Fatigue Causes, Management, and Treatment

Fatigue describes a state of tiredness that does not resolve with rest or sleep. In general usage, fatigue is synonymous with extreme tiredness or exhaustion that normally follows prolonged physical or mental activity. When it does not resolve after rest or sleep or occurs independently of physical or mental exertion, it may be a symptom of a medical condition that may become severe or progressive. Fatigue often has no known cause, and is recognized as being very complex in nature. Fatigability describes a susceptibility to fatigue.

Fatigue Meaning

It is different from drowsiness. Drowsiness is feeling the need to sleep. Fatigue is a lack of energy and motivation. Drowsiness and apathy (a feeling of not caring about what happens) can be symptoms that go along with this.

 

It can be a normal and important response to physical activity, emotional stress, boredom, or lack of sleep. Fatigue is a common symptom, and it is usually not due to a serious disease. But it can be a sign of a more serious mental or physical condition. When it is not relieved by enough sleep, good nutrition, or a low-stress environment, it should be evaluated by your healthcare provider.

Fatigue Classification

Physical Fatigue

Physical, or muscle fatigue, is the temporary physical inability of muscles to perform optimally. The onset of muscle fatigue during physical activity is gradual, and depends upon an individual’s level of physical fitness – other factors include sleep deprivation and overall health.

It can be caused by a lack of energy in the muscle, by a decrease in the efficiency of the neuromuscular junction, or by a reduction of the drive originating from the central nervous system, and can be reversed by rest.

Mental Fatigue

It 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.

However, it has also been shown to decrease physical performance. It can manifest as somnolence, lethargy, directed attention fatigue, or disengagement. Research also suggests that mental fatigue is closely linked to the concept of ego depletion.

Primary vs secondary Fatigue

In some areas, it has been proposed that fatigue be separated into primary fatigue, caused directly by a disease process, and secondary fatigue, caused by more general impacts on the person having the disease.

Symptoms of fatigue

It 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 judgment,
• 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, and
• Low motivation.

Fatigue Causes

Fatigue is a normal result of work, mental stress, anxiety, overstimulation and under-stimulation, jet lag, active recreation, boredom, lack of sleep, or disease.

Lifestyle factors

Taking an honest inventory of things that might be responsible for your fatigue is often the first step toward relief. It may be related to:

1. Alcohol or drug use
2. Excess physical activity
3. Jet lag disorder
4. Lack of physical activity
5. Medications, such as antihistamines, cough medicines
6. Not enough sleep
7. Unhealthy eating habits

Acute fatigue

Causes of acute fatigue include:

• Depression,
• Chemical causes, such as dehydration, poisoning, low blood sugar, or mineral or vitamin deficiencies.

Temporary fatigue is likely to be a minor illness like the common cold as one part of the sickness behavior response that happens when the immune system fights an infection.

Prolonged fatigue

Prolonged fatigue is a self-reported, persistent (constant) fatigue lasting at least one month.

Chronic fatigue

It is a self-reported fatigue lasting at least six consecutive months. Chronic fatigue may be either persistent or relapsing, which is a symptom of many diseases and conditions.

Conditions that feature fatigue

Some major categories of conditions that feature fatigue include:

• Autoimmune diseases, such as celiac disease, lupus, multiple sclerosis, myasthenia gravis, Sjögren’s syndrome, and spondyloarthropathy,
• Anxiety disorders such as generalized anxiety disorder,
• Blood disorders such as anemia and hemochromatosis,
• Cancer, in which case is called cancer fatigue,
• Chronic fatigue syndrome (CFS),
• Substance use disorders including alcohol use disorder,
• Depression and other mental disorders that feature depressed mood,
• Developmental disorders such as autism spectrum disorder,
• Eating disorders, which can produce fatigue due to inadequate nutrition,
• Endocrine diseases or metabolic disorders: diabetes mellitus, hypothyroidism, and Addison’s disease,
• Fibromyalgia,
• Gulf War syndrome,
• Heart failure,
• HIV,
• Idiopathic chronic fatigue (ICF), is chronic fatigue with no known cause that does not meet the chronic fatigue syndrome criteria,
• Inborn errors of metabolism such as fructose malabsorption,
• Infectious diseases such as infectious mononucleosis or tuberculosis,
• Irritable bowel syndrome,
• Kidney diseases e.g. acute renal failure, and chronic renal failure,
• Leukemia or lymphoma,
• Liver failure or liver diseases e.g. Hepatitis,
• Lyme disease,
• Neurological disorders such as narcolepsy, Parkinson’s disease, Postural Orthostatic Tachycardia Syndrome, and post-concussion syndrome,
• Physical trauma and other pain-causing conditions, such as arthritis,
• Sleep deprivation or sleep disorders, e.g. sleep apnea,
• Stroke, and
• Thyroid diseases such as hypothyroidism.

A side effect of medications

Fatigue may also be a side effect of certain medications (e.g. lithium salts, ciprofloxacin); beta blockers, which can induce exercise intolerance; and many cancer treatments, particularly chemotherapy and radiotherapy.

Inflammation

Inflammation has been linked to many types of fatigue. Findings implicate neuroinflammation in the etiology of fatigue in autoimmune and related disorders.

Fatigue Diagnosis

One study concluded about 50% of people receive a diagnosis that could explain the fatigue after a year with the condition. In those people who have a possible diagnosis, musculoskeletal (19.4%) and psychological problems (16.5%) are the most common. Definitive physical conditions were only found in 8.2% of cases.

Medical history

If a person decides to seek medical advice, the overall goal is to identify and rule out any treatable conditions. This is done by considering the person’s medical history, and any other symptoms that are present, and evaluating the qualities of the fatigue itself.

The affected person may be able to identify patterns, such as being more tired at certain times of day, whether fatigue increases throughout the day, and whether it is reduced after taking a nap.

Quality of sleep

Because disrupted sleep is a significant contributor to fatigue, a diagnostic evaluation considers the quality of sleep, the emotional state of the person, sleep pattern, and stress level.

The amount of sleep, the hours that are set aside for sleep, and the number of times that a person awakens during the night are important. A sleep study may be ordered to rule out a sleep disorder.

Screening for psychological conditions

Depression and other psychological conditions can produce fatigue, so people who report it are routinely screened for these conditions, along with substance use disorders, poor diet, and lack of physical exercise, which paradoxically increases fatigue.

Basic medical tests

Basic medical tests may be performed to rule out common causes. These include blood tests to check for infection or anemia, a urinalysis to look for signs of liver disease or diabetes mellitus, and other tests to check for kidney and liver function, such as a comprehensive metabolic panel.

Other tests may be chosen depending on the patient’s social history, such as an HIV test or PREGNANCY test.

Comparison with sleepiness

Fatigue is generally considered a more long-term condition than sleepiness (somnolence). Although sleepiness can be a symptom of a medical condition, it usually results from a lack of restful sleep or a lack of stimulation.

Chronic fatigue, on the other hand, is a symptom of a greater medical problem in most cases. It manifests in mental or physical weariness and inability to complete tasks at normal performance. Both are often used interchangeably and even categorized under the description of ‘being tired.’

It is often described as an uncomfortable tiredness, whereas sleepiness is comfortable and inviting.

Measurement

Fatigue can be quantitatively measured. Devices to measure medical fatigue have been developed by Japanese companies, among them Nintendo (canceled). Nevertheless, such devices are not in common use outside Japan.

Fatigue Management

Medications are reviewed as some have side effects that may contribute to fatigue and the interactions of medications are complex.

Psychostimulants such as methylphenidate, amphetamines, and modafinil have been used in the treatment related to depression, chronic fatigue syndrome, and medical illnesses such as cancer. They have also been used to counteract fatigue in sleep loss and in aviation.

Fatigue Treatment

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 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).

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

Natural Home Remedies for Fatigue

Go easy on foods high in refined carbohydrates

Bread, spaghetti, and cake are not your best choices. These foods make your blood sugar rise rapidly, then crash quickly. You’ll end up feeling weak and tired. Eat more high-fiber foods that are rich in complex carbohydrates, such as whole-grain cereals, whole-wheat bread, and vegetables. This help stabilizes blood sugar.

Cut down on your intake of unhealthy fats

According to a 2016 study, people who consume diets high in fat are more likely to experience fatigue throughout the day. Aim to have no more than 10 percent saturated fat in your diet.

Eat spinach once a day

This is an old-time remedy for relieving fatigue, and we all know what it did for Popeye. You can’t go wrong. Spinach contains potassium as well as many B vitamins, all of which are important to energy metabolism.

Supplement your energy stores

Ginseng is an age-old cure for that run-down feeling. Look for a supplement containing at least 4 percent ginsenosides, and take two 100-milligram capsules daily. This herbal remedy stimulates your nervous system and will help to protect your body from the ravages of stress. (Off-limits if you have high blood pressure)

Consider taking a magnesium supplement, as a deficiency in the mineral could have you feel tired. Magnesium is involved in hundreds of chemical reactions in the body. It plays a role in changing protein, fat, and carbohydrates into energy sources.

Know the best fatigue-fighting beverages

Sip water all day long—at least eight glasses. Don’t wait until you’re thirsty, because your “thirst alarm” isn’t always accurate. Even a little dehydration can make you fatigued.

Keep caffeinated drinks to a minimum. The caffeine in coffee and some sodas can give you a short-term burst of energy, but following that “rush,” there’s typically a “crash.”

Finally, limit alcohol consumption. Alcohol depresses your central nervous system, and it reduces your blood sugar level.

Exercise regularly

Most days of the week, try to get at least 30 minutes of exercise—it’ll give you an energy boost and also help you sleep better. Consider taking up yoga or tai chi. These ancient forms of exercise allow you to get physical activity, but they also include relaxation components that can be reinvigorating.

Don’t have the time for a 30-minute workout? Try just 10 minutes of low-level exercise. Usually, people with fatigue have a decreased supply of adenosine diphosphate (ADP), an intracellular “messenger” involved in energy metabolism. Translation: There’s not enough “spark” in the engine. Almost any kind of activity will help-singing, taking deep breaths, walking, or stretching.

Ayurveda Remedies for Fatigue

All three doshas are aggravated by fatigue but Kapha is mainly disturbed by physical fatigue, Vata by mental fatigue, and Pitta by emotional fatigue. According to aggravated dosha pacifying, diet and lifestyle should be followed.

• Stop smoking and alcohol
• Take ayurvedic massage or abhyanga
• Herbs like Ashwagandha, Brahmi, Shatavari, Amla, Saffron, Shilajit, etc are helpful. Ayurvedic formulations like Chyawanprash, Dasamoolarishtam, drakshasava, drakshavaleha, aswagandharishtam, etc are also beneficial but should be taken only after a doctor’s prescription.
• Include spices like ginger, black pepper, turmeric, cinnamon, etc. in food to improve digestion.
• Consume fresh and seasonal fruit, vegetables, ghee, and easy-to-digest food.
• Have your food at fixed times.
• Follow regular routine even on weekends.
• Avoid mental work right before sleeping.
• Sleep early and at a fixed time.
• Do yoga, pranayama, and meditation according to aggravated dosha.

Siddha remedies for Fatigue

 

Reference: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/fatigue