Treatment For Fatigue In Ms

What Does It Feel Like

Not everyone experiences fatigue the same way, and the feeling can be difficult to explain to others. In general, there are two types of MS fatigue: a general feeling of extreme tiredness and muscular fatigue.

MS fatigue is different from regular tiredness. Some people with MS describe the fatigue as feeling like youre weighed down and like every movement is difficult or clumsy. Others may describe it as an extreme jet lag or a hangover that wont go away.

For others, fatigue is more mental. The brain goes fuzzy, and it becomes difficult to think clearly. Fatigue may affect the eyesight, as well as your ability to speak without slurring your words.

MS fatigue is also distinguished by the following characteristics:

• occurs on a daily basis
• often occurs in the morning even after a good night of sleep
• tends to worsen as the day progresses
• is aggravated by heat and humidity
• may come on suddenly

People with MS fatigue may need to recharge their batteries with frequent rest and a short daily nap, but its also possible to plan and schedule your daily activities to help conserve energy.

To conserve energy, try these tips:

While conserving energy is important, too much rest can be counterproductive. Exercising daily is essential for maintaining muscle strength and building endurance. Try these exercises and activities for MS.

There are several other lifestyle changes and remedies that can help you battle fatigue. These include:

Bone Up On Calcium And Vitamin D

According to the NMSS, research is increasingly showing that low vitamin D levels in the blood may be a risk factor for developing MS, though more research is needed to find out whether vitamin D has any impact on disease activity in people with the condition.

But experts do know that getting enough vitamin D and calcium is key for bone health among people who already have MS.

Its a good idea to incorporate foods high in vitamin D and calcium into your diet, especially if you have been on steroids for a long time, Eng says, because one side effect of steroids is poor bone health. Low levels of weight-bearing activity, such as walking, can also lead to weak bones and a higher fracture risk.

Steroids are often prescribed only as a short-term, first-line treatment for MS exacerbations usually for three to five days via IV, and sometimes followed by a tapering oral dose for one to three weeks.

But some comorbid conditions that are common in people with MS, including inflammatory bowel diseases like Crohns disease or ulcerative colitis, require long-term steroid use. And per the NMSS, steroid treatment can lead to bone loss if used for prolonged periods of time.

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Other Causes Of Fatigue

Some fatigue experienced by people with MS is not actually caused by the MS. For example, a person might feel fatigued due to poor sleep, infection, medications, or depression.

Medications taken to solve other problems can contribute to fatigue. If you look at your pill bottles, some say, May cause drowsiness or Do not operate heavy machinery while taking this medication. These warnings indicate that the medicine is sedating, i.e., it can make you tired. Medications that are used to treat bladder dysfunction, spacticity, and pain can cause fatigue in MS patients. If this is the case and you are experiencing fatigue, a good place to begin is to review all of your medications with your physician.

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Does My Fatigue Medication Actually Help

As the medication I use to help me manage my fatigue is a controlled substance, I have to actually drive to my neurologist’s office so he can physically write me a new prescription when I need a refill. Yesterday was one of those “trip to the doctor’s for a refill” days, and while he was writing me a new script, he asked me, “So, would you say that this actually helps?”

What Are Some Medical Treatments For Ms

In general, if possible, it is good to avoid using medications. People with MS often take several medications. Limiting the number of medicines is good medical practice. It is also important in reducing costs. However, if fatigue continues to interfere with activities, medications may be useful. These medications may include:

Last reviewed by a Cleveland Clinic medical professional on 01/28/2019.

References

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I Take A Daily Morning Dose Of Coenzyme Q10 Capsules Supplements From Holland & Barrett As Recommended By My Ms Nurse And They Certainly Do Work For Me And Others I Have Passed The Recommendation On To They Somehow Raise My Energy Levels In The Morning They Are Still Not Fantastic But Better With Them Than Without Dont Take Too Many Or You May Not Sleep Well

Vitamin D and omega 3

Diet

Other therapies

AcupunctureOxygen therapyAction Potential Simulation Therapy

We asked the MS community to share their 10 top tips for managing fatigue, they are…

Does This Surprise You

People with MS have been using these medications for years in an effort to tame the fatigue monster, so its no wonder I was surprised by these results. Maybe I shouldnt have been. The folks at the National MS Society remind us that no medications are approved specifically to treat MS fatigue. Everything that people with MS use is prescribed off-label.

Clinical trials of meds for MS fatigue have produced mixed results. As the Cleveland Clinics website reports, two studies have looked at modafinils effects on MS fatigue. One showed a significant effect on fatigue, but the other did not. Interestingly, the clinic also noted that a recent study found that taking two regular aspirins twice a day significantly reduced MS fatigue.

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Review Your Current Medications

It may surprise you that the very medications you are taking for your MS symptoms may be contributing to your fatigue. Some include:

• Anticholinergic medications used to treat urinary incontinence
• Muscle relaxants used to treat spasticity
• Medications for treating tremor

Some disease-modifying MS medications can add to stress, which begets fatigue, as well.

Other medications that are commonly associated with fatigue include antihistamines for treating allergies and antihypertensives for treating high blood pressure. These medications are not used more often in MS than they are otherwise, but they can add to your already existing fatigue if you take them.

Speak with your healthcare provider about whether your medication could be adding to your fatigue or feeling of fogginess. Your practitioner may suggest switching your medications or changing the time of dosing.

Tip : Regulate Your Sleep

Sleep problems are often behind the fatigue that people with MS experience.

Whether you have trouble falling asleep, staying asleep, or getting the amount and type of sleep you need to awaken feeling refreshed, the result is the same: You feel tired.

To help prevent these problems, its important to regulate your sleep. This might involve identifying and treating other MS symptoms that cause sleep problems for example, urinary dysfunction.

If all else fails, you can talk with your doctor about using sleep medications for a short period of time.

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Exercise Therapy For Fatigue In Multiple Sclerosis

Background

Multiple sclerosis is a chronic disease affecting over 1.3 million people globally. MS is characterized by diffuse damage to the central nervous system, leading to a wide range of different physical and cognitive symptoms. One of the most prominent and disabling symptoms of MS is fatigue. Currently, there is no effective medicine to reduce fatigue in people with MS. Treatment with exercise may be a way to reduce fatigue either directly by changing how the body works, for example hormonal function, or indirectly through improved physical activity and general health.

Study characteristics

We searched scientific databases for clinical trials comparing exercise to no exercise or other treatments in adults with MS. The evidence is current to October 2014.

Key results

We found 45 trials, involving 2250 people with MS, assessing the effect of exercise therapy using self reported fatigue. We used 36 studies, involving 1603 people with MS, in an analysis. Combined, these 36 trials supported the idea that exercise therapy may be a promising treatment to reduce fatigue without side events. This finding seems especially true for endurance training, mixed training , or ‘other’ training . To assess the safety of exercise therapy we counted the number of reported MS relapses in the people receiving exercise therapy and in people in a non-exercise group and did not find a significant difference.

Quality of the evidence

What Is The Best Treatment For Fatigue In Multiple Sclerosis

Although fatigue seems to be a vague and subjective symptom, it is one of the leading reasons why victims of MS are unable to work.

No drugs are very useful for this symptom, but some are still prescribed.

Amantadine may reduce fatigue, usually in doses of 100 mg twice daily.

Modafinil and selective serotonin reuptake inhibitors such as fluoxetine also are prescribed.

Simple commonsense measures may be more useful, such as resting during the day and reorganizing the home and workplace for better efficiency.

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How Ms Fatigue Is Different To Other Types Of Fatigue

Ordinary fatigue is described as a sensation of muscular tiredness and weakness. It is the tired feeling everyone experiences after an excessively busy day or a lack of sleep. It is the type of fatigue that is usually managed by rest and a good nights sleep. Ordinary fatigue is quite different to the fatigue experienced in MS.

Fatigue associated with MS is described as an overwhelming sense of tiredness that can occur at any time of the day without warning. MS-fatigue usually occurs more rapidly, lasts longer and takes more time to recover from than ordinary fatigue.

MS-fatigue can occur for no apparent reason or after relatively mild exertion, such as a short period of walking, writing or reading, with an immediate need to rest.

Treating Fatigue In Patients With Multiple Sclerosis May Significantly Improve Quality Of Life And Requires A High Index Of Suspicion For Coexisting Sleep Disorders

Jonathan L. Carter, MD

Fatigue is a ubiquitous and often under-recognized symptom in patients with multiple sclerosis . Prevalence estimates for fatigue are as high as 70% to 90% in unselected patients with MS, and it may be the leading cause of disability in patients with mild or early relapsing-remitting MS.1-3 Fatigue is a complex and multifaceted symptom that is poorly understood despite extensive study. Patients with MS may have differing definitions for fatigue. Sleep disorders are more common in patients with MS compared to the general population, including obstructive sleep apnea , central sleep apnea, and restless legs syndrome and resulting from conditions such as neuropathic pain, nocturnal leg spasms, and others. Therapy for MS-related fatigue may be partially successful, but many patients continue to have significant fatigue despite treatment. Chronic sleep deprivation can lead to worsening fatigue, depression, cognitive inefficiency, and fibromyalgia symptoms. Treatment of sleep disorders may significantly improve quality of life but requires a high index of suspicion for the presence of coexisting sleep disorders along with MS-related fatigue. In this article, we address differences between primary and secondary fatigue in patients with MS, possible physiologic mechanisms of MS-related fatigue, nonpharmacologic and pharmacologic therapy for fatigue, recognition and diagnosis of coexisting sleep disorders, and therapies to treat sleep disorders.

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Speech And Swallowing Difficulties

A speech and language therapist can help you find ways to overcome problems with speech and swallowing.

For example, they can offer advice about foods that are easy to swallow and recommend exercises to strengthen the muscles used in speech and swallowing.

If swallowing problems become very severe, some people need to be fed using a tube, which is fitted into the stomach through the skin.

What Does It Mean For A Fatigue Medication To Work

Now do keep in mind, this is all based on my own experience with these medications. I am 100% sure that not everyone will totally agree with everything I have to say because we are all different. I’ve said it a million times before and I’ll say it at least a million more times what works for one doesn’t work for all. If it did, we probably wouldn’t have such a large assortment of medications to choose from. As well, if you are thinking about starting one of these medications for the first time , I think it’s important to start one with the right expectations. Ask yourself, what does it mean for a fatigue medication to “work”?

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Using Your Energy Wisely

You may need to think ahead as you budget your energy each day. This can be tricky, but once you get into the flow of your routine, conserving your energy can be a smart way to battle your fatigue. A few ways to best utilize your energy include:

• Building rest times into your schedule, like an afternoon 20-minute power nap
• Planning energy-draining activities for the morning when you are less fatigued
• Asking your family to take on more of the heavy-duty household chores
• Using your scooter or wheelchair to get around throughout the day

Medical Marijuana And Multiple Sclerosis

It is possible to manage some of the specific symptoms of multiple sclerosis with the aid of medical marijuana. Proponents of cannabis suggest that the plant helps with severe pain and fatigue. These are two of the most pertinent MS symptoms. There is a suggestion that marijuana can also assist with mood changes and stress.

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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.

Finding Help And Taking Help Thats Offered

People might say to you If theres anything you need or If theres 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!

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It’s Not A Simple Answer

Before answering, I had to pause and think for a few seconds because I found this question to be so interesting. As an MS specialist who has been prescribing his patients this stuff for years, he obviously knew the objective facts as to whether or not it’s efficacy was clinically significant, so I assumed he was asking for my subjective opinion. I told him that for me, it wasn’t as simple as “yes” or “no,” and that’s what made me want to write today’s post.

Tip : Limit Certain Drinks

Certain behaviors may seem to help with fatigue, but in the end, they may cause more problems than they solve.

Drinking a hot beverage may sound like a good way to wind down if youre having trouble sleeping, but coffee and tea typically contain caffeine.

Be sure to check whether your drink contains caffeine. It can prevent you from falling asleep, leading to fatigue the next day.

Similarly, while alcohol may help you feel sleepy after you first drink it, it can make it harder to get a restful nights sleep later.

Consider behaviors that may be contributing to poor sleep habits and fatigue and try to take steps to adjust them.

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