Symptoms
Fatigue is a physiological and subjective response of the organism to mental and physical exertion. It is undesirable when it occurs rapidly, frequently, and excessively. Fatigue manifests itself, among other things, in a lack of energy, exhaustion, weakness, listlessness, and reduced performance and motivation. It can also be accompanied by irritability. Fatigue occurs acutely and chronically.
Causes
Mental and physical stress and physiological causes:
- An imbalance between exertion and recovery, such as physical or mental overuse.
- Stress
- Sleep disorders, sleep deprivation
- Pregnancy, age
- Lack of motivation and boredom
- Adolescence: fatigue is common and to some extent normal in adolescents. The causes include growth, lack of sleep and social and school demands.
- After surgery
Diseases (secondary fatigue):
- Viral infectious diseases such as a cold, influenza, mononucleosis, HIV, hepatitis, tapeworms. Fatigue also occurs post-infectious after the end of the disease.
- Hypothyroidism
- Cancers
- Low blood pressure
- Heart disease such as heart failure, cardiac arrhythmias.
- Psychiatric disorders such as a depression, anxiety disorders.
- Metabolic diseases: Diabetes mellitus
- Liver disease, renal insufficiency
- Dehydration
- Respiratory diseases such as a COPD
- Multiple sclerosis
Deficiency states:
- Vitamin or mineral deficiency, such as an iron deficiency with anemia.
- Malnutrition, malnutrition, loss of appetite, weight loss, anorexia.
Many drugs, stimulants and intoxicants:
- Antidepressants, antihistamines, benzodiazepines, sleeping pills, beta blockers, painkillers, opioids, muscle relaxants.
- Alcohol, GHB, cannabis
- Withdrawal symptoms
Fatigue with no diagnosable cause:
- Idiopathic fatigue
Diagnosis
The diagnosis is made in medical treatment based on the patient’s history, with a physical examination and laboratory methods. It must be clarified whether it is only a physiological fatigue or whether there is an underlying disease.
Nonpharmacologic treatment
- Physiological fatigue caused by an imbalance between exertion and rest can be treated with rest, relaxation, and adequate sleep.
- Good sleep hygiene
- Healthy diet
- Physical activity, sports, social contacts
- Good physical fitness
- Change or if possible discontinue medications that cause fatigue
- Treat causative diseases
- Reduce overloads
Drug treatment
Drug treatment depends on the cause. Stimulants such as caffeine:
- Preparations and herbal extracts containing caffeine, such as coffee, black tea, energy drinks, mate and guarana, are most commonly taken for the prevention and treatment of fatigue.
Tonics (tonics):
- Tonics contain, among other things, vitamins, trace elements, minerals, herbal remedies such as ginseng, sugars and amino acids and are traditionally administered for fatigue, in the past often as a syrup to take. They are most effective when there is actually a deficiency.
Vitamins and minerals:
- Vitamins, minerals and trace elements are also administered as mono-preparations, for example, iron in a proven iron deficiency.
Dextrose:
- Dextrose contains the sugar glucose and is suitable as a tonic in case of hunger pangs or hypoglycemia.
Amino acids:
- Arginine aspartate, glutamine, phosphoserine, citrulline.
Plant adaptogens:
Antihypotensives:
- Agents against low blood pressure such as etilefrin.
Thyroid hormones:
- Levothyroxine (T4) and liothyronine (T3) are administered to replace the missing endogenous hormones in diagnosed hypothyroidism.
Unless medically indicated, amphetamines and modafinil should not be used for the treatment of fatigue because of the adverse effects. Also not suitable are intoxicants such as cocaine or nicotine, which can lead to dependence and severe side effects.
