HEALTH – FATIGUE: An Overview

 

 

Dr. JESSICA DOWE M.D., Ph.D.

 

FATIGUE:  

An Overview 

By Dr. J. Dowe

 

The birth of a dream and the fulfillment of an achievement are grand!  But, life brings us frustration gaps. At times, we feel fatigued, all bound, and grinded up. Fatigue is a feeling or sensation of tiredness, weariness, exhaustion, weakness or low energy.  The Bible tells us in Isaiah 40:31, “But, those who wait on the Lord, they shall run and not be weary, they shall walk and not faint”.

            But, what do you do while you are waiting?  Listed below are a few pearls that may help you along the way.

Fatigue

Fatigue is a common reason that brings a person to the office. It is seen one to four times a day or 25% of the time.  One in three (33%) of teens report it three to four times a week.  The elderly report fatigue or a lack of energy quite often. Men typically differ from women.  Men say they are tired and women say they have a depressed mood or have anxious feelings. These feelings often manifest in the chest as palpitations.

Fatigue is classified as secondary, physiologic, or chronic. Still, there is a different disease called Chronic Fatigue Syndrome. 

Secondary fatigue is caused by an underlying medical condition and may last one month or longer, but generally lasts less than six months.  This condition involves such conditions like systemic infections, Thyroid disease, Anemia or low iron, and diseases that weaken the immune system like Diabetes, Rheumatoid arthritis, Lupus and Cancer.  Some medicines can cause fatigue like blood pressure medicines or stress. The Journal of Epidemiology showed that African American women compared to their Caucasian counterpart who reported to feel more discrimination on their jobs had more abdominal fat and was reported to have more social stress. These factors led to more secondary fatigue.  Sleep apnea, another reason for secondary fatigue, can cause high blood pressure and high pressure in the lungs (Pulmonary Hypertension) and if not treated can require oxygen and cause Congestive Heart Disease (CHF).

Physiologic fatigue is initiated by inadequate rest, low or no physical activity or mental strain unrelated to a medical condition.  This type of fatigue is more common in kids, teens and the elderly.  This fatigue lasts for two or more weeks and usually cannot identify a cause.  Treatment centers on getting adequate sleep, generally 6 to 7 hours a night.  It may also involve seeking sleep hygiene techniques (awake the same time every day, go to bed the same times, increase exercise in afternoons, but avoid in evenings, no coffee after 4 pm, increase sunlight exposure, taking naps for less than an hour).  Caffeine is recommended for shift workers who have difficulty with fatigue. Another agent that can be used is Modafinil rather than stimulants like Ritalin/Adderall which the latter agents can cause irritability, restlessness, d dry mouth/eyes and headaches, the longer they are used.  Also, there is abuse potential with all amphetamines.

Chronic fatigue is defined as fatigue that last longer than six months.  It occurs in 40 out of 100,000 people.   It can occur in all ages including children.  Women, minorities, and persons with lower educational and occupational statuses have a higher prevalence of chronic fatigue. Quite typically, the fatigue that last for six months or longer usually no explanation can be determined. 

Chronic Fatigue Syndrome is also a fatigue that lasts for more than six months but has specific criteria that suggest this syndrome.  Diagnostic criteria for Chronic Fatigue Syndrome involves 1) Major criteria (at least six months’ duration, does not resolve with bed rest; reduces daily activity to less than 50 percent; other conditions have been excluded), 2) Physical criteria (low grade fever, no exudative  pharyngitis; lymphadenopathy), and 3) Minor criteria (Sore throat, mild fevers, lymph node pain, generalized muscle weakness, myalgia, prolonged fatigue after exercise, new onset headaches, arthralgia, sleep disturbances, neuropsychological symptoms like photophobia, forgetfulness, confusion, difficulty thinking) 

Summary

Fatigue, no matter the cause, is associated with an imbalance of sleep, stress, or psychological coping skills. It can also be associated with an imbalance of God and emotional instability.  We have not oftentimes because we ask not.  It says in the bible in Hebrews 10:35, “Do not lose your confidence….It has great rewards”. Consider these things while you wait on God’s ultimate and final will. 

 

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