Courtesy of Prevention
A lot of the patients Sandra Adamson Fryhofer, MD, sees in her Atlanta
internal medicine practice are just plain tired. In fact, her women
patients, especially those over the age of 40, are most likely to
schedule appointments for persistent fatigue or bring it up at their
annual exams.
Both men and women tend to blame fatigue on a too-busy lifestyle.
And much of the time they're right. But Dr. Fryhofer takes all "I'm
tired all the time" complaints very seriously. "It's very easy for
someone to say, 'I'm just feeling tired because I'm run-down and have
too much going on,'" she says. "But the bottom line is that fatigue
could be a sign of a medical condition that can be treated."
Tired All the Time
Courtesy of Prevention
While many things can cause fatigue -- from the ridiculous (your dog is snoring at the foot of your bed, and you can't sleep) to the obvious (you're staying up to watch David Letterman) -- here are some of the more common causes of fatigue that can be diagnosed at the doctor's office with a combination of tests and a thorough exam.
Depression
More than "the blues," depression is a major illness that affects the way we sleep, eat, and feel about ourselves and others, explains Kathy HoganBruen, PhD, former senior director of prevention for the National Mental Health Association in Alexandria, VA.
Anemia
Anemia may be caused by an iron or vitamin deficiency, blood loss, internal bleeding, or a chronic disease such as rheumatoid arthritis, cancer, or kidney failure. In some cases, anemia may be a side effect of a medication that you're taking, such as chemotherapy for cancer patients.
Women of childbearing age are especially susceptible to iron-deficiency anemia because of blood loss during menstruation and the body's need for extra iron during pregnancy and breastfeeding, explains Laurence Corash, MD, adjunct professor of laboratory medicine at the University of California, San Francisco.
Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a chronic disease that involves inflammation in the lining of the joints. It happens when the body's immune system turns against itself and attacks healthy joint tissue, sometimes resulting in irreversible damage to bone and cartilage.
Diabetes
In type 2 diabetes, which accounts for 90 to 95 percent of diabetes in the US, the body either doesn't make enough insulin or doesn't use insulin effectively. Type 2 usually develops gradually, most often in people over age 45, but it's occurring earlier in life as Americans become more overweight.
Thyroid Disease
The thyroid gland, about the size of the knot on a man's tie, is found in the front of the neck. Thyroid-stimulating hormone (TSH) produced by the pituitary gland causes the thyroid gland to secrete two hormones, thyroxine (T4) and triiodothyronine (T3), that control metabolism. Too much thyroid hormone (hyperthyroidism), and metabolism speeds up. Too little thyroid hormone (hypothyroidism), and metabolism slows down.
Karl Grup, Getty Images
Tired All the Time?
Her
advice: Give yourself about 2 to 3 weeks to make some lifestyle
changes. Get more sleep, trim your social calendar, eat more wholesome
foods, drink more fluids, take a multivitamin, and cut back on caffeine
and alcohol. "If you have made the changes that make sense, and you're
still feeling the symptoms of fatigue, then you need professional
help," says Dr. Fryhofer.
While many things can cause fatigue -- from the ridiculous (your
dog is snoring at the foot of your bed, and you can't sleep) to the
obvious (you're staying up to watch David Letterman) -- here are some
of the more common causes of fatigue that can be diagnosed at the
doctor's office with a combination of tests and a thorough exam.
The fatigue caused by anemia is the result of a lack of red blood
cells, which contain hemoglobin, a protein that brings oxygen from your
lungs to your tissues and cells. In addition to feeling tired, you may
feel weak and short of breath.
Anemia
Anemia may be caused by an iron or vitamin deficiency, blood loss,
internal bleeding, or a chronic disease such as rheumatoid arthritis,
cancer, or kidney failure. In some cases, anemia may be a side effect
of a medication that you're taking, such as chemotherapy for cancer
patients. Women of childbearing age are especially susceptible to
iron-deficiency anemia because of blood loss during menstruation and
the body's need for extra iron during pregnancy and breastfeeding,
explains Laurence Corash, MD, adjunct professor of laboratory medicine
at the University of California, San Francisco.
Symptoms: Anemia may be the first sign of a serious illness, so
it's important to recognize the symptoms and seek treatment as soon as
possible. Fatigue is a major symptom. Others include extreme weakness,
difficulty sleeping, lack of concentration, rapid heartbeat, chest
pains, and headache. Simple exercise, such as climbing the stairs or
walking short distances, can cause fatigue.
The Tests: A thorough evaluation for anemia includes a complete
physical exam and blood tests, including a complete blood count (CBC),
to check the levels of your red blood cells and hemoglobin. It's also
standard to check the stool for blood loss. Sugar, also called glucose,
is the fuel that keeps your body going. And that means trouble for
people with diabetes who can't use glucose properly, causing it to
build up in the blood. Without enough fuel to keep the body running
smoothly, people with diabetes often notice fatigue as one of the first
warning signs.
In people with type 1 diabetes, usually occurring first in
childhood or the young-adult years, the body doesn't produce insulin, a
hormone that converts sugar, starches, and other food into energy. They
must take daily insulin injections to survive.
Diabetes
In type 2 diabetes, which accounts for 90 to 95 percent of diabetes in
the US, the body either doesn't make enough insulin or doesn't use
insulin effectively. Type 2 usually develops gradually, most often in
people over age 45, but it's occurring earlier in life as Americans
become more overweight.
Symptoms: Extreme fatigue is one of the early warning signs that
your blood sugar level is out of control, says Christopher D. Saudek,
MD, professor of endocrinology and metabolism at Johns Hopkins
University School of Medicine in Baltimore and president of the
American Diabetes Association. Other symptoms of diabetes include
excessive thirst, frequent urination, extreme hunger, weight loss,
irritability, vaginal yeast infections, and blurred vision.
The Tests: There are two major tests for diabetes: the fasting
plasma glucose test and the oral glucose tolerance test. The more
common is the fasting plasma glucose test, also known as fasting blood
sugar test. With a simple blood draw, usually first thing in the
morning, it measures your blood glucose level after fasting for 8
hours.
For the glucose tolerance test, blood is drawn twice: just before drinking a glucose syrup, then 2 hours later.
NEXT: Thyroid Disease and Depression
