Fatigue

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Fatigue

Contents of this page:

a.. Alternative names

b.. Definition

c.. Considerations

d.. Common Causes

a.. Home Care

b.. Call your health care provider if

c.. What to expect at your health care provider's office

Alternative names

Tiredness; Weariness; Exhaustion; Lethargy

Definition Return to top

Fatigue is a feeling of weariness, tiredness, or lack of energy.

Considerations Return to top

Fatigue is different from drowsiness. In general, drowsiness is feeling the need

to sleep, while fatigue is a lack of energy and motivation. Drowsiness and

apathy (a feeling of indifference or not caring about what happens) can be

symptoms of fatigue.

Fatigue can be a normal and important response to physical exertion, emotional

stress, boredom, or lack of sleep. However, it can also be a nonspecific sign of

a more serious psychological or physical disorder. When fatigue is not relieved

by enough sleep, good nutrition, or a low-stress environment, it should be

evaluated by your doctor. Because fatigue is a common complaint, sometimes a

potentially serious cause may be overlooked.

The pattern of fatigue may help your doctor determine its underlying cause. For

example, if you wake up in the morning rested but rapidly develop fatigue with

activity, you may have an ongoing physical condition like an underactive

thyroid. On the other hand, if you wake up with a low level of energy and have

fatigue that lasts throughout the day, you may be depressed.

Common Causes Return to top

There are many possible physical and psychological causes of fatigue. Some of

the more common are:

a.. Anemia (including iron deficiency anemia)

b.. Sleep disorders like ongoing insomnia, obstructive sleep apnea, or

narcolepsy

c.. Ongoing pain

d.. An allergy that leads to hay fever or asthma

e.. An underactive thyroid (hypothyroidism)

f.. Use of alcohol or illegal drugs like cocaine, especially with regular use

g.. Depression or grief

Fatigue can also accompany the following illnesses:

a.. Infection, especially one that takes a long time to recover from or treat,

like bacterial endocarditis (infection of the heart muscle or valves), parasitic

infections, AIDS, tuberculosis, and mononucleosis

b.. Congestive heart failure

c.. Diabetes

d.. Chronic liver or kidney disease

e.. 's disease

f.. Anorexia or other eating disorders

g.. Arthritis, including juvenile rheumatoid arthritis, which affects children

and teens

h.. Autoimmune diseases such as lupus

i.. Malnutrition

j.. Cancer

Certain medications may also cause drowsiness or fatigue, including

antihistamines for allergies, blood pressure medicines, sleeping pills,

steroids, and diuretics.

Chronic fatigue syndrome (CFS) is a condition that starts with flu-like symptoms

and lasts for 6 months or more. All other possible causes of fatigue are

eliminated before this diagnosis is made. Little relieves CFS, including rest.

Home Care Return to top

Here are some tips for reducing fatigue:

a.. Get adequate, regular, and consistent amounts of sleep each night.

b.. Eat a healthy, well-balanced diet and drink plenty of water throughout the

day.

c.. Exercise regularly.

d.. Learn better ways to relax. Try yoga or meditation.

e.. Maintain a reasonable work and personal schedule.

f.. Change your stressful circumstances, if possible. For example, switch

jobs, take a vacation, and deal directly with problems in a relationship.

g.. Take a multivitamin. Talk to your doctor about what is best for you.

h.. Avoid alcohol, nicotine, and drug use.

If you have chronic pain or depression, treating either often helps address the

fatigue. However, some antidepressant medications may cause or worsen fatigue.

Your medication may have to be adjusted to avoid this problem. DO NOT stop or

change any medications without instruction from your doctor.

Stimulants (including caffeine) are NOT effective treatments for fatigue, and

can actually make the problem worse when the drugs are stopped. Sedatives also

tend to worsen fatigue in the long run.

Call your health care provider if Return to top

Call your doctor right away if:

a.. You are confused or dizzy.

b.. You have blurred vision.

c.. You have little to no urine, or recent swelling and weight gain.

Call your doctor if:

a.. You have ongoing, unexplained weakness or fatigue, especially if

accompanied by fever or unintentional weight loss.

b.. You have constipation, dry skin, weight gain, or intolerance to cold.

c.. You wake up and fall back to sleep multiple times through the night.

d.. You have headaches.

e.. You are taking any medications, prescription or non-prescription, or using

drugs that may cause fatigue or drowsiness.

f.. You feel sad or depressed.

g.. You have insomnia.

What to expect at your health care provider's office Return to top

Your doctor will obtain your medical history and perform a complete physical

examination, with special attention to your heart, lymph nodes, and thyroid. He

or she may ask questions about your lifestyle, habits, and feelings.

Questions may include:

a.. How long have you had fatigue? Did it develop recently or awhile ago?

b.. Have you had fatigue in the past? If so, does it tend to occur in regular

cycles?

c.. How many hours do you sleep each night? From when until when? Do you awake

feeling rested or fatigued? Do you have trouble falling asleep? Do you awake

during the night? Do you snore or does someone who sleeps nearby tell you that

you snore?

d.. Do you feel fatigued or tired throughout the day? Does it tend to get

worse as the day goes on or stays about the same?

e.. Do you feel bored, stressed, unhappy, or disappointed?

f.. How are your relationships?

g.. Has anyone in your life recently passed away?

h.. Have you had more activity (mental or physical) lately?

i.. What is your diet like?

j.. Do you get regular exercise?

k.. Do you have any other symptoms like pain, headaches, or nausea?

l.. Have you had any recent change in appetite (up or down) or weight (up or

down)?

m.. Do you fall asleep uncontrollably during the day?

n.. Do you take any prescription or non-prescription medications? Which ones?

Diagnostic tests that may be performed include the following:

a.. Blood tests for anemia, thyroid function, and possible infection.

b.. Urinalysis

Update Date: 11/1/2003

Updated by: A. Hart, M.D., Department of Internal Medicine, a

division of Newton-Wellesley Hospital, Newton, Ma., and Senior Medical Editor,

A.D.A.M., Inc. Previously reviewed by Bridget Martell, M.D., Department of

Internal Medicine, Albert Einstein College of Medicine, New York, NY. Review

provided by VeriMed Healthcare Network (11/18/2002).