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Fatigue
Aka: Fatigue, Asthenia, Fatigue Red Flags
- See Also
- Fatigue in Cancer
- Fatigue Causes
- Chronic Fatigue Syndrome
- Fatigue Diagnostic Testing
- Medication Causes of Fatigue
- Definitions
- Fatigue
- Unable to perform activity repeatedly
- Asthenia
- Physical exhaustion without weakness
- Types
- Secondary Fatigue (20% of non-chornic causes)
- Fatigue with underlying medical cause
- Fatigue lasts between 1 and 6 months
- Physiologic Fatigue (80% of non-chronic causes)
- Fatigue due to lifestyle causes
- Chronic Fatigue
- Fatigue that lasts longer than 6 months
- See Chronic Fatigue Syndrome
- Causes
- Fatigue Causes
- See Medication Causes of Fatigue
- Symptoms
- Frequent presentations
- "I can't get out of bed in the morning"
- "I'm feeling 'all in'"
- "I'm tired all the time"
- Lack of pep or energy
- Usually complaint of "always tired"
- However on careful questioning, varies throughout day
- Low vitality
- Persistent Exhaustion or Tiredness
- Strongly desire rest or sleep
- Associated symptoms
- Subjectively weak
- Headache
- Assorted pain
- Symptoms: Differentiate from Sleepiness
- Fatigue is provoked by activity with delayed recovery
- Exercise offers a temporary respite from Sleepiness
- Nonrestorative rest and sleep
- Sleepiness improves with a nap
- Poor muscle endurance and mental exhaustion
- Diagnosis: Factors suggestive of psychogenic cause
- Fatigue lasting longer than 4 months
- No associated signs or symptoms
- Fatigue that is worse in morning
- Improves with activity
- Fluctuating course
- Stressful social history
- Exhaustive lifestyle
- History of psychological condition
- Symptoms: Red Flags (suggestive of organic or physical cause)
- Fatigue relieved with rest or sleep
- Refreshed in morning
- Less than ordinary activity causes Fatigue
- Ill appearing, tired or worn patient
- Weight loss
- Dyspnea
- Signs: Red Flags (suggesting Organic Fatigue Causes including neoplasm)
- Lymphadenopathy
- Cardiac murmur
- ThyroidGoiter
- Edema
- Inflammatory Arthritis findings
- Decreased muscle tone or other focal neurologic deficit
- Careful Neurologic Exam is critical
- Labs
- See Fatigue Diagnostic Testing
- Management
- Daily Exercise (30 minutes of Moderate Aerobic Activity)
- Stress reduction
- Adequate sleep (8 hours per night)
- See Sleep Hygiene
- Treat underlying causes of Fatigue
- Anemia
- Depression
- Course
- Fatigue may persist for >1 year in 50% of patients
- References
- Goroll (2000) Primary Care Medicine, Lippincott, p. 41
- Lipken in Dornbrand (1992) Ambulatory Care, p. 5-8
- Morrison (2001) Obstet Gynecol Clin North Am 28:225-40 [PubMed]
- Rosenthal (2008) Am Fam Physician 78(10): 1173-9 [PubMed]
- Valdini (1988) J Fam Pract 26:33-8 [PubMed]