Fatigue is among the most frequently occurring symptoms affecting people with multiple sclerosis (MS), impacting about 80 percent of those with the condition. And while some medications can be helpful in treating MS-related fatigue, there are also lifestyle modifications that can help ease this common symptom.
During MyMSTeam’s Dec. 16 live Q&A event, neurologist Dr. Aaron Boster shared the following 10 lifestyle adjustments that can be helpful in managing fatigue associated with MS.
“Spending time outside in the sun helps fatigue,” Dr. Boster said. Previous studies have demonstrated that sun exposure helps reduce MS-driven fatigue, and the sun is also an excellent source of vitamin D.
“Maybe the most impactful lifestyle change is sleeping,” Dr. Boster said. Although this may seem obvious, the reality is that a lot of people with MS don’t get adequate sleep at night.
“They’re setting themselves up for failure because they’re only budgeting for six hours of sleep — they’re entering bed at midnight and their alarm is set for 6:00 a.m.,” Boster said. “So even before we start our day, we’ve cut our legs off, so to speak, because we’re not getting adequate restorative sleep. I can’t tell you how often we try to burn the candle at both ends and steal time at the cost of our health.”
“Exercise and movement help fatigue,” Dr. Boster said. Although some people with MS avoid exercising because they fear they might overheat, there are ways to avoid excessive heat when moving with MS. For instance, exercising in the water can be helpful, as can exercising during cooler times of day.
People with MS-related fatigue should always schedule time to rest. “Someone who’s resting is smart,” Boster said. “Recognize that fatigue is a symptom of a disease, and we have to treat that symptom, and sometimes treating the symptom means taking a nap, and there’s no shame in that.”
“Upping your water game helps fatigue,” Dr. Boster said. Studies support this, indicating that better hydration leads to lower fatigue. In addition, dehydration can contribute to fatigue symptoms, so boosting water intake can help.
“There are medicines that are used very frequently in MS — for bladder dysfunction, for mood, for pain — which make you super tired,” Boster said. “So if you’re trying to live your best life and not be exhausted, look at your medicines and ask the doctors which ones are contributing to fatigue and which can be removed or cut in half.”
In addition, physicians might be able to prescribe medications to help boost energy levels, which can work well in conjunction with lifestyle changes.
“A nutritious diet, which avoids heavily processed foods and sugar-related foods, helps fatigue,” Dr. Boster said. Certain diets have been studied to evaluate their impact on MS-related fatigue, and it’s important for people with MS to talk about dietary choices with their neurologists to ensure that they aren’t eating foods that worsen fatigue.
“Supplementing low levels of vitamin D or B12 can help fatigue,” Dr. Boster said. People with low levels of these nutrients can also get them from food or other natural sources. Neurologists can provide advice on whether supplementation is a good idea, as well as appropriate dosages.
Some people with MS feel stressed that they don’t have the same energy levels of their peers or family members, but that shouldn’t lead to guilt. “A lot of people with MS have stress surrounding fatigue because their spouse is at work or the world is going on, and they’re on the couch because they’re so exhausted and they feel guilty,” said Dr. Boster. “And we have to just do away with that guilt, because they didn’t ask to have MS. They didn’t ask to be exhausted. We have to just acknowledge you didn’t do anything that caused this — your fatigue is the result of a disease.”
Dr. Boster offered an analogy: “I wear glasses. Without glasses, I can’t see the screen. I have no shame or guilt about wearing glasses. In fact, I think I’m smart for wearing glasses. Treating fatigue is similar. There should be no guilt associated with trying to address fatigue.”
“Fatigue is the single most common symptom in MS, across all age groups, across all disease states,” Dr. Boster said. “It’s the leading cause of loss of work among people impacted by MS.” It’s important to accept that it may be part of life with MS — but that working with a medical team and enacting lifestyle changes to address fatigue can help.