Fatigue is the second-most common symptom of primary biliary cholangitis (PBC) (after pruritus, or itchy skin). It affects up to 80% of people with PBC and can severely affect quality of life.
The challenges of living with chronic fatigue on top of other PBC symptoms can lead to mental health issues such as depression, social isolation and low energy and motivation. Though there is no treatment for chronic fatigue, there are still steps patients can take to reduce its impact on daily life.
One of PBC’s most common symptoms
One of the earliest symptoms, fatigue creates a significant daily burden for people with PBC.
What is PBC?
Primary biliary cholangitis (PBC) is a rare, chronic autoimmune disease that primarily affects the liver. In PBC, the body’s immune system mistakenly attacks the small bile ducts within the liver, causing inflammation and gradual destruction of these ducts. Bile, a substance essential for digesting fats and removing toxins, becomes trapped in the liver, leading to liver damage over time.
Many patients living with chronic fatigue from PBC report feeling socially isolated because they lack the energy to attend events or engage with others. Fewer than 20% of patients with severe fatigue from PBC are able to work.
The disease also negatively affects the ability of such patients to provide care for others, like children or other family members. As 90% of people with PBC are women, struggling with fatigue can add extra difficulty to the challenges of everyday life.
Learn more about PBC signs and symptoms
Understanding the cause of your fatigue
It can be difficult to know if your fatigue is related to your PBC or other comorbidities, but knowing the cause can help.
If you are a perimenopausal or menopausal woman living with PBC, your fatigue could be due either to changes in your hormones or to your PBC. Other autoimmune conditions can co-exist with PBC, including celiac disease, hypothyroidism and anemia, as well as other diseases such as diabetes, renal failure and heart failure.
It’s important to talk to your health care provider about your symptoms. Fatigue caused by other medical conditions may be able to be eased. Even though there is no specific treatment for fatigue caused by PBC, it’s still important to discuss, as well. Fatigue is an indicator of disease progression, as it is associated with cirrhosis of the liver. It therefore needs to be closely monitored.
How to combat fatigue without exacerbating symptoms
Fatigue is a common symptom of PBC and other liver diseases, and there are steps you can take to help manage its severity. Talk to your doctor about a personalized approach to managing your fatigue.
- Take your medication: While the first-line treatment for PBC doesn’t help fatigue, it will help support your liver function and slow disease progression.
- Eat healthy: Maintain a balanced diet that avoids excess sugar, fat or alcohol.
- Take vitamin supplements: Your doctor will advise you on which vitamins you should take. Iron, calcium and vitamins A, D, E and K may be recommended.
- Exercise regularly: A light exercise program has been shown to reduce fatigue in PBC patients.
- Light therapy: Morning light treatment helps improve sleep quality and reduces daytime sleepiness.
- Prioritize sleep: Though it may go without saying, any steps that encourage a restful night of sleep can help fight against fatigue.
Preserving your quality of life by staying consistent in taking medications and living a healthy, lightly active lifestyle will contribute to the health of your liver and your well-being.
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