What causes Fatigue?

What causes Fatigue

Today we are going to talk about fatigue and its causes

Fatigue is a feeling of constant tiredness or weakness and can be physical, mental or a combination of both. It can affect anyone, and most adults will experience fatigue at some point in their life.

Fatigue is a symptom, not a condition. For many people, fatigue is caused by a combination of lifestyle, social, psychological and general wellbeing issues rather than an underlying medical condition.

Although fatigue is sometimes described as tiredness, it is different to just feeling tired or sleepy.

Everyone feels tired at some point, but this is usually resolved with a nap or a few nights of good sleep. Someone who is sleepy may also feel temporarily refreshed after exercising.

If you are getting enough sleep, good nutrition and exercising regularly but still find it hard to perform everyday activities, concentrate or be motivated at your normal levels, you may be experiencing fatigue that needs further investigation.

Check out the following resources to help you with fatigue:

Diagnosis and Treatment of Chronic Fatigue Syndrome and Myalgic Encephalitis: https://amzn.to/3cZXya5

Chronic Fatigue Syndrome: A Treatment Guide: https://amzn.to/3p6ggPn

Adrenal fatigue: https://amzn.to/3p2Chyw

Symptoms of fatigue

• There may be lack of motivation or the ability to begin an activity:

1. the person tires easily once the activity has begun

2. the person has mental fatigue or difficulty with concentration and memory to start or complete an activity.

While fatigue can last for a prolonged period of time, the presence of chronic fatigue is different than chronic fatigue syndrome, which has specific set of two criteria set for by the Centers for Disease Control and Prevention as follows:

1. post-exertional malaise

2. impaired memory or concentration

3. unrefreshing sleep

4. muscle pain

5. multi-joint pain without redness or swelling

6. tender cervical or axillary lymph nodes

7. sore throat

8. headache

Other words that a person might use to describe fatigue may include:

Lethargic, listless, lack of energy, tired, worn out, weary, exhausted, malaise, or feeling run down.

Causes of fatigue

The wide range of causes that can trigger fatigue include:

Mental health issues

Fatigue is a common symptom of clinical depression, either due to the depression itself or associated problems, such as insomnia.

Fatigue can also result from the following mental health issues:

• stress

• bereavement and grief

• eating disorders

• anxiety

• boredom

• emotional exhaustion or burnout

• life events, such as moving home or getting a divorce

Endocrine and metabolic reasons

Health conditions and other factors that affect hormones can cause fatigue. These include:

• Cushing’s syndrome

• kidney disease

• electrolyte problems

• diabetes

• thyroid conditions

• pregnancy

• hormonal contraception, including birth control pills and the implant

Drugs and medications

Certain drugs and medications can cause fatigue. These include:

• some antidepressants

• anxiety medications

• antihypertensives

• statins

• steroids

• antihistamines

• Sedatives

Medication withdrawal can also cause fatigue until the body adjusts.

Heart and lung conditions

Heart and lung conditions can affect blood flow in the body or cause inflammation and may lead to fatigue. These include:

• pneumonia

• arrhythmias

• asthma

• chronic obstructive pulmonary disease

• valvular heart disease

• coronary heart disease

• congestive heart failure

Sleep problems

The following sleep factors can also lead to fatigue:

• working late

• working shifts

• jet lag

• sleep apnea

• narcolepsy

• insomnia

• reflux esophagitis

Chemicals and substances

Vitamin deficiencies, mineral deficiencies, and poisoning can all affect sleep and cause fatigue.

Consuming caffeinated or alcoholic beverages can also disrupt normal sleep, especially close to bedtime. Using products containing nicotine can also disrupt sleep.

Medical conditions

Several medical conditions can cause fatigue, including:

• anemia

• diabetes

• high blood pressure

• obesity

• heart disease

• chronic fatigue syndrome

• weakened immune system function

• fibromyalgia

• systemic lupus

• rheumatoid arthritis

• gastroesophageal reflux disease

• inflammatory bowel disease

• cancer and cancer treatments, including chemotherapy and radiation therapy

• massive blood loss

Fatigue can also be a symptom of infection. Some infections that cause extreme tiredness include:

• malaria

• tuberculosis

• infectious mononucleosis

• cytomegalovirus

• HIV

• flu

• hepatitis

Chronic pain

People with chronic pain may wake up frequently throughout the night. They may also wake up feeling tired and poorly rested, having been unable to get good quality sleep.

The combination of chronic pain and a lack of sleep can cause persistent tiredness and fatigue.

Being overweight or underweight

Overweight increases the risk of fatigue by increasing the risk of conditions that have fatigue as a common symptom, such as diabetes or sleep apnea.

Carrying more weight and experiencing joint or muscle pain can lead to or exacerbate fatigue.

Similarly, people with underweight may tire easily, depending on the cause of their condition. Eating disorders, cancer, chronic diseases, and an overactive thyroid can all cause weight loss, as well as excessive tiredness and fatigue.

Too much or too little activity

A person with fatigue may not feel able to exercise, and a lack of exercise can cause further fatigue. A lack of exercise may eventually cause deconditioning, making it harder and more tiring to perform a physical task.

Fatigue can also affect healthy individuals after prolonged, intense mental or physical activity.

Is there a test to diagnose fatigue?

The key to finding the cause of fatigue in a patient is the care the health care professional takes in compiling a medical history. It is important to ask questions not only about the loss of energy but also about other potential problems that the patient may be experiencing such as shortness of breath, sleep patterns, hair loss, color of the stools, or any of the myriad of questions that might provide information as to what organ system may be involved.

Usually, a history is taken by the health care professional asking questions about the quality and quantity of fatigue. Examples of some of the questions the health care professional may ask include:

• Does the patient feel well in the morning when they wake?

• Does the fatigue progress through the day?

• Does the person nap unexpectedly or take excessive amounts of stimulants such as caffeine to complete daily activities?

• Does the fatigue come on gradually or abruptly?

• Is it a daily occurrence or intermittent/periodic?

• What makes it better and what makes it worse?

• How has the patient's life changed because of the fatigue?

• Is the fatigue more mental than physical?

Other associated symptoms with fatigue include:

• weight loss,

• chest pain and shortness of breath,

• vomiting and diarrhea,

• fevers and chills,

• muscle weakness or pain, and/or

• anxiety and depression.

It is also appropriate for the health care professional to ask questions about the patient's social situation and to also ask about their psychologic state of mind. Alcohol and drug abuse screening questions should be expected as routine.

Because fatigue is such a non-specific symptom, each answer may direct the health care professional to explore a different potential cause.

A full physical examination is important to look for underlying signs of illness. The general appearance of the patient is important looking for hygiene, vital signs, and evidence of anxiety or agitation. Examination and evaluation of the different systems of the body (heart, lungs, abdomen, neurological system, etc.) and combining any abnormal findings with the clues found in the history taking may help make the diagnosis.

Special attention may be taken to palpate (feel) for an abnormal thyroid gland, swollen lymph nodes, listen for abnormal heart sounds including murmurs and to check for normal muscle tone and reflexes.

Depending on the findings in the history and physical examination, blood tests and other imaging studies may be ordered. Initial screening blood tests may include:

• CBC (complete blood count that includes a red blood cell, white blood cell and platelet count);

• electrolytes (sodium potassium, chloride, carbon dioxide, and sometimes calcium and magnesium);

• glucose (blood sugar);

• BUN/creatinine (to measure kidney function);

• TSH or thyroid stimulating hormone;

• monospot;

• ferritin;

• tests for deficiencies in vitamins B12, D, folic acid, and iron;

• CPK (elevated in illnesses that cause muscle inflammation); and/or

• ESR or erythrocyte sedimentation rate (non specific blood marker for inflammation in the body).

CPK and ESR screening tests are rarely done initially. The decision to obtain X-rays, CT scans, electrocardiogram (ECG, EKG) and other imaging or testing will depend upon the individual patient's circumstances and what the health care practitioner suspects may be the underlying cause of the fatigue.

When is it time to see your doctor?

You should make an appointment with your doctor if you’re feeling fatigued and you:

• can’t think of anything that might account for your fatigue

• have a higher-than-normal body temperature

• have experienced unexplained weight loss

• feel very sensitive to colder temperatures

• regularly have trouble falling or staying asleep

• believe you may be depressed

If you’ve made efforts to address the most common lifestyle causes, such as lack of rest, poor eating habits, and stress, without success, and your fatigue has continued for two weeks or more, make an appointment with your doctor. In some cases, your fatigue might be caused by a serious medical condition. Go to the hospital immediately if you experience fatigue along with any of the following symptoms:

• rectal bleeding

• vomiting blood

• severe headache

• pain in your chest area

• feelings of faintness

• irregular heartbeat

• shortness of breath

• severe pain in your abdominal, back, or pelvic region

• thoughts of suicide or self-harm

• thoughts of harming another person

How will your doctor treat fatigue?

Your doctor’s recommended treatment plan will depend on what’s causing your fatigue. To make a diagnosis, they will likely ask you questions about:

• the nature of your fatigue, including when it started and whether it gets better or worse at certain times

• other symptoms that you’ve been experiencing

• other medical conditions that you have

• your lifestyle and sources of stress

• medications that you’re taking

If your doctor suspects you have an underlying medical condition that’s causing your fatigue, they may order some medical tests. For example, they may order blood or urine tests.

What are some lifestyle changes that can help reduce fatigue?

A number of measures can help lessen fatigue caused by daily activities. To help boost your energy levels and overall health:

• drink enough fluids to stay hydrated

• practice healthy eating habits

• exercise on a regular basis

• get enough sleep

• avoid known stressors

• avoid a work or social schedule that’s overly demanding

• take part in relaxing activities, such as yoga

• abstain from alcohol, tobacco, and other illicit drugs

These lifestyle changes may help ease your fatigue. It’s also important to follow your doctor’s recommended treatment plan for any diagnosed health conditions. If left untreated, fatigue can take a toll on your physical and emotional well-being.

Can fatigue be prevented?

Fatigue as a symptom can occur as the result of many causes and therefore, prevention is not an issue. More importantly, the early recognition of fatigue will allow a person to seek medical care and potentially have an earlier diagnosis of the underlying cause made.

Sometimes, symptoms like fatigue arise gradually and it is difficult for the person to realize that there is a problem. It may take an outside perspective from a friend or family member to appreciate a difference in function. Self-awareness of gradual decline in body performance is often difficult as a person makes repeated small accommodations to complete daily activities.

Summary

A range of health conditions and lifestyle factors — such as diabetes, depression, and chronic pain, among others — can lead to fatigue.

If fatigue and sleepiness are affecting a person’s daily life and none of the tips in this article work, they should see a doctor for advice.

To help with diagnosis, a person can keep a diary of their sleep habits and symptoms. After making a diagnosis, a doctor will be able to suggest some appropriate symptoms.

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Check out the following resources to help you with fatigue:

Diagnosis and Treatment of Chronic Fatigue Syndrome and Myalgic Encephalitis: https://amzn.to/3cZXya5

Chronic Fatigue Syndrome: A Treatment Guide: https://amzn.to/3p6ggPn

Adrenal fatigue: https://amzn.to/3p2Chyw