Fatigue is a common and often debilitating symptom that can happen at all stages of a migraine attack. In the prodrome phase, it may signal that an attack is coming and can be a good reminder to listen to your body, to slow down, rest and practice self-care. Fatigue can continue through the aura and attack stages and is often at its worse during the postdrome stage, sometimes lasting for several days. Many people with migraine report feeling tired and low-energy most of the time, regardless of where they fall in an attack cycle. Fatigue is a difficult and invisible symptom that impacts all aspects of life.
What does migraine fatigue feel like?
Fatigue can come in varying forms and intensities. It can be very physical and feel like weakness, lack of energy, or extreme exhaustion. It can also be mental, and present as confusion, difficulty concentrating or focusing, and include emotional changes.
What causes fatigue?
Like all things migraine, the exact cause of fatigue is hard to pinpoint. Living with pain depletes our energy levels. Pain also impacts our ability to lead healthy lifestyles as it limits how active we can be, how well we sleep, and the time we have to prepare and eat healthy foods. In addition, fatigue is a common side effect of many medications.
When it comes to migraine-related fatigue, it’s a bit of a chicken and the egg situation—which comes first?! To complicate matters further, fatigue is also a symptom of many other comorbid conditions, so it’s important to discuss it with your doctor, especially if it is disruptive to your quality of life.
Common comorbidities that cause fatigue include:
- Thyroid disorders
- Chronic Fatigue Syndrome
- Fibromyalgia
- Lupus
- Multiple Sclerosis
- Sleep disorders (such as Excessive Daytime Sleepiness, Sleep Apnea, Restless Leg Syndrome, and others)
- Autoimmune Diseases
- Depression/Anxiety
Managing Fatigue
The mental and physical effects of fatigue are difficult as they impact all areas of life. Though it is difficult, keeping up with a healthy lifestyle and practicing self-care can help.
1. Exercise
Though it may feel like the last thing you want to do when you’re tired, getting regular exercise can help increase energy levels by releasing endorphins—our bodies’ natural painkillers. Read more about the benefits of exercise and tips for getting moving here.
2. Hydrate
Dehydration can make fatigue worse and is also a migraine trigger. Migraine-associated nausea and vomiting can make it tough to stay hydrated. Making sure to drink enough water each day is an important way to bring your energy level up.
3. Choose fueling and brain-healthy foods
You can read about the importance of a healthy diet for migraine management here. Try adding energy-boosting foods like these to your daily diet, bearing in mind to avoid those foods which are migraine triggers for you or which you are sensitive/allergic to:
- Bananas
- Lean protein
- Nuts
- Eggs
- Apples
- Oatmeal
- Avocado
- Berries
4. Ask about supplements
Talk to your doctor about which supplements may help increase your energy levels. Common supplements for energy support include:
- Vitamin B (B-2 Riboflavin, B-12 and/or B-6 for energy support)
- Vitamin D
- Magnesium
- Iron (be sure to check with your doctor first)
- CoQ10
5. Rest and practice good sleep hygiene
Since pain depletes our energy quickly, it is important to get rest outside of your regular sleep hours if your body needs it. Resting can be as simple as sitting on the couch and reading a book, taking a long bath, listening to music, or doing something creative. On top of that, making sleep a priority is important for managing migraine and fatigue. Get tips for getting better sleep here.
6. Take care of your mental health
Anxiety and depression often come along with migraine and can be extremely taxing. Be kind to yourself, rest when you need to, and try some soothing activities to help you relax. Get more tips and read more about managing mental health here.