A Little More Strength To Carry The Weight
In my experience, it’s not like you take a pill and, just like that, no more fatigue until the pill wears off. When I take my medication, the fatigue is still there, but it becomes easier to work through it kind of like how cold medication doesn’t eliminate a cold, but it may help reduce the symptoms of one. If you think of fatigue like the weight of a huge boulder on your back that you have to walk around with, I would say that these medications don’t really remove the weight of the boulder but instead give you a little more strength to carry it. The heaviness in my body caused by my fatigue is always there, but these medications make it a little less difficult to not be crushed by it. At least that how it feels to me.
Cocoa May Help Curb Fatigue Typically Associated With Multiple Sclerosis
May offer easy, safe approach to persistent symptom, if confirmed in larger studies, suggest researchers
Cocoa may help curb the fatigue that is typically associated with multiple sclerosis , suggest the results of a small feasibility trial, published online in the Journal of Neurology Neurosurgery & Psychiatry.
Cocoa, like dark chocolate, is rich in flavonoidssubstances found abundantly in fruit and vegetables and associated with anti-inflammatory properties.
If the findings are confirmed in larger studies, it may offer a simple dietary approach to a persistent and hard to treat symptom, which affects nine out of 10 people with MS, suggest the researchers.
The causes of mental and physical fatigue experienced by people with MS are complex, and likely to include neural, inflammatory, metabolic, and psychological factors. None of the currently available approaches offers long term relief, say the researchers.
Previous research suggests that dark chocolate, containing between 70 and 85 per cent cocoa solids, is associated with an improvement in subjectively assessed fatigue in people with chronic fatigue syndrome .
This prompted the researchers to see if it might also be worth exploring its potential in helping to tackle the fatigue associated with MS.
Participants were instructed to wait 30 minutes before taking any prescribed medication or eating or drinking anything else, but otherwise to stick to their usual diet.
Journal: Journal of Neurology Neurosurgery & Psychiatry
What Are Symptoms Of Fatigue
There are two major types of fatigue in MS. These two types of fatigue are probably separate problems related to the MS.
The first type is a general feeling of tiredness. It may feel as if one has not slept the night before. This feeling may be worse in the afternoons or after activity. People may feel that they are unable to do as many tasks without getting tired as they did before.
A second type of fatigue is muscular. In this type, there is increased weakness after repeated activity. Often, this occurs with walking. People may find that they are dragging one leg or are more unsteady.
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Weighing Decisions About Stimulants
All medications carry the risk of side effects. Determining whether the possible risks are worth the potential benefits is a complex decision-making process that factors in many variables. Make your neurologist your partner, and work closely with them to weigh the risks and benefits of adding a stimulant to your MS treatment regimen.
To avoid dangerous drug interactions, make sure all your health care providers and your pharmacist are up to date on the medications you take including over-the-counter remedies and nutritional supplements for each health condition.
Finding A Water Pt Specialist
Your healthcare team may be able to recommend a local physical therapist specializing in water therapy. Your provider and physical therapist may ask questions to confirm that water therapy is a safe and appropriate treatment option for you. Check with your insurance provider to discuss the coverage available for this treatment based on your policy.
High temperatures can worsen MS symptoms in many people. Check with your healthcare provider to see what pool temperatures are recommended for your health.
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Using Your Energy Efficiently
As well as making positive lifestyle choices to increase the energy you have, the other side to managing fatigue is to use that energy in the most efficient way. You need to:
Plan ahead and balance your busy diary between essential everyday tasks and fun activities to boost your mood. Try to prioritise so that you can use precious time wisely.
Delegate you may find this hard at first as you mistakenly think this is a loss of control, but actually, delegating allows you to take back control and focus on what is most important. Think of yourself as the CEO of your life, delegating lower priority tasks. Likewise, consider how everyday tasks can be done in a more time-efficient way.
Pace yourself and rest when you need to. By saving energy you can put it towards what is most important to you.
What Is Multiple Sclerosis
Multiple sclerosis, commonly known as MS, is a chronic illness that affects the brain, spinal cord, and optic nerves in the eyes. Vision, balance, muscular control, and other basic bodily functions have a risk of impairment due to MS. Everyone with the condition experience numerous symptoms. Some individuals just experience minor symptoms and might not require medical attention.
Others will struggle to get around and complete everyday duties. The immune system attacks myelin, a fatty substance that wraps around your nerve fibres to protect them. This is the main cause of MS.
The nerves will be harmed if myelin isnt present. Because of the impairment, the brain is unable to convey messages appropriately throughout the body. The nerves dont perform as well as they should to assist the body in moving and feeling appropriate.
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Organise Your Living And Work Spaces
You might find there are practical changes that can be made to the places you work and live. Maybe re-organising desks or cupboards, or adjusting the temperature or lighting to suit you better.
Sometimes, the simplest of changes can make the workplace or home more energy efficient for you.
An occupational therapist can help you assess the spaces you use at work and at home – and may suggest adaptations or equipment that could help. For more information about the support that occupational therapists can offer, and how to find one, download or order our leaflet Occupational therapy and MS.
Q: Should Any Tests Be Performed In Ms Patients With Fatigue
A: There is no diagnostic test for primary MS fatigue. At any time in the presence of chronic fatigue, and more particularly in the context of new onset or acute worsening of fatigue, potentially treatable causes and contributing factors should be ruled out. For example:
- Current medications should be reviewed, looking for drugs that can cause sedation and could be decreased or stopped, before adding a symptomatic medication for fatigue.
- Depression should be ruled out as a screening tool)
- Labwork should be ordered to rule out acute or chronic comorbidities that can be secondary causes of fatigue
- New MS disease activity should be ruled out through a detailed interview, thorough examination, and if appropriate imaging studies. Fatigue can be the initial symptom of an MS exacerbation, or reflect acute CNS inflammation in the absence of clinical exacerbation
- Other factors that are amenable to lifestyle changes should be explored
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Fish Or Cod Liver Oil
Fish liver oil and cod liver oil are not the same as plain fish oils, which many people take for the omega-3 fatty acids. Liver oils from fish contain omega-3 fatty acids as well as vitamins A and D, which can cause overdose effects in large amounts.
Some research indicates that cod liver oil isnt as helpful as regular fish in the diet.
Its important to note that the vitamin D in cod liver oil may have a prior to the onset of MS. In general, however, vitamin D and the fatty acids found in fish liver and its oils may offer a variety of health benefits from which people with MS arent excluded.
Ask The Expert: Coping With Ms Fatigue
5 August 2018
If you have MS, its likely youve experienced that overwhelming feeling of tiredness or sudden lack of energy that defines MS fatigue. Its one of the most common symptoms of MS and many people find that the heat can make it worse. We put your questions on fatigue to occupational therapist, Kate Hayward
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Make Sure You Understand The Possible Side Effects
Infusion reactions are a common side effect of OCREVUS, which can be serious and may require you to be hospitalized. Most infusion reactions are mild to moderate, and treatable with infusion adjustments and medicines.* Post-infusion, you will be monitored for at least 1 hour for signs and symptoms of an infusion reaction. Tell your healthcare provider or nurse if you experience any reactions up to 24 hours after your infusion.
- redness on your face
*These findings were learned from relapsing MS studies and are comparable with rates seen in the PPMS study .
I Remembered To Laugh
While I stand behind all of the tips on my list, and they made a big impact for me, I believe laughter is honestly one of the most important things you can do. Humor and laughter boost your energy, protect you from the damage of stress, and improves your mood. Laughter is good for your soul, its free, and lets face it, everyones happier when you laugh together.
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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 P’s” to make daily activities easier and less draining. We’ll explore both approaches below.
What Is Ms Fatigue
Fatigue in MS is a feeling of constant exhaustion, tiredness or weakness, and can be physical, mental or a combination of both. It is distinct from and more debilitating than general feelings of sleepiness or physical tiredness. Unlike ordinary fatigue, MS-related fatigue usually occurs more rapidly, lasts longer and takes longer to recover from. It has often been suggested that the term MS fatigue is a poor descriptor of the condition, as it fails to capture the full spectrum of the experience for people with MS. Research suggests that the type of activity undertaken by a person with MS does not necessarily reflect the type of fatigue impairment experienced. That is, on some days, its not caused by overdoing it or working too hard, it happens regardless of the amount of activity undertaken.
MS fatigue may be temporary such as during a relapse, an infection or unrelated illness, during periods of stress or when starting some medications to treat MS or MS-related symptoms. In other cases, MS-related fatigue can be chronic and ongoing, despite adequate rest. Additionally, other MS symptoms may be exacerbated during times of severe fatigue. For some people, other symptoms such as depression and anxiety can also seem to worsen MS-related fatigue.
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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.
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!
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Helping Others Understand Your Ms Fatigue
Fatigue is one of those invisible symptoms that others have a really hard time understanding.
They may think youre just being lazy, you’re uninterested, or youre just not trying hard enough. Its up to you to help them understand.
We have heard many descriptors of fatigue from people with MS. Here are a few:
- Its like slogging through mud with heavy boots on.
- I feel like I have weights on my arms and feet.
- My brain just hits a wall and stops working until I give it a rest.
Encourage the people in your life to ask questions. And be sure to give clear signals about whats going on with you. For example, just give a thumbs up when youre doing well and have energy to use, and a thumbs down when youre out of gas.
Even people who love and care about you cant read your mind, so keep trying to communicate to help them understand.
Behavioral And Educational Interventions
Several published reviews and studies have examined the effectiveness of various types of behavioral and/or educational interventions for management of fatigue in pwMS, which included group fatigue management programs, energy conservation programs, and psychotherapies . A meta-analysis investigated overall effectiveness of different types of educational programs on reducing the impact or severity of self-reported fatigue in pwMS . The authors included eight RCTs, involving 662 pwMS. Educational interventions included a fatigue management program, energy conservation programs, mindfulness interventions, and CBT. The authors found significant global improvement with a large pooled treatment ES for the educational interventions of 0.54 .
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Heat Seems To Make My Fatigue Worse Why Is This
Kate says: Lots of people with MS can experience heat sensitivity fatigue. This is because the myelin sheath around the nerve acts an insulator and to work efficiently, sending messages from the brain to the body, the nerve needs to maintain a constant temperature. It only needs to increase in temperature by about half a degree to not work as efficiently so it can take longer for the messages to get through. This tends to quickly reverse when you cool down. It can be useful to think about how you might try and keep cool so perhaps having a cool bath or shower rather than a hot one, having a window open when youre cooking and sometimes even avoiding large spicy meals, which can increase your body temperature, can be helpful.
Planning and prioritising what youre doing, when you can save energy and when you can do different activities can be really helpful
What Causes Ms And Ms Fatigue
Its unclear why someone develops multiple sclerosis . Its not linked to any specific health practice, and its unclear whether it is avoidable. So far, research reveals that a mix of hereditary and environmental variables contribute to the cause.
MS fatigue is among the most unpleasant symptoms of the disease. MS fatigue may be distressing, and it can interfere with job and family life, mental and physical health, and social and recreational activities for some people. Fatigue can be a major symptom of the active inflammatory disorder, or it can be a secondary sign of other medical disorders.
So what exactly causes this fatigue? Cytokines are a large group of tiny proteins that play a key role in cell signalling. The central nervous system interacts with inflammatory cytokines, neurons, and cells. Cell signals in these sensory neurons can cause fatigue and discomfort. However, a changed neuroendocrine system may be able to control inflammation and excessive stimulation.
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What Did The Research Team Do
The research team assigned patients by chance to take the medicines in one of four sequences. Patients started with one medicine and took it for six weeks. Before starting the next medicine, patients stopped taking medicine for two weeks. Patients repeated this process for all three medicines and the placebo.
All patients had a screening visit at one of two health centers the centers were in Maryland and California. Five weeks after patients started each medicine, they completed online surveys about fatigue, sleepiness, and quality of life. To learn if patients took the medicine as prescribed or had adverse events, the research team contacted patients five times by phone, email, or text during the time they were taking each medicine.
Patients with MS, doctors, an MS specialist, and a member of an advocacy group helped plan the study.
