Health Tips - Fatigue

What is Fatigue?

Fatigue is a symptom. Not a disease state. So, when someone is coming to talk about feeling tired or sleepy, we really have to get to the bottom of what's causing the fatigue, because something is causing that symptom.

We look at fatigue as something where you're not having enough energy throughout the day to get through normally, or mental exhaustion where you're not having the fortitude to continue doing an activity.

And fatigue is really important to discuss between that lack of energy and actual sleepiness. Sleepiness is a normal function. We only are built to have so much in our personal battery, whether it's our mind or our bodies, to get things done. And we need sleep to recharge. But fatigue means, even though we're sleeping, we're still just really, really low energy and easy to peter out.

Lifestyle-based Fatigue

When we look at the causes of fatigue, I like to look at things that are short-term and more long-term. So, short-term, think of, I caught the flu and I was really worn down and just had really, little energy all day long to get things done, if you've been cramming for a test and you've used a lot of mental energy, and afterwards, you're just feeling really worn out, needing to recharge, like stressors, too. So, if you lost someone that you loved and are really struggling with that emotion, sometimes that uses up a lot of energy.

When fatigue is a main concern and we're trying to get to the root of it, I always want patients to start with the basics. And the basics can be done without having to go to the doctor, too. I want you to take a look at lifestyle, things that go in and out of the body, and things that affect you directly in day-to-day life.

First is diet. In the American diet, oftentimes we're lacking the good nutrition we need. We eat a lot of processed foods and we're missing our fruits and vegetables. So, first things first. Take a look from the beginning. Are you eating a lot of processed foods, or eating a lot of junk? It's not really good fuel. It's like putting ethanol 85 in your Ferrari. It's not going to run very well. So, go back to the basics. Go back to more fresh fruits and vegetables, lean meats, good proteins, and cut out the candy bars and the soda. And that also includes cutting down the alcohol, too. Because alcohol certainly can lead a lot to the changes in energy.

Next step is exercise. Exercise is incredibly important for the body to regenerate itself, and it actually helps a lot with energy. People put a lot of energy into exercise, but exercise actually gives back and helps people feel more energetic, too. If you're not getting enough, the body doesn't get enough of the stimulation, enough of the endorphins, and enough of the training for muscles and heart to really help you feel better.

The third thing that I would have people take a look at would be sleep. So, even if you're getting your hours of sleep, the question is, do you have good-quality sleep? If you're waking up every hour to go to the restroom or you're tossing and turning, oftentimes it's a sign that something is not resting in the body. If you don't get adequate rest, our body doesn't have the ability to process all of your thoughts throughout the day, doesn't have time to regenerate a lot of it's cells that need special time when you sleep. So, if sleeping is disrupted over and over, it's going to lead to fatigue and symptoms of tiredness.

Another important thing to look into when people are complaining about fatigue is their stress management. So, if you have a stressful job and you're working long hours and you've got deadlines ... you know, bosses that put a lot of pressure on you, after a long period of time, that will really start to wear you down. And that's kind of where a lot of this emotional fatigue comes in. Because that's just as important as how much energy your body has.

If you've also had stressors, losing someone very important to you and the amount of impact that that places on you, that's really going to increase your stress level. And that uses up a lot of energy. So really, trying to go back to, what are your main stressors, and what can you do to relieve it? Sometimes going back to the basics with cleaning up your diet, making sure you're getting good exercise, or sleeping well may have a lot to do with how you can handle your stress.

Substance use is also very important when we're trying to figure out fatigue. So, smoking, drinking alcohol, marijuana use, or any of the illicit drugs are not the best substances to be used. They are often used to give us a good sensation. People like a buzz from the nicotine in cigarettes that they use for stress management, but in the end, it ends up being very harmful to the system in many ways. The nicotine sometimes overloads the neuro circuits and all the other by-products of smoking tobacco really cause just about every bad cancer that we know about in the body.

Alcohol use as well. While some people may use that to help with stress or feeling anxious, oftentimes it depresses the mind. Energy levels really suffer as a result from that. So really, I would also try to eliminate as many of those from your diet as possible, and almost let the body heal itself to see if it helps with your energy levels.

Next Steps to Treat Fatigue

After you've really worked through the basics and tried to modify everything you can on your own, it's fair to go to the doctor or your health care provider and ask for health about fatigue. In fact, I get quite a bit of that in my office at all times of year. Sometimes, it's a little bit worse in the wintertime, because the lack of sunlight, the colder temperatures, and the darker days, overall, sometimes make people feel tired, fatigued, et cetera.

So, since fatigue is a multi-component problem, I think most doctors will spend some time doing a really good history and physical. They're going to ask you a lot of questions about your fatigue, what your typical energy level should be like, and asking a lot of things about your lifestyle at home. Once that's gone through, I think a good physical exam is also really important. Sometimes if there are physical problems with any of the glands in the body, or dysfunction of any of our organs, that will sometimes be found on physical exam.

We usually start with basic labs if we want to look at some blood work for other causes of fatigue. Oftentimes, we'll look at blood count to try to rule out anemia or any abnormal cells. We'll look at a metabolic panel to check your electrolytes, check your kidney or your liver function, because both of those organs, kidney and liver, if they have disease states and they're not working normally can lead to fatigue.

We also like to check some basic vitamin levels. Vitamin D has been found to impact fatigue. And where we live up in Ohio, we don't have as much sunlight as if you're living in Florida all year long. So, people who live in the north tend to have lower levels of vitamin D. B-12, and folate, which are vitamins that have a lot to do with metabolism are also often checked. One thing that is nice about the American diet is that a lot of our foods, like our cereals and grains, are well fortified with B vitamins. So, having low B-12 or folate tend to be a little less common. We see it often in alcoholics and people who don't eat very well in general.

Sometimes if we suspect a heart issue, we can also do an EKG and check the electrical signature of the heart. If the heart is not beating normally, or it's not pumping blood efficiently, it also can lead to easy tiredness and fatigue.