Hepatitis C: An In-Depth Guide

Extreme tiredness (fatigue)

Extreme tiredness is also called fatigue. People often describe it in terms of having "good days and bad days".

Sometimes a string of good days will be followed by days of feeling totally "wiped out". For other people, fatigue is a daily companion. They feel extremely tired in the morning and completely exhausted before the end of an ordinary workday. They experience a total lack of energy to the point of feeling unable to make any physical or mental effort. This feeling happens even after a full night's sleep.

Extreme tiredness is also called fatigue. People often describe it in terms of having "good days and bad days".

Experiencing pain and discomfort adds to tiredness by causing loss of sleep and sapping energy during the day. Such a state of chronic weariness may cause a lot of negative changes in life. For example, extreme tiredness can ruin your interest in fun activities and cause you to be impatient with others.

Cause

Extreme tiredness is the most common symptom of Hep C. Severe fatigue may even develop in people whose tests show few or no changes in the liver.

Fatigue is also a side effect of direct-acting anti-viral medications (DAAs) and ribavirin. If DAA’s are the cause of fatigue, this side effect will often diminish after the first few weeks of treatment.

Treatment

  • Start a gentle exercise program: Being physically inactive will eventually cause your muscles to weaken and you will lose strength and stamina. It would then not be a surprise if you began to avoid even the simplest of chores because it would require a major effort. Start a gentle exercise program, such as walking, that gradually increases in difficulty as you recover your strength and stamina.

Tips

Plan ahead: Plan your day so that you have time to rest. Take several breaks or short naps rather than one long rest period.

Save your energy: It is important to remain physically active if you are able. However, there may be times, particularly if you are on treatment or have advanced liver damage, where you may need to conserve your energy. Look around your home or workplace and see if you can reorganize the environment so you spend less time in energy-sapping positions like bending, reaching or pulling. Examples:

  • lower your shelves, use an assistive device such as an electric can opener, or keep equipment all in one area. Your kitchen is a good place to start your reorganization.
  • use a cart with wheels for transporting heavy items like groceries and laundry
  • use delivery services
  • double your recipes when you cook so you'll have leftovers to freeze
  • have a homemaker service (if you can afford it) deal with heavy household chores

Ration energy by pacing yourself: On days that you feel well, you're probably tempted to do all you can to catch up. Try not to overdo it. It is a much better strategy to balance activity with rest or to alternate between a heavy and a light chore. Making to-do lists, in which you write tasks under headings such as must do, heavy chore and light chore, may help to clarify which jobs are high priority. As you go through your day, take a moment to estimate the energy you have left and match it with an activity or chore remaining on your to-do lists.

Try an easier or shorter version of an activity you enjoy rather than give up because you cannot do it for as long as you would normally like.

Be aware of your "windows of energy": Take notice of any pattern to the changes in your energy level over the course of the day. Do you feel strongest during the morning or mid-afternoon? Take advantage of this pattern by saving the hardest things to do for the time when you are most energetic. Try an easier or shorter version of an activity you enjoy rather than give up because you cannot do it for as long as you would normally like.

Ask for help: Try not to let feelings of pride or guilt stand in the way of getting help with an exhausting task. Inviting others to share your difficulties often eases the burden of extreme tiredness. A support group is an excellent place to learn coping tips from other people going through a similar experience.