If you have IBS you may also experience fatigue. In fact around 60% of people with IBS experience extreme exhaustion, and fatigue is the third most common non-digestive complaint.
This is more than just tiredness, it’s feeling weak, ill and completely lacking in energy, and it’s something I see in my clients a lot.
Here are ten common causes of fatigue in IBS.
1. Anaemia and IBS
Anaemia and IBS are both very common, so sometimes you have both. Some studies have shown a higher prevalence of iron deficiency anaemia in patients with IBS compared to people who don’t have it.
I’ve also written about how iron absorption can be reduced when you have an overgrowth of bacteria in your digestion.
There is no evidence that IBS causes anaemia. But, if you are prone to a very fast transit time food may be passing through you quicker than you can absorb the nutrients you need.
You can become anaemic due to other gut disease such as coeliac disease, Inflammatory Bowel Disease, or diverticular disease. It’s important your doctor is involved in understanding what is going on in your digestion.
Don’t take iron supplements unless you have low iron stores. Get tested before taking iron supplements. If you need to increase your iron try a supplement with iron bisglycinate, rather than ferrous sulphate, or ferrous fumarate which commonly cause cramping, constipation or stomach aches.
We know that cells in your gut can up regulate iron absorption when needed, and these may be affected by gut bacteria. Sometimes improving your gut bacteria can improve iron levels (see my post about SIBO and iron levels for more details on this)
You can increase your iron intake through dietary changes like eating meat, fish, eggs, and green leafy vegetables and lentils.
2. Low functioning thyroid can cause fatigue in IBS
Our thyroid releases hormones which controls our cell metabolism, so affects how quickly each cell does it’s work. It’s common that IBS and hypothyroidism go hand in hand, and some reports even suggest SIBO may be present in more than half of patients with hypothyroidism.
Hypothyroidism can slow your digestive motility causing constipation, nausea or reflux. A low functioning thyroid may also give you severe fatigue, both of which can be confused with IBS.
Ask your doctor for a full thyroid panel blood test or find a thyroid specialist Nutritional Therapist to support you.
3. Chronic Fatigue Syndrome and IBS
Persistent fatigue that lasts for over six months and isn’t better when you rest could be CFS. If you’re also experiencing migraines, sore lymph nodes, flu-like aching or muscle pains, palpitations or sleep problems the fatigue could be related to CFS.
One of the most common causes of IBS is post-infectious inflammation which leads to ongoing digestive issues. One study found people infected with Giardia lamblia in Norway had increased risk of both IBS (43%) and CFS (26%) 10 years after the infection.
4. Fatigue in IBS can be caused by undereating
If you are over restricting your diet, either due to food anxiety, or trying to avoid reactions, you may not be eating enough food.
If you don’t have enough protein, fats and carbohydrates you can begin to feel very weak, have sleep problems, or a low mood.
Try using a diet diary to see what you’re eating in a week, and look at whether you’re low in any major food groups.
5. Poor diet in IBS can cause fatigue
Maybe you’re eating enough food, but it’s not the sort of food that is really giving your body the nutrients that it needs.
You could be low in iron, protein, or carbohydrates which all help to give us energy. Surviving on processed foods low in essential vitamins and minerals can lead to fatigue.
Working with a qualified nutritionist can help to identify how to broaden your diet variety in a way that doesn’t trigger symptoms. If you’re stuck between not knowing which dietary changes to make to make for the best it can feel very confusing – read my article about how to make dietary compromises for IBS
6. Sleep problems can be worse for people with IBS
If you’re not getting around 8 hours of quality sleep you may feel very tired. People with IBS seem to have poor sleep, but there is limited evidence as to why. Some people with IBS wake more frequently during the night.
It could be blood sugar management, poor diet, anxiety, abdominal pains or other GI symptoms.
We feel more pain when we are very tired, feel more anxious and have increased hunger hormones. This can make us crave starchy foods for a quick glucose fix. Some people report more abdominal pain, anxiety, and fatigue after a bad night’s sleep.
Sleep hygiene tips like reducing stress, exercise, having dark room, and blocking blue light before bed can all help improve your sleep quality.
7. Anxiety and IBS can increase fatigue
Fatigue is linked to more severe IBS symptoms, worse Quality of life scores, distress, anxiety sensitivity, and perceived stress. When we’re anxious we tend to feel exhausted, due to the tension in muscles, lack of sleep and constant hypervigilance.
Prolonged exposure to stress can leave us low in B vitamins and Magnesium, both of which are needed for energy production. Anxiety and stress can also de-prioritise digestion, meaning that your bloating, gas and cramps can increase.
8. Inflammation in IBS is associated with fatigue
We know that people with IBS may have a higher count of Mast Cells in the gut. These are cells that can activate an immune response when triggered by an allergen, gut microbes, pathogens or other immune complexes.
Higher levels of mast cells in the gut are associated with increased fatigue and people with IBS who had a higher immune activation in the colon had higher anxiety and depression. Mast cells may also trigger your nervous system, increasing abdominal cramps and pains.
Resolving this low level inflammation in the gut can take time, but diet and lifestyle changes for inflammation can play an important role in feeling better.
Improving your balance of bacteria in your gut may help address some of the triggers for mast cell activation. One of the best things you can do for gut diversity is eat a varied diet – my Aim for 30 course can show you how to do that.
9. Inactivty could be driving IBS fatigue
Regular exercise might be the last thing on your mind when you’re feeling exhausted, but regular movement, however small, has been shown to improve fatigue. Moving your body also helps to reduce anxiety, which can be raised in people with IBS.
You don’t need to be climbing mountains or doing Cross Fit, just a simple slow walk or some quiet yoga at home can be a good first start.
If you’re feeling exhausted, and want someone to guide you through eating well when you have IBS or SIBO then please get in touch, I can help you figure out what works for you. Email me on info@goodnessme-nutrition.com or use the contact page to book a free discovery call.
IBS Nutritionist
Hi, I'm Anna Mapson, registered Nutritional Therapist.
I help people with IBS and SIBO get control of unpredictable gut symptoms to find long term relief from painful and embarrassing IBS without restrictive dieting.
I can help you to:
- understand your digestion better, so you recognise your triggers
- eat a well balanced diet, with tasty meals that are simple to prepare
- reintroduce your trigger foods so you can get back to enjoying food again
Find more about my 3 month 1:1 Gut Reset programme.
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I am interested to learn the best dietary for my ibs and current weakness. What diet do you suggest? Sheryl
Hi Sheryl, it’s really hard to give one specific diet that will help because everyone’s IBS is so different. Starting with the basics is normally a good place, getting enough protein per day, eating a range of fruits and vegetables (aim for 5+ a day) and sufficient fibre (aiming for 30g a day). Variety is also important to feed the gut microbes. Let me know if you’d like to talk to me about working on a personalised diet plan that can address your individual symptoms. You can just book a quick call to chat t me here: https://calendly.com/annamapson/30min
Feeling very tired
Does eating lots of nuts alleviate my weakness? I was diagnosed with IBS last month. Is it a serious illness that i need to worry about?
Yes, IBS is very serious. Some of the sumptos
Are absolutely debilitating and completely wreck your quality of life. The constant running to the bathroom in excess of 20 times a day (for me), the feeling of being in the verge of fainting/throwing up/bathroom run and let’s not forget the total lack of energy to the point of just laying down because that is all the energy you have is horrible to find a path around/over. One last honorable mention symptom (for me) is some sort of anxiety. When symptoms are at their worst, for someone to
even speak with an elevated tone sends me in to the bathroom. This, is so not me. Dealing with anxiety is new for me. So, yes, it is serious. Please seek treatment, work with a nutritionalist who is familiar with IBS. Avoid fast food, at all costs. Stay away from caffeine, too, as there is a link between the belly flipping and caffeine and the inflammation factor. (Sometimes I look like I’m 6 months pregnant from the bloating/swellIng after a meal). Please make healthy changes now for a better future outcome.
Hi Anna,
It’s been such a painful depressing exhausting three months for me. I an writing this to you while crying desperately needing help.
I have ibs c , i have to strain so much to go to the toilet although I’m always hydrated and making sure I have a high fibre diet. Lately I noticed that whenever I have a bowel movement pain I would get so warm sweaty and start shaking I have to strain and I find this so tough to go through I feel sometimes I might pass out. After , I want to sleep as I get so exhausted and I have no energy to go through with the day. For some reason my blood sugar went down to 4 and i never had problems with blood sugar before. I have severe iron deficiency and vitamin D deficiency. Anyhow, my family thinks it’s all in my head and no one seems to understand what I’m going through. I don’t know who to turn to anymore, I really need your help. I’m feeling so weak and tired all the time I have no energy and feel really depressed .
Oh Sally this sounds really tough, have you been speaking to your doctor? It’s important to ensure your doctor thinks it’s IBS, and nothing else. Have you been tested for SIBO? I’ll send you an email or perhaps you’d like to arrange a call with me to discuss your situation? You can book a call here – https://calendly.com/annamapson/30min
I hope to hear from you soon.
It’s not in your head. The body is complicated and interrelated. A functional nutritionist is a good resource, but you may want to add a consultation with a medical doctor who incorporates functional medicine into their practice. Feeding a poor microbiome the foods that aggravate the situation increases inflammation and inhibits the absorption of nutrients.
It’s not in your head I know because your symptoms sound exactly like mine
What kind of costs are involved in the consultation process?
Hi Chad you can read about my IBS nutrition programme here, including the costs. Gut Reset Programme At the moment the 3 month programme is £480.
I have had IBS for over 20 years and I have learned that getting plenty of sleep, reduce any stress when and where you can and lastly staying away from foods I know aggravate my IBS all help.
I suggest a daily food diary so that whenever your IBS plays up you can check your food diary and if you see I certain food may be the cause.
Having said that I still get caught off guard when my IBS sends me spiralling down health wise. Lately I have been so fatigued that I blame work or other factors and forget that IBS could be the cause.
I have ibsc and in pain all the time
Pain is very fatiguing. What help have you had from your doctors? If you’d like to speak to me about working together on your diet and digestion please set up a call here – https://calendly.com/annamapson/30min