FATIGUE

SYSTEMS, CAUSES AND TREATMENT

CONTENT

INTRODUCTION
CLASSIFICATION
CAUSES & SYMPTOMS
DIAGNOSIS & TREATMENT
REFERENCES
INTRODUCTION

Fatigue is a subjective feeling of tiredness which is distinct from

weakness, and has a gradual onset.
Unlike weakness, fatigue can be alleviated by periods of rest.
Fatigue can also be described as the lack of energy and motivation (both
physical and mental). This is different than drowsiness, a term that
describes the need to sleep. Often a person complains of feeling tired and
it is up to the health care professional to distinguish between fatigue and
drowsiness, though both can occur at the same time.
Also, fatigue can be a normal response to physical and mental activity; in
most normal individuals it is quickly relieved (usually in hours to about a
day, depending on the intensity of the activity) by reducing the activity.
INTRODUCTION

Many illnesses can result in the complaint of fatigue and they can be
physical, psychological, or a combination of the two.
Often, the symptom of fatigue has a gradual onset and the person
may not be aware of how much energy they have lost until they try
to compare their ability to complete tasks from one time frame to
another.
They may presume that their fatigue is due to aging and ignore the
symptom. This may lead to a delay in seeking care.
While it is true that depression and other psychiatric issues may be
the reason for fatigue, it is reasonable to make certain that there is
not an underlying physical illness that is the root cause.
INTRODUCTION

Individuals with fatigue may have three primary complaints;

however, it can vary in each person;
There may be lack of motivation or the ability to begin an activity;
the person tires easily once the activity has begun; and
the person has mental fatigue or difficulty with concentration and
memory to start or complete an activity.
INTRODUCTION

Other Words that are used to describe fatigue may include the following;
lethargic,
listless,
lack of energy,
tired,
worn out,
weary,
exhausted,
malaise, or
feeling run down
CLASSIFICATION

Physical fatigue Mental Fatigue

CLASSIFICATION

Physical fatigue
Physical fatigue, or muscle fatigue, is the temporary physical inability of a
muscle to perform optimally.
The onset of muscle fatigue during physical activity is gradual, and depends
upon an individual's level of physical fitness, and also upon other factors,
such as sleep deprivation and overall health.
It can be reversed by rest.
CLASSIFICATION

Mental fatigue
Mental fatigue is a temporary inability to maintain optimal cognitive performance.
The onset of mental fatigue during any cognitive activity is gradual, and depends upon an
individual's cognitive ability, and also upon other factors, such as sleep deprivation and
overall health.
Mental fatigue has also been shown to decrease physical performance
It can manifest as somnolence, lethargy, or directed attention fatigue.
It can be dangerous when performing tasks that require constant concentration. For
instance, a person who is sufficiently somnolent may experience micro-sleep - micro-sleep
(MS) is a temporary episode of sleep or drowsiness which may last for a fraction of a second
or up to 30 seconds where an individual fails to respond to some arbitrary sensory input and
becomes unconscious. MSs occur when an individual loses awareness and subsequently
gains awareness after a brief lapse in consciousness, or when there are sudden shifts
between states of wakefulness and sleep.
CAUSES & SYMPTOMS

Medically, fatigue is a non-specific symptom, which means that it has many possible
causes and accompanies many different conditions. Fatigue is considered a symptom,
rather than a sign because it is a subjective feeling reported by the patient, rather than
an objective one that can be observed by others.
Fatigue and 'feelings of fatigue' are often confused.
People who are tired, still have a fair bit of energy but are apt to feel forgetful and
impatient and experience muscle weakness following work, which is often alleviated by
rest.
People who are fatigued, on the other hand, experience difficulty concentrating, anxiety,
a gradual decrease in stamina, difficulty sleeping, and increased sensitivity to light.
Occupations that require an individual to work long hours or stay up overnight can lead
to fatigue.
 CAUSES & SYMPTOMS

Common Causes of Fatigue

anemia; hypothyroidism; diabetes; electrolyte abnormalities; kidney disease; liver disease;
Metabolic/Endocrine
Cushing's disease

Infectious mononucleosis; hepatitis; tuberculosis; cytomegalovirus; HIV

Infectious
infection; influenza (flu); malaria and many other infectious diseases

congestive heart failure; coronary artery disease; valvular heart disease; COPD; asthma;
Cardiac (heart) and Pulmonary (lungs)
arrythmias; pneumonia

antidepressants; anti-anxiety medications; sedative medications; medication and drug

Medications
withdrawal; antihistamines; steroids; some blood pressure medications; some antidepressants

depression; anxiety; drug abuse; alcohol abuse; Eating disorders (for

Psychiatric (Mental Health)
example; bulimia; anorexia); grief and bereavement

sleep apnea; reflux esophagitis; insomnia; narcolepsy; shift work or work shift
Sleep Problems
changes; pregnancy; Extra night hours at "work"

Vitamin Deficiencies vitamin B12 deficiency, vitamin D deficiency, folic acid deficiency, iron deficiency

cancer; rheumatology illnesses such as rheumatoid arthritis and

Other systemic lupus; fibromyalgia; chronic fatigue syndrome; normal muscle exertion;
obesity; chemotherapy and radiation therapy
 CAUSES & SYMPTOMS

Fatigue is a symptom of an underlying disease and is described in many ways

from feeling weak to being constantly tired or lacking energy.
There may be other associated symptoms depending upon the underlying cause.
Individuals with heart disease, lung disease, or anemia may complain of
associated shortness of breath or tiring easily with minimal activity.
Persons with diabetes may complain of polyuria (excess urination), polydypsia
(excess thirst), or change of vision.
Those who have hypothyroidism may also have symptoms of feeling cold, dry
skin and brittle hair.
 SYMPTOMS

Other associated symptoms of fatigue include;

weight loss,
chest pain and shortness of breath,
vomiting and diarrhea,
fevers and chills,
muscle weakness or pain, and/or
anxiety and depression.
 DIAGNOSIS & TREATMENT

It is appropriate for the health care professional to ask questions about the
patient's social situation and to also ask about their psychologic state of mind.
Alcohol and drug abuse screening questions should be expected as routine.
Because fatigue is such a non-specific symptom, each answer may direct the
health care professional to explore a different potential cause.
A full physical examination is important to look for underlying signs of illness.
The general appearance of the patient is important looking for hygiene, vital
signs, and evidence of anxiety or agitation
Examination and evaluation of the different systems of the body (heart, lungs,
abdomen, neurological system, etc.) and combining any abnormal findings with
the clues found in the history taking may help make the diagnosis.
 DIAGNOSIS & TREATMENT

The key to finding the cause of fatigue in a patient is the care the health care professional takes
in compiling a medical history. It is important to ask questions not only about the loss of energy
but also about other potential problems that the patient may be experiencing such as shortness
of breath, sleep patterns, hair loss, color of the stools, or any of the myriad of questions that
might provide information as to what organ system may be involved.
It is appropriate for the health care professional to ask questions about the patient's social
situation and to also ask about their psychologic state of mind. Alcohol and drug abuse screening
questions should be expected as routine.
Because fatigue is such a non-specific symptom, each answer may direct the health care
professional to explore a different potential cause.
A full physical examination is important to look for underlying signs of illness. The general
appearance of the patient is important looking for hygiene, vital signs, and evidence of anxiety or
agitation
Examination and evaluation of the different systems of the body (heart, lungs, abdomen,
neurological system, etc.) and combining any abnormal findings with the clues found in the
history taking may help make the diagnosis.
 DIAGNOSIS & TREATMENT

Examples of some of the questions the health care professional may ask include:
Does the patient feel well in the morning when they wake?
Does the fatigue progress through the day?
Does the person nap unexpectedly or take excessive amounts of stimulants such as
caffeine to complete daily activities?
Does the fatigue come on gradually or abruptly?
Is it a daily occurrence or intermittent/periodic?
What makes it better and what makes it worse?
How has the patient's life changed because of the fatigue?
Is the fatigue more mental than physical?
 DIAGNOSIS & TREATMENT

Since fatigue is a symptom of an underlying condition, the treatment depends

upon the condition that is causing the fatigue, regardless of whether it is
physical, psychological or a combination of the two.
Fatigue as a symptom can occur as the result of many causes and therefore,
prevention is not an issue. More importantly, the early recognition of fatigue will
allow a person to seek medical care and potentially have an earlier diagnosis of
the underlying cause made.
Sometimes, symptoms like fatigue arise gradually and it is difficult for the
person to realize that there is a problem. It may take an outside perspective
from a friend or family member to appreciate a difference in function. Self-
awareness of gradual decline in body performance is often difficult as a person
makes repeated small accommodations to complete daily activities.
 REFERENCES

1. http://www.medicinenet.com
2. http://www.onhealth.com
3. https://en.wikipedia.org
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