By Cathy Chapman, MSA Coalition Patient Representative

It is documented that fatigue is a symptom of MSA and is prevalent in the early stages while remaining persistent over time.

Everyone experiences MSA symptoms differently, and fatigue is no exception. Here are some signs to be mindful of:

  • Weakness or feelings of heaviness, especially in the arms and legs
  • Lack of energy/exhaustion
  • Lack of interest in daily activities
  • Taking extra effort to accomplish everyday tasks
  • Difficulty concentrating
  • Overwhelmed by feeling fatigued
  • Inadequate sleep

It is not documented what causes fatigue, but it is likely related to the symptoms of MSA.

  • Regulation of temperature (being too hot or too cold)
  • Visual problems (blurry or double vision)
  • Sleep disturbances (REM sleep, sleep apnea) – Consult with your doctor about treatment for any sleep issues
  • Physical energy it takes to complete daily tasks
  • Pain
  • Orthostatic hypotension – consult with your doctor regarding treatment
  • Medications you are currently on – monitor the medications you are taking, especially new medications that have been prescribed)
  • Being less active due to physical limitations – consult with your health care team about helpful and safe exercises

A sudden onset of fatigue could indicate an infection (UTI or lung) or something unrelated to MSA. This should be discussed with your doctor immediately.


  • Drink plenty of water to stay hydrated
  • Use a wheelchair to conserve energy and allow yourself to participate in a planned outing
  • Monitor how you are feeling and plan your day accordingly
  • Allow for quiet days during the week
  • On a good day, it’s easy to over do it. Pace yourself and allow for periods of relaxation.
  • When planning an outing or activity, allow plenty of time for rest before and to recover afterwards
  • Asking for help from family and friends can be difficult to do, but they are happy to help