Multiple Sclerosis and Chronic Fatigue Syndrome
Fatigue is one of the most common symptoms of Multiple Sclerosis (MS), and it affects most people with MS at one time or another.
Fatigue is an invisible symptom and can be extremely difficult to explain to other people. The closest human condition that helps explain it is extreme tiredness, but we all know that doesn’t really touch on what it feels like. If you’re tired, you can get a few early nights and that should make you feel better, but fatigue doesn’t respond like that.
Fatigue can feel like your limbs are weighed down with lead, and simple tasks like holding a knife and fork can feel impossible. It can be physical but can also be cognitive, making thoughts sluggish, speech more difficult and affecting memory and concentration.
Fatigue is experienced by around 80% of MS sufferers, but MS isn’t the only condition that can cause fatigue. Many different conditions can result in crippling fatigue, but the best-known condition is Chronic Fatigue Syndrome (CFS).
What Is CFS?
CFS was previously known as Myalgic Encephalomyelitis (ME) and I remember it being referred to as “Yuppie Flu". It’s widely misunderstood, and perhaps this is because the symptoms are invisible. The media portrayed sufferers as lazy, and many people didn’t believe it was a true illness.
Luckily, this stigma seems to have improved as CFS/ME is now better understood. I know many sufferers and, believe me, it’s a very real and disabling condition.
Symptoms of CFS/ME
CFS/ME is a long-term illness and has a wide range of symptoms, the most common of which is extreme tiredness. As with MS, the chronic fatigue experienced isn’t as simple as “feeling tired"; it can be hugely life limiting and have an impact on work, social life and relationships.
Other symptoms include the following:
- Feeling generally unwell
- Sleep problems
- Muscle or joint pain
- Headaches
- Sore throat or sore, swollen glands
- Cognitive problems such as thinking, remembering or concentrating
- Flu like symptoms
- Feeling dizzy or sick
- Fast or irregular heartbeat (heart palpitations)
As with MS, these symptoms can vary from day to day or even within the same day. Many of the symptoms are similar to those of MS or other conditions, so it’s important to get the correct diagnosis from your health care professional.
How is CFS/ME Diagnosed?
Unlike MS, there are no specific tests for CFS/ME so it’s diagnosed by ruling out other conditions that may be causing your symptoms.
Your doctor will ask about your medical history and if your symptoms don’t improve on their own, a diagnosis of CFS/ME may be considered.
Understanding Multiple Sclerosis and Chronic Fatigue Syndrome
Since many of the symptoms of MS will overlap with CFS/ME, it can be difficult to differentiate between the two conditions. I’ve spoken to many people online who have been diagnosed with both, but who have trouble understanding where one condition starts and the other stops.
MS can be diagnosed using MRI scans, lumber punctures and other tests, and the chronic fatigue experienced can be a symptom of MS.
For instance, my fatigue can be managed as long as I rest, pace myself and watch what I eat, so I guess if I had CFS/ME it wouldn’t improve.
Treatments
What can be done to improve fatigue in CFS/ME?
Most people with CFS/ME get better over time, unlike MS which we are unfortunately stuck with. Some people never make a full recovery and it’s likely there will be periods where CFS/ME get better or worse, similar to relapses in MS.
Symptoms can be improved using Cognitive Behavior Therapy (CBT) to improve how the sufferer copes with the illness.
A structured exercise program known as graded exercise therapy (GET) can also help, although too much strenuous exercise can make fatigue worse. Medication can also help to control pain, nausea and sleeping problems.
Causes of CFS/ME
As with MS, the causes of CFS/ME are unknown but some theories include:
- Viral infections
- Bacterial infections
- Issues with the immune system
- Hormone imbalance
- Genetic factors
- Mental health conditions
Living with Multiple Sclerosis and Chronic Fatigue Syndrome
If you’re unlucky enough to have been diagnosed with both multiple sclerosis and chronic fatigue syndrome, or are dealing with chronic fatigue caused by one or the other, the symptom feels the same and can be as disabling as physical symptoms.
Get to know your own illness and notice any triggers that make symptoms worse. Rest as much as you can and make sure you look after the rest of your health.
My fatigue is greatly improved, for example, by being strict about my diet. I avoid gluten and dairy and find that keeping my weight down generally makes me feel better. I allow myself as much sleep as I can get and work part-time to avoid exhaustion. I also don’t beat myself up if I have to cancel social events to manage my fatigue, and I make sure I don’t over do things as I know I’ll pay the following day!
Allowing yourself the rest you need goes a long way in managing fatigue, and never be afraid to ask for help.