What are the common causes of fatigue. How is fatigue diagnosed. What are effective treatments for fatigue. When should you see a doctor about fatigue. How can lifestyle changes help reduce fatigue.

Understanding Fatigue: More Than Just Being Tired

Fatigue is a complex and multifaceted condition that goes beyond simple tiredness or sleepiness. It represents a state of profound exhaustion that affects both physical and mental functioning. Unlike normal tiredness that can be relieved by rest, fatigue often persists even after periods of sleep or relaxation.

What exactly is fatigue? Fatigue can be defined as:

• A subjective feeling of low energy, exhaustion, or lack of motivation
• Objectively impaired physical or cognitive performance
• A combination of both subjective and objective symptoms

Fatigue impacts a significant portion of the population. Studies indicate that 5-20% of people experience persistent, clinically significant fatigue that interferes with daily functioning. Women are twice as likely as men to report fatigue, though it affects people of all ages and occupations.

The Prevalence and Impact of Fatigue

How common is fatigue as a medical complaint? Fatigue is one of the most frequent reasons people seek medical care. It is the primary complaint in 5-10% of primary care visits and an important secondary symptom in another 5-10% of cases. This high prevalence underscores the significant burden fatigue places on both individuals and the healthcare system.

The impact of fatigue on quality of life can be profound. It interferes with work productivity, social relationships, and the ability to engage in enjoyable activities. For many, fatigue creates a vicious cycle – the less one does due to fatigue, the more deconditioned and fatigued they become.

The Challenge of Diagnosing Fatigue

Why is fatigue often challenging for doctors to diagnose and treat? There are several factors that complicate the clinical approach to fatigue:

1. Fatigue is a non-specific symptom associated with numerous medical and psychiatric conditions
2. There is no single objective test to measure or quantify fatigue
3. Patient and doctor perceptions of the significance of fatigue often differ
4. The underlying mechanisms of fatigue are not fully understood

This diagnostic challenge can lead to frustration for both patients and healthcare providers. A thorough medical evaluation is often necessary to identify or rule out potential underlying causes.

Common Causes of Fatigue

What are the most frequent medical causes of fatigue? Fatigue can result from a wide array of conditions, including:

• Anemia
• Thyroid disorders (both hypothyroidism and hyperthyroidism)
• Chronic fatigue syndrome/myalgic encephalomyelitis
• Sleep disorders like sleep apnea or insomnia
• Depression and anxiety
• Chronic pain conditions
• Heart disease
• Autoimmune disorders like lupus or rheumatoid arthritis
• Infections (acute or chronic)
• Cancer and cancer treatments
• Medications (as a side effect)

In many cases, fatigue results from a combination of factors rather than a single cause. Lifestyle factors like poor diet, lack of exercise, chronic stress, and insufficient sleep can exacerbate fatigue from medical conditions.

Idiopathic Fatigue

What happens when no clear medical cause for fatigue is found? In some cases, extensive testing fails to reveal a specific underlying condition. This is referred to as idiopathic fatigue. While frustrating for patients, idiopathic fatigue is not uncommon. However, it’s important to note that the absence of a diagnosed cause doesn’t mean the fatigue isn’t real or significant.

The Diagnostic Process for Fatigue

How do doctors approach diagnosing the cause of fatigue? The diagnostic process typically involves several steps:

1. Detailed medical history, including onset and pattern of fatigue, associated symptoms, and lifestyle factors
2. Physical examination
3. Basic laboratory tests (complete blood count, thyroid function, metabolic panel)
4. Screening for mood disorders like depression and anxiety
5. Sleep evaluation if sleep disorders are suspected
6. Further specialized testing based on clinical suspicion

It’s crucial for patients to provide a thorough description of their fatigue, including how it impacts daily activities and any patterns they’ve noticed. This information can provide valuable clues for diagnosis.

When to Seek Medical Attention for Fatigue

When should someone consult a doctor about fatigue? While occasional tiredness is normal, persistent fatigue that significantly impacts daily life warrants medical evaluation. Seek medical attention if:

• Fatigue lasts for more than 2 weeks despite adequate rest
• Fatigue is accompanied by other concerning symptoms like fever, unexplained weight loss, or severe pain
• You experience sudden onset of extreme fatigue
• Fatigue is affecting your ability to work or maintain relationships

Treatment Approaches for Fatigue

How is fatigue treated? The treatment approach for fatigue depends on the underlying cause. When a specific medical condition is identified, treating that condition often improves fatigue. For example:

• Anemia may be treated with iron supplements or other interventions
• Thyroid disorders can be managed with medication
• Sleep apnea might be addressed with CPAP therapy
• Depression may be treated with psychotherapy and/or medication

For idiopathic fatigue or when treating the underlying condition doesn’t fully resolve symptoms, a multifaceted approach is often beneficial. This may include:

1. Cognitive Behavioral Therapy (CBT) to address thoughts and behaviors that may perpetuate fatigue
2. Graded exercise therapy to gradually increase physical activity levels
3. Sleep hygiene improvements
4. Stress reduction techniques like mindfulness or meditation
5. Nutritional counseling
6. Medications to address specific symptoms (used judiciously)

The Role of Lifestyle Modifications

How can lifestyle changes help combat fatigue? Regardless of the underlying cause, certain lifestyle modifications can often help improve energy levels:

• Establishing a consistent sleep schedule
• Engaging in regular physical activity (even if starting very gradually)
• Eating a balanced diet rich in fruits, vegetables, and whole grains
• Staying hydrated
• Managing stress through relaxation techniques or counseling
• Limiting alcohol and caffeine intake
• Quitting smoking

These changes can be powerful tools in managing fatigue, but should be implemented gradually and in consultation with a healthcare provider.

The Psychological Aspects of Fatigue

How does fatigue affect mental health, and vice versa? The relationship between fatigue and psychological well-being is complex and bidirectional. Chronic fatigue can lead to feelings of frustration, hopelessness, and depression. Conversely, mental health conditions like depression and anxiety often manifest with fatigue as a primary symptom.

Addressing the psychological aspects of fatigue is crucial for effective management. This may involve:

• Cognitive behavioral therapy to reframe negative thought patterns
• Mindfulness practices to reduce stress and improve present-moment awareness
• Support groups to connect with others experiencing similar challenges
• Counseling to develop coping strategies and address underlying emotional issues

The Impact of Chronic Fatigue Syndrome

What is chronic fatigue syndrome, and how does it differ from other forms of fatigue? Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME), is a complex disorder characterized by extreme fatigue that doesn’t improve with rest and worsens with physical or mental activity. Unlike general fatigue, CFS/ME:

• Persists for at least six months
• Is not explained by other medical conditions
• Is often accompanied by other symptoms like muscle pain, cognitive difficulties, and post-exertional malaise
• Significantly impairs daily functioning

The exact cause of CFS/ME remains unknown, and treatment typically focuses on symptom management and improving quality of life. A multidisciplinary approach involving medical care, rehabilitation, and psychological support is often most effective.

Fatigue in Special Populations

How does fatigue manifest in different demographic groups? While fatigue can affect anyone, certain populations may experience it differently or be at higher risk:

Fatigue in the Elderly

Older adults may be more susceptible to fatigue due to:

• Age-related changes in sleep patterns
• Increased prevalence of chronic health conditions
• Medication side effects
• Decreased physical activity

Managing fatigue in the elderly often involves addressing underlying health issues, reviewing medications, and promoting safe physical activity.

Fatigue in Adolescents

Teenagers may experience fatigue due to:

• Hormonal changes
• Academic and social pressures
• Poor sleep habits (often exacerbated by electronic device use)
• Nutritional deficiencies

Addressing fatigue in adolescents may involve sleep education, stress management techniques, and ensuring proper nutrition.

Fatigue in Pregnant Women

Fatigue is common during pregnancy, especially in the first and third trimesters. It can result from:

• Hormonal changes
• Physical demands of pregnancy
• Sleep disturbances
• Anemia

Managing fatigue during pregnancy involves balancing rest with light exercise, proper nutrition, and addressing any underlying health issues under medical supervision.

The Future of Fatigue Research and Treatment

What advancements are on the horizon for understanding and treating fatigue? As research into fatigue continues, several promising areas are emerging:

• Biomarker identification: Researchers are working to identify biological markers that could objectively measure fatigue and potentially lead to more targeted treatments.
• Neuroimaging studies: Advanced brain imaging techniques are providing new insights into how fatigue affects brain function and structure.
• Personalized medicine approaches: As our understanding of individual genetic and physiological differences grows, treatments may be tailored more precisely to each patient’s unique profile.
• Novel pharmaceutical interventions: New medications targeting specific pathways involved in energy metabolism and cognitive function are in development.
• Integrative approaches: There’s growing interest in combining conventional medical treatments with complementary therapies like acupuncture, mindfulness, and nutritional interventions.

These advancements hold promise for improving both the diagnosis and management of fatigue in the future. However, it’s important to note that research takes time, and patients should work closely with their healthcare providers to explore currently available evidence-based treatments.

The Role of Patient Advocacy

How can patients play a role in advancing fatigue research and treatment? Patient advocacy has become increasingly important in driving research priorities and improving care for fatigue-related conditions. Patients can contribute by:

• Participating in clinical trials
• Sharing their experiences with researchers and healthcare providers
• Joining patient advocacy groups
• Raising awareness about the impact of fatigue on daily life

By actively engaging in these ways, patients can help shape the future of fatigue research and ensure that treatments address the issues most important to those living with chronic fatigue.

Coping Strategies for Living with Chronic Fatigue

What practical steps can individuals take to manage daily life with chronic fatigue? Living with persistent fatigue can be challenging, but there are strategies that can help improve quality of life:

1. Energy conservation: Prioritize activities and use energy-saving techniques like sitting instead of standing when possible.
2. Pacing: Break tasks into smaller, manageable chunks and alternate periods of activity with rest.
3. Establishing routines: Create consistent daily schedules to help regulate energy levels.
4. Adaptive equipment: Use tools like shower chairs or electric can openers to reduce physical exertion.
5. Mindfulness and relaxation techniques: Practice methods like deep breathing or progressive muscle relaxation to manage stress and conserve energy.
6. Journaling: Keep a fatigue diary to identify patterns and triggers, which can help in developing personalized management strategies.
7. Building a support network: Connect with friends, family, or support groups who understand the challenges of living with chronic fatigue.

It’s important to work with healthcare providers to develop a personalized management plan that addresses individual needs and circumstances.

The Importance of Self-Advocacy

How can patients effectively communicate their fatigue to healthcare providers? Self-advocacy is crucial when dealing with a complex symptom like fatigue. Tips for effective communication include:

• Keeping detailed records of symptoms, including severity and impact on daily activities
• Preparing specific questions before medical appointments
• Being honest about the impact of fatigue on quality of life
• Requesting referrals to specialists if needed
• Following up on test results and treatment plans

By actively participating in their care, patients can help ensure that their fatigue is taken seriously and addressed comprehensively.

Fatigue | The BMJ

Clinical Review

ABC of psychological medicine

BMJ
2002;
325
doi: https://doi.org/10.1136/bmj.325.7362.480
(Published 31 August 2002)

Cite this as: BMJ 2002;325:480

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1. Michael Sharpe,
2. David Wilks

Fatigue can refer to a subjective symptom of malaise and aversion to activity or to objectively impaired performance. It has both physical and mental aspects. The symptom of fatigue is a poorly defined feeling, and careful inquiry is needed to clarify complaints of “fatigue,” “tiredness,” or “exhaustion” and to distinguish lack of energy from loss of motivation or sleepiness, which may be pointers to specific diagnoses (see below).

Weary 1887 by Edward Radford (1831-1920)

Prevalence—Like blood pressure, subjective fatigue is normally distributed in the population. The prevalence of clinically significant fatigue depends on the threshold chosen for severity (usually defined in terms of associated disability) and persistence. Surveys report that 5-20% of the general population suffer from such persistent and troublesome fatigue. Fatigue is twice as common in women as in men but is not strongly associated with age or occupation. It is one of the commonest presenting symptoms in primary care, being the main complaint of 5-10% of patients and an important subsidiary symptom in a further 5-10%.

Fatigue as a symptom—Patients generally regard fatigue as important (because it is disabling), whereas doctors do not (because it is diagnostically non-specific). This discrepancy is a potent source of potential difficulty in the doctor-patient relationship. Fatigue may present in association with established medical and psychiatric conditions or be idiopathic. Irrespective of cause, it has a major impact on day to day functioning and quality of life. Without treatment, the prognosis of patients with idiopathic fatigue is surprisingly poor; half those seen in general practice with fatigue are still fatigued six months later.

Distribution of the complaint of fatigue in the population

Causes of fatigue

The physiological and psychological mechanisms underlying subjective fatigue are poorly understood. Fatigue may rather be usefully regarded as a final common pathway for a variety of causal factors. …

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Causes, Diagnosis, Treatment & More

Fatigue: Causes, Diagnosis, Treatment & More

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Medically reviewed by Elaine K. Luo, M.D. — By Krista O’Connell — Updated on April 18, 2023

Fatigue can occur with many different mental and physical health conditions. Some causes can be serious. You may be able to relieve fatigue with lifestyle changes to exercise, diet, and sleep.

Fatigue is a term used to describe an overall feeling of tiredness or lack of energy. It isn’t the same as simply feeling drowsy or sleepy. When you’re fatigued, you have no motivation and no energy. Being sleepy may be a symptom of fatigue, but it’s not the same thing.

Fatigue is a common symptom of many medical conditions that range in severity from mild to serious. It’s also a natural result of some lifestyle choices, such as lack of exercise or poor diet.

If your fatigue doesn’t resolve with proper rest and nutrition, or you suspect it’s caused by an underlying physical or mental health condition, see your doctor. They can help diagnose the cause of your fatigue and work with you to treat it.

There are many potential causes of fatigue. They can be divided into three general categories:

• lifestyle factors
• physical health conditions
• mental health issues

Lifestyle factors

If you’re experiencing fatigue, your activities and other lifestyle choices may be the root cause. For example, fatigue can result from:

• physical exertion
• lack of physical activity
• lack of sleep
• being overweight or obese
• periods of emotional stress
• boredom
• grief
• taking certain medications, such as antidepressants or sedatives
• using alcohol on a regular basis
• using illicit drugs, such as cocaine
• consuming too much caffeine
• not eating a nutritious diet

Physical health conditions

Many medical conditions can also cause fatigue. Examples include:

• anemia
• arthritis
• fibromyalgia
• chronic fatigue syndrome
• infections, such as cold and flu
• Addison’s disease, a disorder that can affect your hormone levels
• hypothyroidism, or underactive thyroid
• hyperthyroidism, or overactive thyroid
• sleep disorders, such as insomnia
• eating disorders, such as anorexia
• autoimmune disorders
• congestive heart failure
• cancer
• diabetes
• kidney disease
• liver disease
• chronic obstructive pulmonary disease (COPD)
• emphysema

Mental health issues

Mental health conditions can also lead to fatigue. For example, fatigue is a common symptom of anxiety, depression, and seasonal affective disorder.

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

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.

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.

Last medically reviewed on May 2, 2019

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• Always tired? 7 hidden causes for your fatigue. (2017).
  health.clevelandclinic.org/always-tired-7-hidden-causes-for-your-fatigue
• Fatigue in older adults. (2016).
  nia.nih.gov/health/fatigue-older-adults
• Mayo Clinic Staff. (2018). Fatigue. https://www.mayoclinic.org/symptoms/fatigue/basics/definition/sym-20050894
  

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Apr 18, 2023

Written By

Krista O’Connell

Edited By

Frank Crooks

May 2, 2019

Medically Reviewed By

Elaine K. Luo, MD

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Medically reviewed by Elaine K. Luo, M.D. — By Krista O’Connell — Updated on April 18, 2023

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symptoms, diagnosis, treatment of chronic fatigue – Department of Neurology NCC No. 2 (Central Clinical Hospital RAS)

Chronic Fatigue Syndrome (CFS) is a disease that is characterized by an endless feeling of fatigue, loss of strength, overwork, which does not go away even after sound sleep and long rest. Psycho-emotional stress on the human nervous system is the main cause of this disease. Residents of megacities aged 25 to 45 years are most susceptible to chronic fatigue syndrome, and women suffer more from this disease. Until recently, it was believed that only adults were susceptible to the disease, but now the diagnosis of “chronic fatigue syndrome” has begun to haunt children, especially of school age.

Causes of chronic fatigue.

Until now, the exact causes leading to chronic fatigue syndrome have not yet been established. However, risk factors that can provoke the onset of this disease exist:

• Wrong lifestyle (frequent lack of sleep, lack of sunlight and fresh air, nicotine and alcohol use, etc.)
• Chronic diseases (lead to emaciation)
• Psychological disorders (constant stress, frequent depression, anxiety)
• Unbalanced diet (poor quality food, excess or lack of food, lack of vitamins)
• Unfavorable environment (ecological situation in cities is much worse than in rural areas)
• Infections and viruses (the constant struggle of the body with viruses leads to general fatigue)

Symptoms of the disease.



A distinctive feature of chronic fatigue is constant overwork, which does not disappear after a sound sleep and a long rest. This painful condition can last for more than six months.

Other symptoms of chronic fatigue:

• Insomnia
• Migraine
• Fatigue
• Decreased immunity
• Spinal and muscular pain
• Mental impairment
• Constant exhaustion
• Enlarged lymph nodes (armpits and neck)

This disease must be treated, so that in the future it does not lead to the development of serious neuropsychiatric diseases.

Diagnosis of chronic fatigue.

Often, chronic fatigue syndrome is difficult to diagnose due to the fact that most of the symptoms occur in other diseases. At the same time, the symptoms of this disease are manifested in a complex, and not one at a time. Only a specialist can make an accurate diagnosis after a detailed examination and a detailed medical history. Sometimes, in order to exclude other pathologies, the doctor may refer the patient to a blood or urine test. The main diagnostic sign of the disease is the occurrence of a persistent feeling of fatigue, which does not disappear after a good rest, and bad mood, loss of appetite, apathy, general weakness are concomitant factors. This condition can be supplemented by frequent colds, exacerbation of chronic diseases, which significantly reduces efficiency and exacerbates the feeling of constant fatigue.

Depending on the manifestation of the symptoms that provoked this disease, the patient can visit the following specialists:

• Therapist
• Psychologist
• Neurologist
• Endocrinologist
• Immunologist

You can make an appointment with the specialists you are interested in in Moscow at the NCC Clinic No. 2 (Central Clinical Hospital of the Russian Academy of Sciences).

Treatment of chronic fatigue.

• Medication (vitamins, immunomodulators, homeopathic, anti-inflammatory drugs, antidepressants, antivirals)
• Physiotherapy (physiotherapy, acupuncture, soothing massage, hydrotherapy, etc. )
• Recommended good sleep, diet, planned daily routine.

Disease prevention.

• Proper nutrition
• Rational daily routine planning
• Sports activities
• Healthy sleep
• Refusal of bad habits.

If a situation arises in which a professional consultation of a neurologist becomes necessary, contact the specialists of the NCC No. 2 (CCH RAS). The best doctors of the capital will help you restore your health. Registration is available 24 hours a day on the website. You can also make an appointment with a neurologist by phone during working hours of the Central Clinical Hospital.

symptoms and treatment – Harmony of health

Chronic fatigue syndrome is a disease in which the human body experiences constant mental and physical weakness. Weakness occurs for unexplained reasons and may last for six months or more. People faced a similar ailment back in the 30s of the last century, but in fact, the diagnosis of chronic fatigue syndrome was first made only in 1988 year. Until that time, chronic fatigue was considered to be an accompanying symptom of various diseases, including infectious ones.

The feeling of extreme fatigue due to physical or mental overexertion has been experienced by many. As a rule, such a feeling arises after a responsible event or difficult work and disappears due to relaxation. In the case of ordinary overwork, a person is able to easily determine the cause of his fatigue and overcome it. With chronic fatigue syndrome, everything is different: the patient finds it difficult to remember when, why and under what circumstances he felt tired. This condition can deeply disturb and oppress the patient.

Modern medicine associates the appearance of chronic fatigue syndrome with a continuous acceleration of the pace of life and an increase in the flow of information. Any infectious disease can serve as an impetus for the onset of the disease. At the end of the acute period of infection, the patient may experience some weakness, fatigue and depression. Normally, this condition should pass in three weeks. With chronic fatigue syndrome, symptoms persist even after six months, and the patient has to turn to a medical center for professional help sooner or later.

Chronic fatigue syndrome: symptoms

The main symptom is endless fatigue that does not leave a person even after prolonged sleep and rest. Most patients develop a concomitant ailment – constant insomnia. Its appearance can be triggered by any factor – a change in the time zone, a change in work schedule, or banal stress.

Very often, chronic fatigue is accompanied by a significant deterioration in performance and attention, a sharp deterioration in the psycho-emotional state. Apathy, depression, hypochondria may develop. In some cases, against the background of chronic fatigue, phobias occur. There are cases of violation of thermoregulation and a sharp decrease in body weight.

With chronic fatigue syndrome, the patient often complains of dizziness, headaches, photophobia, dry eyes. Possible pharyngitis, tachycardia, soreness of the lymph nodes. Women may experience increased premenstrual syndrome.

Chronic fatigue syndrome: prevention

A healthy lifestyle is the surest way to avoid the development of the syndrome. Eat right, control the level of mental stress, do not forget about the benefits of adequate physical training. A person who adheres to the correct daily routine and knows how to avoid stressful situations is less susceptible to any diseases. Even if stress still overtakes you, allow yourself to relax and unwind.

Take at least short breaks while you work. If your work is associated with mental stress, do not be lazy to interrupt for simple physical exercises. Oddly enough, constant sitting is very tiring, so allowing the body to switch from mental work to physical work from time to time is very useful. No less useful for maintaining a healthy mental background is a change of scenery.