Why am I so tired and what can I do about it? How to combat the most common symptom of multiple sclerosis

Fatigue occurs in up to 80% of patients with Multiple Sclerosis. It is believed to be related to the impaired nerve conduction which occurs as a result of the damaged myelin and axons (nerves). It is by far the most common symptom of MS and is one of the leading factors in persons leaving the workforce.

Before treating fatigue, however, it is important to know if any other conditions could be causing the fatigue. There are some disorders that can cause severe fatigue, so it’s important to identify and treat those as well. Here are several questions we ask when discussing fatigue with our patients:

How are you sleeping?

If you’re not sleeping well, this will greatly contribute to daily fatigue. Factors which can contribute to poor sleep include frequent urination at night, depression, sleep apnea, muscle tightness, nerve pain, caffeinated products, and lack of exercise.

What is your B12 level?

B12 is a vitamin in our bodies that helps with cell metabolism and normal function of the brain and nervous system, as well as the formation of blood. Some people are not able to absorb B12 well, which leads to symptoms including severe fatigue. The blood level of B12 can be easily checked in a blood test.

Have you had your thyroid checked?

Thyroid disorders can also cause severe fatigue. Persons with MS are three times as likely to also have a thyroid disorder. A blood test can be performed to check this.

Do you participate in regular exercise?

Lack of exercise can contribute to fatigue in MS. Clinical research studies have shown that exercise improves fatigue. It is important to know the types of exercise that are appropriate for your condition, so check with your neurologist before starting any exercise program. They may also advise you to see a physical therapist to create a home exercise program for you.

Do you experience depression?

Depression is very common in persons with MS. Depressed mood can cause a multitude of symptoms, including fatigue. If you feel you may be depressed, talk to your doctor. Some of the medications for depression can also improve fatigue.

Most importantly, if you are experiencing fatigue, talk with your doctor about the possible causes and treatment options for you.