"I do not look ill, but I am finished by four o'clock." Fatigue in CMT is not a side issue. It often shapes more of your day than the weakness itself.
Why walking costs so much
Someone who cannot lift their foot easily raises the knee higher, swings the hip, compensates with the back and watches constantly where the foot lands. That gait uses considerably more energy than an ordinary step, and it demands continuous attention. That mental effort is a part of the fatigue that is rarely named.
First, rule things out
Blaming fatigue on CMT too quickly is a classic trap. Have the ordinary causes checked before you accept it:
- Anaemia, thyroid problems, vitamin B12 or D deficiency.
- Sleep apnoea or poor sleep quality — including from pain or cramps.
- Depression and anxiety, which often show up as fatigue first.
- Side effects of medication, for instance drugs for nerve pain.
Spread energy rather than save it
Most people with CMT work in peaks: catch up on everything on a good day, then pay for two days. Pacing breaks that cycle.
- Take a break before you are exhausted, not after. A short break in time beats a long one afterwards.
- Spread heavy tasks across the week instead of into one day.
- Look with an occupational therapist at the tasks that cost most. Sitting instead of standing while cooking, things at working height, a second set of items upstairs and downstairs: such changes deliver more than they sound like.
- Accept aids for distance. A good orthosis lowers the energy cost of walking; a scooter for the long stretches saves energy for where you actually want to spend it.
Exercise helps, overload does not
It sounds contradictory, but better fitness reduces fatigue. The point is dosage: moderate effort with enough recovery, not training to exhaustion. Read more under Sport & exercise.