Saturday, 14 March 2015

Features of Fatigue

Weiland TJ, Jelinek GA, Marck CH, Hadgkiss EJ, van der Meer DM, Pereira NG, Taylor KL. Clinically Significant Fatigue: Prevalence and Associated Factors in an International Sample of Adults with Multiple Sclerosis Recruited via the Internet.
PLoS One. 2015 Feb;10(2):e0115541

BACKGROUND: Fatigue contributes a significant burden of disease for people with multiple sclerosis (PwMS). Modifiable lifestyle factors have been recognized as having a role in a range of morbidity outcomes in PwMS. There is significant potential to prevent and treat fatigue in PwMS by addressing modifiable risk factors.
OBJECTIVES: To explore the associations between clinically significant fatigue and demographic factors, clinical factors (health-related quality of life, disability and relapse rate) and modifiable lifestyle, disease-modifying drugs (DMD) and supplement use in a large international sample of PwMS.
METHODS: PwMS were recruited to the study via Web 2.0 platforms and completed a comprehensive survey measuring demographic, lifestyle and clinical characteristics, including health-related quality of life, disability, and relapse rate.
RESULTS: Of 2469 participants with confirmed MS, 2138 (86.6%) completed a validated measure of clinically significant fatigue, the Fatigue Severity Scale. Participants were predominantly female from English speaking countries, with relatively high levels of education, and due to recruitment methods may have been highly pro-active about engaging in lifestyle management and self-help. Approximately two thirds of our sample (1402/2138; 65.6% (95% CI 63.7-67.7)) screened positive for clinically significant fatigue. Associations were present between clinically significant fatigue and several demographic, clinical, lifestyle, and medication variables. After controlling for level of disability and a range of stable socio-demographic variables, we found increased odds of fatigue associated with obesity, DMD use, poor diet, and reduced odds of fatigue with exercise, fish consumption, moderate alcohol use, and supplementation with vitamin D and flaxseed oil.
CONCLUSION: This study supports strong and significant associations between clinically significant fatigue and modifiable lifestyle factors.


What do you think? What can be done to reduce fatigue

8 comments:

  1. "...we found increased odds of fatigue associated with obesity, DMD use, poor diet, and reduced odds of fatigue with exercise, fish consumption, moderate alcohol use, and supplementation with vitamin D and flaxseed oil."

    Hmm. I am bang on an ideal weight for my height, have never used DMDs (I have PPMS), exercise as much as I can, eat lots of fish, am t-total, take 800IU of vitamin D every day and put flaxseed in my porridge. But fatigue when doing anything involving my legs is a major problem for me. So I might have thought that these countermeasures don't help, but then, I suppose the way to look at is to imagine how I would be if I was fat, ate junk and was to binge drink and puff on cigarettes on a regular basis. I'd be a wreck, I reckon. But this kind of blindingly obvious isn't it?

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    1. I was thinking the exact thing. I also exercise, keep weight down, etc. if I weighed 20 more pounds I believe I would need a wheelchairs.

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  2. I too am t total, gave up occasional alcohol drinking not long after my I had my first relapse. I eat fish two or three times a week, 3000iu a day of Vit D, exercise every day, take stress management, go to bed early, no junk food, don't smoke, i'm not overweight. Have RRMS and get fatigue also in my legs.

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  3. Vitamin D has been labelled an enemy of good health today (see: http://www.scotsman.com/news/health/high-levels-of-vitamin-d-linked-to-heart-attacks-1-3718771)

    What say you men?

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    1. Interesting it mentions ...
      “If your vitamin D level is below 50 or over 100 nanomol per litre, there is an greater connection to deaths.
      For me 5000iu vit D a day is far too high, I do eat eggs and fish already.

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  4. I do exercise,get som tan from the sun( vitamin D) reduce th intake of saturated fats and eat healthy and my fatigue disappeared 2008.

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  5. Here's a very recently published report (27th Feb 2015) on fatigue from a dietary approach which has both similarities and complete opposites to the Professor Jelinek OMS approach which is the subject of the article cited above.
    http://www.dovepress.com/multimodal-intervention-improves-fatigue-and-quality-of-life-in-subjec-peer-reviewed-fulltext-article-DNND

    It seems to depend partly on which dietary/lifestyle "guru" approach you want to believe will work (or not work) for you, and there's plenty of them out there - all claiming positive results for MSers. I'm not saying that there isn't something in the dietary approaches - on the contrary - good diet is critical for good health, but the definitions of "good diet" are constantly being challenged. There is so much variation and contradiction - include dairy/exclude dairy, avoid sat fats/include sat fats, eat meat/don't eat meat, eat only fish as a source of animal protein, eat lots of grains/carbohydrate or avoid them like the plague, gluten is the enemy, leaky gut/candida causes MS, and so on. It's total minefield, with some people adopting The China Study as a new bible for our times, and other evidence being put forward refuting considerable chunks of its content.

    For anyone who is interested in how "Big Agri" (the agricultural industry equivalent of Big Pharma) has influenced what we eat today, try and get hold of the BBC series by Jacques Peretti called "The Men Who Made Us Fat" - that is a real eye opener - makes Big Pharma look like a kindly grandmother!

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