5 Natural Remedies for Multiple Sclerosis Fatigue

Multiple sclerosis (MS) is an autoimmune condition that affects the central nervous system (brain and spinal cord). MS symptoms vary from person to person, depending on what parts of the brain and spinal cord are affected. But fatigue is one symptom that most people living with MS have in common. 

Multiple sclerosis fatigue goes beyond simply feeling tired. It can interfere with work, relationships, and daily activities. If you’re living with multiple sclerosis fatigue, here are some natural remedies you can try to ease your symptoms.  

What is multiple sclerosis fatigue?

Multiple sclerosis fatigue is a common symptom of MS. Most people with MS will experience periods of fatigue throughout their lives. Even though MS can cause severe physical symptoms, fatigue is the most common reason many people with MS aren’t able to work or complete their daily tasks. 

Multiple sclerosis fatigue is different from other types of fatigue because it:

• Tends to happen every day

• Gets worse throughout the day

• Doesn’t get better with good quality sleep or rest 

• Is more severe and lasts longer than regular fatigue

• Isn’t related to how much physical activity you do

• Keeps people from completing their everyday activities

• Can get worse with heat and humidity

• Isn’t related to sadness, depression, or other emotions

What are the symptoms of multiple sclerosis fatigue?

Multiple sclerosis fatigue goes beyond “ordinary” fatigue. It can include both physical and mental symptoms. 

Multiple sclerosis fatigue can feel like:

• Physical exhaustion

• Extreme tiredness or sleepiness

• Sluggishness

• Difficulty concentrating (“brain fog”)

• Lack of mental energy

• Trouble thinking or remembering things

• Taking longer to complete tasks

• Loss of motivation or interest in things

What causes multiple sclerosis fatigue?

Researchers aren’t sure what causes multiple sclerosis fatigue. But it’s likely related to inflammation in the brain and spinal cord. 

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It takes more energy for inflamed and damaged nerves to pass messages to the rest of the body. Nerves are constantly sending signals — this means people with MS may need to use a lot more energy to power every part of their body. In theory, this could cause overwhelming fatigue. 

Treatment options for multiple sclerosis fatigue

There is no treatment for multiple sclerosis fatigue. Medications that treat multiple sclerosis can slow physical symptoms. But these treatments don’t seem to stop or lessen multiple sclerosis fatigue. 

But that doesn’t mean you can’t take steps to help your symptoms. There’s some evidence that natural remedies can help with multiple sclerosis fatigue. Natural remedies don’t always have a lot of evidence to support their use. But they are generally safe for most people, so it can be worth giving them a try to see if they work for you. Here are five you can try.

1. Active cooling 

Multiple sclerosis fatigue tends to get worse in hot or humid conditions. So it makes sense that cooling techniques may help lessen fatigue. Experts recommend trying “active cooling” to help with MS symptoms. This includes using things like:

• Cooling vests

• Cooling pads

• Portable air conditioners

It also includes keeping rooms at cool temperatures and drinking cold water throughout the day. 

In one 2022 review, researchers found that cooling therapy helped ease fatigue symptoms and improved people’s quality of life. Another 2023 review found that cooling garments, like cooling vests, not only eased fatigue but also helped with mobility and strength.

Cooling therapy is generally safe for most people to use since items don’t get too cold to cause cold injuries. Your healthcare team can help you adjust your cooling devices so you get the most benefit from therapy. 

2. Exercise

It may seem counterintuitive, but exercise may actually help improve multiple sclerosis fatigue and not make it worse. 

In one 2015 review, researchers found that people who exercised regularly reported less fatigue than those who didn’t. Another 2020 review showed the same results. This was true across many types of exercise programs including strength training, endurance training, and low-impact activities like yoga and water aerobics. There’s some evidence that adding balance exercises to a regular exercise routine may offer additional fatigue-fighting benefits.

Work with your healthcare team, including a physical therapist, to come up with an activity routine that’s right for you. They can help you find the right balance of activities that meet your physical needs. 

3. Nutrition

Right now, there’s no official nutrition guidelines for people living with multiple sclerosis. Researchers have looked at whether different diets and eating styles can affect MS symptoms, including fatigue. Many of these studies are small and have other shortcomings, which makes it difficult to know how to use their results.

But there’s some evidence that a diet that’s high in whole grains, fruits, and vegetables can help ease multiple sclerosis fatigue. In one well-designed study, people who followed a low-fat diet had a significant reduction in fatigue symptoms after 12 weeks. 

Another review found that people who followed Mediterranean and paleo diets, which are high in plant-based foods and whole grains, reported less fatigue symptoms and better physical and mental wellness. 

4. Energy conservation 

Energy conservation is a type of therapy that focuses on simplifying tasks so they are easier to complete. An occupational therapist works with you to review your everyday activities at home, school, and work. Then they help you come up with ways to complete these activities so you use less physical and mental energy. This may help reduce fatigue.

In one review, researchers found that people who used energy conservation techniques reported less fatigue than people who didn’t use the techniques. They also reported that energy conservation techniques improved their mood and social relationships. 

Your healthcare team can help connect you to an occupational therapist if you are interested in trying energy conservation. 

5. Supplements

Like diet changes, there’s not a lot of strong evidence showing that supplements can help reduce multiple sclerosis fatigue for most people.

One review of studies found that people who took vitamin D supplements had less fatigue than those who didn’t. Another study found that people who took probiotics reported less fatigue and pain.

One well-designed study found that people who took a general multivitamin that also contained coenzyme Q10 reported having less fatigue. These people also had lower markers of inflammation in their blood at the end of the study. 

But it’s important to talk with your healthcare team before adding supplements to your daily routine. First, people in these studies weren’t taking large amounts of supplements. Depending on your diet, you may already be getting enough of these nutrients. You may not need any additional supplements. Your healthcare team can help you find the right combination of vitamins and minerals. They can also help you find the best quality supplements.  

When should you seek care for multiple sclerosis fatigue?

It’s never too early to get care for multiple sclerosis fatigue. Fatigue can take a toll on your personal and professional life. It can impact your work performance and your relationships. Your healthcare team can help you find a combination of treatments to help ease your symptoms so you can get back to doing the things you love. 

Why trust our experts?

Written by:

Jennifer Sample, MD

After a fellowship, Dr. Sample worked as the medical director at the University of Kansas Hospital Poison Center (The University Of Kansas Health System Poison Control Center), which served the state of Kansas for poison exposures. In 2007, she returned to Children’s Mercy Hospital in Kansas City, Missouri, as a consultant in clinical pharmacology and medical toxicology.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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