Tired All the Time?
Tired All the Time?
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.
Symptoms: Hyperthyroidism causes muscle fatigue and weakness, which you may notice first in the thigh muscles. Exercises such as riding a bike or climbing stairs become more difficult. Other symptoms include unexplained weight loss, feeling warm all the time, increased heart rate, shorter and less frequent menstrual flows, and increased thirst.
Hyperthyroidism is most commonly diagnosed in women in their 20s and 30s, but it can occur in older women and men too, says Robert J. McConnell, MD, co-director of the New York Thyroid Center at Columbia Presbyterian Medical Center in New York City. In postmenopausal women, hyperthyroidism may lead to osteoporosis.
Hypothyroidism causes fatigue, an inability to concentrate, and muscle soreness, even with minor activity. Other symptoms include weight gain due to water retention, feeling cold all the time (even in warmer weather), heavier and more frequent menstrual flows, and constipation.
Hyppthyroidism is most commonly diagnosed in women past the age of 50. In fact, as many as 10 percent of women past 50 will have at least mild hypothyroidism, says Dr. McConnell.
The Test: Thyroid disease can be detected with a blood test for TSH. Too much thyroid hormone, and TSH goes down; too little thyroid hormone, and TSH goes up. "Thyroid disorders are so treatable that a thyroid test should be done in all people who complain of fatigue and/or muscle weakness," says Dr. McConnell.
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.
Without treatment, the symptoms of depression may last for weeks, months, or even years. So it's important to recognize the warning signs and get help.
Symptoms: We don't all experience depression in the same way. But commonly, depression can cause decreased energy, changes in sleeping and eating patterns, problems with memory and concentration, and feelings of hopelessness, worthlessness, and negativity.
The Test: While there is no blood test for depression, your physician may be able to identify it by asking you a series of questions related to your mental health. If you experience five or more of the symptoms at right for more than 2 weeks, or the symptoms interfere with your life, see your doctor or mental health professional. Your doctor may also recommend a thorough physical exam to rule out other issues.
* Fatigue or loss of energy
* Sleeping too little or too much
* A persistent sad, anxious, or "empty" mood
* Reduced appetite and weight loss, or increased appetite and weight gain
* Loss of interest or pleasure in activities once enjoyed
* Restlessness or irritability
* Persistent physical symptoms that don't respond to treatment, such as headaches, chronic pain, or constipation and other digestive disorders
* Difficulty concentrating, remembering, or making decisions
* Feeling guilty, hopeless, or worthless
* Thoughts of death or suicide
Source: National Mental Health Association
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.
Symptoms: RA is not always easy to diagnose early, because many symptoms (such as fatigue, low energy, loss of appetite, and joint pain) are shared by other health conditions, including other forms of arthritis such as fibromyalgia and lupus. Also, anemia and thyroid disorders, which also cause fatigue, are even more common in people with RA, according to John Klippel, MD, president and CEO of the Atlanta-based Arthritis Foundation.
Rheumatologists look for at least four of the following criteria in diagnosing RA: morning stiffness in and around the joints lasting at least 1 hour before maximum improvement; at least three joint areas with simultaneous soft tissue swelling or fluid; at least one joint area swollen in a wrist, knuckle, or the middle joint of a finger; simultaneous involvement of the same joint areas on both sides of the body; lumps of tissue under the skin; and bone erosion in the wrist or hand joints, detected by x-ray.
The Tests: A thorough physical exam by a rheumatologist can provide some of the most valuable evidence of the disease, but there is also a test for the presence of rheumatoid factor, an antibody found in the blood. About 80 percent of people with RA test positive for this antibody, but the test is not conclusive since you can test positive and not have RA, and test negative when you do have RA.
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