Fatigue
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| ICD-10 | R53. |
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| ICD-9 | 780.7 |
| DiseasesDB | 30079 |
| MedlinePlus | 003088 |
| MeSH | D005221 |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-525-6884
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Overview
The word fatigue is used in everyday living to describe a range of afflictions, varying from a general state of lethargy to a specific work-induced burning sensation within one's muscles. It can be both physical and mental. Physical fatigue is the inability to continue functioning at the level of one's normal abilities[1][2][3]. It is ubiquitous in everyday life, but usually becomes particularly noticeable during heavy exercise. Mental fatigue, on the other hand, rather manifests in somnolence.
Types
Physical fatigue
Physical fatigue or muscle weakness (or "lack of strength") is a direct term for the inability to exert force with ones muscles to the degree that would be expected given the individual's general physical fitness. A test of strength is often used during a diagnosis of a muscular disorder before the etiology can be identified. Such etiology depends on the type of muscle weakness, which can be true or perceived as well as central or peripheral. True weakness is substantial, while perceived rather is a sensation of having to put more effort to do the same task. On the other hand, central muscle weakness is an overall exhaustion of the whole body, while peripheral weakness is an exhaustion of individual muscles.
Mental fatigue
- See also: Somnolence
In addition to physical, fatigue also includes mental fatigue, not necessarily including any muscle fatigue. Such a mental fatigue, in turn, can manifest itself both as somnolence (decreased wakefulness) or just as a general decrease of attention, not necessarily including sleepiness. In any case, this can be dangerous when performing tasks that require constant concentration, such as driving a vehicle. For instance, when a person is sufficiently somnolent, he or she may experience microsleeps. However, objective cognitive testing should be done to differentiate the neurocognitive deficits of brain disease from those attributable to tiredness.
Causes
Fatigue is typically the result of working, mental stress, jet lag or active recreation, depression, and also boredom, disease and lack of sleep. It may also have chemical causes, such as poisoning or mineral or vitamin deficiencies.
The sense of fatigue is believed to originate in the reticular activating system of the lower brain. Musculoskeletal structures may have co-evolved with appropriate brain structures so that the complete unit functions together in a constructive and adaptive fashion.[4] The entire systems of muscles, joints, and proprioceptive and kinesthetic functions plus parts of the brain evolve and function together in a unitary way.[5]
Diseases
Temporary fatigue is likely to be e.g. common cold. Chronic fatigue, on the other hand, meaning of six months or more duration, is a symptom of a large number of different diseases on conditions.
Medications
- Beta blocker medication causes fatigue, especially after exertion, inducing exercise intolerance. [6]
Diagnosis
Laboratory Findings
- Complete blood count (CBC)
- Chemistries
- Calcium
- Urinalysis
- Glucose
- Thyroid stimulating hormone
- ppLiver function tests]]
- Stool guaiac
- Screening for chronic infection, malignancy, cardiopulmonary disease and psychiatric disease
- Age-appropriate cancer screening
- Pregnancy test
- Appropriate cultures and/or serolgy
- Lyme titers
- Hepatitis workup
- Anemia workup
- Thyroid function tests
Differential Diagnosis of Causes of Fatigue
- Acute Hepatitis
- Acute Renal Failure
- Addison's disease
- AIDS
- Anemia
- Ankylosing Spondylitis
- Anorexia Nervosa
- Anxiety or Panic Disorder
- Arthritis
- ATRT – Brain Cancer
- Autoimmune disease
- B12 Deficiency
- Bipolar Disorder
- Bulimia Nervosa
- Cancer Syndrome
- Cerebrovascular arteriosclerosis
- Certain medications, e.g. lithium salts, ciprofloxacin
- Chemical dependency
- Chronic fatigue syndrome (CFS)
- Chronic Hepatitis
- Chronic infectious mononucleosis
- Chronic Liver Disease
- Chronic Obstructive Pulmonary Disease (COPD)
- Chronic pancreatitis
- Chronic pyelonephritis
- Chronic Renal Failure
- Cirrhosis
- Clinical depression
- Congenital Heart Disease
- Congestive Heart Failure
- Connective Tissue Disease
- Conn's Syndrome
- Coronary Artery Disease
- Crohn's Disease
- Cushing's Disease
- Fever
- Dermatomyositis
- Diabetes Mellitus
- Diabetes
- Drugs (intoxication or withdrawal)
- Medication side effects
- Emphysema
- Endometriosis
- Epstein-Barr Virus
- Fibromyalgia
- Gastrointestinal bleeding (GI)
- Giant Cell Arteritis
- Hemochromatosis
- Hepatitis C
- HIV
- Hyperparathyroidism
- Hyperthyroidism/Graves' Disease
- Hypopituitarism
- Hypotension
- Hypothyroidism
- Hypothyroidism / Hashimoto's Thyroiditis
- Idiopathic Hypersomnia
- Infective endocarditis
- Inflammatory Bowel Disease
- Influenza
- Interstitial Cystitis
- Lead poisoning
- Leukemia
- Lymphoma
- Local infection
- Lyme disease
- Lymphoma
- Major Depression
- Malignancy
- Malnutrition
- Mitral valve prolapse/Mitral regurgitation
- Mononucleosis
- Multiple sclerosis
- Muscular Dystrophy
- Myasthenia gravis
- Myelodysplastic Syndrome
- Neoplasm
- Neuromuscular weakness
- Obesity
- Osteomyelitis
- Other chronic lung disease
- Overnutrition
- Parkinson's disease
- Perimenopause
- Pernicious anemia
- Pickwickian Syndrome
- Pneumonia
- Polycythemia Vera
- Polymyalgia Rheumatica
- Polymyositis
- Poorly controlled asthma
- Post-Cancer Fatigue
- Post-Concussion Syndrome
- Pregnancy
- Primary Biliary Cirrhosis (PBC)
- Psychosomatic
- Reye’s Syndrome
- Sarcoidosis
- Sheehan's Syndrome
- Sinusitis
- Sjogren's Syndrome
- Sleep Apnea
- Sleep deprivation
- Sleep disorder
- Sleep disorders, e.g. insomnia, obstructive sleep apnea, or narcolepsy
- Sprue
- Starvation
- Subacute bacterial endocarditis
- Systemic Lupus Erythematosus
- Tension headache
- Thrombotic Thrombocytopenic Purpura
- Tuberculosis
- Ulcerative colitis
- Valvular Heart Disease
- Viral hepatitis
- Wegener's granulomatosis
- Wilson's Syndrome
Treatment
- Treatment of underlying medical etiologies
- Discontinue (or switch) harmful/aggravating medications
- Schedule regular physical activity
- Improvement of sleep hygiene
- Cognitive behavioral psychiatric therapy
- Referral to possible support groups
- Weight loss (for obesity)
- Supportive care, healthy diet, moderate exercise (chronic fatigue syndrome and fibromyalgia)
See also
- Somnolence
- Insomnia
- Combat stress reaction (Battle fatigue)
- Malaise
- Asthenia
- Paresis
- Debility
- Muscle weakness
- Muscle fatigue
- Infectious mononucleosis
- Celiac disease (gluten sensitivity)
Pharmacotherapy
Acute Pharmacotherapies
- Antidepressants
References
- ↑ Gandevia SC (1992). "Some central and peripheral factors affecting human motoneuronal output in neuromuscular fatigue". Sports medicine (Auckland, N.Z.) 13 (2): 93-8. PMID 1561512.
- ↑ Hagberg M (1981). "Muscular endurance and surface electromyogram in isometric and dynamic exercise". Journal of applied physiology: respiratory, environmental and exercise physiology 51 (1): 1-7. PMID 7263402.
- ↑ Hawley JA, Reilly T (1997). "Fatigue revisited". Journal of sports sciences 15 (3): 245-6. PMID 9232549.
- ↑ Edelman, Gerald Maurice (1989). The remembered present: a biological theory of consciousness. New York: Basic Books. ISBN 0-465-06910-X.
- ↑ Kelso, J. A. Scott (1995). Dynamic patterns: the self-organization of brain and behavior. Cambridge, Mass: MIT Press. ISBN 0-262-61131-7.
- ↑ Fatigue caused by medications.
External links
Acknowledgements
The content on this page was first contributed by Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3] Phone:617-525-6884
List of contributors:
Suggested Reading and Key General References
Suggested Links and Web Resources
For Patients
de:Müdigkeitfi:Väsymys fr:Fatigue (physique) he:עייפות nl:Vermoeidheidsq:Lodhja (trupore) th:อาการปวดเมื่อย yi:מיעדקייט
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
