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

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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?

The answers can give the patient and their doctor some insight into three major categories of problems that can have fatigue as a symptom:

  1. sleep problems,
  2. mental health, and
  3. medications.

In addition, such questions can provide insight about short-term normal fatigue such as bereavement, exercise, or changes in normal activity.

The other types of questions are a bit harder for both the patient and the doctor to use as clues because if the patient responds positively, often the physician will be need some additional testing done (possibly by other doctors or tests with results that will not be immediately available to your physician) to uncover or clarify an answer. If you have a primary physician, that doctor should already have most of these questions partly or fully answered. However, the primary care doctor may not have these answers if you see multiple physicians, have not seen you doctor "...in quite a while..." or you are seeing a physician for the first appointment. Examples of such questions include:

  • Did the fatigue develop gradually or quickly?
  • Do you have a history of diabetes, thyroid or other medical problems in your family?
  • Have you had a recent illness (for example, the flu, mononucleosis, "viral" illness)?
  • Have you traveled outside of the U.S.?
  • What is your current medical history (asthma, chronic obstructive pulmonary disease [COPD], congestive heart failure [CHF] or coronary artery disease [CAD])?
  • What is your surgical history (neck, kidney, liver)?
  • What are the current medications you take, their dose and frequency?
  • Have you had any medical tests performed recently and what were the results?

Why Am I So Tired? The Many Causes of Fatigue Resources

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Medically Reviewed by a Doctor on 11/26/2013