PBC SYMPTOMS
Some symptoms go beyond discomfort, affecting your day-to-day routine and sense of well-being. These challenges can feel intense or draining, but remember that you are not facing them alone. Many people with primary biliary cholangitis (PBC) share similar experiences and understand what you’re going through.
Common PBC symptoms
Symptoms vary from person to person, but common symptoms include:
Fatigue
“It’s severe exhaustion that I can’t explain.”
PBC-related fatigue can feel like whole-body exhaustion, brain fog, or needing longer recovery time from daily activities.
Severe itching
“There is nothing that helps.”
Intense itching can lead to loss of sleep and difficulty participating in daily activities.
These are not the only symptoms of PBC. Beyond physical and mental symptoms, many people also experience an emotional burden of the disease.
It’s important to understand that PBC symptoms:
- Are unique to each person
- Can change over time
- Do not necessarily mean disease progression (or worsening)
Fatigue is the most common symptom of PBC.
Up to 78% of people living with PBC experience chronic fatigue that is more intense than general fatigue.
In both…
- Feeling drained and tired
- Being slowed down
- Struggling to do all you need to do
(00:00) Fade in from black; Chris starts video with clapperboard and introduction.
Voiceover: This is Chris’ story, take 1.
(00:03) Aerial views as Chris and her husband walk together through their neighborhood.
(00:10) Chris bakes in kitchen.
Voiceover: Every December, my kitchen turns into a cookie factory. I bake about a thousand cookies, all kinds.
On-screen title: Real PBC Talk: Featuring Chris’ Journey With Fatigue
(00:30) Trays of baked cookies are shown; then, in a flashback, zoom in to a picture of Chris’ mom. Then zoom in on a picture of Chris as she proceeds to pull a recipe box from a cabinet.
Voiceover: Sugar, ginger snap, and my specialty, chocolate crinkle. It started as something my mom and I did together, and after she passed, I kept it going.
(00:40) Far view of Chris bringing down recipe box from cabinet. Then change to testimonial view of Chris sitting in chair. Then, close-up of a recipe card as she gathers ingredients to begin baking.
Voiceover: For my family and for me. My name is Chris. I'm a mom, a grandma, and a woman living with PBC.
(00:50) Overhead shot of ingredients and mixing bowl as she starts preparing the recipe.
Voiceover: Because of my PBC-related fatigue, I can't bake everything in a single marathon weekend anymore. I need to do it in steps. Measure the ingredients one weekend.
(01:00) Close-up of baking ingredients on the cutting board, Chris adding dough to cookie tray.
Voiceover: Mix and freeze dough the next. Bake a few trays at a time. Sometimes I start in early November.
(01:10) Soft-focus transition to Chris speaking directly to camera, sharing her experience, and end with aerial view of trees.
Voiceover: That's what living with primary biliary cholangitis has taught me. Sometimes you have to find new ways to keep doing what you love.
(01:20) Chris lays down in bed, showcasing the struggles to get out of bed and illustrating the impact of fatigue on daily activities.
Voiceover: For years, I just felt myself getting more and more tired. Not a normal tiredness that a nap could fix.
(01:30) Close-up of Chris and husband holding hands. Camera focuses on husband and then Chris talking at kitchen table.
Voiceover: But a serious type of exhaustion. I would tell my husband that I felt like I was running on an empty battery. When I was finally diagnosed with PBC,
(01:40) She carries laundry through the house; interview shot of Chris and then shows her climbing the stairs.
Voiceover: It actually made sense. There was a reason I was feeling this fatigue. I knew I wasn't lazy. I wasn't imagining it. My body was trying to tell me something,
(01:50) Testimonial view of Chris, close-up of Chris at kitchen table from husband POV.
Voiceover: And I needed to listen. I don't experience much PBC-related itch, so fatigue is the hardest symptom for me to manage.
(02:00) She picks up and looks at a framed family photograph with her father. Over her shoulder POV.
Voiceover: Some days I feel like I've been awake for 48 hours straight. My fatigue affects every aspect of my life, like how I interact with people,
(02:10) View from Chris’ back at a desk working.
Voiceover: How I care for my 88-year-old dad, and even how I do my job. But over time, I've learned to adapt.
On-screen title: LIFE WITH PBC-RELATED FATIGUE
(02:20) Close-up of Chris working from behind and testimonial view.
Voiceover: I've spent more than 30 years in healthcare reimbursement, most of it in community health. But after my diagnosis, I knew I needed to prepare a change.
(02:30) Her husband continues baking while she rests on the couch in the background.
Voiceover: I work part-time now, still doing what I find meaningful. I'm lucky to have a lot of support. My husband has been incredible.
(02:40) She smiles while sitting by the window, holding a book and turning on a salt lamp. In the background is her husband doing dishes.
Voiceover: He jumps in to help with housework and runs meals over to my dad when I can't. Every night, about an hour before bed, I turn on my salt lamp,
(02:50) Close-up of Chris reading and a Zoom call with several participants.
Voiceover: Open a book and enjoy the moments of calm before falling asleep. I've found support online, too. Connecting with others who understand this kind of fatigue
(03:00) Different angles of Chris over the phone. Then testimonial view and last, Chris and husband sit together outside their home, sharing a quiet moment of support and companionship.
Voiceover: Helps me remember that I'm not alone. That's something I tell others now. Talk to your healthcare provider. Don't brush off your symptoms or assume it's just stress.
(03:10) Chris and husband talking on porch while Chris holds laptop. Then, shot of them walking together outdoors.
Voiceover: Trust your gut and speak up. You deserve to be heard. Not every day is easy, but I've learned to really appreciate the good ones,
(03:20) Shot of grandson’s picture over mantle and shot of Chris brushing hair and looking at the mirror in bathroom.
Voiceover: When I can walk outside, cook a meal, or just have the energy to spend time with my grandson. Even if all you did today was get dressed, that's something to celebrate.
(03:30) Chris back in kitchen baking. Close-up of decorated cookies on a serving platter.
Voiceover: Living with PBC is a lot like baking those cookies. It takes patience, planning, and the willingness to rest between batches.
(03:40) Summary shots of Chris in testimonial chair, looking lovingly at husband (from husband’s shoulder POV), reading book on couch and smiling warmly at camera in the kitchen.
Voiceover: PBC may slow me down, but it's also taught me to listen to my body, take care of myself, and find joy in small victories.
(03:50) Final shot of Chris standing up from chair on porch with husband, kissing him on the cheek.
Voiceover: When you're in tune with your body, you can still find ways to be you. PBC can never take that away.
On-screen: Talk to your doctor about fatigue at your next appointment. Visit RealPBCTalk.com to learn more about PBC and download our Doctor Discussion Guide.
©2026 Ipsen Biopharmaceuticals, Inc. All rights reserved. NON-US-004491 February 2026
Sponsored by Ipsen Biopharmaceuticals, Inc. Chris has been compensated for her time.
(00:00) Fade in from black; Chris starts video with clapperboard and introduction.
Voiceover: This is Chris’ story, take 1.
(00:03) Aerial views as Chris and her husband walk together through their neighborhood.
(00:10) Chris bakes in kitchen.
Voiceover: Every December, my kitchen turns into a cookie factory. I bake about a thousand cookies, all kinds.
On-screen title: Real PBC Talk: Featuring Chris’ Journey With Fatigue
(00:30) Trays of baked cookies are shown; then, in a flashback, zoom in to a picture of Chris’ mom. Then zoom in on a picture of Chris as she proceeds to pull a recipe box from a cabinet.
Voiceover: Sugar, ginger snap, and my specialty, chocolate crinkle. It started as something my mom and I did together, and after she passed, I kept it going.
(00:40) Far view of Chris bringing down recipe box from cabinet. Then change to testimonial view of Chris sitting in chair. Then, close-up of a recipe card as she gathers ingredients to begin baking.
Voiceover: For my family and for me. My name is Chris. I'm a mom, a grandma, and a woman living with PBC.
(00:50) Overhead shot of ingredients and mixing bowl as she starts preparing the recipe.
Voiceover: Because of my PBC-related fatigue, I can't bake everything in a single marathon weekend anymore. I need to do it in steps. Measure the ingredients one weekend.
(01:00) Close-up of baking ingredients on the cutting board, Chris adding dough to cookie tray.
Voiceover: Mix and freeze dough the next. Bake a few trays at a time. Sometimes I start in early November.
(01:10) Soft-focus transition to Chris speaking directly to camera, sharing her experience, and end with aerial view of trees.
Voiceover: That's what living with primary biliary cholangitis has taught me. Sometimes you have to find new ways to keep doing what you love.
(01:20) Chris lays down in bed, showcasing the struggles to get out of bed and illustrating the impact of fatigue on daily activities.
Voiceover: For years, I just felt myself getting more and more tired. Not a normal tiredness that a nap could fix.
(01:30) Close-up of Chris and husband holding hands. Camera focuses on husband and then Chris talking at kitchen table.
Voiceover: But a serious type of exhaustion. I would tell my husband that I felt like I was running on an empty battery. When I was finally diagnosed with PBC,
(01:40) She carries laundry through the house; interview shot of Chris and then shows her climbing the stairs.
Voiceover: It actually made sense. There was a reason I was feeling this fatigue. I knew I wasn't lazy. I wasn't imagining it. My body was trying to tell me something,
(01:50) Testimonial view of Chris, close-up of Chris at kitchen table from husband POV.
Voiceover: And I needed to listen. I don't experience much PBC-related itch, so fatigue is the hardest symptom for me to manage.
(02:00) She picks up and looks at a framed family photograph with her father. Over her shoulder POV.
Voiceover: Some days I feel like I've been awake for 48 hours straight. My fatigue affects every aspect of my life, like how I interact with people,
(02:10) View from Chris’ back at a desk working.
Voiceover: How I care for my 88-year-old dad, and even how I do my job. But over time, I've learned to adapt.
On-screen title: LIFE WITH PBC-RELATED FATIGUE
(02:20) Close-up of Chris working from behind and testimonial view.
Voiceover: I've spent more than 30 years in healthcare reimbursement, most of it in community health. But after my diagnosis, I knew I needed to prepare a change.
(02:30) Her husband continues baking while she rests on the couch in the background.
Voiceover: I work part-time now, still doing what I find meaningful. I'm lucky to have a lot of support. My husband has been incredible.
(02:40) She smiles while sitting by the window, holding a book and turning on a salt lamp. In the background is her husband doing dishes.
Voiceover: He jumps in to help with housework and runs meals over to my dad when I can't. Every night, about an hour before bed, I turn on my salt lamp,
(02:50) Close-up of Chris reading and a Zoom call with several participants.
Voiceover: Open a book and enjoy the moments of calm before falling asleep. I've found support online, too. Connecting with others who understand this kind of fatigue
(03:00) Different angles of Chris over the phone. Then testimonial view and last, Chris and husband sit together outside their home, sharing a quiet moment of support and companionship.
Voiceover: Helps me remember that I'm not alone. That's something I tell others now. Talk to your healthcare provider. Don't brush off your symptoms or assume it's just stress.
(03:10) Chris and husband talking on porch while Chris holds laptop. Then, shot of them walking together outdoors.
Voiceover: Trust your gut and speak up. You deserve to be heard. Not every day is easy, but I've learned to really appreciate the good ones,
(03:20) Shot of grandson’s picture over mantle and shot of Chris brushing hair and looking at the mirror in bathroom.
Voiceover: When I can walk outside, cook a meal, or just have the energy to spend time with my grandson. Even if all you did today was get dressed, that's something to celebrate.
(03:30) Chris back in kitchen baking. Close-up of decorated cookies on a serving platter.
Voiceover: Living with PBC is a lot like baking those cookies. It takes patience, planning, and the willingness to rest between batches.
(03:40) Summary shots of Chris in testimonial chair, looking lovingly at husband (from husband’s shoulder POV), reading book on couch and smiling warmly at camera in the kitchen.
Voiceover: PBC may slow me down, but it's also taught me to listen to my body, take care of myself, and find joy in small victories.
(03:50) Final shot of Chris standing up from chair on porch with husband, kissing him on the cheek.
Voiceover: When you're in tune with your body, you can still find ways to be you. PBC can never take that away.
On-screen: Talk to your doctor about fatigue at your next appointment. Visit RealPBCTalk.com to learn more about PBC and download our Doctor Discussion Guide.
©2026 Ipsen Biopharmaceuticals, Inc. All rights reserved. NON-US-004491 February 2026
Sponsored by Ipsen Biopharmaceuticals, Inc. Chris has been compensated for her time.
Up to 70% of people have itching that is sometimes severe
Keeping track of symptoms
Simple approaches like keeping a symptom diary or completing a short self-assessment can help you keep track of how PBC is affecting your daily life
Tracking fatigue
It's hard to note every time you feel tired. Instead, it can be helpful to track each time you skip an event, stay home from work, or delay a chore. We designed the Fatigue Assessment Tool to help you do just this. Fill it out and bring it to your next appointment to help your doctor understand your experience.
You deserve to be heard
Symptoms like fatigue are a significant part of your PBC experience. Your doctor is there to listen and offer solutions to help manage them. Be sure to have an open and honest conversation about symptoms.
The Fatigue Assessment Tool makes it simple to track the day-to-day impact of fatigue
Bring it to your next appointment to help your doctor understand your experience.
Learn about treatment response and monitoring disease progression
