Fatigue is probably the most common symptom of multiple sclerosis and the majority of people with MS (PwMS) experience it at some point in their disease course, often chronically and for the entire course of the disease.
The fact that fatigue is one of the most commonly observed symptom by MSers is well known. It is important to note from the above quote (and I can vouch for it), fatigue is more or less there all the time, no matter what category of MS you are in.
Using immune theory as the basis, it is still difficult to explain the feeling of fatigue.
- The process of neuro impairement is due to the immune attacks on the iron (or dead cells) build up also leading to destruction of healthy cells.
- Even when MS is in remission (i.e. when immune is not), the feeling of fatigue stays with the patients even when they are recovering from recent neuro damage
- Fatigue has been attributed to lot of factors like improper sleep etc but these are speculations at best
Bring in CCSVI and things become a little more clearer ...
Feeling of fatigue makes sense since the improper blood flow is almost a permanent fact of MSers irrespective of category of the disease. The brain is starved of oxygen (one of its primary needs) almost all the time.
I think this is another aspect of MS that CCSVI makes it very clear, even to a common person like me. Though as a side note, I have had days (more in the beginning and less there after) when I have felt almost normal (including fatigue). Now that is still a mystery ...