What a feeling of constant fatigue can mean

In recent years more and more patients have been addressing their doctor, causing a feeling of constant and hardship. Fatigue is a common, non-specific symptom, with a wide range of causes, including acute and chronic medical disorders, psychological conditions, drug toxicity or substance use. Fatigue ‘The term ‘fatigue’ may be used to describe the difficulty or inability to initiate activity (subjective sense of weakness), the reduced ability to maintain activity (easy fatigue), or the difficulty of concentration, memory and emotional stability (psychic fatigue), separately or in combination. Some patients with the term “fatigue” essentially refer to an uncontrolled need for sleep, explains Polychronous Friday MD, MSc, Pathologist Director VII of the Metropolitan General Pathological Clinic and continues: “Acute fatigue is defined as that with a duration of less than one month, subacute fatigue has a duration of 1-6 months, while chronic fatigue is defined as that with a duration of > 6 months”. 21-33% of patients visiting primary care areas describe fatigue as a very important problem, with about seven million visits annually to the U.S. Fatigue and causes Acute fatigue: Acute fatigue is most commonly attributed to a recent stress agent or an acute medical condition, which can often be diagnosed based on its other clinical manifestations. For example, a flu patient will describe fatigue in combination with fever and respiratory symptoms. Patients with acute fatigue associated with an identifiable medical or psychosocial condition require minimal or no evaluation. Hypoxia and chronic fatigue: Causes include… • Cardiopulmonary diseases such as heart failure, chronic obstructive lung disease, sleep apnea • Endocrinological/ Metabolic diseases, such as hypo/hyperthyroidism, chronic renal or hepatic disease, electrolytic disorders (e.g. hypokalaemia) • Haematological diseases (e.g. anaemia) • Neoplasmic diseases • Infectious diseases such as COVID-19 disease, infectious mononucleosis, viral hepatitis, HIV infection, tuberculosis • Rheumatological conditions such as fibromyalgia, rheumatic polymyalgia, systemic lupus erythematos erythematosus • Psychological conditions such as depression, anxiety disorder etc. • Neurological conditions such as multiple sclerosis • Side effects of a drug (e.g. benzodiazepines, antidepressants) or use of substances (e.g. alcohol, cannabis, cocaine) “The clear cause of chronic fatigue can be detected in about 2/3 of patients. In several cases the feeling of hardship can simply be explained by overwork (many hours of work, a few hours of sleep). In a very small percentage chronic fatigue can be explained by chronic fatigue syndrome (CFS), an unknown cause disorder but with strong evidence of neurological dysfunction and clear diagnosis criteria. The disease is characterized by exhausting fatigue with non-revigorating sleep, neurological damage, muscle weakness and pain, headaches, sore throat etc. Fatigue and associated symptoms deteriorate dramatically after minimal physical or cognitive activity, which is referred to as PEM (Post-Exertional Malaise, Disease after Exercise). PEM is the main symptom and occurs mostly with a 24 hour delay after activity leading to a reduction of at least 50% of the patient’s energy and activity level. Finally those who do not meet the criteria for CFS and there is no other explanation for their fatigue are said to suffer from idiopathic chronic fatigue,” says Mr. Management of the chronic fatigue patient Initial assessment of the patient who is suffering from underacute or chronic fatigue includes taking a complete medical history, clinical examination, and basic laboratory tests (general blood, electrolytes, renal function, hepatic biochemistry, TKE, TSH, CPK, CRP). Further diagnostic evaluation is determined by the presence or absence of findings. “ Patients with a diagnosed cause of chronic fatigue based on initial evaluation by an experienced doctor should be treated specifically for the condition. For idiopathic fatigue the use of antidepressant drugs, cognitive behavioral therapy and/or classified therapeutic exercise has been recommended,” concludes Mr.