Ask the Doc about…Fatigue and MS

Hey Doc-
I have fatigue issues related to a chronic health condition (MS). Any advice about helpful complementary alternative methods to help out? I’m trying to keep my western medicine drug load down.


Fatigue is a complicated issue, notoriously so. It is also a very common complaint, and one of the hallmarks of chronic illnesses of the nervous and immune systems (including MS as well as rheumatoid arthritis, chronic fatigue syndrome, and lupus). Luckily, the world of alternative medicine offers many options that won’t interfere with your drug regimen.

As a naturopathic doctor, I always begin with analysis of the diet. First, make sure you’re getting enough calories to get you through your day. We often forget that a “calorie” is a unit of energy provided by food, not an evil little demon sent to plague us. Trying to maintain activity and deal with a chronic illness is nearly impossible with insufficient calories. For this reason, I don’t recommend dieting for weight loss or extreme fasting for those with chronic illness.

Make sure you schedule enough time into your day to eat, and that you are not (purposefully or inadvertently) going for long periods of time without nourishment. Fluctuations in blood sugar will sap the body’s energy very quickly.

The food you’re eating should be nourishing to your system. This means different things for different people. Plenty of water, dark green vegetables, and whole grains are a good set of guidelines to start with. Avoid food additives, as there is suspicion that they may contribute to MS. They certainly don’t provide any benefit.

Adequate protein is important to maintain energy throughout the day. The definition of “adequate” varies from source to source, but somewhere between 30-75 grams a day, from animal or vegetable sources, is necessary. Eating some protein at every meal helps even out blood sugar, thus evening out energy.

Pay attention to the way the foods you eat affect your fatigue. Tiredness after eating can sometimes be a sign of reaction to a particular food. If some meals leave you sleepy, try to avoid those foods for a few days and see if this makes a difference.

If you are having issues with digestion, fatigue is sure to follow. Stomach aches, bloating, diarrhea, constipation, and excessive gas are all signs that your digestion could use some help. Again, pay attention to how your symptoms relate to the foods you eat, and consider consulting a naturopathic doctor or other practitioner for this issue.

Sleep and exercise are the other key components in maintaining energy. If your illness interferes with your sleep, consider acupuncture to address any pain and discomfort that you have. Chinese medicine is a complete system that can address digestion and other symptoms of your illness as well, and acupuncture will not interfere with any meds that you may be taking.

Exercise might be difficult if you are experiencing pain or weakness, but it is imperative to do what you can each day. It is equally important not to overdo exercise. Don’t give in to the temptation to overwork and over-exercise on your good days; this can lead to a relapse of fatigue symptoms. Instead, find the fine line between “enough to feel good” and “too much”. This line is different for everybody, and will be different for you from day-to-day as well. Respect your body’s limits; pain does not equal gain.

T’ai chi and yoga are excellent for maintaining strength, flexibility, and balance, and can be done very gently or with more intensity. Avoid “hot” yoga, as excessive heat will drain energy quickly, especially for those with MS.

Energy medicine, such as homeopathy and flower essences, will not interfere with pharmaceuticals and can be very helpful with resolving the base causes of fatigue. Finding the right remedy does take time, so be prepared to be patient and answer lots of questions if you are working with a practitioner. If you are experimenting on your own, keep in mind that each remedy has its own personality, and you may not find the perfect match right away.

Addendum, September 2 2012: Some people with MS (or MS-like symptoms) have reported relief from their symptoms when they remove gluten from their diets. I would not go so far as to say that gluten causes MS, but I think it is worth trying a gluten-free diet to see if it helps you.

Gluten is a protein that is found in wheat and some other grains. It is ubiquitous in the American diet, so read labels carefully if you are trying to go gluten-free.

Please work with a naturopathic doctor or another nutrition expert to ensure that your diet provides all the nutrients and calories that your body needs.

Please send me any questions you have pertaining to your health, particularly how it relates to your art.

My answers are given for information purposes only. If you need specific medical advice, please contact me or another healthcare practitioner for an in-depth appointment. The internet is good for a lot of things, but good medical care can only be given by someone who has met you.

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