Why Study The Obvious
I led what could only have been a collective chorus of DUH! when I read what seemed to me completely obvious.
It wouldnt be beyond reason to wonder why a study into something so very obvious would even be done.
And then I thought about it less emotionally and more analytically. Maybe documentation, via research studies like this, are exactly what we need .
Other Causes Of Anemia
Anemia may not be a symptom of MS or a side effect of MS treatment. There are three main potential causes of anemia:
- Insufficient RBC production
- Blood loss
- Excess destruction of RBCs
Many different health conditions and situations can affect the number of RBCs and cause dysfunction. These can include:
- Not getting enough iron, vitamin B12, or folic acid in your diet
- Having heavy menstrual bleeding
- Pregnancy
- The metabolic disorder G6PD deficiency
- A condition known as aplastic anemia
- Colon cancer or colon polyps
How Is Ms Fatigue Different From Normal Fatigue
Fatigue in MS is different in many ways from the tiredness people may experience as the result of a long day at work or a late night out. Fatigue is also different from sleepiness, although staying in bed may be the only thing that seems to help at times. According to the National Multiple Sclerosis Society, people with MS commonly experience fatigue that persists daily, even after plenty of sleep, and worsens as the day goes on.
When fatigue affects people with MS in these ways, it may also be referred to as lassitude. MS fatigue is typically more severe than normal fatigue, and may interfere with work, school, and tasks of daily life. In fact, MS fatigue is a primary reason people with MS have to reduce work hours or stop working altogether.
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Obvious Research May Lead To Better Treatments
Another reason research into something like MS fatigue is important is so that new and better treatments for symptoms can be developed, tested, and approved.
Further studies were presented by the pharmaceutical company Janssen at the 2021 Americas Committee for Treatment and Research in Multiple Sclerosis Forum this past February.
These studies highlighted not only the prevalence of fatigue experienced by people with MS, but also its effects on work productivity and activity impairment as well as economic and humanistic burdens of MS fatigue.
They even reported information on the use of changes in MS fatigue as a factor in judging MS treatments a success.
Fatigue Due To Disrupted Sleep
MS causes a variety of symptoms that disrupt sleep. Muscle spasms, pain, bladder problems and breathing difficulties can all affect sleeping patterns.
Usual treatment
The solution to this type of fatigue lies with identifying why the sleep is being disrupted and treating the underlying problem. Your GP or neurologist can help with this.
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Fatigue Caused By Disability
MS can cause problems with mobility and muscle control. Compensating for these disabilities requires greater energy and effort than would otherwise be necessary to perform daily tasks. When some muscles cannot perform certain tasks other muscles are used instead and the extra work can tire those muscles, leading to additional fatigue.
Usual treatment
Neurophysiotherapists and physiotherapists can demonstrate exercises to strengthen and maintain body functioning and there is a range of equipment available to help conserve energy and reduce stress on muscles and joints. Occupational therapists can suggest modifications to your home or workplace to improve your efficiency and reduce the effort involved in daily tasks. Regional MS Community Support Staff, friends, family members and other people with MS can be useful sources of practical advice on ways to reduce energy needs.
Loss Of Or Change Of Taste And Smell
Research has shown that many people who have MS experience changes in how food tastes and smells. One study, published in April 2016 in Journal of Neurology, found that a significant number of people with MS have a decreased ability to sense all four basic areas of taste: sweet, sour, salty, and bitter, and that these taste deficits that are linked to MS-related lesions throughout the brain.
Its not common, but other people with MS have reported hyperosmia, or an abnormally heightened sense of smell or abnormal sensitivity to odors.
Before you assume that MS is the cause of impaired or decreased taste, get your symptoms checked out by your doctor, as new loss of taste and smell can also be a symptom of COVID-19, among other conditions.
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Take Good Care Of Your Overall Health
Maintaining a healthy weight and optimal blood pressure and cholesterol levels, and avoiding type 2 diabetes can all help with MS fatigue, says Dr. Conway.
“A healthy diet and a regular exercise program can really help, says Cohen. If you are physically out of shape and overweight, everything you do requires more energy.
Q: Are There Any Medications For Ms Fatigue
A: Symptomatic medications can be considered concurrently with other interventions. There are no medications approved by the FDA for the treatment of MS fatigue. The most commonly used off-label symptomatic medications are amantadine and modafinil. Clinical trials have shown conflicting evidence regarding their efficacy.
Amantadine is indicated as an antiviral and in Parkinsons disease and has dopaminergic effects. Usual doses are between 100 and 200 mg per day taken in am and midday if necessary. Side effects are mostly mild and reversible. The most frequently reported side effects are: anxiety, insomnia, nightmares, and livedo reticularis.
Modafinil was initially approved for narcolepsy. The starting dose is usually 100 mg daily. The dose can be titrated up to 400 mg per day, with an average dose of 200 mg per day. The most frequent side effects are headaches, nervousness, irritability, anxiety, and nausea. Modafinil is a controlled substance. More recently armodafinil has been proposed off label to treat MS fatigue, but there is no published data on its efficacy.
Antidepressants, particularly selective serotonin reuptake inhibitors, may help with fatigue. This effect could be mainly related to the improvement of depression and associated sleep disturbance. Activating antidepressants, such as fluoxetine, venlafaxine, and bupropion can also be helpful.
Results of one clinical trial suggested that two 325 mg aspirin twice a day can be effective on MS fatigue.
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Living With Multiple Sclerosis And Chronic Fatigue Syndrome
If youre unlucky enough to have been diagnosed with both multiple sclerosis and chronic fatigue syndrome, or are dealing with chronic fatigue caused by one or the other, the symptom feels the same and can be as disabling as physical symptoms.
Get to know your own illness and notice any triggers that make symptoms worse. Rest as much as you can and make sure you look after the rest of your health.
My fatigue is greatly improved, for example, by being strict about my diet. I avoid gluten and dairy and find that keeping my weight down generally makes me feel better. I allow myself as much sleep as I can get and work part-time to avoid exhaustion. I also dont beat myself up if I have to cancel social events to manage my fatigue, and I make sure I dont over do things as I know Ill pay the following day!
Allowing yourself the rest you need goes a long way in managing fatigue, and never be afraid to ask for help.
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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Overwhelming Disruptive And Difficult To Explain Fatigue Is The Most Common Ms Symptom
Everyone knows what it feels like to be tired. But MS fatigue is different from regular fatigue.
- It can come on suddenly, even after a good night’s sleep.
- It generally worsens over the course of the day.
- It tends to increase with heat and humidity.
Your MS fatigue is likely to feel different from anything you’ve felt before.
It may feel totally overwhelming at times, yet it remains invisible to other people. It can be one of the hardest symptoms for family, friends, and colleagues to understand.
You might find that fatigue interferes with every aspect of your life. To combat fatigue and take back control, get to know this symptom, factors that can worsen it, and ways to manage your energy.
Actions For This Page
- Multiple sclerosis is a disease of the central nervous system that can affect the brain, spinal cord and optic nerves.
- Common symptoms include fatigue, bladder and bowel problems, sexual problems, pain, cognitive and mood changes such as depression, muscular changes and visual changes.
- See your doctor for investigation and diagnosis of symptoms, since some symptoms can be caused by other illnesses.
- Whilst there is not yet a cure for MS, researchers are making promising progress and discoveries about the treatment and management of MS every day.
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What Can Cause Anemia In Ms
Disease-modifying therapies are medications proven to reduce disease activity in MS, reducing the number of relapses and slowing the development of lesions in the central nervous system . Certain disease-modifying therapies can potentially cause anemia as a side effect. These include:
Rarely, people taking fingolimod or interferon-beta-1b have developed autoimmune hemolytic anemia, in which the immune system destroys RBCs.
Similarly, treating MS with alemtuzumab can result in the development of an autoimmune thyroid condition called Graves disease. Anemia is a common symptom of thyroid diseases.
Some side effects are common, and others are rare. Not everyone will experience every side effect associated with medication. If you have concerns about a potential side effect, consult your health care provider rather than discontinuing the medication. They may be able to recommend ways to manage side effects.
Also, some drugs must be carefully tapered off rather than stopped abruptly to avoid withdrawal effects such as flare-ups in relapsing-remitting MS.
Speech And Swallowing Changes With Ms
Speech and swallowing changes can occur due to affected nerves being damaged. This may present as changes to the voice tone and quality, or coughing when eating.
These symptoms should be reported to your MS healthcare team for assistance from a speech therapist, who can advise on appropriate management.
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Finding Support For Ms And Fatigue
When you join MyMSTeam, you gain a support network of almost 159,000 people who are living with MS. Members often ask questions and share tips about managing fatigue.
Was fatigue an early MS symptom for you? Has your doctor ever asked you to complete a fatigue assessment questionnaire? Comment below or start a conversation on MyMSTeam.
Medications Used To Treat Ms
Medications used for the treatment of fatigue can be helpful but are usually not the magic answer to curing fatigue.
Neurologists sometimes prescribe drugs such as the following to MS patients who need to manage fatigue:
- Symmetrel
- Provigil
- Ritalin
Talk to your healthcare provider about whether one of these medications would be useful for you. It’s also important to understand that there are different strategies for taking these medications. It’s not an all or nothing deal.
For instance, a person with MS may only take their Provigil if they know they are going to have a long, grueling day. Another person may rely on daily Ritalin to manage fatigue.
These medications also have side effects, such as cardiovascular ones, which may not be safe for you.
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Engage In Regular Physical Activity
I encourage exercise for my patients, says Conway. In my experience, it can make fatigue worse at first, but if a person can get over the initial hump, it can actually improve fatigue, he says.
If youre not sure how to get started with exercise or need some help identifying exercises that will improve your fitness without wearing you out, trying working with a physical therapist or a personal trainer who is knowledgeable about MS.
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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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You Are Not Alone With Ms Fatigue
On MyMSTeam, the social network and online support group for those living with multiple sclerosis, members talk about a range of personal experiences. Coping with MS fatigue is one of the most popular topics.
Is a daily struggle with fatigue part of your life with MS? How do you manage your MS fatigue? Share your experiences with fatigue in the comments below or by posting on MyMSTeam.
Secondary Fatigue And Well Being
Coping with fatigue can be draining. Thus, feelings of tiredness and exhaustion can lead to more feelings of tiredness and exhaustion. However, maintaining a healthy lifestyle can help you cope better with fatigue. Keeping physically fit is very helpful and it is possible to develop a balanced programme of activity that takes account of any limitations. A physiotherapist can help with specific exercises, but they must be aware of the potential limitations MS imposes.. Managing time and energy and minimising stress is also important. Whether at work, home or elsewhere, conserving energy and taking periodic breaks will make a big difference to how much can be done each day. It may be useful to plan each weeks work, social and late-night activities in advance so that the most important activities take priority. Maintaining a healthy and balanced diet is important for everyone, but especially for people with MS. Be aware that excessive alcohol can increase fatigue and toxins like nicotine should be avoided. Each days activities should include opportunities for relaxation and moments of high energy should be balanced with adequate rest periods.
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What Is The Best Medication For Ms Fatigue
There are stimulants for MS fatigue that can assist with variable degrees of success, in addition to lifestyle adjustments and energy conservation strategies. Some of these medications include:
- Alertec : used to often alleviate daytime nausea. This medication considerably reduces fatigue in persons with MS. Mild headaches and sleeplessness are common side effects.
- Amantadine affects dopamine levels in the body, resulting in less exhaustion in MS patients. Insomnia and disturbing dreams are two common side effects.
- Vitamins: Vitamin B, in particular, aids in the conversion of food into energy that your cells can use. It also helps to maintain the health of your bodys nerves and blood cells, as well as prevent different types of fatigue that can make you feel weak and tired.
- Ritalin : activates the central nervous system, which aids in the treatment of MS symptoms including tiredness. Nervousness, shivering, and sleeplessness are common adverse effects.
- Antidepressants: usually given to alleviate exhaustion. Anxiety and despair may often contribute to feelings of exhaustion, and fatigue can lead to a poor mood or thoughts of depression. Antidepressant therapy may aid in the treatment of both depression and fatigue.
Ongoing Research Is Needed
Research on fatigue and early MS continues to evolve. With research showing that fatigue in early MS may predict faster and more severe disease progression, neurologists are taking fatigue more seriously. More studies are needed, but its becoming clear that fatigue may be a key aspect of understanding early MS.
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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
Are There Other Causes Of Fatigue Besides The Ms
Obviously, people with MS can be tired for other reasons. For example, they may have sleep disorders that interfere with restful sleep. People with MS may have a condition called restless leg syndrome, where they feel that they have to move their legs to get relief. They may also have periodic leg movements, which is when legs kick involuntarily during sleep. Another condition affecting sleep is sleep apnea, which is also common among the general population.
Certain medications may affect sleep or cause fatigue. Alcohol or drug use may alter sleep or cause drowsiness. Sometimes, people have other medical conditions, such as infections, anemia, or a reduced thyroid function, which can increase fatigue.
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