When I told my dear friend from residency training, Doctor Bonnie, that I was starting a medical blog, she delivered up a host of “Bonnie-isms” that only she could construct. As her husband so eloquently puts it, “Living with Bonnie is like living in a high school musical. She delivers lines all day.” And my favorite line is the basis of this post – “The F-word: fatigue” It’s so Bonnie, she’s a genius.
So, why is Fatigue the medical F-word?
Fatigue is a common complaint in any medical office. To me, it’s a fancy way of saying “I’m tired all of the time and don’t have the energy level that I used to have.” Patients will describe fatigue as anything from not being able to be as active or stay active as long as before to difficulty with sleep or even memory. Statistics show that up to 33% of patients complain of fatigue. That’s 1/3 of your patients in a day. It’s frustrating to patients and, believe it or not, equally frustrating to Doctors.
The cause of MY fatigue – charts, charts, and more charts
The problem is that ongoing fatigue (not the kind you get with a new baby) can be caused by MANY different things and whittling down that list can be difficult. Pending the underlying cause, it can be equally difficult to treat. Unfortunately, there is no magic energy pill. Whoever invents that is going to buy a private island someday and I am going to visit them with a huge bouquet of flowers.
Let’s simplify the list of fatigue causes.
Common Causes of Fatigue and Accompanying Symptoms to Consider:
- Medication Side Effects – MANY medications cause fatigue. Bring a list of meds to your Doctor’s appointment to review.
- Substance Abuse – Alcohol, marijuana, and narcotics cause fatigue as can the depression that may be behind the abuse.
- Depression and Anxiety – tearfulness, sadness, nervousness, or general lack of “feeling emotions”
- Anemia – or low Hemoglobin levels from inadequate dietary intake or blood loss
- Cancer – low energy associated with low-grade fever and weight loss are considered the “B symptoms” of cancer
- Low Sodium and High Calcium Levels – typically accompanied by nausea and increased thirst
- Thyroid Disease – weight gain, constipation, and dry skin are symptoms of low thyroid levels (#thyroid)
- Kidney Disease – decreased urination, nausea
- Liver Disease – stomach bloating, blood in the stool
- Heart Disease – shortness of breath with exercise, swelling in the legs, inability to sleep flat
- Lung Disease – generalized shortness of breath, cough
- Sleep Apnea – snoring, obesity, breath-holding during sleep
- Autoimmune Disease – especially fibromyalgia (more to come on that)
- Infections – from common infections like Mono to rare infections like Tuberculosis
- Lifestyle – work, stress, having a baby, teenagers, a husband that probably has undiagnosed sleep apnea and keeps you up at night. Oh, sorry, personal problems.
The best approach to getting the correct diagnosis in as few visits as possible is to SCHEDULE a PHYSICAL with your Doctor. Many of these diagnoses are metabolic – meaning lab work is needed for diagnosis. Relevant cancer screening is updated at physicals and many Doctors include depression and memory screening with physicals as well. A physical is the best place to start.
And, to make it even easier, PRINT MY CHECKLIST BELOW and take it to your appointment. Be sure to give it to the nurse first to share with your Doctor. It WILL help streamline your appointment and everyone, including the next patient waiting, will appreciate that.
Simple Solution:
Fatigue – the medical F-word. It’s not such a simple complaint. So many ways to describe it and so many causes. Print out my Fatigue Checklist to narrow down your list. Schedule a PHYSICAL with your Doctor to look for the most potential causes in one visit. And someone come up with a magic energy pill for me and Doctor Bonnie.
For more on Causes of Fatigue, check out:
https://www.mayoclinic.org/symptoms/fatigue/basics/causes/sym-20050894
https://www.healthline.com/health/fatigue#lifestyle-changes
For more Blog Posts on Fatigue:
https://doctormome.com/is-it-sleep-apnea-or-just-exhaustion/