Coping with Fatigue in Parkinson's
I have dealt with fatigue in many chronic illnesses, including Parkinson's disease (PD). But, fatigue was never thought to be part of Parkinson's disease until recently. In recent years, we have learned that fatigue can and does occur in Parkinson's. This pesky symptom can be one of the prodromes (pre-motor symptoms) of PD. As you all know, fatigue can wreak havoc with anyone's body as it did me when I first began having PD symptoms. Having fatigue can also make all other symptoms seem much worse than they really are.
So, what can we do to prevent or improve fatigue?
First recognize that fatigue is a non-motor symptom of PD. We should avoid things that can exacerbate our fatigue like....
We know PD patients have a lot of trouble sleeping, so discuss treatment options with your physician to alleviate this problem. Now that I am sleeping well, I have more energy and don’t feel run down like before.
Make sure you are not anemic; a large number of PD patients have B12 deficiency which can lead to anemia and subsequent fatigue. A simple blood test can tell you if you are deficient. If you are below 400ng/ml you will need replacement in the form of IM (intramuscular) injection, sublingual, or nasal spray formulations to ensure absorption into the body. Most people will require replacement indefinitely due to having a chronic illness.
Vitamin D deficiency
Half of PD patients have insufficiency and 1/4 have a deficiency - this can cause aches and pains as well as general malaise. Make sure your doctor is checking your blood routinely and replacing as needed.
Infections, especially those of the urinary tract (more common in women), can lead to general malaise mimicking or exacerbating fatigue.
Just like infections, not being hydrated can make you feel run down. So, make sure you drink plenty of water, particularly in extreme weather conditions.
Another common cause of feeling fatigued is the PD medications themselves. Many of these are sedating (i.e. dopamine agonists).
Constipation is a chronic problem for all of us who live with PD. The simple act of being constipated can cause lethargy in and of itself. Ask your doctor to help get a good bowel regimen which might include medications, dietary changes, as well as an exercise program.
Thyroid disease, diabetes, depression, and uncontrolled high blood pressure can cause fatigue - make sure you get a general physical exam on a yearly basis, or more frequently, if there is a family history or you're at risk. Get blood checked for these treatable conditions because having PD does not exclude you from having other more common and frequent medical problems which can lead to fatigue as well.
Finally, as I said at the beginning, fatigue can be a symptom of PD itself. Once you have ruled out other things, you can treat this by adjusting PD medications. I've found that one of the best treatments for this is amantadine which will help both motor and non-motor symptoms. Another medication which also helped is Zoloft (sertraline), which has been FDA approved for chronic fatigue syndrome.
Make sure that you drink plenty of fluids, get a good night’s rest, and don’t forget that PD does not prevent us from having other illnesses. Learn to listen to your body. If you have severe fatigue discuss it with your physician ASAP.
Have you seen our new forums yet?