Paging Dr. Frischer - Fatigue

Fatigue is one of the most common complaints I get from my patients, but I actually look forward to hearing it brought up! The cause might be physical, emotional, or both, and the subject presents a perfect opportunity to discuss life and health habits in greater detail. Those who suffer from fatigue show a lack of energy, motivation, or ability. They tire easily once they start an activity, and may lack the concentration or motivation to complete it. Roughly 20% of Americans claim to have fatigue serious enough to interfere with a normal life.

Fatigue is often confused with weakness, drowsiness, shortness of breath, and any number of other complaints, including a simple and normal reaction to extreme physical, emotional, or mental activity.

Note that fatigue is a symptom and not a disease. Many illnesses and conditions, both physical and emotional, can lead to fatigue. It is a common side effect of numerous medications, and other causes include:

• Conditions that cause poor circulation, such as heart disease
• Illnesses that affect metabolism, like hypothyroidism
• Anemia
• Various infections
• Inflammatory diseases, like rheumatoid arthritis and lupus
• Diseases that affect sleep, such as sleep apnea
• Most cancers

Sometimes, no cause can be identified.

Chronic fatigue syndrome is an illness where severe fatigue continues for six months or longer without any other known cause. However, even when the fatigue is long-term, the Center for Disease Control (CDC) requires four or more additional symptoms to diagnose chronic fatigue syndrome: post-exertion malaise, impaired memory or concentration, un-refreshing sleep, muscle pain, multi-joint pain with no redness or swelling, tender cervical or axillary lymph nodes, sore throat, or headache.

See your doctor immediately if fatigue comes on suddenly, is not relieved by adequate rest, becomes chronic or excessive, is accompanied by new unexplained symptoms, or is associated with passing out or nearly passing out. Be prepared to give a thorough history, and your physician will perform a physical exam and order laboratory tests (which may include blood work, EKG, and x-rays). Be sure to discuss the pattern of the fatigue throughout the day, any shortness of breath, chest pain, weight loss, sleep patterns, hair loss, anxiety or depression, blood in your stool, and alcohol or drug use.

The good news is that for many causes of fatigue, there are straightforward treatments.

Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

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Published: March 12, 2015 - Volume 13 - Issue 48