Feeling persistently tired or worn out — also called fatigue — is a common symptom of Hodgkin lymphoma and non-Hodgkin lymphoma (NHL). Fatigue can be caused by lymphoma itself, or it can be a side effect of lymphoma treatments like chemotherapy and radiation therapy.

Other health conditions and circumstances can also impact your energy levels. Here’s what lymphoma tiredness feels like, why it happens, and what you can do about it.

What Does Lymphoma Fatigue Feel Like?

Fatigue from cancer or cancer treatment is called cancer-related fatigue. Unlike just normal tiredness, cancer-related fatigue doesn’t improve after a good night’s sleep.

Cancer-related fatigue can significantly affect day-to-day life. MyLymphomaTeam members have shared how fatigue interferes with their daily activities:

• “Trying to take a shower wears me out.”
• “I am normally a very active and high-energy person. Now, it’s a chore to shower.”
• “Most days, I have to MAKE myself vacuum, wash clothes, and do other chores.”

Persistent Fatigue After Lymphoma Treatment

In some cases, fatigue continues for months or even years after lymphoma treatment ends. It’s especially common after a stem cell transplant because it can take time for the body to fully recover.

“Sometimes posttreatment, people will have some fatigue that can linger for months or even, in some cases, a year later,” explained Dr. Timothy Fenske, a hematologist-oncologist who specializes in treating people with Hodgkin and non-Hodgkin lymphoma. “Some people might be in remission — they’re done with treatment, but they never quite got back to where they were pretreatment.”

Members of MyLymphomaTeam report lingering fatigue after treatment. “Hubby is FINALLY starting to get his energy back six months after his last chemo,” a MyLymphomaTeam member wrote.

Another member commented, “I have been tired for six years. I don’t think you ever get over that.”

What Causes Fatigue in Lymphoma?

Cancer-related fatigue has lots of potential causes. “Fatigue is tricky,” shared Dr. Fenske. “It can be a symptom of lymphoma. It can be a side effect of treatment. It can also be a sign of other problems that may be related or unrelated.”

The following factors can contribute to fatigue with lymphoma:

• Side effects of chemotherapy, radiation therapy, or other treatments
• Anemia (low red blood cell count), which may be caused by cancer cells in the bone marrow or by chemotherapy
• Dehydration from treatment side effects, like vomiting and diarrhea
• Side effects of antinausea medications used for chemotherapy side effects
• Pain or pain medication
• Muscle weakness from inactivity
• Anxiety or depression
• Sleep disturbances
• Poor appetite

Life circumstances, like undergoing treatment while working and raising children, can also contribute to fatigue.

“We have to separate out what’s just normal fatigue because the person’s got three little kids or a stressful job, and now they have cancer on top of it, and what’s actually a serious side effect or maybe even a sign of their lymphoma coming back,” Dr. Fenske explained. “You have to put it in context to try to figure out what level of fatigue we are dealing with and how persistent it is.”

8 Strategies To Help Manage Fatigue

When you discuss fatigue with your doctor, they’ll try to understand all the different factors related to your tiredness. Your doctor will ask questions to learn how fatigue affects your daily activities. You may be asked to rank your fatigue levels. Your doctor may order a blood test to check for anemia.

You may need changes to your treatment plan or lifestyle to get your energy back. Here are some steps your healthcare team may suggest.

1. Address Anemia Caused by Cancer Treatment

Fatigue and weakness are common symptoms of anemia. Your doctor can find out if your anemia is related to cancer treatment and decide the best way to manage it. Treatment may include supplements, dietary changes, or blood transfusions.

2. Ask Your Doctor About Adjusting Dosages

Pain management can also help you improve your quality of life. However, certain pain medications may make fatigue worse. If you believe that your pain medication may be making you more tired, talk to your doctor. Find out if the dosage or type of medication can be changed to lessen your fatigue while still managing your pain.

3. Take Care of Your Mental Health

Coping with the emotional impact of lymphoma can make fatigue worse. For example, depression can cause sleep disturbances and tiredness. Treatment for depression may include antidepressant medication or therapy.

Talk therapy, such as cognitive behavioral therapy, can help decrease fatigue as you work on cancer-related issues such as stress, fear, and lack of social support, which may be making your fatigue worse.

4. Explore New Drug Options for Treating Fatigue

Researchers are studying certain drugs to see if they can help with cancer-related fatigue, including:

• Psychostimulants, which may improve energy, mood, and concentration
• Steroids, such as dexamethasone, for people with advanced cancer
• Bupropion, an antidepressant

While some of these drugs are still undergoing clinical trials (research studies that investigate potential new treatments), your doctor may be able to explore with you other medications that have been shown to help with fatigue.

5. Look Into Dietary Supplements

Certain dietary supplements are also being studied for their effectiveness in managing cancer-related fatigue, including:

• Ginseng
• Coenzyme Q10
• L-carnitine

Before starting any dietary supplements, talk with your doctor to make sure these products are safe to take with your other medications and won’t cause unwanted side effects.

6. Try To Get More Exercise

Physical activity during and after treatment for lymphoma can help improve your energy levels. One MyLymphomaTeam member shared, “Working through the pain and moving around seems to actually make me feel better than sitting.”

Staying active when you have lymphoma can be difficult, but there are many physical and mental benefits, such as improved mental health and appetite. Consult your healthcare team before starting a new exercise program, especially if your lymphoma has spread to your bones.

7. Notch Up Your Nutrition

Consulting a nutritionist or dietitian can help ensure you’re taking in enough nutrients, especially if cancer treatments are causing nausea or vomiting. “Eat a lot of fruits and vegetables, and drink plenty of fluids,” one MyLymphomaTeam member recommended to another living with fatigue.

Read about nutrition tips for feeling your best from registered dietitian Kimberly McCloskey, including suggestions for managing anemia and dehydration.

8. Shorten Naps To Feel Better Rested

Getting adequate rest at night and taking short naps during the day — a half hour or less — can help manage fatigue. Long naps can sometimes backfire, making you feel more tired and interfering with nighttime sleep. Establishing a consistent bedtime routine can also help reduce fatigue.

Find What Works for You

The best plan to manage severe fatigue will vary from person to person. Finding ways to take care of yourself and prioritize your most important tasks can help you balance rest and activity.

MyLymphomaTeam members have different approaches to finding balance. “I do what I can, when I can. I am not pushing myself,” a MyLymphomaTeam member posted.

Another member commented, “I rest when I need to, but I refuse to change my social activities.”

Join the Conversation

On MyLymphomaTeam, people share their experiences with lymphoma, get advice, and find support from others who understand.

How do you manage lymphoma tiredness? Let others know in the comments below.