Myalgic Encephalitis / Chronic Fatigue Syndrome is a common co-morbid condition of fibromyalgia. Some specialists argue that the two conditions are slightly different manifestations of the same underlying disease process. Others consider them to be two very separate entities – to the point where many suffers have been diagnosed with both as separate diseases.
Either way, it is very common for fibro-warriors to also suffer severe fatigue. (As if chronic pain wasn’t enough on its own!)
Most people have tried being over tired. It might be due to study, working too much, partying too hard, a newborn or a sick child. Any number of things might lead to being overly tired. So you would think that other people would understand. But while you might be able to understand bone weary tiredness, for most people this can be remedied with enough caffeine in the short-term, and a good long sleep to get you back to normal in the longer term.
But to truly understand fatigue in the sense of chronic fatigue, I think you have to actually experience it. It is being so tired that you are unable to keep your eyes open as soon as the lights dim, where it’s a struggle to put one foot in front of the other, where your muscles are so tired that you shake as soon as you stand up and you can’t lift a glass up to your mouth. Sometimes, it’s being so tired that sitting up in bed for 30 mins means you have to lie back down and have a nap to recover. But that sleep you get is not restorative. It might get you back to zero energy rather than negative. It is that horrendous sap of energy that a bad bout of influenza will give you, but it lasts for weeks or months, or for some people years.
Thankfully, I am not that bad most of the time. It takes a lot of management to avoid being that bad. Before I stopped working, that was pretty much my days off. Now it will only happen if I push too hard or the Fibro-Troll invites some friends over in the form of an extra injury or cold/flu.
So what do I do to manage fatigue?
I stopped working. This is not an option for everyone and it was a decision I really struggled with. For me, being a Vet was part of my identity. It wasn’t just what I did, it was who I was. Giving this up was one of the hardest decisions I ever had to make. And guess what? The world didn’t stop turning. I had 2 years of income protection insurance, which was a huge hassle and stress to get. But since then we have only had my Knight’s income. We’ve made sacrifices, but we manage. I’m a lucky woman.
Pacing. If I had to choose just one thing that I do to help manage fatigue, it would be pacing.
One thing that is very common among Fibro-Warriors and others with chronic illnesses is the boom and bust cycle. I was guilty of this (and sometimes still am). I would push until I had finished something instead of just going to bed. Or I felt a little better, so I would decide to clean the house or go shopping. I wouldn’t feel too terrible while I was doing it, but the next day or week the Fibro-Troll would have the whole family over for a reunion. I would barely be able to walk to the bathroom, let alone do anything remotely productive.
So I have had to learn to pace. This means setting a timer – on a good day this might be 20 or 30 mins. On a medium day, it might only be 10. On a bad day, I give myself permission to get nothing done. I do my housework or physical thing until the timer goes off. And then I stop (most of the time) and REST. If I do this, then some days I can do an hour or two of physical work spread out over the day and not end up crippled for the next three days.
Improve Sleep Quality. Non-restorative sleep or insomnia is very common and only adds to the fatigue. My issue is more the non-restorative sleep, although I do have occasional bouts of insomnia.
I will go into this in more detail in a post dedicated to sleep.
Vitamin and mineral supplements. I take quite a few supplements, but only one stands out as being specifically for fatigue, and that is vitamin B12. I take a sublingual (under the tongue) methylated version of B12. I accidentally ordered the non-methyl version recently and it simply doesn’t do the same job.
The other supplements I take that are partially for fatigue are:
- Magnesium – I take a powdered oral form that has other vitamins and minerals
- Vitamin D – one of the symptoms of low Vitamin D is fatigue, but it is important to have this tested before starting any supplements
- Bioflam – I mentioned this in my recent post on dysmenorrhoea, it has a bunch of B vitamins in it that are supposed to help with fatigue.
- CoQ10 – Co-enzyme Q10 is supposed to assist with ATP production (the body’s main source of energy) so it theoretically helps with fatigue. I’ll talk more about this when I write my post on migraines and headaches.
Hyperbaric Oxygen Therapy. I have an entire post dedicated to this. You can read more about it here.
Diet. A healthy diet avoiding processed foods and too much sugar is vital for me to manage my fatigue. If I let some “crap” sneak in, then the fatigue (and pain!) is much worse. I go into my reasoning in more detail here.
Chronic fatigue is a complicated and difficult symptom to manage. It is much more involved than just getting some more sleep. I still haven’t got it perfect, but it is a work in progress.
