People with Crohn’s disease often experience periods of fatigue that can be severe and affect their daily activities. Fatigue can occur due to nutritional deficiencies, anemia, and other causes.

Crohn’s disease is a type of ​​inflammatory bowel disease (IBD). It is a chronic condition that affects the digestive system and causes inflammation of the gastrointestinal tract.

Common symptoms of Crohn’s disease include:

Another common symptom of Crohn’s disease is fatigue.

Fatigue is more than just feeling tired — a person with physical fatigue may find it physically challenging to carry out everyday activities. They may have difficulty climbing the stairs or walking short distances. Fatigue can occur during flare-ups and periods of remission.

Mental fatigue may cause a person to find it difficult to concentrate and stay focused.

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​​Fatigue is a common symptom that has links to a range of chronic illnesses, including Crohn’s disease.

According to one 2020 review, fatigue affects about 50% of people with IBD. And some estimates suggest that it may be even more common.

Crohn’s disease may have several effects that can lead to fatigue, such as:

  • Inflammation: When inflammation occurs in the digestive tract, the body produces chemical signals in response to the inflammation. These signals can cause tiredness and a lack of energy. They can also contribute to a feeling of fatigue.
  • Anemia: One 2014 study suggests that anemia occurs in around 24% of people with IBD. When a person has anemia, there are not enough red blood cells to transport enough oxygen to the body’s tissues. As a result, the person may experience tiredness and weakness.
  • Nutritional deficiencies: People with Crohn’s disease may have low levels of iron, vitamin B12, and folate. These deficiencies have links to weakness and fatigue.
  • Medication side effects: Certain Crohn’s disease medications can cause fatigue. Steroids can interfere with a person’s sleep patterns. Immunomodulators, such as methotrexate and 6-MP, can also lead to fatigue.
  • Anxiety: People with Crohn’s disease have an increased risk of experiencing anxiety, of which fatigue is a symptom.
  • Prolonged poor sleep: People with Crohn’s disease may experience poor quality sleep. This may be because certain symptoms, such as stomach pain, can interrupt sleep. If a person experiences reduced quality sleep for several nights, they may develop fatigue.

Fatigue is a common symptom of Crohn’s disease. However, doctors often do not recognize this symptom in people with IBD, so people may not receive adequate treatment for it.

People can manage chronic fatigue in various ways. Below are some tips that someone with Crohn’s disease may find useful.

Managing anemia

According to the Crohn’s and Colitis Foundation, about 1 in 3 people with Crohn’s disease or ulcerative colitis have anemia. Irritation and swelling in the intestines can mean the body does not absorb iron as it should, leading to anemia.

Anemia can cause fatigue in people with Crohn’s disease. A person may wish to take oral iron supplements to help manage their anemia. If this does not work, a person can discuss taking intravenous iron with their doctor.

Treating anemia may help people manage their fatigue.

Managing nutrition

A person may also wish to focus on adding more vitamin B12 and folate, or folic acid, to their diet. Deficiencies in these nutrients can cause extreme fatigue.

People can get vitamin B12 from supplements or a variety of foods, including:

  • animal liver and kidneys
  • clams
  • sardines
  • beef
  • tuna
  • dairy products such as milk, cheese, and yogurt
  • some nutritional yeast products

Food manufacturers also fortify other foods with vitamin B12, including some types of soy milk and breakfast cereals.

Learn about the other symptoms of vitamin B12 deficiency.

A person can add folate to their diet by eating:

  • legumes such as beans, peas, and lentils
  • asparagus
  • eggs
  • leafy greens
  • beets
  • citrus fruits such as oranges, grapefruit, lemons, and limes
  • Brussels sprouts
  • broccoli
  • nuts and seeds
  • beef liver

Learn more about folate deficiency.

Treating inflammation

The body’s response to inflammation can cause fatigue. Therefore, if a person has Crohn’s disease, they may wish to treat their inflammation to help manage fatigue.

A person could ask their doctor about biologic therapies, such as infliximab, to treat inflammation. Nonbiologic medications for inflammation, such as immunomodulators, are also available.

Switching medications

If a person’s medication is causing their fatigue, they may wish to switch to a different medication. They can speak with a doctor, who may be able to suggest alternative treatment options.

Treating anxiety

Around 1 in 3 people with IBD experience high anxiety levels. This anxiety may be related to symptoms, but it can also be present when people are not experiencing symptoms.

A person with Crohn’s disease may wish to seek counseling to help manage their anxiety. Other options include cognitive behavioral therapy and anxiety medications.

If a person is experiencing anxiety due to Crohn’s disease, they can speak with a medical professional, who may be able to treat the condition.

Learn about the different types of mental health services available.

Improving sleep

A person can try several methods to improve their sleep, including these healthy sleep habits:

  • establishing a consistent bedtime routine
  • ensuring their bedroom is at a comfortable, cooler temperature when going to sleep
  • making sure their room is quiet and dark when going to sleep
  • avoiding looking at screens for up to an hour before going to sleep
  • avoiding eating shortly before going to sleep

Learn more tips for improving sleep.

Exercising regularly

Regular physical activity can help improve sleep and reduce symptoms of fatigue. If a person is not very physically active, they could gradually introduce exercise into their routine as they are able.

Learn more about exercise for people with Crohn’s disease.

Avoiding smoking

Avoiding smoking may help a person with Crohn’s disease manage their symptoms. Cigarette smoking worsens the symptoms of Crohn’s disease, which can worsen and contribute to fatigue. By stopping smoking and reducing symptoms, people can help improve their fatigue.

Learn 11 tips on giving up smoking.

IBD increases a person’s risk of developing chronic fatigue syndrome (CFS).

CFS is a long-term condition that can cause pain and extreme fatigue. It is a serious condition that can last a long time and affect a person’s ability to perform everyday tasks.

Symptoms of CFS include:

  • a reduced ability to perform everyday tasks
  • the feeling of a “crash” after physical or mental exertion
  • the development of sleep disorders, including vivid dreaming, restless legs, muscle spasms, and sleep apnea
  • dizziness
  • issues with memory
  • aches and joint pain

If a person feels that they have CFS, they need to speak with a medical professional.

Does Crohn’s disease and IBD cause extreme fatigue?

People with Crohn’s disease and other forms of IBD can experience extreme fatigue due to nutritional deficiencies, inflammation, and other reasons. Severe fatigue may also happen if a person has chronic fatigue syndrome.

How do you get rid of fatigue from Crohn’s disease?

People with Crohn’s disease may be able to reduce their fatigue by addressing the potential causes. This may involve treating anemia, any nutritional deficiencies, inflammation, and anxiety. It may also involve changing medications or practicing good sleep hygiene.

Do you need more sleep with Crohn’s?

Crohn’s disease may cause fatigue, which can make a person feel tired or sleepy. Improving sleep habits and addressing other causes of fatigue, including anemia, may help reduce fatigue.

Fatigue commonly occurs with Crohn’s disease. It can occur during flare-ups of the condition and periods of remission.

A range of factors can cause this fatigue, including the body’s response to inflammation, anxiety associated with Crohn’s disease, anemia, nutritional deficiencies, and pain that affects sleep.

To manage fatigue, a person with Crohn’s disease may wish to treat their inflammation, manage their anemia, follow a nutritious diet, and develop effective sleep habits.