Fatigue

Published on 10/03/2015 by admin

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Last modified 10/03/2015

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Chapter 13 FATIGUE

Theodore O’Connell

Fatigue is defined as a subjective state of sustained lack of energy or exhaustion with a decreased capacity for physical and mental work, which persists despite sufficient rest. Fatigue is one of the most common complaints in adults presenting for primary care in the United States and must be differentiated from weakness or exertional difficulties.

Acute viral syndromes are a common cause of fatigue and are usually self-limited. Fatigue that persists longer than 1 month generally warrants investigation. Although fatigue is usually the symptom of which the patient complains, careful history documentation often reveals associated symptoms. A targeted physical examination may lead to additional diagnostic clues. A laboratory examination may not be required in all cases of fatigue, but targeted testing may help the clinician pinpoint the cause of the patient’s symptoms.

Depression is the most common cause of clinically important fatigue in patients presenting for primary care. Fatigue is common in the elderly population and may represent part of the normal aging process. However, fatigue should not be attributed to advanced age alone. Rather, fatigue as a consequence of advanced age should be a diagnosis of exclusion.

Causes of Fatigue

Addison disease

Allergic rhinitis

Anorexia nervosa

Bipolar disorder

Bulimia nervosa

Carbon monoxide poisoning

Chronic pulmonary disease

Chronic sinusitis

Coccidioidomycosis

Cushing disease

Cytomegalovirus infection

Dermatomyositis

Epstein-Barr virus infection

Heavy metal exposure

Helminth infestation

Hepatitis B or C

Hyperthyroidism

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