IBD fatigue is more than being “just tired.” These tips can help you manage it.
Symptoms of inflammatory bowel disease (IBD) can vary quite a bit, from typical gastrointestinal (GI) pains to joint pain. One of the most commonly experienced symptoms is fatigue.
Many people will still experience fatigue even when their GI symptoms are in remission. This level of fatigue makes it difficult to keep up with a well-rounded life of working, socializing, and creating. It can be discouraging and frustrating.
Early on, I named my fatigue “Crohn’s fatigue,” because it was unlike any other type of tiredness I had ever felt. It’s more than just being tired. It’s a whole-body lethargy.
When that last bit of energy is gone, there is little more to do but lay down. It feels like being out of commission.
Now that I’ve lived with IBD for a decade and a half, I’ve had plenty of time to figure out the ways to maintain life with limited energy, because we all know there’s no pause button on life.
This may be easier said than done, depending on what your job is and whether you have kids.
Humans are hard-wired to have the most energy earlier in the day because our bodies produce the most cortisol when we wake up. Cortisol is the primary stress hormone in the body and plays a role in waking us up and keeping energy up during the day.
The level of cortisol should decrease during the day, which lends itself to melatonin production. Our bodies produce the most melatonin in the evening and maintain those levels to help us stay asleep.
The balance between melatonin and cortisol is part of our innate circadian rhythm. Think of it like a see-saw effect. When one is at its high point, the other is at its low point. However, there are diet and lifestyle factors that can throw off this balance.
That’s why it’s best to plan for energy-draining activities earlier in the day when you can handle it.
Consider scheduling these types of activities earlier in the day:
- going to appointments
- cleaning, doing laundry, and prepping meals
- meeting friends (aim for lunch instead of dinner)
- working out
This can even apply to tasks for your job. If possible, schedule meetings and activities that require “heavy lifting” in the first half of the day and leave tasks that could be categorized more as “maintenance” in the afternoon.
During the times I had the worst fatigue, I knew I couldn’t spend a Saturday doing multiple activities.
For example, going to the mall, then meeting a friend for lunch, and then coming home to clean would not work for me. One or two of those would bring me to my limit for the day.
I know it’s tempting to use weekends as a time to catch up on errands and your social life, but try scheduling only one or two bigger activities each day.
If you need to commit to more plans, try to schedule time in between for a power nap or just to lay down and rest.
Sure, it’s ideal to get a fulfilling night’s sleep every night without the help of naps. But it’s not always that easy for people with IBD.
And your sleep can get disrupted in other ways from abdominal pain, night sweats, or trips to the bathroom.
When I have a bad night’s sleep, I feel like a zombie the next day.
If you work from home, give yourself permission to nap, or at least lay down to rest if naps don’t come easy to you. A wakeful rest is better than nothing.
If working from home isn’t an option, consider talking to your employer about adjustments to your schedule to work with your energy levels. Under the Americans with Disabilities Act, employers are required to provide reasonable accommodation for employees living with a disability.
Food is an important part of having high energy levels. Luckily, this is something in our control every time we go to the grocery store.
Some foods that aren’t great for supporting energy levels are:
- candy, baked goods, and other sweets
- refined carbohydrates
- chips and other highly processed snack foods
Some foods that are great for supporting energy levels are:
- quality protein sources like eggs, beef, and fish
- whole food sources of carbohydrates like sweet potatoes, squash, and fruits
- quality fats and oils, like extra-virgin olive oil and grass-fed butter
- nuts and nut butters
To make sure you’re eating energy-supporting foods most of the time, stock up on these when you go grocery shopping. That way, you’ll always have something nutritious in reach.
High-sugar foods are tempting in the moment, but their benefit is short lived without long-lasting energy to go with it.
Having IBD puts you at risk for nutritional deficiencies.
This can be from inflammation in the intestine preventing nutrients from being absorbed properly or from diarrhea and vomiting preventing proper nutrient absorption.
Your doctor can order a basic blood draw to check for nutrients. Some nutrients to check for in particular are:
- B vitamins
If needed, you can take supplements of any nutrients you’re deficient in or focus on eating more foods that the nutrient is found in. Work with your doctor or a practitioner versed in supplementation and make sure the supplements won’t interfere with any medication you’re on.
It may sound obvious, but making sure that your sleep environment is optimal is really important. Run through these sleep tips and see if there’s anything you can improve:
- Keep the room at a comfortable temperature that’s not too hot or cold, around 65°F (18.3°C).
- Make sure your bedroom is dark, without any technology lighting up the room.
- Stop using technology (like your phone) a couple of hours before bed.
- Use blue-light blocking technology in the evening.
- Don’t consume caffeine in the afternoon or evening.
- If you tend to wake up hungry, have a small snack before bed.
- Get sunlight during the day to help regulate your cortisol and melatonin levels.
- Try a sound machine or playing ASMR before bed if you have trouble falling asleep.
Without good sleep hygiene, we sabotage our chance at feeling energetic the next day before we even wake up.
If you’re not doing anything on this last, just try focusing on one at a time.
Fatigue is something most people with IBD will experience at some point, if not regularly.
If this is a challenge for you, don’t be hard on yourself if you can’t be very productive some days.
Some days will be more intense than others, but don’t forget that there are things you can do to manage and improve your energy.
And always take one day at a time!
Alexa Federico is an author, nutritional therapy practitioner, and autoimmune paleo coach who lives in Boston. Her experience with Crohn’s disease inspired her to work with the IBD community. Alexa is an aspiring yogi who would live in a cozy coffee shop if she could! She’s the Guide in the IBD Healthline community and would love to meet you there. You can also connect with her on her website or Instagram.