Fibromyagia fatigue is the second rated major symptom of fibromyalgia behind pain and can be more impactful than pain itself at times. Fatigue, like pain, varies day to day, month to month. It is a heavy constant state of weariness and lack of energy as well as a mental fatigue that is immensely hard to get around.
This overwhelming exhaustion really amplifies our brain fog which makes concentration difficult and just makes it hard to remember things even more.
According to the National Fibromyalgia Association, fibromyalgia affects between 3 and 6 percent of people worldwide. Roughly 76 percent of people with fibromyalgia experience fatigue that doesn’t go away even after sleep or rest.Healthline
Other than sleep dysfunction, another theory behind our fatigue is the result of our bodies trying to deal with then onslaught of pain. That the constant reaction and response to the pain signals in our nerves leads to us being exhausted. I believe it is likely a bit of both. Since I have more than one pain condition I am quite aware that constant pain is extremely draining. Likewise, poor sleep quality and quantity also seem to impact my fatigue levels.
I decided to write on this topic for fibromyalgia awareness month because I have really hit a major wall of fatigue these last few weeks that has been extremely hard to cope with. Partly that is due to the compounding fatigue factors of comorbid conditions but also the fact that fatigue with fibromyalgia simply can be severe at times.
Factors on why fatigue can be such an issue
- Medications- some medications we are on can make fatigue worse. And if we find fatigue is extremely hard to cope with it is worth talking to our medical professionals about a medication check and possible change.
- Stress- A chronic illness is a pretty stressful state to exist in and to manage. When we add in external stress factors into that it can flare up our symptoms. But we also have to consider that we are in a state of Chronic Stress- this can contribute to a lot of problems health wise and some speculate it can even be a trigger for the onset of fibromyalgia in the first place. Either way, chronic stress is not a good state for the body to exist in. And trying to reduce stress has always been a management goal I use.
- Anxiety/depression- I certainly know depression amplifies my fatigue and also sucks away my motivation. Trying to maintain motivation and routines then becomes a momentous effort and is extremely hard to sustain. I do, and then I don’t… then I do… then I don’t. It is just a constant battle to try and manage things and being constantly exhausted such that I just want to rest. Depression makes you 4 times more likely to have fatigue. And when you have fatigue you are 3 times more likely to have depression.
- Lifestyle- This sort of ties in with the above factors. As in, we all are aware of things that benefit us to manage our health but sustaining and maintaining those routines can be extremely difficult. However, eating well and having good nutrition can help with fatigue.
- Sleep dysfunction- With fibromyalgia it is part of the syndrome to have sleep dysfunction, insomnia, and unrefreshed sleep and we are also more likely to have other sleep disorders like Restless Leg Syndrome and Sleep Apnea. “80% of fibromyalgia sufferers encounter poor sleep.That’s because they have a brain-wave pattern typically seen in awake people, according to Harvey Moldofsky, M.D., head of the Sleep Disorders Clinic of the Centers for Sleep and Chronobiology in Toronto.The pattern, called “alpha intrusions” or “alpha abnormality,” could prevent you from sinking into the deep sleep stages needed to feel refreshed” (Everyday Health) This is a major factor in fatigue. A lot of researchers point to this as a the main factor for our fatigue but more research is really needed to figure it out.
What can we do about fatigue?
It can be a difficult problem to tackle because we have energy production issues with fibromyalgia. But there are factors we can try to manage to help with our fatigue levels.
- Stress reduction– Management of stress is a great place to start and there are a lot of ways to try and reduce chronic stress. You can start a gratitude journal, set time aside from hobbies, socialize (when and if you can), meditation practices, relaxation breathing, or even mild to moderate exercise… all of these can help reduce stress.
- Pacing and energy management– We know we have to pace to manage pain- on good pain days and bad pain days. But we also have to pace to manage our energy levels. Doing too much can really flare up that fatigue for days even. So make your day simple, set limits, and stay within those limits- even on good days. Just like with pain we have to pace on good days as well- too much causes flares and we end up in a boom and bust cycle. Setting time aside to rest has helped me a lot lately. Even a short nap in the day can help manage energy for the rest of the day or before you go out.
- Exercise– I know for me exercise helps manage physical and mental fatigue. Even mild and moderate exercise, which is all I am really capable of. And I am not even capable of it every day. So even what I can do, actually helps with fatigue. It is just hard to stick to the habit of it. But I know it definitely does help. But we Have to start really slow and increase very slowly because it can cause flares and it is also itself exhausting. So slow and easy.
- Focus on sleep- This is tricky but many specialists agree that fibromyalgia sleep dysfunction causes a lot of issues with fibromyalgia. So managing sleep is a major factor. A good start is with sleep hygiene. I really like to create some serious chill time before bed to get in the right mindset. But still, doesn’t always help much when I wake up 800 times a night. However, you may have to discuss with your doctor some options to help you get quality sleep.
- Do a medication check- This is a good thing to do once in a while anyway. But if you think a medication is seriously causing fatigue issues it is worth discussing to see if something different would be better or altering the dosage might help.
- Comorbid conditions- We have to also try to manage our comorbid conditions that could be compounding pain and fatigue. This is a very tricky one, I find.
- Alternative therapies- there may be a few alternative therapies to try that may work for you. Such as massage therapy or acupuncture.
Supplements that may help
There are certain supplements that I always take that can help with fatigue as well. And some that are recommended that I do not take but have considered.
Always remember to tell your doctor which supplements you are taking just in case they conflict with medications you are taking.
- B complex– I take a vitamin B complex. It has all the B vitamins in it. ““Food needs to be converted to energy for your body to run,” Dr. Teitelbaum explains. “B vitamins help build energy molecules” – especially after a fibromyalgia flare-up, when fatigue is likely to be at its worst.” (Everyday health)
- Magnesium- One recommended for fibromyalgia overall anyway. However, there are different kinds of magnesium. Some may upset your digestive system if you have IBS-D like I do. I take Magnesium Glycinate due to my digestive issues. But if you can tolerate Magnesium citrate then it is quite beneficial “Low levels can disrupt sleep, a problem suffered by 80% of fibromyalgia patients. At the same time, chronic sleep problems can further reduce magnesium levels in cells, according to a 2004 Japanese study.” (Everyday Health)
- Coenzyme Q10 – I don’t actually take this one but it is often recommended. I just can’t afford to take too many supplements so it just never made it to my list. But it supposed to be great for energy production. “A double-blind, placebo-controlled clinical Source found that taking 300 mg a day of CoQ10 significantly reduced pain, fatigue, morning tiredness, and tender points in 20 people with fibromyalgia after 40 days.” (healthline) But that was a really small study.
- Rhodiola: This supplement is something I use for mental and physical fatigue specifically. And it works for me and I continue to take it regularly.
- Vitamin D– It was recommended by my doc to take 5000 iu of vitamin D and so I do. ““Vitamin D deficiency is common in fibromyalgia patients because they often avoid sun exposure,” says Pamela Yee, M.D., of the Center for Health and Healing in New York.” (Everyday Health) I don’t see that it helps with pain or other issues but I do see it can be beneficial in regards to a deficiency or comorbid issues.