Fatigue from CD20 therapies like Kesimpta and Ocrevus is definitely a thing, especially what people call the ‘crap gap’. Ocrevus tends to hit before the next 6-monthly infusion, but with Kesimpta the cycle is shorter so if you delay a dose because you’re ill or run down, you can really feel it. For me personally, pacing was the game changer. Weirdly, exercise creates energy once you stop trying to redline yourself constantly. Sleep, decent food, extra carbs when fatigue is heavy, and even just 6 minutes on a treadmill to wake the body up can help massively. I wouldn’t stop a DMD lightly though without speaking properly with your MS team. Sometimes the fatigue is the MS itself, poor sleep, stress, low vitamin levels, infections, kids draining your soul like tiny caffeinated vampires 🧛‍♂️😂, or the medication. It’s hard to untangle. I’ve had RRMS around 80 months now on CD20 therapy and still work full time, train, raise kids and function well, but pacing was the missing piece for me