If you have hepatitis C, you’re probably used to feeling fatigued. This feeling of extreme tiredness or lack of energy that doesn’t go away with sleep can be draining.

Roughly of people with chronic hepatitis C experience fatigue.

Keep reading to learn how treatment, anemia, and depression can trigger hepatitis C-related fatigue.


It’s not entirely clear why some people with hepatitis C feel fatigued.

Hepatitis C comes from a virus, so some studies suggest that fatigue may be due to your body fighting an infection that won’t go away.

Other studies suggest that fatigue may be due to liver injury, while other experts believe that separate conditions, such as depression, may cause feelings of fatigue in people with hepatitis C.

Fatigue and Treatment

In addition to being a symptom of the disease itself, fatigue is also a side effect of some medications used to rid the body of the hepatitis C virus (HCV).

Severe fatigue is quite common with two hepatitis C drugs: interferon and ribavirin. You may even feel like you have cold or flu-like symptoms.

If you’re going through a course of HCV treatment with these medications, it’s a good idea to plan ahead and to limit your activities. Asking friends and family for help with everyday tasks, such as grocery shopping, cleaning, driving, and childcare, can give you the extra time you need to rest.

While going through treatment can be tiring, the good news is that new medications for hepatitis C are available. Some of these medications have reduced the time it takes to go through a course of treatment. Some people can even be treated for HCV without ribavirin and interferon. These changes have helped to reduce treatment side effects, including fatigue.

Hepatitis C and Anemia

Some medications for hepatitis C, especially ribavirin, can cause anemia. Anemia is a condition that occurs when you don’t have enough healthy red blood cells to carry oxygen to other parts of your body.

Symptoms of anemia may include:

  • extreme tiredness or weakness
  • difficulty sleeping
  • difficulty thinking clearly
  • headache
  • dizziness or fainting
  • paleness or lack of skin color
  • feeling cold
  • shortness of breath

Tell your doctor if you’re experiencing any of these symptoms. A simple blood test can show if your hemoglobin levels, the parts of red blood cells that carry oxygen, are low.

If your hemoglobin levels are too low, your doctor may reduce the dose of your hepatitis C medications.

Fatigue and Depression

For those with a history of depression, some medicines used to treat HCV can actually worsen depression.

Depression can lead to feelings of extreme tiredness and lack of energy. Depression is one of the side effects of interferon therapy, even in people who’ve never before experienced depression.

A review of from 2012 found that 1 in 4 people that take interferon and ribavirin for hepatitis C develop depression during treatment.

If you have a history of depression, it’s important to make sure the condition is well controlled with antidepressant medications before starting hepatitis C treatment.

Contact your doctor if you experience the following symptoms of depression during treatment, even if you’ve never before been diagnosed with depression:

  • feeling sad, anxious, irritable, or hopeless
  • losing interest in the things you usually enjoy
  • feeling worthless or guilty
  • moving slower than usual or finding it hard to sit still
  • extreme tiredness or lack of energy
  • thinking about death or giving up

Tips for Fighting Fatigue

Hepatitis C, as well as treatment, can be draining and leave you feeling fatigued. Here are some tips to fight this feeling:

  • Try going to sleep and waking up at about the same time every day.
  • Reenergize your body by taking short naps.
  • Go on regular walks, or try some other form of moderate exercise such as yoga or tai chi.
  • Take a mild pain reliever, such as acetaminophen (Tylenol), before your interferon injection. (Talk to your doctor before trying this.)
  • Drink plenty of water throughout the day.

If these tips don’t work, make sure to speak with your doctor. They can provide other suggestions so you can start feeling energized again.