Tired


What is it about ?

Anyone can feel tired after a long day at work or after strenuous sports activity. It is therefore not necessarily abnormal to feel tired. It’s a signal your body is sending to tell you that you need to recover. This recovery can be mental or physical.

Sometimes fatigue comes with other symptoms as well, and you feel like there is ‘something else’. Certain illnesses, but also their period of convalescence, can lead to exhaustion or a general lack of energy. In some diseases, fatigue is the first or even the only symptom.

Here are some examples of common illnesses that cause fatigue: thyroid disorders (insufficient production of hormones by the thyroid gland (hypothyroidism) Where abnormally high production of hormones by the thyroid gland (hyperthyroidism)), diabeteskidney disease anemia, infections (for example mononucleosis, HIV infection, Lyme disease), heart failure, neurological diseases such as Parkinson disease and dementia, fibromyalgia, liver diseases, cancer, … Lung diseases such asasthma and chronic bronchitis, poor quality of sleep, snoring andSleep Apnea can also be the cause of fatigue during the day.

Fatigue can also be caused by certain medications, such as antidepressants and certain pain relievers.

Certain working conditions such as shift work (by system of breaks) or long working days.

The normal aging process results in decreased performance with age. But, if you tire more quickly than people your age, it could be a sign of illness.

Burnout

Burnout and overwork are disorders often accompanied by increasing exhaustion. You then experience not only physical fatigue, but also mental fatigue.

The terms overwork and burnout are often used interchangeably. Burnout is the result of prolonged exposure to stress, which upsets the balance between your ability to resist and the load you are supporting. Stress is actually your body’s adaptation to a load, which is not completely negative. If this adaptation is not enough, you can develop burnout. Burnout is usually not the consequence of overwork, but rather of poor management of stress and pressure (due to deadlines, for example) generated by your job or a job that you don’t. do not like.

Burnout and depression sometimes look alike. In the event of burnout, things outside of work still give you pleasure, which depression does not.

The solution may lie in limiting your workload. Discuss this with your doctor.

Chronic fatigue syndrome or CFS

Since 2015, we no longer officially speak of CFS, but of “systemic exercise intolerance disease” (systemic exertion intolerance disease or SEID).

The diagnosis of SEID can only be made when a person meets a series of criteria:

  • Very severe fatigue which lasts for more than 6 months, which is recent or definite onset, which is not caused by excessive exertion and which is not relieved by rest. The person experiences considerable difficulty in continuing to take part in professional, social or personal activities;
  • An unpleasant sensation after physical activity (discomfort after exertion);
  • A non-restful sleep;

The person may also suffer from concentration and memory problems. Symptoms can also worsen when standing.

The diagnosis is difficult to make. It is often preceded by numerous medical examinations.

To this day, SEID remains a poorly understood condition. The cause is not well known. Several theories exist, but none have been clearly proven. SEID could be due to a previous poorly healed infection and / or hormonal imbalance. Certain psychosocial factors can also intervene.

Treatment consists of, among other things, cognitive behavioral therapy and drug therapy. Drugs are generally little or not effective in treating SEID; vitamins and other food supplements are even less so. On the other hand, drugs can have serious side effects.

Many people with SEID have their symptoms improve or go away over time.

Maintaining physical activity can have a beneficial effect on fatigue. The doctor and physiotherapist can help you. Opinions differ as to the ideal treatment for SEID and the effectiveness of the different treatments must be assessed on a case-by-case basis. In Belgium, there are also centers specializing in the management of SEID.

What is its frequency?

Fatigue is a very common complaint in general medicine. Of all the people who see their GP annually, around 1% complains of fatigue. But a cause at the origin of fatigue is only found in 20 to 30% of them. Psychosocial factors play a role for 75% of patients complaining of fatigue.

How to recognize it?

You experience fatigue that you have never felt before. The state of fatigue is not temporary. You are no longer able to do the same activities at the same pace as before. You have difficulty getting started or taking initiatives. You need a lot more time to recover after physical or mental exertion. You’re tired, but long nights of sleep don’t seem to solve the problem. Sometimes fatigue persists and gets worse after physical activity. You react less quickly to certain stimuli, you become dispersed and you have the impression of forgetting many things. Fatigue can go hand in hand with a feeling of worry, depression, general weariness and a lack of pleasure in taking part in activities that once gave you pleasure. It may also suggest that there is an underlying depression.

How is the diagnosis made?

The doctor can work with you to find the causes that may explain your fatigue. Doctors look at complaints of fatigue from a physical, mental and social perspective. This is why the doctor will ask you a number of questions in order to assess as precisely as possible what you mean by fatigue and to establish the possible cause. Symptoms such as weight changes, sweating, pain and nausea may indicate certain physical problems.

The doctor will try to rule out important causes such as burnout, depression or serious internal illness. To do this, he may decide to prescribe additional supplements.

If fatigue is the only symptom, the benefits of more exams are rather limited. Tests are used more to rule out diseases than to demonstrate their presence. The first test is usually a blood test, but it only reveals the cause in 5% of cases. It can then be supplemented by a urinalysis, a electrocardiogram (ECG) or an x-ray of the lungs if justified on the basis of the patient’s story.

What can you do ?

Even though fatigue is extreme, good personal hygiene is still important. a healthy lifestyle is the basis of treatment: moderate your alcohol consumption, stop smoking, keep moving and eat a healthy and varied diet. Make sure you follow good sleep hygiene. If necessary, try to reach a healthy weight.

While the effort required to be physically active can be considerable, staying active is scientifically proven to improve symptoms. Discuss with the doctor or physiotherapist beforehand the most appropriate type of physical exercise and its intensity. Also tell the doctor about any medications you are taking.

What can your doctor do?

Once the diagnosis is made or when the cause of the fatigue is known, the doctor can start treatment. This depends on the problem causing your fatigue. If an illness is causing your fatigue, it should be taken care of.

The treatment must be well coordinated. That is why it is very important to have a good relationship with your doctor, because he can manage your file from A to Z. This will avoid many unnecessary or double examinations. The general practitioner supports you and motivates you in your treatments and can accompany you towards a healthy lifestyle.

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Source

Foreign clinical practice guide ‘Fatigue’ (2000), updated on 01.03.2017 and adapted to the Belgian context on 20.11.2017 – ebpracticenet