Why Am I So Tired: The Many Causes of Fatigue (cont.)

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Fatigue is mainly a symptom and not a disease in itself. The key is for the doctor, with the patient's help, to discover the underlying cause of fatigue. The patient's input is important because accurate answers to the doctor's questions may lead the doctor toward a diagnosis or, at least, may suggest what medical tests may help provide a diagnosis. For example:

  • If the patient says things like "Starting any project is tiring...It is exhausting to get motivated... Concentration takes all of my energy....or... it takes so much effort just to feel normal," the fatigue may have a mental cause.
  • If the patient says things like "I'm exhausted after walking up a flight of stairs...I lose muscle strength after simple repetitive movements..., or I had a viral infection but now I seem unable to get my normal strength back," the fatigue may have a physical cause.

However, there are reasons that are "normal" for a person to be tired. Normal people who have intense physical or mental challenges can become fatigued. If the intense activity is halted (for example, "Whew! The exam is over"... or... "I had to really run to catch Fluffy after her leash broke"), the fatigue gradually dissipates over hours or a day. When patients describe longer-lasting fatigue or fatigue with otherwise normal activity, then it may be telling the patient and their doctor there is an underlying cause of their tiredness.

So what are some common questions you may hear your doctor ask that gives clues to the underlying causes of fatigue? The first set of questions may lead to some frequently seen causes of fatigue:

  • Are you possibly pregnant?
  • Have you started a new exercise or diet program?
  • Any recent work changes like extended hours or night shifts?
  • Any new stress (death of a family member, teenager rebellion, work pressures, divorce, financial problems)?
  • Are you taking any new medications?
  • Do you get tired at certain times (during or after your period, after interactions with a certain person, or after taking medicine)?
  • Any use of illegal or un-prescribed drugs, herbal products or other supplements?

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