Fatigue is a common symptom of cold agglutinin disease (CAD), an autoimmune disorder characterized by the production of autoantibodies or cold agglutinins that bind to and destroy red blood cells (RBCs) when exposed to cold temperatures.

What causes fatigue in CAD?

The main cause of fatigue in CAD is hemolytic anemia, which refers to low numbers of RBCs as a result of their destruction.

RBCs are responsible for delivering oxygen to all parts of the body, and for removing carbon dioxide that is generated because of metabolic activity.

When RBC numbers are low due to hemolytic anemia, the organs receive less oxygen than required for their normal function. This affects all organs of the body, especially those that require high energy for their function. The result is tiredness and fatigue because the body is not able to keep up with the energy demand of daily tasks.

Management of CAD-associated fatigue

Fatigue in CAD can be overcome by treatments that help resolve hemolytic anemia such as blood transfusions or plasmapheresis, or treatments that address the underlying primary medical issues that cause CAD. These underlying issues include infections, other autoimmune diseases, or lymphoid malignancies.

While hemolytic anemia in CAD is not caused by nutritional factors or deficiency in the generation of new RBCs, a healthy diet can help boost hemoglobin levels and reduce fatigue, especially with food that’s rich in iron (such as beef, dark green leafy vegetables, dried fruits, and nuts), and those that have folate (such as citrus juices, legumes, and fortified cereals) and vitamin B12 (meat and dairy).

A good night’s sleep and resting between chores or tasks can also help the body recover or boost energy levels, and help reduce fatigue.

Last updated: August 7, 2019


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