Fatigue

Definition:
A feeling of lack of energy, weariness, or tiredness.

Alternative Names:
Tiredness; Weariness; Exhaustion; Lethargy

Considerations:
Fatigue is not the same as drowsiness, but the desire to sleep may accompany fatigue. Apathy is a feeling of indifference; this may accompany fatigue but may also exist independently.

Fatigue represents a normal and important response to physical exertion, emotional stress, or lack of sleep.

Fatigue can also be a nonspecific symptom of a psychological or physiologic disorder. Pathologic (illness-related) fatigue is not relieved by adequate rest, adequate sleep, or removal of stressful factors. Fatigue that is not relieved by normal means, or that occurs in the absence of a known cause or other symptoms should be medically evaluated.

The pattern of fatigue may help delineate its underlying cause. Individuals who arise in the morning rested but, with activity, rapidly fatigue may have an ongoing condition or disease. Individuals who awaken fatigued and the level of fatigue remains constant throughout the day may be suffering from depression. However, these are not absolutes and chronic fatigue should be evaluated by a health care provider.

In many cases, fatigue is related to boredom, unhappiness, disappointment, lack of sleep, or hard work. Because fatigue is such a common complaint and is often caused by psychological problems, its potential seriousness is often overlooked.

Common Causes:


Home Care:
There are no direct cures for the most common fatigue problems. Taking a vacation, changing jobs, undertaking new activities, and making marital adjustments can be helpful.

A balanced diet, a program for regular exercise (within prescribed limits), and adequate rest are recommended.

Set priorities, maintain a reasonable schedule, and develop good sleep habits.

Chronic fatigue can often be reduced by alleviating pain, which may interfere with rest, and nausea (if present) which may lead to malnutrition.

Taking stimulants does not work and can actually make the problem worse when the drugs are discontinued. Tranquilizers generally intensify fatigue. Vitamins may not solve the problem, but if taken in moderation probably won't hurt.

Call your health care provider if:
  • there is prolonged, unexplained weakness or fatigue particularly if accompanied by other unexplained symptoms.


What to expect at your health care provider's office:
The medical history will be obtained and a physical examination performed. The examiner may inquire into lifestyle and feelings. If fatigue is not caused by a physical disorder, the patient may be referred for psychological counseling.

Medical history questions documenting fatigue may include:
  • sleep pattern
    • How much do you sleep?
    • What hours do you sleep?
    • Do you awake feeling rested or fatigued?
  • quality
    • Does the level of fatigue remain constant throughout the day?
    • Does fatigue get worse as the day goes on?
  • emotional state
    • Are you feeling boredom, unhappiness, or disappointment in your life?
  • other
    • Have you had unusual activity lately?
    • How are your relationships?
    • What is your diet like?
    • Do you get regular exercise?
    • What other symptoms are present? Is there pain? nausea?
    • What medications are being taken?
  • time pattern
    • Has fatigue only been developing recently?
    • Has it been lasting for weeks to months?
    • Does fatigue occur in regular cycles?
Physical examination will include special attention to the heart, lungs, and thyroid gland.

Diagnostic tests that may be performed include: After seeing your health care provider:
You may want to add a diagnosis related to fatigue to your personal medical record.


Review Date: 11/30/2001
Reviewed By: Steven Angelo, M.D. Department of Internal Medicine, Yale School of Medicine, Hospital of Saint Raphael, New Haven, CT. Review provided by VeriMed Healthcare Network.

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