House Calls / Dr. Michael Schwartz
Fatigue is one of the most common complaints during a patient visit. Statistics show that six out of every 10 patients complain of symptoms of sleepiness, exhaustion or lack of energy. Given this frequency, the cause is often difficult to diagnose.
Sometimes fatigue can be a normal symptom, for example, from lack of sleep. However, it is often the result of something more serious that requires consultation with your physician.
Causes of fatigue include:
If someone is getting less than six to eight hours of sleep they are likely to be tired. However, quality of sleep is as important as quantity. Sleep can be interrupted by such things as alcohol, sleep apnea or restless leg syndrome. A sleep study can be ordered by your physician to determine the quality of your sleep and assess disorders.
Psychiatric conditions such as stress, anxiety and depression can lead to poor sleep. Early morning awakening is a common complaint. Your doctor might recommend medication or a psychiatric consultation.
One of the most common side effects of medications is fatigue. Often, this side effect lessens with time. However, your doctor should review your medications to determine if they are causing your fatigue.
Caffeine overdose is a very common cause of fatigue. Most people drink tea, coffee or soda and frequently reach for more of these caffeinated drinks when they are tired. A trial of stopping all caffeine products for 72 hours and increasing fluids such as juices and water may alleviate all symptoms of fatigue.
Many bacterial and viral infections can cause fatigue including ailments such as the common cold, flu, mononucleosis or even a urine infection. However, more serious infections include diseases such as HIV/AIDS or chronic fatigue syndrome. Simple blood tests can identify many of these disorders.
Patients who lack certain vitamins can suffer from fatigue. A multi-vitamin taken daily often helps. Most vitamin deficiencies can be identified by routine blood tests.
Anemia and blood deficiencies
Low red blood cell count, low iron levels, or genetic disorders such as thalassemia or sickle cell anemia can cause fatigue. These measurements are routinely checked during a physical exam.
Autoimmune and inflammatory diseases such as lupus, rheumatoid arthritis, fibromyalgia, multiple sclerosis and other chronic disorders commonly cause fatigue. Your doctor may refer you to a specialist, e.g. a rheumatologist, for further evaluation.
Probably one of the most common causes of fatigue is dehydration. Lack of fluid causes the body to expend energy to maintain normal body functions. Proper fluid intake (including water, juices and power drinks) can treat the symptoms of fatigue.
Malignancies (and the treatment for cancers) commonly result in fatigue. Cancers overwhelm the body's immune system creating multiple deficiencies including fluid balance and nutritional status. Proper preventative screening can help identify (and often prevent) certain cancers. Consult with your physician about tests such as mammograms, colonoscopies, pap smears, PSA (prostate screening) and other tests to help detect certain cancers.
Thyroid disease, menopause, and other endocrinologic disorders can cause fatigue. Your doctor can order simple blood tests to rule out these conditions and refer you to a specialist if abnormalities are detected.
Heart disease can cause fatigue. If a patient complains of exertional fatigue, an EKG (heart test) should be performed. In addition, your doctor might order a stress test and echocardiogram (sonogram) to evaluate heart function.
Allergies and their treatment (anti-histamines) often cause fatigue. An allergy consult can identify if you have allergies. Non-sedating treatments include allergy shots.
Fatigue is common and its causes are vast. If you are suffering from fatigue, schedule a physical examination. Often your doctor can identify the cause and prescribe an effective treatment to alleviate the problem. It is time to wake up and feel great once again.