Living with MS: 21 Tips to Reduce Cog-fog and Fatigue

Discover the key steps to reduce the most common MS symptoms so you don’t have to suffer while living with MS.

Written by MasterHealth Staff

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Living with MS can present with many challenges, sometimes requiring lifestyle modifications and the addition of functional supports at home or work, depending on the stage of MS that you’re currently at.

 

Many people can live with MS with few physical limitations, which is why some of the most common life-altering MS symptoms are considered ‘invisible’ – brain fog, chronic fatigue, pain, anxiety and depression.

 

The occurrence of MS flare ups and relapses can become more common if the appropriate dietary and lifestyle interventions are not in place to limit inflammation and reduce the formation of new MS lesions, which can negatively impact someone’s quality of life.

MS fatigue is reported as a symptom in roughly 75-95% of people living with MS. It’s associated with a reduced quality of life as it can make it extremely difficult to complete basic daily tasks, like bathing, eating, or socializing. MS fatigue can be acute, lasting up to 1 month, or it can be chronic, lasting 1-6 months or longer.


There are two types of MS fatigue:

  • Primary fatigue is believed to be a result of the damage to nerve cells within the brain. When there are fewer nerve cells, more energy is required to transmit messages between nerves for a specific action, like walking or speaking, leading to increased fatigue.

  • Secondary fatigue is considered a side-effect of the symptoms of MS, such as fatigue from pain, muscle spasms, and/or a disturbed sleep.
Living with MS Fatigue

MS fatigue is persistent, even with a good night’s rest. It can be overwhelming and disproportionate to the activities or tasks at hand, and can occur unexpectedly at any time of day.

 

A helpful analogy to understand MS fatigue is the “Spoon Theory”, coined by Christine Miserandino, which likens living with chronic illness to having a set number of spoons each day. These spoons represent a person’s energy.

 

According to this theory, one or two spoons are taken away from the different experiences and tasks someone might have throughout the day – let’s say, 2 spoons for bathing, 3 for socializing, and 1 for cooking.

 

People living with MS, spondylitis, chronic fatigue syndrome, and other chronic diseases often start their day with fewer spoons compared to others. This means, by the end of the day, someone with a chronic illness (sometimes referred to as a “spoonie”) only has a few, if any, spoons remaining for even the most basic tasks.

MS fatigue is best combatted through dietary modifications, a regular exercise regimen, specific supplements, and a solid sleep routine.

 

A diet that has been proven to help improve fatigue, and disease severity in people living with MS is The Wahls Diet™, a component of The Wahls Protocol®.

 

Dr. Terry Wahls created The Wahls Protocol® to improve her own disease outcomes while living with MS, and has since effectively reversed her immobility by following the components of this protocol.

 

The Wahls Protocol® incorporates exercise and MS-specific supplements and foods  that can help to increase your energy and mental clarity (such as Coenzyme Q-10 and organ meats), while supporting your overall health.

About half of all people living with MS will develop some degree of brain fog, affecting memory, concentration, information processing, problem solving, and visuospatial abilities. 

 

MS brain fog is believed to be caused by a combination of cell damage, brain lesions, and inflammation. Symptoms are often mild in most people, but can increase due to stress, diet, fatigue, heat, and even some medications.

Living with MS Cog Fog

MS brain fog, sometimes called cog-fog (short for cognitive fog) or brain haze, can sometimes feel like searching for words or trying to remember where you put your keys like a needle in a haystack. It can also be described as feeling “out of it” for most of the day.

 

Some common symptoms of cog-fog include difficulties with:

  • Memory
  • Conentration
  • Focusing
  • Following complex instructions
  • Planning
  • Problem solving

Similar to MS fatigue, combating MS brain fog is best done by implementing healthy habits and lifestyle, including diet, physical exercise, sleep, and stress reduction.

 

Since MS brain fog is believed to be due to cell damage and inflammation, the best diet for MS is one that eliminates highly inflammatory and immune-activating foods – i.e. dairy, gluten, refined sugars, and any other food sensitivities. The Wahls Diet™ is a great place to start!

 

Poor sleep is another important contributor to brain fog, since this is when your brain consolidates information, repairs, and regenerates. Getting 8-9 hours of sleep is recommended. It’s best to head to bed before 10pm and maintain consistent sleep and wake times so that you can optimize healing.


The Wahls Protocol® app-based program is an excellent tool for people living with MS looking to get on track to eliminate inflammatory triggers and set healthy habits. It’s customizable to your preferences and needs, keeps you accountable to meeting your health goals, and so much more!

When living with MS and experiencing brain fog and fatigue, it’s helpful to adopt the following strategies to help “clear the fog”, so to speak.

 

When remembering new information:

  • Focus your attention on what you want to remember (like where you parked your car).
  • Focus on one thing at a time and try not to multitask your attention.
  • Take a mental picture of what you want to remember.
  • Turn information into songs to improve recall (like someone’s name or the platform where you parked your car).

When interacting with others:

  • Try to maintain eye contact and focus on the person you’re interacting with.
  • Ask people to repeat details or clarify what they told you.
  • Take your time when searching for words. Try substituting or describing the word if you still can’t think of it.
  • Take notes on topics that come up that you’d like to discuss further.

When trying to remember to do important tasks:

  • Repeat information out loud.
  • Write it down! Jot down to-do lists and record upcoming appointments.
  • Create reminders on your electronic device or use a paper day planner.
  • Have a routine. Always schedule recurring tasks for the same time everyday (i.e. taking medication or supplements), and keep important items (such as keys) in the same place.
MS-Cog-Fog

For managing fatigue:

  • Focus on one thing at a time to avoid burning out your energy.
  • Take advantage of your peak time during the day. Your peak time is the time during the day you feel most alert and the least drowsy.
  • Take frequent breaks before you fatigue. Pace yourself with work and prioritize important tasks.
  • Reduce work and home related stress. Ask for help if you need it.

If you’re struggling with concentration, organization, and planning:

  • Reduce distractions and work in a quiet, un-cluttered space.
  • Talking to yourself may help focus your attention and intention (i.e. announce why you’re going to another room so you don’t forget, or announce information you don’t want to forget).
  • Try to avoid busy environments (i.e. crowds or traffic), and focus on one task at a time.
  • Organize your home and work space to avoid misplacing items (i.e. keep all your bills, receipts, or notes in designated folders so they’re easy to find).
  • Break down complicated tasks into more do-able chunks.

MS pain can vary from person to person, ranging from muscle aches, joint pain, and nerve pain. 

 

Most often, muscle and joint aches are due to increased immobility and inflammation. Some muscle pains, like spasms and cramping are a result of nerve damage and impaired signal conduction to the connecting muscle. 

 

In people living with MS, nerve pains can be some of the more uncomfortable and even excruciating pains, with electric shock, burning, sharp or squeezing characteristics.

 

While pain killers can be a quick fix to relive pain, you can also find relief by eliminating the cause of your flare-up and reducing inflammation through diet and lifestyle interventions. 

Anxiety and depression are two other commonly reported symptoms associated with MS, and are 3 times more likely to occur in people living with MS than in the general population. This is believed to be due to the impacts that the disease can have on one’s life more than occurring as an individual symptom of MS.

 

The everyday and long-term unpredictability of MS can create added anxiety, while anticipating and grieving the loss of your physical abilities can often create a sense of hopelessness, leading to depression. These effects can greatly reduce a person’s quality of life.

Connecting for MS

Connecting with others living with MS can have a positive impact on your mental health, reducing inflammation and disease outcomes. It’s important to find a qualified therapist or a peer group who can understand and relate to your difficulties. This can help to reduce your feelings of hopelessness, uncertainty, and isolation.

 

In a 2020 study, patients with MS who had greater social support were found to have improved quality of life, reduced anxiety and depression, and improved disease outcomes.

 

This is why social connection has been integrated into the MasterHealth app – to provide a place to connect with others and share experiences. Within this feature, you’re supported throughout your entire health journey through group challenges and daily encouragement so that you can successfully reach your health goals.

Whether you’ve been newly diagnosed, or have been living with MS for several years, you can begin improving your quality of life and living symptom-free simply by changing your daily habits. 

 

Focusing on diet and eliminating highly inflammatory foods is a critical step in this journey, while regular exercise, healthy sleep and mindfulness practice can further reduce the inflammation in your body that contributes to your symptoms and flare-ups.

 

For added accountability and community support, the Wahls Protocol® mobile program in the MasterHealth app is a great place to start. It offers guidance at every step of the way, and sends you daily reminders to complete important health tasks, all customized to you!

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Dr. Terry Wahls – The Wahls Protocol®

Begin to take the critical steps you need to reduce MS fatigue and brain fog and get back to living your life, one healthy habit at a time.

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