Fatigue Causes

Aka: Fatigue Causes, Fatigue Differential Diagnosis

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II. Causes: Psychogenic and Lifestyle (80%)

  1. Recovery from surgery (Fatigue may persist 12 weeks even following minor surgery)
  2. Sleep disorder (e.g. Insomnia)
  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
    3. Severe Obesity
  6. Substance Abuse or medications
    1. Illicit Drug abuse or Substance Use Disorder
    2. Alcohol Use Disorder
    3. Tobacco Abuse
    4. Caffeine
    5. Amphetamines
    6. Sedative-Hypnotics medications or Tranquilizers

III. Causes: Organic (20%)

  1. Cardiopulmonary
    1. Coronary Artery Disease
    2. Congestive Heart Failure
    3. Cardiomyopathy
    4. Chronic Obstructive Pulmonary Disease
    5. Pulmonary Hypertension
    6. Valvular Heart Disease
    7. Atrial Fibrillation
  2. Infectious
    1. Febrile states
    2. Hepatitis B
    3. Hepatitis C
    4. HIV Infection or AIDS
    5. Lyme Disease or other Tick Borne Illness
    6. Chronic Mononucleosis
    7. Parvovirus B19
    8. Influenza
    9. Post-Covid Long-Term Effects (Long COVID)
    10. Coccidioidomycosis
    11. Giardiasis
    12. Syphilis
    13. Tuberculosis
    14. West Nile Virus
  3. Metabolic disorder
    1. Diabetes Mellitus
    2. Hypothyroidism
    3. Hyperthyroidism
    4. Hyperparathyroidism
    5. Hypopituitarism
    6. Addison's Disease (Adrenal Insufficiency)
    7. Cushing's Disease
  4. Hematologic or Oncologic Disorder
    1. Anemia
    2. Lymphoma
    3. Leukemia
    4. Occult malignancy
    5. Heavy Metal Toxicity (e.g. Lead Poisoning, Iron Overload)
  5. Renal Disease
    1. Acute Renal Failure
    2. Chronic Kidney Disease
    3. Hypercalcemia
    4. Hypokalemia
  6. Liver Disease
    1. Acute Hepatitis
    2. Chronic hepatitis
    3. Cirrhosis
  7. 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
    9. Rheumatoid Arthritis
    10. Systemic Lupus Erythematosus
  8. Gastrointestinal disorder
    1. Celiac Disease (Gluten Sensitive Enteropathy) or other Food Allergy
    2. Inflammatory Bowel Disease
    3. Cirrhosis
  9. Gynecologic
    1. Endometriosis
    2. Pregnancy
    3. Premenstrual Syndrome
  10. Neurologic
    1. Multiple Sclerosis
    2. Myasthenia Gravis
    3. Parkinson Disease
    4. Narcolepsy
    5. Dementia
    6. Chiari Malformation
    7. Seizure Disorder
    8. Traumatic Brain Injury
    9. Cerebrovascular Accident
  11. Miscellaneous
    1. See Medication Causes of Fatigue
    2. Sleep Apnea
    3. Narcolepsy
    4. Vitamin B12 Deficiency
    5. Gulf War Syndrome

IV. References

  1. Lipken in Dornbrand (1992) Ambulatory Care, p. 5-8
  2. Goroll (2000) Primary Care Medicine, Lippincott, p. 41
  3. Latimer (2023) Am Fam Physician 108(1): 58-69 [PubMed]
  4. Rosenthal (2008) Am Fam Physician 78(10): 1173-9 [PubMed]

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