What is fatigue?
Fatigue is a feeling of tiredness, or a need to rest because of lack of energy. It normally manifests itself in a physical or mental state. Although the two are different, experts reveal that they go hand in hand ie if a person is physically exhausted; they will also get mentally tired.
In his description of Physical fatigue, Magara Perez, enrolled nurse and specialist in diagnosis in Mugongo health services in the outskirts of Kampala, says that when a person overworks, his muscles will get worn out which leads to glucose depletion and thus resulting into fatigue. With this muscle weakness, he revealed that a person cannot do things as easily as they used to for instance, performing simple tasks such as carrying a mere bag may become much harder than before.
On the other hand, he says, someone suffering from mental fatigue has concentrating issues. It is always difficult for them to concentrate on anything simply because the brain is exhausted.
When the symptoms are severe, the patient might not want to get out of bed, or perform daily chores simply because they are always in a state of sleepiness, has a decreased level of consciousness, and in some cases shows signs similar to that of a person in an intoxicated state.
When does one get fatigue?
Fatigue can affect people at any age. As Magara says, it normally affects healthy individuals after intense mental or physical activity which normally occurs when there is glucose depletion in the body. As disclosed by Jill Corleone, a Dietitian in the US, glucose is to the body’s muscles as gas is to the car – it’s the fuel that makes the muscles work.
He says, “When you eat food that contains carbohydrates, such as bread or fruit, your body breaks it down into glucose. This is absorbed by your intestines, sent to your bloodstream and delivered to not only your muscles but also your nervous system.
The glucose that is not used immediately for energy is stored as glycogen in your muscles and liver; it is used in between meals or during periods of exercise.”
He refers to ‘running out of glucose’ as a point where someone suddenly feels very tire and lacks any energy to perform any task because glucose is also the primary fuel for the brain.
Signs and symptoms of fatigue
The fatigue signs and symptoms may be of a physical, mental or emotional nature.
According to Magara, sleepiness/drowsiness is the first sign people will notice to believe that they are fatigued. However, he says while sleepiness is normally related with fatigue, on its own, it can be a different condition. He explains that fatigue is usually a more chronic (long-term) condition than sleepiness.
And while sometimes sleepiness can also be a sign of fatigue, on its own, sleepiness is generally caused by not having enough proper, restful sleep, or a lack of stimulation.
On the other hand, he points out that the main symptom of fatigue is exhaustion (total loss of strength) which results after a physical or mental activity.
Here, a person does not feel refreshed even after resting or sleeping. As Magara puts it, this exhaustion comes with severe fatigue. It is the kind of fatigue that may undermine the person’s ability to carry out their usual activities unlike mild fatigue which a person can sleep off and disappear.
Apart from the above, other signs and symptoms of fatigue that might manifest include: nausea, aching or sore muscles, painful lymph nodes, apathy or lack of motivation, difficulty in concentrating, dizziness, hallucinations, impaired hand-to-eye coordination, headache, impaired judgment, indecisiveness, irritability, loss of appetite, moodiness, poorer immune system function, low sex drive etc…
Causes of fatigue
Magara discloses that there is an endless list of causes of fatigue and some of these are classified under several lifestyle problems and some diseases. Mild fatigue for instance may result from overwork, poor sleep, anxiety, stress, boredom, or lack of exercise while chronic fatigue syndrome is a uncommon cause of severe, persistent fatigue.
Among the common causes of fatigue according Dr. Mary Lowth, UK author of ‘The Human Body’ is mental (psychiatric) health problems. The causes of mental health problems include: grief (bereavement), eating disorders, alcohol abuse, drug abuse, anxiety, boredom, and divorce.
She says fatigue is a common symptom of mental health problems, such as depression. She reveals that sometimes fatigue and depression may become so severe that it is the reason why many people may consider suicide as a way to end their pain.
In addition, a stressful situation at work or at home may also cause fatigue according to Christian Nordqvist, writer in Medical News Today. He divulges that this type of fatigue usually clears up when the stress is relieved.
He states that sometimes in order to perform, people need a certain amount of stress to invigorate them – a kind of mental pressure to ‘get them going’. However, when stress levels become excessive, they can easily cause fatigue.
Persistent (chronic) diseases
Many chronic diseases such as chronic lung disease, heart disease particularly heart failure, diabetes and Peripheral vascular disease commonly cause muscle weakness which results into severe fatigue. In some conditions this is due to reduced blood and nutrient supply to muscles.
As disclosed by Dr. Lowth, lung conditions such as Chronic Obstructive Pulmonary Disease (COPD) and heart failure cause a reduction in the ability of the body to take in oxygen. Muscles require a fast supply of oxygen from the blood, particularly when exercising. Reduction in oxygen intake leads to easy tiring.
She says that in people with diabetes, abnormally high levels of sugar remain in the bloodstream instead of entering the body’s cells, where it would be converted into energy.
The result is a body that runs out of steam despite having enough to ‘eat’. As diabetes progresses, she adds that the blood supply to small nerves is also lost. This means that when the nerve serving a muscle fibre dies then the muscle fibre will also stop working.
As an expert in human body mechanism, Dr. Lowth says patients with chronic pain typically wake up tired, even after having slept for a long time. For many, pain disrupts their sleep, which also leaves them tired.
As revealed by Magara, infectious diseases and infections such as malaria, various tropical diseases, flu and hepatitis are likely causes of fatigue simply because parasites of many of these infections feed on glucose which results into glucose depletion.
Overweight and underweight
Overweight/obesity is a rapidly growing problem in much of the world today. According to Magara, obese people are much more likely to experience fatigue, for various reasons.
Having to carry a lot of weight is tiring, and also obese people have higher risk of developing diseases and health conditions where fatigue is a common symptom, such as diabetes and sleep apnea. Being underweight according to Jill Corleone may mean there is less muscle strength. He says a very thin person may tire more easily compared to fat person.
Experts disclose that a good diet and exercise regime can do way with obesity and under weight.
According to Magara, whenever the body is dehydrated, it tires and weakens very quickly. He says, “When you don’t have sufficient fluids, you can’t be as strong as that person who has them.
Chemicals and substances
Besides causing dehydration, Healthwise website reveals that consuming too many caffeinated or alcoholic beverages may make it harder to get to sleep, or stay asleep, especially if you drink them close to bedtime. With little sleep, the likeable result is fatigue.
A vitamin or mineral deficiency
Dr. Lowth discloses that another cause of fatigue is anemia or iron deficiency in the body. Anemia has many causes, including heavy periods, poor diet, blood loss, pregnancy, genetic conditions, infections and cancers. It reduces the ability of the blood to carry oxygen to muscles so they tire more easily.
Secondly, a person’s body also needs sufficient vitamin B12 in order to produce healthy red blood cells. So a deficiency in this vitamin can also cause anemia. The main sources of B12 as she discloses are meat and dairy products, eggs, liver, shellfish, and enriched cereal, rice, and beans or iron supplements.
In addition, she says a deficit of vitamin D can also sap bone and muscle strength. “This vitamin is unique in that your body can produce it when your skin is exposed to sunlight, but there also aren’t many natural food sources of it. You can find it in some types of fish (such as tuna and salmon) and in fortified products such as milk, orange juice, and breakfast cereals.”
As revealed by Dr. Nordqvist, many medicines can cause muscle weakness and muscle damage as a side-effect or an allergic reaction. Usually this begins as tiredness although it can progress to permanent changes if the medicines are not stopped.
He notes that medicines in common use which can occasionally cause fatigue include statins (used for cholesterol), some antibiotics (including ciprofloxacin and penicillin) and anti-inflammatory painkillers (such as naproxen and diclofenac), some antidepressants, antihypertensive, steroids, antihistamines, sedatives, and anti-anxiety drugs.
Sleeplessness or apnea can also lead to fatigue. According to Nordqvist, some people think they have enough sleep, and yet sleep apnea gets in the way. This briefly stops a person’s breathing throughout the night. Each interruption wakes him/her for a moment, but he/she may not be aware of it and the end result is sleep depravity despite spending eight hours in bed.
To work on sleep apnea, experts advise losing weight if one is overweight, quitting smoking, and acquiring a CPAP device to help keep airway passages open while a person sleeps. They also urge people to make sleep a priority and keep a regular schedule by especially banning laptops, cell phones, and televisions from the bedroom.
“As we age, our muscles tend to lose strength and bulk, and they become weaker,” says Dr. Lowth. She notes that whilst most people accept this as the natural consequence of age – particularly great age – it remains frustrating for them to be unable to do the things they could manage when younger.
However, she adds that exercise can still be beneficial for old age because it increases muscle power and strength especially with a careful and safe exercise routine.
A fatigue diagnosis as revealed by Magara is a bit challenging given the fact that fatigue a lifestyle problem and a symptom of many disease and infections. In order to diagnose fatigue, he says the following diagnostic procedures and tests may be carried out:
The doctor will evaluate the quality of the patient’s sleep, their emotional state, sleep patterns and stress levels. He will also ask the patient some questions regarding lifestyle, diet, alcohol consumption, illegal drug consumption, etc.
He will also look at the patient’s medical history and if he/she is suffering from any illnesses, he will want to take note of that and medications the patient is currently on.
Diagnostic tests will include urine tests, x-rays, blood tests, etc. Magara reveals that a blood test of RBS (Random Blood Sugar) is carried out to find the amount of glucose in the blood. He adds that a complete blood count will also be conducted to analyze the levels of different blood cells in the body.