Urban Housecalls: Understanding Fatigue
Sunday, December 4, 2011

By Karla Robinson, MD

Characterized by a lack of motivation, lack of energy, and lack of concentration, fatigue is a common complaint experienced by more than thirty percent of people in this country.  While the term is often mistakenly used interchangeably with drowsiness, fatigue really is a separate condition, and is sometimes the sign of something more serious.  

Drowsiness commonly refers to the desire for more sleep.  Fatigue on the other hand, while it can certainly have drowsiness as one of the symptoms, it is a condition marked by the inability to initiate activities due to low energy, and the inability to sustain activities due to tiring quickly.

It is also important to know that the symptoms of fatigue are not improved by sleep, and those suffering from it often awaken feeling just as tired as they did when they went to bed.

Is stress to blame?

It is always easy to blame fatigue on busy schedules, active lifestyles, and inevitable stressors in life.  Intense or prolonged stress is often a byproduct of the fast paced society we live in.  

However, when exposed to it for long periods of time, stress can cause biochemical changes to take place in the body causing physical and emotional fatigue.

Unfortunately, this can lead to low energy, exhaustion, difficulty with concentration and memory and a host of medical conditions.

When under stress, a hormone known as cortisol is released.  This is the same hormone that is secreted in large amounts during the “fight-or-flight” response when being challenged with a particular stressor. 

Cortisol does have great protective benefits when in an acute episode of stress including providing fuel and energy for the body.  However, chronic exposure to this “stress hormone” can lead to obesity, high blood pressure, high blood sugar, poor immunity, thyroid dysfunction, and generalized fatigue.
Are there any other causes of fatigue I should be concerned about?

While stress may certainly be the cause of fatigue in a vast majority of cases, sometimes fatigue can be a sign of an underlying medical issue.  There are many illnesses and
diseases that may have fatigue as a symptom, but some of the more common illnesses would include iron-deficiency anemia, sleep apnea, thyroid dysfunction, diabetes, and depression.  If these conditions have not been previously diagnosed, fatigue can often be the presenting symptom that leads to the diagnosis and treatment of these illnesses.

How can we determine the cause of my fatigue?

In order for your medical provider to determine the cause of any fatigue you may be experiencing, it is necessary to perform a thorough assessment of any factors that could be contributing to the symptoms. This would include a review of all medications you may be taking, as some have a side effect of fatigue.

Be sure to inform your physician if you have been under unusual amounts of stress, or if you have been having any other symptoms out of the ordinary.  There may be a link between the fatigue and the hair loss, or the fatigue and the excessive urination at night.  Be sure to mention everything to ensure a proper evaluation is performed.

After a physical exam is performed, simple tests in the office can provide some clues to the source of the fatigue as well.  A simple blood count may reveal anemia or any infectious causes of fatigue, while a metabolic panel can show any abnormalities in blood sugar, kidney function, or electrolytes such as sodium or potassium.   Thyroid lab screening is necessary to rule out any thyroid dysfunction, and a urine sample may also be requested.  

There may be times where additional tests may need to be performed to determine the cause of the fatigue.

Can I ever have my energy back?

It is important to know that fatigue can resolve if the proper causes are identified.  In the case of stress-induced fatigue, decreasing stress levels can lead to rapid improvement in the symptoms of low energy.  If an underlying medical condition is the culprit, prompt diagnosis and treatment can certainly lead to a lifestyle full of energy and prevent many

Recognize that fatigue may be a warning sign and it should always prompt you to action.  If you have been experiencing symptoms of fatigue, be sure to speak with a medical provider.

For more information log on to urbanhousecallmagazine.com.

This was printed in the December 4, 2011 - December 17, 2011 Edition


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