Medical Evaluation - When To See A Doctor: Chronic Fatigue
Content provided by the Faculty of the Harvard Medical School
Medical evaluation
A careful description of your symptoms can help narrow down the diagnosis, but you'll also need a physical examination. The doctor will look for physical signs of illness, such as swollen lymph nodes or organs (such as the liver or spleen) or unusual lumps in your breasts or abdomen, and will check for the tender points that occur with fibromyalgia.
The National Institutes of Health recommends certain laboratory tests as part of a routine workup for anyone with debilitating fatigue that has lasted at least six months. These tests can detect evidence of anemia, infection, and other illnesses that cause fatigue.
Complete blood count (CBC). One of the most common laboratory tests, the CBC provides information about several blood components, including red blood cells and different types of white blood cells. Abnormal findings can indicate anemia, infection, and other conditions.
Manual differential white blood cell count. The body produces different types of white blood cells, which help fight infections. The relative percentages of each type can help determine the sort of infection you might have, such as whether it's viral or bacterial.
Erythrocyte sedimentation rate (ESR) chemistry panel. This test determines the rate at which red blood cells (erythrocytes) settle to the bottom of a test tube. The rate is elevated in various infections, inflammatory diseases, and cancers.
Thyroid-stimulating hormone (TSH) test. Produced by the pituitary gland, TSH helps regulate the production of thyroid hormones. The TSH test is usually ordered to diagnose hyperthyroidism or hypothyroidism.
Test for antinuclear antibodies (ANAs). When a person's immune system mistakes the nuclei of certain cells in his or her own body for foreign threats, it produces ANAs. These antibodies are found in the blood of people with autoimmune diseases that cause muscle pain and weakness, such as lupus. They can be detected by examining a blood sample using an ultraviolet microscope.
Urinalysis. Testing a urine sample can reveal many things about how your body is functioning. It can detect high glucose levels (a sign of diabetes) as well as evidence of kidney disease and infections.
Test for rheumatoid factor. If your doctor suspects rheumatoid arthritis from your description of your symptoms or the examination, he or she may suggest this test. Rheumatoid factor is a protein that the immune system produces, usually in people who have rheumatoid arthritis.
The weaker sex?Many surveys here and abroad show that women are about one and a half times more likely to feel fatigued than men are. One explanation could be that, in general, women are more likely to tell their doctors when they feel fatigued. But that's not the only factor. Women are also more likely to report and seek care for some of the illnesses that cause fatigue, for example, emotional disturbances such as depression and anxiety, iron-deficiency anemia, or multiple sclerosis. Biological differences no doubt also play a role. Fluctuations of estrogen through the menstrual cycle, as well as during pregnancy and menopause, can cause drowsiness or insomnia. Perhaps as important as biological differences are gender roles. A woman's workday is less likely to end once office hours are over. Even with men sharing more of the work at home, studies show that women spend more time on household responsibilities such as cooking, cleaning, caring for children, and looking after aging parents — even when they work full time. In short, women seem to have more reason to feel fatigued. |
Specialized testing
If your doctor can't make a diagnosis based on the standard physical exam and tests, he or she may order one or more of the following specialized tests:
Tests for specific infections. If the doctor thinks a chronic infection might be causing your fatigue, blood tests can identify problems such as Lyme disease, hepatitis C virus, and HIV (human immunodeficiency virus).
Computed tomography (CT) scans. CT scans can detect cancers deep within the body and enlargement of organs.
Magnetic resonance imaging (MRI) scans. Like CT scans, MRI scans can detect deeply placed cancers and enlarged organs. In addition, an MRI of the head can be especially valuable when neurological problems are suspected. MRIs can detect multiple sclerosis and the spots of inflammation in the brain that are seen in some people with chronic fatigue syndrome.
Chest x-ray. The doctor will order a chest x-ray if he or she suspects that you have heart or lung disease.
| Last updated: | January 23, 2007 |
|---|
Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.
This information is not intended to replace the advice of a doctor. By using AOL Body, you indicate that you have read, understood, and agreed to our Terms of Service, Use of Content Agreement and AOL Body Advertising Policy. Read more about our content partners.
Search
Where Does it Hurt?
If you're experiencing aches and pains we can help you find answers. Find out what your symptoms mean for your health.
