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Hi Nancy,   I hear you about feeling so tired all the time.  I, too, experience extreme fatigue.  But unlike Paula, I can't do hours at the gym.   Eating well, staying hydrated, getting appropriate exercise, and sleeping well, all serve to assist us in maximizing our natural energy potentials.  Some MS patients will also benefit from pharmaceutical treatments, but there are so many possible causes for fatigue and lack of energy.   Here's a post that Dr. Gross wrote regarding Fatigue and Sleepiness in MS.  There's some great information there.   Personally, I've used Provigil to combat one type of fatigue.  When I started treating my spasticity with Baclofen, I found that I was able to do things much more easily which gave me more energy.   Perhaps you should let your neurologist know how much tiredness and lack of energy are impacting your daily life.  Your doctor should be able to help find the cause.