requires you to use extra energy to move around.
- Certain medications taken for MS or other conditions
- Heat exposure, such as sitting outside on a warm day.
Once youve begun to manage all the issues that contribute to your tiredness, you can tackle MS fatigue.
With the help of your healthcare team, you can identify which factors contribute to your fatigue, and what tools and strategies can be of aid. You can also use the 4 Ps to make daily activities easier and less draining. Well explore both approaches below.
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Any Kind Of Exercise Could Help
It seems to go against common sense to exert yourself if you experience fatigue. But there is strong evidence that exercise helps keep your body working at its best and can improve strength, fitness and mood.
Its possible to do too much exercise, so balance the exercise with rest. And keep cool while you exercise, especially if heat makes your fatigue worse.
You might want to plan your exercise and avoid long sessions to prevent overheating. Some people find water-based exercise helpful for maintaining a steady temperature.
Cooling vests may also help. A physiotherapist can help you devise a suitable exercise programme.
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Eat Little And Often Throughout The Day
Eating small meals and snacks can help to keep your energy up.
Experts recommend four to six small meals a day, which includes healthy snacks, to help keep your blood glucose steady.
Protein shakes, protein bars, or a handful of unsalted nuts make great snacking options, and are ideal before doing any exercise too.
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Are We Making The Right Choices In Foods To Fight Fatigue
The moment we feel low on energy or tired, we turn to caffeinated drinks or energy bars to perk up ourselves. A cup of coffee, a can of energy drink, a granola bar or some sugary snack looks so appealing when we are tired. But do these choices help? Doctors and nutritionists believe that they may provide initial energy high but soon the levels plummet, and we end up feeling more tired than before.
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Begin Your Day With A Good Breakfast
A good breakfast can help improve concentration, strength, and endurance, but what is good?
Eng advises, Look for foods that contain at least three grams of fiber per serving. Those might include oatmeal, whole-grain breads or pancakes, high-fiber breakfast cereals, and grains such as brown rice or quinoa. Add some fruit or vegetables for more nutrients and fiber.
Include some protein from foods such as eggs, low-fat dairy products, soy milk, seeds and nuts or nut butters and a small amount of healthy fats in your meal, too, to feel satiated longer.
Do A Mental Health Check
Check in with yourself to establish what mental patterns may be causing low energy levels. Anxiety symptoms include feeling worried, irritable, and nervous. Symptoms of depression include feeling sad, restless, and hopeless. Both conditions can lead to unhealthy sleep patterns and cause tiredness.
Consider seeing a therapist for talk therapy, known as cognitive behavioral therapy . This method helps you to get to the root cause of emotional issues so that they can be addressed and overcome.
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Changing The Way I Move Around The House To Save Energy
I know that tasks drain me faster than they do most people, so I do my best to plan around that. I conserve and utilize my energy in the most efficient ways I can. What does that mean? Well, for me, a lot of this means planning my day better. For example, simply changing the way I do things around the house. If I need to use the bathroom and will be passing through the kitchen, I give some thought as to what I might soon need from the kitchen, so I dont have to make another trip back through there. Maybe that means refilling my drink sooner than I planned so that it coincides with my trip to the bathroom. It may seem silly, but small changes like that add up. Essentially, I try to make the most of my movements. I discuss this train of thought more in MS, Ergonomics, and the Economy of Movement.
Tips To Conserve Energy
Use Adaptive Aids.Reachers, dressing aids, and other adaptive equipment can significantly help conserve energy when dressing, bathing, and performing other household and personal activities. Many of these items may be obtained through MSAAs Equipment Distribution Program . Please visit mymsaa.org or call 532-7667 for more information.
Shop from Home.Rather than using valuable energy walking around stores, use catalogs or order items online. In addition to avoiding the crowds and exhaustion from walking through stores or malls, ordering clothes allows you to try them on at your leisure when your energy level is highest. Many grocery stores also offer online ordering with either free delivery or a minimal charge for delivery.
Take Fewer Steps.Try to take care of as many things as possible in one room to eliminate extra trips.
Consider Telecommuting.A great way to conserve energy is to reduce the amount of time spent traveling to and from work. Ask your employer about working part of the week from home.
Dont Get Overheated.This can cause fatigue. Wear your cooling vest or other cooling apparel and try to go outside either early in the morning or later in the evening, when temperatures are at their coolest.
The following medications, among others, are prescribed for depression. These have been found to help lessen fatigue in certain individuals. Antidepressants may need to be taken for several weeks before seeing an effect.
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The Top Herbs And Supplements For Ms
The following list doesnt cover every available herbal or supplementary option for treating the symptoms of MS. Instead, the list offers a brief summary of the important information about each of the most common herbs and supplements that people with MS use.
Although some research into how ashwagandha can protect the brain has been promising, its not been studied well enough to know whether it can effectively treat multiple sclerosis or its symptoms.
A Word About Locally Grown Fresh Versus Canned Or Frozen Vegetables:
Eating seasonal and locally grown produce is a wonderful and beneficial goal. It is good for our health, good for your local economy and it supports local farmers which is always a good idea. BUT what if you dont have access to these resources?. If you would still like to have farmers market fresh local produce but lack the energy to add another stop to your shopping list consider a CSA. They vary in their offerings but some farmers make deliveries to your doorstop.
If frozen or canned vegetables are what you have access to or can reliably obtain, rest easy. They are often just as nutritious as the fresh. Processes like flash freezing ensure that nutrients are preserved. Canned vegetables are going to be higher in sodium due to the canning process and so should be rinsed well before cooking. The important thing is that you are eating more vegetables! Read some more about fresh versus frozen or canned vegetables here.
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Is Food A Part Of The Problem
A recent study compared the dietary intake of antioxidants and anti-inflammatory nutrients in individuals with MS compared to healthy control population. The results of the study, which used food frequency questionnaires to obtain information about dietary intake, revealed that study participants with MS were consuming diets deficient in Folate, Vitamin E, Magnesium, Lutein-Zeaxanthin and Quercitin. In other words, MS participants were not eating adequate amounts of these beneficial nutrients. The results of the study are to be presented at the American Academy of Neurologys 67th Annual Meeting in Washington, DC, April 2015.
Symptoms Of Multiple Sclerosis
There are many symptoms of multiple sclerosis. Symptoms tend to become more severe as the disease progresses.
Common symptoms of MS include:
- vision problems
- balance and coordination problems
- a variety of sensations in the limbs, such as prickling, tingling, or numbness
Certain treatments can be very effective in alleviating and even avoiding the unpleasant symptoms of MS. Before using any herbs, supplements, or alternative or complementary therapies to treat MS, discuss the benefits and risks with a healthcare provider.
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Eliminating Other Causes Of Fatigue
Try to remember that the first real step for fighting MS-related fatigue is to eliminate other sources of fatigue, so you’re dealing with just one enemy at a time. Most of these tips, or areas to look at, are small ways to help you can help yourself out when it comes to fatigue.
Do you have some fatigue-fighting tips? Let us know in the comments below!
Thanks so much for reading and always feel free to share!
Devin
How Is Ms Fatigue Different To Ordinary Fatigue
MS fatigue is more than the tiredness that everybody feels after exertion or missing a good nights sleep. This type of tiredness can still affect you, but MS fatigue goes beyond that.
MS fatigue can be physical and mental it saps energy in an instant and can stop you from completing tasks. MS fatigue can be very debilitating and, unlike ordinary fatigue, it can take a long time to recover from.
MS fatigue is often overwhelming. It can happen at any time without warning or without any apparent reason. Some people say they experience MS fatigue after gentle activities such as writing or reading and they immediately need to rest.
Others say that MS fatigue happens after physical exertion, such as taking the dog for a walk or doing the shopping. For others, MS fatigue can happen after cognitive exertion such as working on the computer and completing mentally-demanding tasks. You may also experience MS fatigue when you wake up, in some cases every day, even after a good nights sleep.
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