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Dr. Paul Kasenene

When could fatigue mean a more serious medical problem?


One of the symptoms that take many people to their doctor’s today is the symptom of fatigue. Fatigue affects many people today and if you are one of them you are not alone. In today’s world with our over demanding lifestyles and hectic schedules, the number of people experiencing fatigue is on the rise. And many of the individuals who have fatigue, wouldn’t classify themselves as sick, often report feeling “tired” a lot.

But what exactly is fatigue?

Fatigue is a feeling of excessive tiredness or a lack of energy or a combination of both.

But the big question to ask is, when should feeling tired be of concern to you? Could it be a sign of something more serious or a symptom of a more serious medical problem?

Before you start thinking about a health issue that could be severe, and especially if you're relatively young and otherwise healthy: maybe the problem is that you are not getting enough sleep and rest. Are you getting the recommended 7 to 8 hours of sleep or are you surviving on less than 6 hours?

Usually, if you are experiencing fatigue, trying to get more regular and consistent sleep is the first thing you would like to address. Aim to go to bed early as well as try to get a minimum of 7 hours of sleep each night consistently for about two or more weeks. Also, consider healthy sleep habits or what experts call “sleep hygiene. Good sleep hygiene includes establishing a consistent sleep pattern, limiting daytime naps if you don't fall asleep until late at night and taking a warm bath before you sleep. Sleep hygiene also involves cutting out stimulating drinks like alcohol or coffee close to bed time and keeping screens — televisions, smartphones, and tablets — out of the bedroom if possible. In addition stopping the use of these electronic devices an hour or two before bedtime will go a long way to improving your sleep. These screens and such devices emit excess light, and the stimulation they provide may contribute to sleep problems.

If sleep hygiene measures can reduce your fatigue then probably you were suffering from inadequate rest.

If it doesn't seem just to be a matter of getting an hour or so more of sleep or practicing good sleep hygiene, then your fatigue may be a sign that there is more likely to be a problem that needs to be addressed. Please do note that there is a broad range of medical conditions associated with feeling tired all the time, with some more serious than others.

It is important that you are able to understand the different sign and symptoms that you are experiencing and be able to get an idea of what the problem could be.

But, we must be careful not to simply write off fatigue as lack of rest of being too busy especially when your fatigue persists for a prolonged period beyond despite taking time off to rest, relax and get enough sleep, because fatigue has many causes.

We must know when it is best to seek medical care or when you need help to address your fatigue and especially so if your fatigue is associated with other symptoms.

I will try and highlight an approach that someone can use to assess their fatigue symptoms that may seem to be due to more than just lack of rest.

First, you must ask yourself, what exactly you are experiencing. Is the feeling of lack of energy or tiredness experienced when you are active or when you exert yourself (like after climbing a flight of stairs) or do you feel fatigued even without exertion, throughout most of the day or at rest?

The answer will likely point you to different possible causes.

The first kind of fatigue that is associated with a decreased ability to get around and be active without becoming exhausted or running out of breath changed could point to

  • Anemia (low haemoglobin). If you are a lady, heavy menstrual periods could cause this. But there are many other causes of anemia such as infections, bleeding from the gut and even some types of cancer

  • A heart problem. When the heart is not able to function at its optimum level, then increased activity means compromised delivery of blood and oxygen to the tissues.

  • A respiratory problem.

If you suspect that have this type of fatigue or exhaustion, get it checked out by a doctor.

The second type of fatigue that is experienced even at rest or without exerting yourself can be due to a number of causes, and I will divide them into five major categories

  1. Medical Problems.

Fatigue may be a symptom of an underlying medical condition. And if that is so, it is likely that there would be other symptoms or signs that you are experiencing that can give you a clue of what the problem may be. The following conditions are known to cause fatigue commonly

  • Diabetes. This is one of the most common causes. If this is the case, someone will also likely have symptoms of excessive thirst, excessive urination, and increased hunger

  • Hypothyroidism (Slow thyroid). Associated symptoms include unexplained weight gain, sleep problems, dry skin, constipation and sensitivity to cold.

  • Depression. Being depressed can cause symptoms of fatigue. However, there would also be changes in mood, low appetite, and loss of interest in most activities

  • Less common causes of fatigue but that you may want to ask your doctor about include multiple sclerosis and fibromyalgia

2. Medications

If you have noticed the fatigue after starting medication, then it could be the cause of the fatigue. But even long-term use of drugs can cause fatigue. The most common medications that could be the culprit include;

  • Steroids such as prednisolone

  • Antihistamines

  • Birth control medication and hormonal contraception,

  • High blood pressure medication

  • Anti-cholesterol drugs like statins

  • Protein Pump Inhibitors. These are drugs used to treat ulcers and digestive disorders such as omeprazole

3. Fatigue that may not be evident after medical tests or that may not be commonly thought of

  • Food sensitivity or gut problems. Eating certain foods can cause the body to experience unexplained fatigue together with other symptoms such as a headache, backache, poor sleep, sinus problems, skin rashes, bloating, gas, constipation. Common culprit foods include wheat, dairy, soy and some other foods.

  • Deficiency of essential minerals and vitamins that support the energy generation process such as zinc, magnesium and Vitamin D. Supplementing with these may be the solution to your problem

  • Heavy metal toxicity – If you have been exposed to heavy metals in your food, water, and other sources, you may experience ongoing fatigue. A common culprit is mercury that comes from silver amalgam dental fillings. If you suspect this, please don’t have them removed by an ordinary dentist. Seek someone who has experience in removing them safely or biological dentistry

  • Hormonal imbalance. If you have irregular periods, signs of early menopause, change in sex drive, or any other unclear symptoms that seem related to your hormones, then fatigue may be caused by this. For men always check your testosterone levels if you experience vague fatigue as well as low libido.

  • Others

  1. Allergens. Things that cause allergy

  2. Obesity

  3. Sleep apnoea associated with snoring and waking up frequently at night

4. Stress

If you or someone you know has experienced ongoing, chronic and relentless stress (whether from relationship, challenges at work, financial challenges or any other physical or mental stress), the body could eventually end up experiencing fatigue that may become a problem to them. The adrenal gland (a small gland above the kidney) produces a hormone called cortisol that helps us to undergo chronic stress. However, if the is unrelenting, the gland could get exhausted and fail to continue to support you the stressful period. If you have adrenal exhaustion other symptoms you may experience include palpitations, trouble sleeping, feeling dizzy when you stand up, low blood pressure and craving salt.

5. Chronic Fatigue Syndrome

One condition many people have heard of is , which is a serious disease that leads to more than everyday tiredness. , it includes profound fatigue that lasts for at least six months, cognitive impairment and total exhaustion after even minor exertion. Those symptoms require medical attention and may not go without proper medical evaluation and management. I have found that many people who have experienced fatigue for a long time and especially who seem to be unable to function well even for basic day to day activities have this condition

So, what are the next steps to take if you are feeling fatigued? First, try and improve your sleep hygiene as explained above and get more rest. If that doesn’t solve the problem, I recommend you see a doctor for further evaluation and management.

Some suggestions for being able to get to the bottom of this problem are simply listed below

  • Try and find the cause of the problem with your doctor or medical practitioner. This could involve taking the following tests

  • Blood count and especially Haemoglobin

  • Diabetes or blood sugar screen

  • Thyroid gland test

  • Cortisol levels

  • Testosterone and hormone levels

  • Food sensitivity test

  • If the cause is identified then take steps to manage it

  • Talk to your doctor if you suspect that drugs are the cause

  • If stress is the underlying cause take measures to manage stress and not run away from the stress

  • Important specific steps include

  • Modifying your diet

  • Avoid inflammatory foods

  • Do an elimination diet to try and figure out what foods you may be sensitive to

  • Eat anti -inflammatory foods

  • Purple and red foods are very good to boost energy

  • Use turmeric, ginger and rosemary to reduce any potential inflammation in the body

  • I strongly recommend you correct the deficiencies of any known mineral or nutrients as well as use natural known nutritional complements that improve energy production such as Magnesium, coq10, carnitine, alpha lipoic acid, omega three fatty acids

  • Detoxify your body. This is very important

  • A juice fast is a great way to detoxify your body.

  • Eliminate any known toxins from your body such as mercury

  • Lose weight

  • Always remember the fundamentals to great health

  • Get enough rest and sleep

  • Exercise

  • Drink enough water

  • Lastly, avoid stimulants and energy drinks. Many find themselves using energy drinks, or coffee to remain alert, alcohol, sugar or even medications to sleep especially if they have tried to rest and not gotten any relief. These give you a false sense of energy but can quickly cause dependence and even addiction.

So, I think the key message from this article is that many people suffer from fatigue and if you are one of them you are not alone. It is something that can affect anyone. We must know that fatigue should not always be brushed off as simply being lack of rest or overworking. Sometimes fatigue could be a sign of something more serious, but almost always it can be managed.

It is important that we know and accept when it is time to get help. I recommend you see a functional medicine practitioner like myself to help you if you are struggling with fatigue.

I hope this information has been helpful to you. Please do share it.

I encourage you to follow me on twitter if you don’t already do for more health tips and updates.

Wishing you health and happiness.

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