Why does multiple myeloma cause persistent fatigue?

Persistent Fatigue is a very common presentation of Multiple Myeloma. Anaemia can limit the oxygen delivered to muscles and the brain, causing low energy, breathlessness with activity or difficulty concentrating. The disease may also produce inflammatory signals that make the body feel unwell. Bone pain, poor sleep, reduced appetite, infection, dehydration, kidney problems or high calcium can add to the burden. Treatments, including medicines given for myeloma or pain, may contribute to drowsiness or weakness.

Fatigue can change over time and may have more than one cause. A symptom diary can show whether it is worse after treatment, activity, poor sleep or meals.

Tell your oncology team how fatigue affects walking, work, bathing, eating and sleep. They may review blood counts, kidney function, calcium, medicines, nutrition and hydration to look for treatable contributors. Plan essential tasks for the part of the day when energy is higher, use short periods of gentle movement if tolerated, and balance activity with rest. Choose easy-to-prepare meals and ask for help with demanding chores. Do not start iron, vitamins or stimulants without medical advice, because the cause of fatigue determines whether they are useful.

Contact your care team promptly for fatigue that is rapidly worsening, new breathlessness, chest discomfort, fainting, confusion, marked weakness, fever, very little urine or inability to keep fluids down. These changes can signal anaemia, infection, dehydration, kidney problems or another complication that needs assessment. Seek emergency help for severe breathing difficulty, chest pain, collapse or sudden confusion.

Could anaemia, calcium, kidney function, infection or one of my medicines be contributing? Which blood tests should be checked? How can my treatment plan address fatigue? What level of activity is suitable for me, and whom should I contact if my energy drops suddenly?