Dear Diary,
One of the most frustrating parts of living with multiple autoimmune diseases is trying to explain a symptom everyone thinks they already understand.
Fatigue.
People hear that word and immediately think,
âYouâre just tired.â
If only it were that simple.
People often hear the word fatigue and assume itâs all the same. It isnât. Crohnâs disease and Myasthenia Gravis both cause fatigue, but they do so for very different reasons, and the way they affect my body couldnât be more different.
Learning to recognize the difference has taken time.
Explaining it to others has taken even longer.
The challenge isnât just living with these diseasesâitâs finding the words to explain something invisible to people who have never experienced it.
âNot all fatigue is the same. One disease drains my energy. The other weakens my muscles. Living with both means learning to recognize the difference.â
đż Crohnâs Fatigue: When Your Whole Body Waves the White Flag
Crohnâs disease doesnât just affect the digestive tract.
It affects everything.
Even when Iâm sitting still, my immune system may be working overtime, creating inflammation throughout my body. Add in anemia, nutrient deficiencies, disrupted sleep, dehydration, pain, and the emotional weight of living with a chronic illness, and it becomes the perfect recipe for overwhelming exhaustion.
This isnât the kind of tired that disappears after a nap.
Itâs waking up exhausted after sleeping all night.
Itâs feeling like my battery only charged to 20%, no matter how long it stayed plugged in.
Itâs looking at a simple task and wondering where Iâm supposed to find the energy to begin.
Some mornings, I wake up feeling like Iâve already lived an entire day before my feet even touch the floor.
Crohnâs fatigue is systemic. It isnât tied to using one particular muscle. Instead, it feels as though every part of my body is running on empty because my immune system has been working overtime.
đŞ Myasthenia Gravis: When My Muscles Quit Before I Do
MG tells a completely different story.
With Myasthenia Gravis, my mind still wants to keep goingâŚ
âŚbut my muscles have other plans.
The hallmark of MG isnât simply fatigueâitâs fatigable muscle weakness.
Because MG disrupts communication between the nerves and muscles, the more I use certain muscles, the weaker they become.
I might start a conversation sounding perfectly normal, only to notice my voice becoming softer or slurred as I continue talking.
I may begin eating a meal without difficulty, then suddenly find chewing exhausting halfway through.
Some days, washing my hair feels manageableâuntil my arms decide theyâve had enough.
Walking becomes slower.
Holding my head up becomes harder.
Even breathing can require more effort.
As someone living with MuSK-positive Myasthenia Gravis, breathing isnât something I take for granted. When the muscles responsible for breathing become weak, something as automatic as taking a deep breath suddenly requires conscious effort.
Unlike Crohnâs fatigue, resting those muscles often allows them to regain some strengthâat least temporarily.
Until I use them again.
âď¸ Living with Both: The Battle No One Sees
Hereâs where things become confusing.
Some days, I know exactly which disease is causing my symptoms.
Other daysâŚ
I honestly canât tell.
Am I exhausted because my Crohnâs is flaring?
Or are my muscles becoming weaker because my MG is acting up?
Sometimes the answer isâŚ
Both.
Crohnâs drains my bodyâs energy.
MG drains my musclesâ strength.
Together, they can leave me feeling like Iâve run out of fuel and forgotten how to move.
That combination is difficult to describe unless youâve lived it.
There are days when I have the energy to want to do something, but my muscles wonât cooperate.
There are other days when my muscles might be willing, but the exhaustion from Crohnâs has emptied my tank before Iâve even started.
And then there are the days when both diseases decide to remind me whoâs in charge.
Those are the days that require the most grace.
đ When Both Diseases Show Up Together
One of the hardest lessons Iâve learned is that I donât always have the luxury of saying, âToday itâs my Crohnâs,â or âToday itâs my MG.â
Sometimes they arrive together.
Crohnâs may leave me feeling like every ounce of energy has been drained from my body, while MG weakens the very muscles I need to move, speak, eat, or even breathe comfortably.
Imagine trying to drive a car thatâs completely out of gas while the engine is misfiring.
One problem leaves you without fuel.
The other prevents the car from performing the way it was designed to.
Thatâs what living with both Crohnâs disease and Myasthenia Gravis can feel like.
Itâs not simply being tired.
Itâs navigating two diseases that rob me of energy and strength in different waysâoften at the very same time.
đĄ How I Tell the Difference
Living with both conditions has taught me to become a student of my own body.
When fatigue sets in, I ask myself a few questions.
Do I feel exhausted before Iâve really done anything today?
That often points me toward Crohnâs.
Are my muscles getting weaker the more I use them?
Thatâs usually my MG talking.
Does resting one specific muscle help it recover?
Thatâs another clue itâs MG.
Do I feel like my entire body has been hit by a truck, even after sleeping?
That usually feels more like Crohnâs fatigue.
Sometimes the answers are clear.
Sometimes they arenât.
But learning to recognize these patterns has helped me communicate more effectively with my healthcare team and know when itâs time to slow down, ask for help, or simply give myself permission to rest.
𩺠Why Understanding the Difference Matters
One of the biggest misconceptions about chronic illness is assuming all fatigue is the same.
It isnât.
Crohnâs fatigue is driven by chronic inflammation, anemia, nutrient deficiencies, disrupted sleep, and the bodyâs constant immune response.
Myasthenia Gravis fatigue is different. It is caused by impaired communication between the nerves and muscles, resulting in muscle weakness that worsens with repeated activity and often improves after resting those specific muscles.
Understanding these differences matters.
It helps patients recognize what their bodies are telling them.
It helps healthcare providers better understand our symptoms.
It helps family, friends, coworkers, and caregivers realize why our abilities may change not only from day to dayâbut sometimes from hour to hour.
It also helps us become better advocates for ourselves. When we can recognize whether weâre dealing with systemic exhaustion or muscle fatigability, we can communicate more clearly with our healthcare team and make more informed decisions about pacing our activities.
Because understanding leads to empathy, and empathy changes how we support one another.
âNot every kind of fatigue needs more sleep. Sometimes it needs treatment. Sometimes it needs rest. And sometimes it simply needs understanding.â
đ Reflection Corner
Living with multiple autoimmune diseases has taught me to become a student of my own body.
Iâve learned to ask different questions.
Am I tiredâŚ
Or are my muscles tired?
Do I need sleep?
Do I need rest?
Or do I need to slow down before I reach my limit?
Those answers arenât always obvious, but theyâve become an important part of managing both diseases.
Iâve also learned that just because someone says theyâre tired doesnât mean theyâre experiencing what I am.
And just because I say Iâm fatigued doesnât mean it can be compared to a late night, a busy workweek, or skipping my morning coffee.
Sometimes my body is fighting battles no one else can see.
Iâve stopped trying to prove how tired I am.
Instead, Iâve learned to honor what my body is telling me.
Some days that means pushing forward.
Other days, it means giving myself permission to rest without guilt.
That isnât giving up.
Thatâs survival.
Iâve learned that resting isnât a sign of weakness.
Itâs one of the ways I continue showing up for my family, my advocacy, and myself.
Sometimes the strongest thing I can do is listen to my body instead of fighting against it.
đ To Anyone Living with Multiple Autoimmune DiseasesâŚ
If youâve ever struggled to explain why todayâs fatigue feels different from yesterdayâsâŚ
Youâre not imagining it.
If youâve ever questioned yourself because your symptoms donât always look the sameâŚ
Youâre not alone.
And if youâve ever felt guilty for needing to rest when others couldnât understand whyâŚ
Please remember this:
Your body is carrying burdens most people will never see.
Give yourself the same grace you so freely extend to everyone else.
đŹ Letâs Continue the Conversation
Do you live with Crohnâs disease, Myasthenia Gravis, or another chronic illness?
Can you relate to the difference between systemic exhaustion and muscle weakness?
Or maybe youâre a caregiver, family member, friend, or healthcare professional who is learning what life with an invisible illness really looks like.
Iâd love to hear your perspective.
What has helped you recognize the difference between being âtiredâ and experiencing disease-related fatigue?
Share your thoughts in the comments. Every story shared helps someone else feel seen, understood, and a little less alone.
đ One Last Thought
People often tell those of us with chronic illness,
âYou just need to get more sleep.â
If only it were that easy.
Sleep doesnât stop an immune system from attacking itself.
Sleep doesnât repair disrupted communication between nerves and muscles.
Sometimes rest helps.
Sometimes medication helps.
Sometimes time helps.
And sometimesâŚ
The greatest gift someone can give us is simply believing us when we say weâre struggling.
Because fatigue isnât always about being sleepy.
Itâs about living with diseases that demand more from our bodies than most people will ever see.
If thereâs one thing I hope you take away from todayâs diary, itâs this:
Not all fatigue is created equal.
Sometimes the hardest battles are the ones no one can see.
The next time someone tells you theyâre fatigued, choose compassion over assumptions.
You may never fully understand what theyâre carrying, but believing them could make all the difference.
đ Thank you for spending a few moments with me in todayâs diary.
If this entry helped you better understand the reality of autoimmune diseaseâor reminded you that you arenât aloneâI hope youâll like, comment, share, and subscribe to The Dual Diagnosis Diaries.
Together, we can raise awareness, educate others, advocate for those living with autoimmune diseases and invisible illnesses, and remind every person walking this journey that they are seen, heard, and never alone.
Founder ⢠Author ⢠Advocate ⢠Future Wellness Coach
Kia Lorice
The Dual Diagnosis Diaries đ
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