How to Eat When You’re Exhausted from PSC

By: Brittany Rogers, MS, RD/LDN, CSDH, CPT

Fatigue is one of the most common and difficult symptoms people with primary sclerosing cholangitis (PSC) may experience. In one study, more than 70% of individuals with PSC reported experiencing fatigue¹.

While people with PSC alone can experience significant exhaustion, people with both PSC and IBD may experience even greater fatigue^{2, 3}. Several factors may contribute, including a history of major surgeries⁴, emotional health such as depression or lower overall well-being⁵, autonomic nervous system dysfunction⁶, and liver-related factors such as elevated liver enzymes, altered liver function, and cholestatic itching⁷.

For some people, liver transplant can lead to meaningful improvements in fatigue, though about one-third continue to experience symptoms, with energy gains more common in men than women⁸.

To learn more about fatigue in PSC, watch Dr. Mark Swain’s webinar on Fatigue in PSC: Leveraging Scientific Discovery to Improve Well-Being.

Managing PSC fatigue in daily life

Fatigue can make even routine tasks—like cooking or grocery shopping—feel exhausting. Everyone feels tired at times, but for people with chronic conditions such as PSC, low energy can occur more frequently and may make it harder to maintain good nutrition. Planning ahead and using practical strategies can help you eat well, even on your most exhausting days.

10 strategies for low-energy days

Plan ahead with grocery delivery. Save energy by having groceries brought to your door.
Keep simple meals on hand. Think smoothies, yogurt with fruit, avocado toast, or protein oatmeal.
Batch cook or freeze leftovers. Make single-portion meals to reheat on low-energy days.
Use kitchen appliances. Use slow cookers, pressure cookers, or air fryers to reduce the time spent on your feet cooking.
Choose quick prep ingredients. Pre-cut or frozen vegetables, canned beans, and pre-cooked grains can save time and effort.
Sit while prepping food. Reduce fatigue by chopping, mixing, and assembling while seated.
Stay hydrated. Fatigue can worsen with dehydration. Aim for at least half your body weight in ounces of water per day.
Focus on nutrient-dense foods. Colorful fruits and vegetables, whole grains, and protein all help support energy.
Check for nutrient deficiencies. People with cirrhosis as well as individuals with IBD may be at an even greater risk. Ask your care team about testing and consider a daily multivitamin.
Ask for support. Friends or family can help with meals or grocery shopping—it’s okay to lean on others.

With planning and support, it’s possible to maintain good nutrition and manage fatigue more effectively. Remember, you are not alone—your care team and support system can help you navigate these challenges and find strategies that work for you.

Quick and nutritious meal and snack ideas

When you’re exhausted, it’s completely normal to choose convenient options that are quick and easy to eat. To support sustained energy, it can be helpful to also keep a few nutritious, easy-to-assemble foods on hand that can be prepared in five minutes or less—so you have nourishing choices available when you need them the most.

Quick meal ideas

Scrambled eggs on avocado toast with a side of fresh fruit
Hard-boiled eggs (store-bought or prepped ahead) with microwaveable brown rice and sautéed spinach
Smoothies- with fruits, veggies, nut butter, chia seeds, oats, and yogurt and/or protein powder
Bean, salsa, rice, cheese and avocado tacos
Tuna fish sandwich with a side of fruit
Pita with chickpeas, olives, feta, butter lettuce, and hummus
Bean and cheese quesadillas dipped in guacamole and salsa
Greek yogurt topped with oats, berries, and cinnamon
Peanut butter (or any nut/seed butter) and mashed fruit sandwich

Quick snack ideas

Hard-boiled eggs (store-bought or prepared in bulk)
Smoothies
Edamame, frozen and ready to steam
Toast with nut or seed butter and mashed fruit
Yogurt toast: plain yogurt on toast with sautéed mushrooms and seasoning
Greek yogurt with mandarin oranges
Avocado toast with chia seeds
Energy bites (oats, banana, date syrup, nut or seed butter) batched in advanced
Simply made ready to grab bars

Shelf-Stable Pantry Staples

Exhaustion can hit unexpectedly, so keep shelf-stable foods on hand for quick, nutritious meals. Use this list to create your own personalized pantry:

Grains

Oatmeal
Pasta
Bread
Microwaveable rice

Dairy or non-dairy alternatives

Boxed cow’s milk
Powdered cow’s milk
Shelf-stable non-dairy milks

Nuts and seeds

Flax, hemp, or chia seeds
Raw, unsalted nuts
Almond, peanut, and other nut or seed butters
Nut flours

Produce

Frozen fruits
Frozen vegetables
Unsweetened applesauce
Fruit cups packed in 100% juice
Low-sodium canned tomatoes and tomato sauce
Low-sodium canned vegetables

Beans and legumes

Low-sodium canned beans and lentils
Frozen shelled edamame
Store-bought air dried chickpeas

Fish and meats

Canned tuna packed in water

Final tips for how to eat when you are exhausted from PSC

Prepare your pantry and keep quick meals ready so you can continue eating well, even on the most exhausting days. Small steps—like having a few nutritious staples on hand—can make a big difference in supporting your energy and overall health.

Brittany Rogers, MS, RD/LDN, CSDH, CPT is a Registered Dietitian and founder of Romanwell, an insurance-based telehealth practice in New York dedicated to helping individuals with IBD and complex gastrointestinal and liver conditions, including PSC. Her approach is eating disorder–informed and weight-inclusive, integrating medical nutrition therapy with compassionate, patient-centered care. She serves on the National Scientific Advisory Committee for the Crohn’s & Colitis Foundation and has lived experience with both ulcerative colitis and PSC.

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