Fatigue: Symptoms, Causes, and Treatment

What is Fatigue?

Fatigue is the state of being highly exhausted, both physically or mentally, even after taking a break. It may make it hard to go to work, get out of bed in the morning, or do routine duties. Fatigue can be overwhelming and does not go away with rest like regular tiredness does.

What are the symptoms of fatigue?

Fatigue can come with other symptoms, such as:

• Feeling down or losing interest in activities you used to enjoy.
• Difficulty concentrating.
• Very low energy and motivation.
• Feeling anxious, nervous, or irritable.
• Muscle pain and weakness.

Other symptoms include:

• Tired eyes and legs.
• Whole-body tiredness.
• Stiff shoulders.
• Feeling unwell or uneasy (malaise).
• Boredom and impatience.

What causes fatigue?

Physical Causes

Fatigue can be due to various physical health issues, such as:

• Low iron levels (anaemia).
• Underactive thyroid (hypothyroidism).
• Uncontrolled diabetes.
• Heart failure or lung diseases like asthma or chronic obstructive pulmonary disease (COPD).
• Problems absorbing nutrients (e.g., coeliac disease).
• Vitamin D or vitamin B12 deficiency.
• Pregnancy.
• Chronic fatigue syndrome or fibromyalgia.
• Sleep disorders like sleep apnoea, pain, or anxiety disrupting sleep.
• Infections, including COVID-19, flu, or glandular fever.
• Autoimmune diseases like lupus, multiple sclerosis (MS), or rheumatoid arthritis.
• Side effects of certain medications (including beta-blockers, some painkillers, some antidepressants).

Most physical causes of fatigue are accompanied by other symptoms, like weight gain or shortness of breath, but some underlying causes of fatigue might not produce any additional symptoms.

Psychological Causes

Fatigue can also be linked to mental health issues, including:

• Anxiety and depression.
• Eating disorders (such as anorexia and bulimia)
• Sleep problems.
• Stress, which can either disturb sleep or cause constant tension and worry.

Other causes may include:

• Grief or loss.
• Domestic problems.

Lifestyle Causes

Lifestyle choices can also lead to fatigue, such as:

• Drinking too much alcohol.
• An unhealthy diet, including too many processed foods.
• Overworking without enough rest.
• Caring for young children.
• Using recreational drugs.
• Too much or too little exercise.
• Working night shifts.
• Major life changes, like moving house or getting married.
• Jet lag.

Often, no specific cause for tiredness is found.

When to see a doctor

You do not need to see a doctor if the cause of tiredness is clear, like late nights or a busy schedule. But you should see your GP if:

• Fatigue lasts longer than a few days.
• It affects your ability to work or do daily tasks.
• There is no clear reason for feeling tired.
• It starts suddenly.
• You are over 65.
• You are losing weight without trying.
• Your bowel habits change.
• You have a new, persistent cough or cough up blood.
• You have very heavy periods.

Seek urgent medical help if fatigue is accompanied by:

• Shortness of breath or chest pain.
• Unusually fast, slow, or irregular heartbeat.
• Headache or vision problems, especially after a head injury.
• Nausea, vomiting, or stomach pain.
• Muscle weakness.
• Thoughts of self-harm or harming others.

Tests for Fatigue

If fatigue continues or is linked to other symptoms, your GP may:

• Discuss your symptoms, mood, and lifestyle.
• Do a blood test to check for anaemia, vitamin D or vitamin B12 deficiency, or thyroid problems.
• Refer you to a specialist if a serious underlying condition is suspected.

In some cases, other tests, like a chest X-ray, may be needed.

Treatment for Fatigue

There is no specific treatment for fatigue. It is important to find and address the cause. If a medical issue is not causing it, lifestyle changes can help, including:

• Good Sleep Habits: Aim for 7-9 hours of sleep each night. Avoid caffeine, electronics, or exercise before bed. Keep a consistent sleep schedule.
• Limit Alcohol and Drugs: Avoid illegal drugs and limit alcohol.
• Healthy Diet: Eat a balanced diet and drink plenty of water.
• Manage Stress: Consider ways to reduce stress, like mindfulness, yoga, or talking about your concerns. If stress is work-related, discuss adjustments with your employer.
• Regular Exercise: Moderate exercise, such as walking or swimming, can reduce tiredness. However, avoid over-exercising.
• Maintain a Healthy Weight: Talk to your GP about a healthy weight range and try to stay within it.
• See Your GP: Get checked for infections, deficiencies, or other health conditions. Discuss any medications you are taking to see if they are causing fatigue. If anxiety or depression is involved, talking therapies or medication may help.

Can Fatigue Be Prevented?

Because fatigue has many causes, it cannot always be prevented. However, recognising fatigue early allows you to seek medical help and potentially get an early diagnosis.

Sometimes, people do not notice their fatigue as it develops slowly. Friends or family may notice changes in your energy levels before you do.

For more information or treatment options for fatigue, kindly reach out to us to book an appointment.