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What are some ways I can manage PD-related fatigue?

  1. Fatigue a significant problem for approximately half of PD patients and about a third report it as there most troubling symptom. It has been described as a deep sense of physical or mental exhaustion. There is no apparent cause and often, rest does not help. For many people with Parkinson's disease, fatigue is just as disabling and unpleasant a symptom as bradykinesia (slowed movement) or tremor. Fatigue undermines all kinds of daily activities and can lead to apathy. It feeds into our emotional reactions to PD symptoms and makes them all the harder to bear. It undermines our ability to cope with the challenges PD presents to us each day and makes it more difficult to connect with others which can result in isolation. It can make it difficult to get much-needed exercise.
    Fatigue is commonly reported in early stage PD but is often a problem at all stages. Medications and sleep issues are often contributing factors. Some have reported that melatonin, a hormone produced in the brain that controls our sleep and wake cycles, can be helpful. Others have said that staying active during the day and not taking a nap improves their sleep and reduces daytime fatigue. Another theory is that exercise can help reduce fatigue. Some doctors prescribe Ritalin® or Provigil® are sometimes prescribed for fatigue.
    In spite of the fact that fatigue is such a pervasive problem with PD, little money has been available for research. Studies have been done on potential benefits of acupuncture in reducing fatigue (https://www.ncbi.nlm.nih.gov/pubmed/27028133), but the results were inconclusive. Talk to your movement disorder neurologist if this is a problem for you.

    1. Fatigue is most certainly my most troublesome symptom of PD. I was diagnosed over 4 years ago and have done fairly well with motor symptoms (UPDRS ~10). I exercise quite a bit - on average 1.5 hrs per day - with a combination of walking, stretching, strength training and core exercises. I also spend two hours a week with "therapeutic" exercising run by movement disorder specialists.

      None of this has helped my fatigue which, as stated above, influences my level of apathy towards things I enjoy. Sleep has always been an issue for me - even well before PD diagnosis. I take Melatonin every evening to help fall asleep and benadryl to keep me asleep. However, I wake up with low energy and fatigue easily from both physical and mental exercise. I also take iron supplements.

      II haven't tried acupuncture or Ritalin or Provigil. I hesitate to add meds to my daily routine and I find acupuncture a long shot. I will continue my struggle in the hopes that the fatigue will improve over time. I'm not sure what else to do.

    2. Thanks for this answer. I am currently experiencing these exact problems.

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