Hi Guys,

I'm about 10 weeks post tx and things are going pretty well. I've got the pain mostly under control. I've been trying to eat enough by mouth so that I can have the peg removed and I'm getting pretty close (although I do eat a lot of "junk calories" to hit my calorie goal). My problem is that I have pretty much constant fatigue. I'm just sleepy all the time. I've been sleeping well, I just seem to be tired.

I'm wondering if I should start taking vitamins or meds or something. Anybody else had this problem?

Clint

Clint,
It sounds like you are right on track to me. My fatique lasted well over a year. If you are still on pain meds that will make a difference when you stop those also. Vitamins don't really help much without the nutritional building blocks and if you can eat a healthy balanced diet many think that you don't need vitamins. Most of us did the junk calory thing just to have enough "fuel". I switched back to a healthy diet as soon as I was able. I never had a PEG so I had to rely on oral intake.

The dietician informed me that three cans of liquid norishment contains all the vitamins needed for a daily dose, and I was certainly choking down more than that, so she saw no need to take anything extra.

Also, there are some warnings in the Adjunctive Therapy forum here against antioxidants during treatment, so if you were concerned about that I would recommend you go there, do a search and read some stuff.

I had fatigue to some degree for almost a year too-although in my case that's also because I had 6 more weeks of rad for breast cancer 4-5 months after the oral cancer rad ended! Fatigue can also be a sign your thyroid has shut down. You may want to ask for a test for that.

Nelie

There are a number of studies (and on-going clinical trials) which are showing efficacy of the micronutrient l-carnitine (an amino acid derivative) in addressing cancer fatigue. Several trials have shown that patients who have received cisplatin (and probably also carbo-, though the trials were with cis-) are often deficient in l-carnitine, which is important to the metabolism of fatty acids (and thus energy levels). The various studies have shown no adverse side effects at even high doses and improved energy levels and/or reduction in fatigue in many patients.

My husband took (with his doctors' OK) 500 mg l-carnitine as a liquid in juice or water each day all through treatment and for a couple of months thereafter. This appears to be the dose most cited in study results. He was never terribly fatigued, and this may have helped. (For example, he went birdwatching every weekend through treatment although for only about 2 hours rather than his usual 4.) We also told another Hopkins patient, who was complaining of fatigue, and she emailed us after a week of supplementation to say she also felt less tired and was surprised at the difference in such a short time.

I know this sounds like a testimonial for those fake "energy" pills they tout on TV, and it is also true that many body-builders and athletes take l-carnitine in hopes of improving performance. However, research has indicated that for the normal person, who is not deficient, this supplementation does no good (except to the sellers of the supplements) but there are quite a few studies in fatigued cancer patients which indicate benefit in some (with no adverse effects). NCI has a number of trials underway to get a better handle on this. A google search of "l-carnitine and cancer fatigue" will come up with quite a few references.

It might be worth a try, l-carnitine can be bought as a liquid at GNC and also is in pill form.

And as always, do not take ANYTHING during treatment that you have not run past your doctors for their approval!

Gail

I had fatigue for about 7 months. Sometimes I still stuggle with it but it does get better with time. Nothing really helped me....just time.