Link Between High Blood Pressure Medications and MS Fatigue

Fatigue as a side effect of anti-hypertensives

Woman holding medication pills
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Most of us with multiple sclerosis (MS) suffer from fatigue. In fact, an estimated 50 to 60 percent of people with MS say that fatigue is their most disabling symptom. While much of our fatigue comes from the disease process itself, there are many secondary causes of fatigue in MS, like your medications.

High Blood Pressure Medications and Fatigue

People with MS develop the same age-related and lifestyle-related health problems as people without MS, and one of these common health conditions is high blood pressure or hypertension. Classes of high blood pressure medications include:

  • Diuretics
  • Beta-blockers
  • Alpha-adrenergic blockers
  • ACE inhibitors
  • Calcium-channel blockers

All of the drugs in the above classes have the potential to contribute to MS-related fatigue. The tricky thing too is that the term "fatigue" may not be listed as a side effect. Instead, other terms like tiredness, drowsiness, dizziness, or weakness may be used. 

For someone that does not have MS, these side effects could just be a passing annoyance. However, for those of us who battle MS-related fatigue on a daily basis, any of the discomforts listed above may be enough to tip the balance between a good day and a bad day, fatigue-wise.

Should I Stop My Medication that is Contributing to My Fatigue?

No, you should never stop or change the dosage of your medication without first consulting your doctor. Also, just because it looks like one of your medications may be contributing to your fatigue, this doesn’t necessarily mean the end of this drug for you.

Your doctor may have some ideas about taking the medication at a different time of day or taking it with food. Alternatively, maybe splitting the dose would reduce the side effects, or maybe it comes in a different form, like a time-released version, that might be better for you. Sometimes, trying a different medication within the same class is helpful.

Also, it could be that other factors are contributing to your fatigue and not just the medication. For instance, you may be having spikes of high blood pressure throughout the day, and this is wearing you out. You could also have obstructive sleep apnea, which is a secondary cause of high blood pressure and contributes significantly to fatigue. Likewise, an overactive thyroid may also contribute to high blood pressure and fatigue. 

Keeping a Fatigue Log

One way to take a proactive role in understanding how your medications and other lifestyle habits contribute to your fatigue is by keeping a fatigue log and bringing it to your doctor's appointment. Here are some tips on what to include:

  • How you feel at different times of the day (i.e. write down exactly how you feel — "drowsy", "depressed," or "weak" and the time of day this occurs)
  • Sleep habits — include hours of sleep, presence of snoring, whether you take a sleeping pill
  • The food and drink you consume — be sure to include caffeine, alcohol, and chocolate
  • All medications you are taking, including vitamins, herbals, supplements, and over-the-counter medications — include dosage and time of day

In the end, only you and your doctor can tease these factors apart to optimize your MS and heart health. Be confident that together you can find a solution to help you feel better.

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