Fatigue

Fatigue may occur with other symptoms that vary depending on the underlying disease, disorder or condition. For example, fatigue caused by hypothyroidism may be associated with dry, brittle hair, hair loss, unusual weight gain, and possibly goiter (neck swelling due to enlargement of the thyroid gland). Fatigue associated with depression may occur with excessive crying, insomnia and apathy.

Symptoms that may occur with fatigue include:

• Apathy (feeling indifferent to your surroundings)

• Depression

• Diarrhea or vomiting

• Difficulty concentrating

• Flu-like symptoms (fever, sore throat, headache, cough, aches and pains)

• Loss of appetite

• Pain

• Symptoms of hypothyroidism (unexpected weight gain, dry skin, hair loss, constipation, and cold intolerance)

• Unexplained weight loss

In some cases, fatigue can indicate a serious or life-threatening condition, such as acute heart failure or gastrointestinal bleeding, which should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms:

• Abdominal swelling or severe abdominal pain

• Bleeding symptoms, such as bloody urine, vomiting blood, rectal bleeding, or bloody stools

• Change in level of consciousness or alertness, such as passing out or unresponsiveness

• Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions

• Chest pain, chest tightness, or chest pressure

• Dizziness or lightheadedness

• Heart palpitations

• High fever (higher than 101 degrees Fahrenheit)

• Not producing any urine

• Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking

• Seizure

• Stiff neck, possibly with a rash, nausea and vomiting, fever,  and confusion

• Swelling (edema), including swollen lymph nodes

Fatigue can be caused by a wide variety of diseases, disorders or conditions, such as anemia, low blood pressure (hypotension), chronic fatigue syndrome, and Addison's disease. Although fatigue can be due to relatively mild and temporary conditions, such as jet lag, fatigue can also be caused by serious or life-threatening conditions, such as organ failure or cancer.

Fatigue that lasts for more than six months, is not alleviated by rest, and is not due to a known mental or physical illness is defined as chronic fatigue syndrome (CFS). The cause of CFS is not known at this time.

Fatigue can be due to common conditions including:

• Allergies that cause hay fever or asthma

• Anemia

• Chronic pain

• Dehydration

• Depression

• Endocrine abnormality (thyroid, adrenal gland, etc.)

• Fever

• Hyperthyroidism (overactive thyroid gland) or hypothyroidism (underactive thyroid gland)

• Jet lag

• Perimenopause (the period of time close to menopause) and menopause

• Pregnancy

• Sleep problems such as obstructive sleep apnea and insomnia

Fatigue can be due to a variety of other diseases, disorders and conditions including:

• Addison’s disease (deceased production of hormones by the adrenal glands)

• Cancer

• Chronic fatigue syndrome

• Chronic obstructive pulmonary disease (COPD, includes emphysema and chronic bronchitis)

• Congestive heart failure

• Diabetes (chronic disease that affects your body’s ability to use sugar for energy)

• Fibromyalgia (syndrome associated with long-term, body-wide pain points)

• Infectious diseases, such as HIV/AIDS, influenza and infectious mononucleosis

• Liver or kidney disease

• Myasthenia gravis (autoimmune neuromuscular disorder that causes muscle weakness)

• Rheumatoid arthritis and osteoarthritis

• Systemic lupus erythematosus or other connective tissue disorders

• Toxic environmental exposure

Always tell your doctor about any medications or supplements you are taking, including prescription and over-the-counter medications and herbal or alternative supplements. The following medications may be a possible cause of fatigue:

• Antidepressants

• Antihistamines

• High blood pressure medications or diuretics

• Sleeping medications, tranquilizers, sedatives, and anti-anxiety medications

• Steroids

To diagnose the underlying cause of fatigue, your doctor or licensed health care practitioner will ask you several questions related to your symptoms. You can best help your health care practitioner in diagnosing the underlying cause of fatigue by providing complete answers to these questions:

• Describe the fatigue. Is it constant or intermittent? Is it mild, moderate or severe? Does it occur with or after certain activities or events, such as stress, exercise, or just before the menstrual period?

• How long have you had fatigue?

• What other symptoms do you have with fatigue?

Complications associated with fatigue can be progressive. It is important to visit your health care provider promptly when you experience unexplained fatigue. Once the underlying cause is diagnosed, following the treatment plan you and your health care provider design specifically for you can help reduce potential complications including:

• Decreased overall quality of life

• Depression

• Inability to perform daily tasks and disability

• Malnutrition from loss of appetite associated with fatigue

• Poor quality of life