Fatigue

Fatigue Overview

Fatigue refers to mental or physical state of extreme tiredness and lack of energy. Fatigue is usually a symptom of another disease or condition. It can affect anyone, and most adults will experience fatigue at some point in their life. Physical and mental fatigue are different, but they often occur together. Repeated physical exhaustion can lead to mental fatigue over time.

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 also 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. For many people, fatigue is caused by a combination of lifestyle, social, psychological and general wellbeing issues rather than an underlying medical condition.

When fatigue affects safety, it becomes a public health concern. People with severe fatigue may act similarly to those who are intoxicated.

Fatigue Symptoms

Fatigue can cause a vast range of other physical, mental and emotional symptoms including:

• Chronic tiredness or sleepiness
• Headache
• Dizziness
• Sore or aching muscles
• Muscle weakness
• Slowed reflexes and responses
• Impaired decision-making and judgement
• Moodiness, such as irritability
• Impaired hand-to-eye coordination
• Appetite loss
• Reduced immune system function
• Blurry vision
• Short-term memory problems
• Poor concentration
• Hallucinations
• Reduced ability to pay attention to the situation at hand
• Low motivation

Types of Fatigue

There are two main types of fatigue, physical fatigue and mental fatigue.

A person with physical fatigue may find it physically hard to do the things they usually do, such as climbing the stairs. Symptoms include muscle weakness, and diagnosis may involve completing a strength test.

With mental Fatigue, a person may find it harder to concentrate on things and stay focused. They may feel sleepy or have difficulty staying awake while working.

Causes of Fatigue

The wide range of causes that can trigger fatigue include:

• Medical Causes of Fatigue- Unrelenting chronic exhaustion may be a sign of an underlying illness, such as a thyroid disorder, heart disease or diabetes.
• Lifestyle related causes- Alcohol or drugs or lack of regular exercise can lead to feelings of fatigue.
• Workplace-related causes- Workplace stress can lead to feelings of fatigue.
• Emotional concerns and Stress- Fatigue is a common symptom of mental health problems, such as depression and grief, and may be accompanied by other signs and symptoms, including irritability and lack of motivation.

Fatigue can also be caused by a number of factors working in combination.

Medical Causes of Fatigue

There are a number of diseases and disorders which can trigger fatigue. Several of the following medical conditions can cause fatigue, including:

• Anemia
• Diabetes
• High Blood Pressure
• Obesity
• Heart Disease
• Chronic Fatigue Syndrome
• Weakened Immune System Function
• Fibromyalgia
• Systemic Lupus
• Rheumatoid Arthritis
• Gastroesophageal Reflux Disease (GERD)
• Inflammatory Bowel Disease (IBD)
• Cancer and cancer treatments, including chemotherapy and radiation therapy
• Massive blood loss

Fatigue can also be a symptom of infection. Some infections that cause extreme tiredness include:

• Malaria
• Tuberculosis (TB)
• Infectious Mononucleosis
• Cytomegalovirus
• HIV
• Flu
• Hepatitis

Chronic Pain

People with chronic Pain may wake up frequently throughout the night. They may also wake up feeling tired and poorly rested, having been unable to get good quality sleep. The combination of chronic Pain and a lack of sleep can cause persistent tiredness and fatigue. In one study on fibromyalgia and sleep, half of the individuals with fibromyalgia also had sleep apnea, which contributes to fatigue.

Being Overweight or Underweight

Overweight increases the risk of fatigue by increasing the risk of conditions that have fatigue as a common symptom, such as diabetes or sleep apnea. Carrying more weight and experiencing joint or muscle pain can lead to or exacerbate fatigue.

Similarly, people with underweight may tire easily, depending on the cause of their condition. Eating disorders, Cancer, chronic diseases, and an overactive thyroid can all cause weight loss, as well as excessive tiredness and fatigue.

Drugs and Medications

Certain drugs and medications can cause fatigue, these include:

• Antidepressants
• Anxiety Medications 
• Blood Pressure Medications
• Statins
• Steroids
• Antihistamines
• Sedatives

Medication withdrawal can also cause fatigue until the body adjusts or changes in medicine dosage can also be a cause.

Lifestyle-related Causes of Fatigue

Common lifestyle factors that can cause fatigue include:

• Lack of sleep- Typically adults need about eight hours of sleep each night, some people try to get by on fewer hours of sleep.
• Too much sleep- Adults sleeping more than 11 hours per night can lead to excessive daytime sleepiness.
• Alcohol and drugs- Alcohol is a depressant drug that slows the nervous system and disturbs normal sleep patterns. Other drugs, including cigarettes and caffeine, stimulate the nervous system and can cause insomnia.
• Sleep disturbances- Disturbed sleep may occur for a number of reasons, for example, noisy neighbors, young children who wake in the night, a snoring partner, or an uncomfortable sleeping environment such as a stuffy bedroom or surrounding noisy environment.
• Lack of regular exercise and sedentary behavior- Physical activity is known to improve fitness, health and wellbeing, reduce stress, and boost energy levels, it also helps sleep better.
• Poor diet- Low kilojoule diets, low carbohydrate diets or high energy foods that are nutritionally poor don’t provide the body with enough fuel or nutrients to function at its best. Quick fix foods, such as chocolate bars or caffeinated drinks, only offer a temporary energy boost that quickly wears off and worsens fatigue.
• Individual factors- Personal illness or injury, illnesses or injuries in the family, too many commitments (for example, working two jobs) or financial problems and other stressful situations can cause fatigue.

Workplace-related Causes of Fatigue

Common workplace issues that can cause fatigue include:

• Shift work- The human body is designed to sleep during the night. This pattern is set by a small part of the brain known as the circadian clock. A shift worker confuses their circadian clock by working when their body is programmed to be asleep.
• Poor workplace practices- can add to a person’s level of fatigue. These may include long work hours, hard physical labor, irregular working hours (such as rotating shifts), a stressful work environment (such as excessive noise or extreme temperatures), boredom, working alone with little or no interaction with others, or fixed concentration on a repetitive task.
• Workplace stress- can be caused by a wide range of factors including job dissatisfaction, heavy workload, conflicts with bosses or colleagues, bullying, constant change, or threats to job security.
• Burnout- can be described as striving too hard in one area of life while neglecting everything else. Workaholics, for example, put all their energies into their career, which puts their family life, social life and personal interests out of balance.
• Unemployment- Financial pressures, feelings of failure or guilt, and the emotional exhaustion of prolonged job hunting can lead to stress, anxiety, depression and fatigue.

Psychological Causes of Fatigue

Studies suggest that psychological factors are present in at least 50 per cent of fatigue cases, these may include:

• Depression- This illness is characterized by severe and prolonged feelings of sadness, dejection and hopelessness. People who are depressed commonly experience chronic fatigue.
• Anxiety and Stress- A person who is chronically anxious or stressed keeps their body in overdrive. The constant flooding of adrenaline exhausts the body, and fatigue sets in.
• Grief- Losing a loved one causes a wide range of emotions including shock, guilt, depression, despair and loneliness.

Diagnosis of Fatigue

As fatigue can present a vast range of symptoms and be caused by many different factors working in combination, diagnosis can be difficult. Your doctor may diagnose fatigue using a number of tests including:

• Medical History- Recent events such as childbirth, medication, surgery or bereavement may contribute to fatigue.
• Physical Examination- To check for signs of illness or disease, your doctor may also ask detailed questions about diet, lifestyle and life events to be able to diagnose fatigue.
• Diagnostics Tests- Blood tests, urine tests, x-rays and other investigations are required to find the causes of fatigue. The idea is to rule out any physical causes, for example anemia, infection or hormonal problems.

Treatment of Fatigue

Fatigue is a symptom, something you can feel and describe, not a condition or disease. To reduce your fatigue you first need to understand what the underlying reasons for your fatigue are.

If fatigue is having a negative effect on your quality of life, or causing you distress, then it is important to consider speaking with a health professional. By asking questions, they will help you work out why you are experiencing fatigue, and offer some suggestions on how to find relief.

If necessary, your doctor might suggest certain medical tests if there is a reasonable chance the cause of your fatigue may be an undiagnosed medical issue for example, anemia or thyroid dysfunction, liver problems, or kidney problems.

Fortunately, for most people fatigue will get better over time on its own or with some simple and practical lifestyle changes.

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