Cause of extreme fatigue

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Cause of extreme fatigue

If you're nodding off a few sentences into reading this article (in broad daylight), you and sleep may need to reexamine your relationship. Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy "To be healthy, you need to get enough sleep," says family medicine doctor Matthew Goldman, MD. But getting adequate rest can seem as elusive as winning the lottery. In this Q&A, Dr. Goldman offers ways to once again dream the impossible dream. Q. How much sleep do adults really need? A. The amount of sleep you need varies with age. The National Sleep Foundation recommends that people 18-64 years old get seven to nine hours each night. Adults 65 years and older need seven to eight hours per night. Q. What's a normal level of fatigue for an adult? A. Feeling tired is one of the most common complaints doctors hear about. And fatigue is normal if you had a late night and then feel tired the next day. But fatigue (either normal or extreme) can become a concern when it affects your health and safety. For example, it's a problem if you're likely to doze off in situations where you need to maintain alertness, such as while driving or operating heavy machinery. So talk to your doctor if fatigue is compromising your safety. Your doctor will also want to know how long you've been experiencing symptoms to help determine the cause of your exhaustion. Q. Why am I so tired? A. Certain lifestyle choices and habits can affect how rested you feel. Poor sleep hygiene, shift work, jet lag and substance use (including alcohol and narcotics) can all contribute to extreme fatigue. Certain medications can also affect how tired you feel. These include antihistamines, anticonvulsants, antipsychotics, antidepressants, and pain and anti-anxiety medications. So can taking higher-than-recommended dosages of these medications and medication withdrawal (when you stop taking the medicine). Many health conditions can lead to excessive tiredness, including: Anemia (a common blood disorder).Electrolyte abnormalities.Genetic, neurological and sleep disorders.Heart, lung, thyroid or liver conditions.Mental health issues, including anxiety, depression and bipolar disorder.Metabolic issues, such as diabetes.Obesity.Rheumatological conditions, such as rheumatoid arthritis.Snoring (a breathing disorder).Underlying cancer or infectious disease. Q. How can I prevent fatigue and exhaustion? A. Good sleep hygiene is important. Try to incorporate these sleep habits into your routine: DO: Sleep only as much as you need to feel rested, and then get out of bed.Keep a regular sleep schedule.Exercise regularly, preferably at least four to five hours before bedtime.Make the bedroom environment conducive to sleep.Deal with your worries well before bedtime. DON'T: Try to sleep unless you feel sleepy.Drink caffeinated beverages after lunch.Drink alcohol near bedtime (no "nightcaps").Smoke, especially in the evening.Go to bed hungry.Use light-emitting screens before bedtime. Q. How do you know if fatigue is a sign of a possible health issue? A. Signs that your fatigue could be a symptom of something more include: Lack of physical or mental energy.Inability to stay awake and alert or initiate activity.Unintentionally falling asleep or falling asleep at inappropriate times.Reduced capacity to maintain or complete an activity.Becoming easily fatigued.Difficulty with concentration, memory or emotional stability. Tiredness affecting your ability to work, socialize and participate in family activities is also a red flag -- as is you or your family needing to make accommodations to deal with your symptoms. Q. When should you see a doctor for your fatigue? A. Talk to your provider as soon as you or those around you experience any amount of concern. Simply expressing the problem should lead to a discussion about the topic. Your provider will likely want to evaluate you to determine the severity of your symptoms and potential causes. Typically, the evaluation starts with a thorough history and physical exam. Doctors also use specific questions to measure how tired you feel. Terms like "feeling tired," "experiencing fatigue," "having lack of energy" and "feeling especially sleepy" are often used interchangeably. However, it's important for your provider to distinguish between them to figure out the cause. Based on your responses, your doctor can figure out the appropriate approach for diagnosing you. You may need additional testing, such as lab work, imaging or sleep studies, to determine the cause. Once your provider gets to the bottom of the fatigue issue, they can work with you on how to solve it. Chronic fatigue syndrome (CFS) is a complicated disease for doctors to diagnose -- and even fully understand. CFS is a physical condition, but it can also affect a person psychologically. This means that someone with CFS may feel physical symptoms, such as being very tired and weak (extreme fatigue), headaches, or dizziness. But the person may also notice emotional symptoms, such as a loss of interest in favorite activities. To make it even more complicated, different people with CFS can have different symptoms. And the symptoms of CFS often are similar those of other health conditions, like mono, Lyme disease, or depression. And the symptoms can vary over time, even in the same person. This makes treating the illness complicated because no single medicine or treatment can address all the possible symptoms. What Are the Signs & Symptoms of Chronic Fatigue Syndrome? There's a long list of possible symptoms that someone with chronic fatigue syndrome can have. The most common ones include: severe fatigue, which can make it hard to get out of bed and do normal daily activities sleep problems, such as trouble falling or staying asleep, or not having a refreshing sleep symptoms getting worse after physical or mental effort (this is called post-exertional malaise) symptoms or dizziness that get worse after standing up or sitting upright from a lying down position problems with concentration and memory headaches and stomachaches What Causes Chronic Fatigue Syndrome? Scientists have been researching chronic fatigue syndrome for many years, but they still don't know for sure what causes it. Many doctors believe that the way some conditions interact within the body and mind might leave some people at risk for CFS. For example, if someone has a and is under a lot of stress, the combination of these two things might make them more likely to develop CFS. These things are believed to interact with each other in this way, putting some people at risk for CFS: infections. Experts have wondered if infections like measles or Epstein-Barr virus (the virus that causes mono) might increase the risk for CFS. The role Epstein-Barr plays in CFS is not clear because studies have not confirmed it as a cause. problems with the immune system or the nervous system hormone imbalances emotional stress low blood pressure Who Gets Chronic Fatigue Syndrome? Chronic fatigue syndrome can affect people of all ethnicities and ages, but is most common in people in their forties or fifties. It's very rare in kids. A few teens do get CFS, and it affects more girls than guys. Sometimes different people in the same family get CFS. This may be because the tendency to develop CFS is genetic. How Is Chronic Fatigue Syndrome Diagnosed? Right now, there's no test to tell if someone has chronic fatigue syndrome. Doctors ask a lot of questions (about a person's and the health of family members, medicines, allergies, smoking and drinking habits, etc.). They also will do a thorough physical exam. Doctors also usually order blood, urine (pee), or other tests to check for conditions that cause similar symptoms. They may send a person to see other specialists (such as a sleep specialist or a neurologist) to help with the diagnosis. A doctor may suggest meeting with a psychologist or a therapist who can see whether mental health disorders might contribute to or mask CFS. How Is Chronic Fatigue Syndrome Treated? There's no known cure for chronic fatigue syndrome. But experts say that these lifestyle changes can help: Include regular, carefully planned exercise in your daily routine. Exercise can increase energy and make a person feel better. People with CFS should pace themselves while doing any physical activity that requires exertion. Talk with a doctor what's right for you -- you don't want to overdo it and get discouraged. Studies show that "graded exercise" (which means starting with small activities and slowly working up to a higher level of exercise) is very helpful in CFS recovery. Follow stress-management and stress-reduction techniques. A doctor or therapist can teach these -- they're great ways to take control of some aspects of the illness. Ensure good sleep habits to overcome CFS-related sleep problems. Work on ways to keep track of important things, such as keeping lists and making notes, you have problems with concentration or memory. Meeting regularly with a therapist or counselor can help in CFS treatment. (So can getting involved in a support group for people with CFS.) The main goals of therapy are to help people cope with the illness and to change negative or unrealistic thoughts or feelings into positive, realistic ones. Having a positive feeling that you can get better is very helpful. Therapy and support groups can also help teens with CFS and their parents deal with the academic or social challenges brought on by the illness, such as missed school, falling grades, or withdrawal from friends and social situations. Doctors may suggest over-the-counter or prescription medicines for some of these symptoms. What Else Should I Know? Strong emotions can be a part of the illness, so it's important to recognize and express your feelings. Feelings like sadness, anger, and frustration are completely normal -- and it's important to acknowledge how you feel and recognize that it's not your fault. Recognizing emotions (rather than suppressing them or pretending you're OK) can help you figure out what's behind your feelings and help you manage problems. It can help to keep a daily diary of feelings and energy highs and lows. This also can let you share information that might help your doctor. You can also track trends -- for example, if your energy is high at one time of day and low at another -- that will help you figure out when to exercise or do other activities. Give yourself more time to do things, especially activities that take concentration or physical exertion. Get support from family, teachers, and friends. Get information about CFS from reliable sources. There's a lot of misinformation and confusion about this disease. So it's important to know and trust your sources. Most important, don't give up. Having chronic fatigue syndrome can be hard. But for most people, the symptoms are most severe in the beginning. Later, they may come and go. Teens with CFS generally get better faster and recover more completely than adults do. Most teens get partial or full recovery within 5 years after symptoms began. It's important to keep a positive approach to getting well and to not look for the reason why you have CFS. People who take action and stay positive can have a good outcome. Let's face it: We aren't what we used to be as we get on up there. Aging has many wonderful aspects, but one of the many problems is that we do not have the stamina and energy we did when younger. That is a normal part of aging and just something that comes with the territory. However, being excessively tired or listless can be termed fatigue. Normal Fatigue As mentioned, one common cause of less apparent energy is aging itself. But there are other common causes of this feeling. The most common is lack of proper rest. If you do not get seven to eight hours of sleep, expect to be tired and fatigued. Another is doing too much; for example, working or playing hard without resting properly. It is normal to get worn out in this way and become fatigued. Paradoxically, if one does too little -- the couch potato syndrome -- this also leads to feeling fatigued. Too much caffeine during the day results in loss of sleep at night and fatigue during the day. Too much alcohol leaves one with a dreariness the following day and a form of fatigue. Finally, there are a host of medications that we may be taking that have as a side effect, drowsiness, which is like fatigue. The medicines that cause fatigue are antihistamines found in many cold/flu treatments, prescription pain medicines, beta-blockers for heart disease, sleeping pills, and some anti-depressants. If one has fatigue from any of the things that cause it listed above, you don't have to be a doctor to understand that if you eliminate the cause, then this should remedy the problem. In other words, if you are not getting enough sleep, then get enough by trying to be regular in time of retiring and getting up. If you are doing too much to too little then do the opposite. For example, moderate exercise on a regular basis is a very good treatment for couch potato syndrome. If medicines are the problem, talk to your physician about substitutions with a medicine that does not cause fatigue in you. Today there are often many good medicines that can be used for treatment of a medical problem that vary in their degree of side effects, especially drowsiness. Some fatigue that persists for over two to four weeks and is new to you, can be associated with a medical problem. Fatigue is a very vague and non-specific symptom that accompanies many diseases. It is, for example, expected in cancer treatment and after major surgery. However, it also could be a sign of some medical problems of which you may not be aware. The list is very long, and fatigue does not mean that you have a disease. Some medical problems known to lead to fatigue are: anemia, cancer, chronic heart and kidney disease, obesity, sleep apnea, diabetes and hypothyroidism, to name only a few. If the symptoms of being too tired to do what you used to do persist, and you have ruled out the common causes for normal fatigue, then see your physician to be sure you don't have one of the many diseases that are associated with chronic fatigue. Most of the diseases have a medical treatment that can improve one's lack of energy. Another very common cause of chronic fatigue is psychological in origin. The most common and potentially severe is depression. This is treatable, but needs to be diagnosed by a professional. It is nothing to fool around with or just endure; there are many medicines that are effective to treat depression. Anxiety will lead to chronic fatigue and needs evaluation and a method of treatment. Grief and stress tend to be time dependent, meaning that time makes them better, but both lead to chronic fatigue and can be combated by counseling. The new onset with sudden and profound change in ability to do what one used to do can be an urgent or emergent condition. If the fatigue is associated with chest pain, shortness of breath, irregular heart rate, or sense of imminent passing out, these are urgent conditions that warrant immediate medical attention. These could be symptoms of a serious heart condition or major vascular insufficiency. Likewise, if this type of fatigue is associated with suicidal or homicidal thoughts, then immediate medical attention is required. The bottom line is that being tired or fatigued is expected more as we age than when we were young. There are things we can do to restore some of that old vim and vigor, but there are some conditions that might cause this that require our seeking medical help. Be alert if you are fatigued!

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