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The strict definition of fatigue found in most dictionaries is weariness or lack of energy resulting from physical or mental stress. It is different from drowsiness, which is the need to obtain sleep. The causes of fatigue are varied; it can be a normal response to physical exercise, emotional stress or lack of sleep. It can also be a sign of medical or emotional conditions. So, when do you seek help from a physician? The best rule of thumb may be to see your doctor when the fatigue is not improved by eating a well balanced diet, getting appropriate activity and exercise, and sleeping well.

What are possible causes of fatigue?

  • Anemia − low hemoglobin level in the blood that does not allow proper transport of oxygen to the cells, usually caused by iron deficiency, which can be treated with diet or iron supplementation
  • Medications − most commonly sedatives, pain medications and antidepressants are known causes of fatigue
  • Chronic pain − pain stimulates certain chemicals in the brain and body that may be depleted and cause fatigue
  • Regular use of alcohol, street drugs or narcotics
  • Thyroid underactivity or overactivity
  • Sleep disturbances − including insomnia, sleep apnea and narcolepsy
  • Depression or grief
  • Eating disorders − anorexia, bullemia, malnutrition or vitamin deficiencies
  • Adrenal disorders − insufficiency or overactivity
  • Diabetes
  • Congestive heart failure
  • Autoimmune disorders − lupus, Sjorgren's syndrome, autoimmune arthritis and others
  • Severe infections − such as those that take a long time to recover from or AIDS, tuberculosis, mononucleosis and parasites
  • Liver diseases
  • Kidney diseases

What can you do for fatigue?
The following list includes tips that may help you to reduce fatigue:

  • Eat a healthy, well balanced diet with adequate fluid intake
  • Get as close to eight hours of sleep nightly as possible
  • Exercise regularly
  • Try to maintain a balanced work and personal schedule
  • Relaxation techniques such as meditation, yoga, pilates or tai chi
  • Avoid alcohol, nicotine and drug use
  • Balanced vitamin regimen − talk to your doctor about the best ones to use. You may need testing for possible vitamin deficiencies.

When should you contact a doctor?

  • If you are having dizziness or confusion
  • If you have blurred vision
  • If you have unexplained weight changes
  • If you have constipation, dry skin or cold intolerance
  • If you have headaches that have been present previously
  • If you are depressed or sad

Your physician may need to perform blood test for anemia, diabetes, hormonal disturbances, kidney function, liver function and tests for infections.

What is chronic fatigue syndrome?
Chronic fatigue syndrome is a condition characterized by extreme fatigue unexplained by any underlying medical conditions. The most common characteristic is fatigue worsened by activity whether physical or mental, but not improved with rest. The most common symptoms include not only fatigue but often include loss of memory or concentration, unexplained muscle pain, headaches, difficulty with sleeping and occasionally enlarged lymph nodes. There are no single tests to confirm chronic fatigue syndrome. It most commonly occurs in women over forty who are overweight. Chronic fatigue often leads to depression, work absences and withdrawal from social and family interactions. Many theories exist about the cause of chronic fatigue but none have been proven, including viral infections, immune system disorders and hormonal imbalances in the hypothalamus, pituitary or adrenal glands. Therapies used presently for chronic fatigue include medications such as antidepressants and sleep aids, graded exercise, psychological counseling and stress reduction. Some patients will get improvement with acupuncture, massage and yoga.

Dr. Aulds completed his medical education at Louisiana State University School of Medicine, New Orleans, LA and his Internship and Residency in Obstetrics and Gynecology at Ochsner Medical Foundation, New Orleans, LA.

Dr. Aulds has been an active member of the Huntsville Hospital Medical Staff since 1980.