How to deal with ms fatigue? i feel de-energized and pale all day

Very common in MS: General measures like making sure you get enough sleep, adequate hydration, avoiding excessive exercise, physical therapy with stretching exercise, and avoiding heat/hot weather can help. Pace yourself at work and prioritize activities. Also make sure you schedule periods for rest. In some cases, your doctor may try medications like amantadine and Modafinil to help with the symptoms if severe.

Approaches: Make certain you are getting enough sleep, and even get sleep study if necessary. Treat depression if present. Also, check for thyroid and anemia problems. ?chronic infection? If these are not salient, fatigue can be handled with amantadine, ritalin, Adderall, modafanil, Nuvigil. But the more potent meds such as Gilenya and Tysabri (natalizumab) could also decrease fatigue issues.