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     Volume 4 Issue 38 | March 18, 2005 |

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Fatigue When Lethargy Hits Hard

Atigue is a feeling of weariness, tiredness, or lack of energy.

Alternative Names
Tiredness; Weariness; Exhaustion; Lethargy

Fatigue is different from drowsiness -- drowsiness tends to be simply the feeling of a need for sleep while fatigue involves a lack of energy and motivation as well. Drowsiness and apathy (a feeling of indifference or not caring about what happens) can be symptoms of fatigue.

The pattern of fatigue may help define its underlying cause. Individuals who wake up in the morning rested but rapidly develop fatigue with activity may have an ongoing condition. Individuals who awaken with low energy and have fatigue that persists throughout the day may be suffering from depression. However, these are not absolutes. Chronic fatigue should be evaluated by your health care provider.

Fatigue can be a normal and important response to physical exertion, emotional stress, or lack of sleep. However, it can also be a nonspecific sign of a medically serious psychological or physical disorder. Fatigue that is not relieved by enough sleep, good nutrition, or a low-stress environment should be medically evaluated. Because fatigue is a common complaint, a potentially serious cause can be overlooked.

Common Causes
* Addison's disease (adrenal insufficiency)
*Anorexia or other eating disorders
*Chronic allergic-type disorders
*Hay fever
*Chronic liver disease
*Chronic kidney disease
*Chronic use of illicit drugs such as cocaine or alcohol
*Chronic fatigue syndrome
*Anemia including iron deficiency anemia
*Chronic boredom
*Chronic infection
*Bacterial endocarditis
*Parasitic infections
*Congestive heart failure
*Prescribed drugs
*Juvenile rheumatoid arthritis (a disease affecting children and adolescents)
*Malignancy (cancer)
*Muscle diseases such as muscular dystrophy
*Excessive physical exertion
*Rheumatoid arthritis
*Autoimmune diseases such as systemic lupus erythematosus
*Viral infections
*Sleep disorders
*Chronic insomnia
*Obstructive sleep apnea

Home Care
There are no direct cures for the most common fatigue problems. Ways to help reduce fatigue include the following:
*Getting more sleep
*Learning better ways to cope with stress
*Changing jobs or learning new ways of dealing with career challenges
*Taking a vacation
*Dealing with relationship pro

Chronic fatigue can often be reduced by alleviating chronic pain. Treatment for depression also often helps with this problem, although some antidepressant medications may cause or worsen fatigue. Medication may have to be adjusted to avoid this problem.

A balanced diet, a program for regular exercise (within prescribed limits), and adequate rest are recommended.

Set priorities, maintain a reasonable schedule, and develop good sleep habits.

Taking stimulants does not work and can actually make the problem worse when the drugs are discontinued. Tranquilizers generally intensify fatigue. Vitamins may not solve the problem, but if taken in moderation they may be helpful.

Call your health care provider if
Contact your health care provider if you have prolonged, unexplained weakness or fatigue, particularly if accompanied by fever or unintentional weight loss.

If your fatigue is not caused by a physical disorder, you may be referred for psychological counseling or psychiatric evaluation for depression or other disorders that can lead to this symptom.

Diagnostic tests that may be performed include the
*Blood tests for anemia
*Thyroid function tests
*Other blood studies such as CBC and blood differential

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