Fatigue Causes

Aka: Fatigue Causes, Fatigue Differential Diagnosis

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II. Causes: Psychogenic and lifestyle (80%)

  1. Sleep disorder (e.g. Insomnia)
  2. Recovery from surgery (Fatigue may persist 12 weeks even following minor surgery)
  3. Lifestyle
    1. Work problems or dissatisfaction
    2. Home finances and relationships
    3. Sedentary lifestyle and deconditioning
    4. Inadequate nutrition
    5. Inadequate rest or Overtraining
  4. Mood Disorder
    1. Anxiety Disorder
    2. Major Depression
    3. Bipolar Disorder
  5. Eating Disorder
    1. Anorexia Nervosa
    2. Bulimia Nervosa
  6. Substance Abuse or medications
    1. Illicit Drug abuse
    2. Alcohol or Alcohol Abuse
    3. Tobacco
    4. Caffeine
    5. Amphetamines
    6. Sedative-Hypnotics medications or Tranquilizers

III. Causes: Organic (20%)

  1. Infectious
    1. Febrile states
    2. Tuberculosis
    3. HIV Infection or AIDS
    4. Lyme Disease
    5. Chronic Mononucleosis
    6. Influenza
  2. Metabolic disorder
    1. Diabetes Mellitus
    2. Hypothyroidism
    3. Hyperthyroidism
    4. Hyperparathyroidism
    5. Hypopituitarism
    6. Addison's Disease (Adrenal Insufficiency)
    7. Cushing's Disease
  3. Hematologic Disorder
    1. Anemia
    2. Lymphoma
    3. Leukemia
    4. Occult malignancy
    5. Heavy Metal Toxicity (e.g. Lead Poisoning)
  4. Renal Disease
    1. Acute Renal Failure
    2. Chronic Renal Failure
  5. Liver Disease
    1. Acute Hepatitis
    2. Chronic hepatitis
    3. Cirrhosis
  6. Rheumatologic Disease
    1. Fibromyalgia
    2. Sjogren's Syndrome
    3. Polymyalgia Rheumatica
    4. Giant Cell Arteritis
    5. Polymyositis or Dermatomyositis
    6. Connective Tissue Disease
    7. Sarcoidosis
    8. Chronic Fatigue Syndrome
  7. Gastrointestinal disorder
    1. Celiac Disease (Gluten Sensitive Enteropathy)
    2. Inflammatory Bowel Disease
  8. Neurologic
    1. Multiple Sclerosis
    2. Parkinson Disease
    3. Narcolepsy
    4. Dementia
  9. Miscellaneous
    1. See Medication Causes of Fatigue
    2. Sleep Apnea
    3. Coronary Artery Disease
    4. Congestive Heart Failure
    5. Chronic Obstructive Pulmonary Disease
    6. Vitamin Deficiency

IV. References

  1. Lipken in Dornbrand (1992) Ambulatory Care, p. 5-8
  2. Goroll (2000) Primary Care Medicine, Lippincott, p. 41
  3. Rosenthal (2008) Am Fam Physician 78(10): 1173-9 [PubMed]

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