Rheumatology Book


Fatigue Causes

Aka: Fatigue Causes, Fatigue Differential Diagnosis
  1. See Also
    1. Fatigue (includes Fatigue Red Flags)
    2. Chronic Fatigue Syndrome
    3. Fatigue Diagnostic Testing
    4. Medication Causes of Fatigue
  2. 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
  3. 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
  4. 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]

Fatigue (C0015672)

Definition (CCC) Exhaustion that interferes with physical and mental activities
Definition (MEDLINEPLUS)

Everyone feels tired now and then. Sometimes you may just want to stay in bed. But, after a good night's sleep, most people feel refreshed and ready to face a new day. If you continue to feel tired for weeks, it's time to see your doctor. He or she may be able to help you find out what's causing your fatigue and recommend ways to relieve it.

Fatigue itself is not a disease. Medical problems, treatments, and personal habits can add to fatigue. These include

  • Taking certain medicines, such as antidepressants, antihistamines, and medicines for nausea and pain
  • Having medical treatments, like chemotherapy and radiation
  • Recovering from major surgery
  • Anxiety, stress, or depression
  • Staying up too late
  • Drinking too much alcohol or too many caffeinated drinks
  • Pregnancy

One disorder that causes extreme fatigue is chronic fatigue syndrome (CFS). This fatigue is not the kind of tired feeling that goes away after you rest. Instead, it lasts a long time and limits your ability to do ordinary daily activities.

NIH: National Institute on Aging

Definition (NCI) Overall tiredness and lack of energy.(NICHD)
Definition (NCI) A question about whether an individual has or had a lack of energy.
Definition (NCI_NCI-GLOSS) A condition marked by extreme tiredness and inability to function due lack of energy. Fatigue may be acute or chronic.
Definition (NCI_CTCAE) A disorder characterized by a state of generalized weakness with a pronounced inability to summon sufficient energy to accomplish daily activities.
Definition (NAN) An overwhelming sustained sense of exhaustion and decreased capacity for physical and mental work at usual level
Definition (MSH) The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli.
Definition (CSP) state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli.
Concepts Sign or Symptom (T184)
MSH D005221
ICD10 R53.83
SnomedCT 206767001, 206771003, 158169005, 367392001, 302758002, 139126000, 84229001, 248274002
LNC MTHU013358, LA7542-9
French FATIGUE, Fatigue extrême, Perte d'énergie, Energie diminuée, Ereinté, Lassitude, Sensation de manque total d'énergie, EPUISEMENT, FAIBLESSE, LASSITUDE, Fatigue
English FATIGUE EXTREME, TIREDNESS, WEARINESS, [D]Fatigue, [D]Tiredness, [D]Fatigue (context-dependent category), [D]Tiredness (context-dependent category), Extreme fatigue, Decreased energy, decreased energy, fatigue (diagnosis), fatigue, Feeling of total lack of energy, Fatigue extreme, Tired out, Fatigue NOS, Fatigue [Disease/Finding], rndx fatigue (diagnosis), rndx fatigue, lacking energy, fatigues, loss of energy, tired time, tiredness, fatigue extreme, extreme fatigue, weariness, fatigued, tatt, time tired, energy loss, fatiguing, tired all the time, Lacks Energy, [D]Fatigue (situation), [D]Tiredness (situation), Lacking in energy (finding), Tiredness (finding), I have a lack of energy, FATIGUE, Lack Energy, Energy decreased, Tiredness, Lack of energy, Loss of energy, Weariness, Fatigue (finding), Lack of energy (finding), Lacking in energy, Fatigue, Lack of Energy, lack of energy, Lack (of);energy
Portuguese FADIGA, Fadiga extrema, Sensação de falta total de energia, Perda de energia, Exausto, Energia diminuída, CANSACO, ESGOTAMENTO, EXAUSTAO, Fadiga
Spanish FATIGA, Abatimiento, Sensación de falta absoluta de energía, Pérdida de energía, Fatiga extrema, Cansado, Cansancio, Falta de energía, [D]cansancio (categoría dependiente del contexto), [D]fatiga (categoría dependiente del contexto), ABATIMIENTO, CANSANCIO, FATIGA EXTREMA, [D]cansancio (situación), [D]cansancio, [D]fatiga, faltante de energía, faltante de energía (hallazgo), [D]fatiga (situación), cansancio, falta de energía (hallazgo), falta de energía, fatiga (hallazgo), fatiga, pérdida de energía, Fatiga
German ERMUEDUNG, Mangel an Energie, Muedigkeit extrem, Ueberdruss, Energie abgenommen, abgeschlafft, Gefuehl voelligen Energiemangels, Muedigkeit, ABGESCHLAGENHEIT, MUEDIGKEIT STARK, MUEDIGKEIT, Ermuedung, Ermüdung, Müdigkeit
Italian Affaticamento, Affaticamento estremo, Esaurito, Sensazione di totale mancanza di energia, Perdita di energia, Energia ridotta, Stanchezza
Dutch vermoeid, moeheid, uitzonderlijk moe, verlies van energie, gevoel van energieloosheid, energie afgenomen, vermoeidheid, Moeheid
Japanese 活力低下, 活力喪失感, 活力喪失, 疲労困ぱい, 極度の疲労, 疲労, ヒロウコンパイ, カツリョクテイカ, カツリョクソウシツカン, ヒロウ, キョクドノヒロウ, カツリョクソウシツ
Swedish Trötthet
Czech únava, Utahanost, Extrémní únava, Utahaný, Ztráta energie, Úbytek energie, Únava, Vyčerpanost, Pocit celkového nedostatku energie
Finnish Väsymys
Croatian UMOR
Polish Znużenie, Zmęczenie
Hungarian Kimerültség, Defatigatio, Kifáradt, Teljes energiahiány érzete, Energia elvesztése, Fáradtság, Kimerültség, extrém, Csökkent energia
Norwegian Tretthet, Utmattelse, Trøtthet, Fatigue
Derived from the NIH UMLS (Unified Medical Language System)

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