Heat can also be a factor, with fatigue often increasing during hot weather, after a hot shower or meal or after exercise. Secondary fatigue occurs from the effects of living with MS. For instance, MS symptoms such as depression, pain, spasms or incontinence can all make fatigue worse.
Fatigue in MS also can arise from associated conditions or accumulation of disease burden. Specific causes to consider include sleep disorders, depression, disability status, MS subtype, and iatrogenicity.
Possible triggers include infections and stress, but there may also be no noticeable trigger. Anyone who notices a worsening of symptoms or that new symptoms appear should contact a doctor in case they need additional treatment or monitoring.
People describe it as an overwhelming sense of tiredness with no obvious cause. You may wake up feeling as tired as you did when you went to sleep. Other symptoms, like difficulties with balance, vision or concentration, might also get worse temporarily.
There's conflicting evidence about which drugs, if any, ease MS-related fatigue. Some studies show that amantadine may have a moderate effect for some people. Other research found that modafinil or methylphenidate could improve wakefulness in people with excessive daytime sleepiness (EDS).
High doses of other vitamins can antagonize your immune-modulating, immunosuppressive therapies used to manage MS. Supplements that stimulate the immune system should be avoided in high doses. Those include selenium, zinc, B1, B2, folic acid, B6, vitamin A, biotin, magnesium, copper, and manganese.
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.
Quality sleep is important to maintaining overall health and wellness but sometimes it's hard to get. Lack of restful sleep can cause daytime drowsiness and make some MS symptoms feel worse.
Naps should be avoided when possible. If you need to take a nap for your health and well-being, that's fine, but you can do it in a smart way. My clinic recommends limiting napping to about 30 minutes. And try to do it as early in the day as possible.
Fatigue is more persistent, constant and lingering compared to feeling tired. Feeling fatigue usually interrupts your day-to-day activities and isn't always relieved by sleeping more. “Sometimes the differences between fatigue and being tired can be difficult for people to differentiate.
If you have MS , check with your doctor before starting a routine. People with MS can benefit from at least 30 minutes of physical activity at least three days a week. For someone with MS , exercise that's too aggressive can bring on severe fatigue and injury and exacerbate symptoms.
As expected fatigue was a significant symptom for the people with MS in the studies included, it was commonly experienced and often affected those people severely. Daytime sleepiness was observed less often than fatigue and was usually less severe, but it had a significant impact on the people it did affect.
[1] Sunlight exposure and reduced Vitamin D 3 levels independently contribute to MS risk. The effect of sunlight exposure is supported by decreased signs of actinic skin damage found in MS patients compared to controls.
Sun exposure has been shown to reduce the severity and progression of MS and also lift depression. During sunnier months (late March/early April to the end of September), most people should be able to get enough vitamin D purely through sunlight hitting their skin.
One study noted young people with MS who took a calcium, vitamin D, and magnesium supplement had a reduced number of relapses.
It is a strict exclusion diet that recommends cutting out all dairy, grains, legumes, sugar-rich foods, and any foods that may cause an allergic reaction, such as eggs and yeast. It also recommends reducing the intake of saturated and polyunsaturated fats, salt, and alcohol.
Methylphenidate is a central nervous system stimulant. It is used off-label in MS for fatigue or to improve mental alertness for those with slowed processing, sometimes referred to as “cognitive fog.”
Ocrelizumab (Ocrevus) was approved by the FDA in 2017. This drug reduces relapse rate and risk of disability progression in relapsing-remitting MS . It is also the first DMT to slow the progression of the primary-progressive form of MS .