When Should I Call My Doctor About Fatigue
Itâs normal to feel tired now and then. Everyone experiences occasional, brief fatigue due to illness, sleep disturbances, travel or changes in diet or medication. But you should talk to your healthcare provider if youâre tired all the time. Call your provider if:
- Your fatigue lasts longer than a few days
- Youâre having a hard time going to work or performing daily activities.
- There isnât a clear reason for your fatigue.
- It comes on suddenly.
- Youâre older .
- Youâve also been losing weight.
Fatigue can be a sign of a serious health condition. You should seek immediate medical attention if you have fatigue along with other symptoms, such as:
- Shortness of breath or pain in your chest, arm or upper back.
- Fast, pounding, fluttering or irregular heartbeat.
- Headache or vision problems .
- Nausea, vomiting or abdominal pain.
- Muscle weakness.
Brain Areas And Neurotransmitters
Several brain areas are associated with modulating fatigue , although this area of research remains poorly investigated. These brain areas function through neurons and glia to release neurotransmitters . Neurotransmitters, especially monoamines, are potent at producing arousal, wakefulness, and motivation to perform activities when desired . Dopamine, norepinephrine, epinephrine, glutamate, and histamine are excitatory transmitters. Serotonin and gamma-aminobutyric acid are inhibitory neurotransmitters that prevent neuron signals from continuing . There are many redundancies in the actions of these neurotransmitters, although there are also unique characteristics for receptors on the cells and brain areas that neurotransmitters act upon, as well as functional differences that exist based on the prior state of the brain cells and the concentration of the neurotransmitters. Inflammatory molecules are affected by neurotransmitters and vice versa , which can lead to behavior changes including those affecting fatigue.
How To Work With Your Doctor To Understand Fatigue
While fatigue is a common experience, Dr. Berman believes both patients and healthcare professionals do not know enough about how to manage fatigue well.
Dr. Berman said doctors generally do not do a good job addressing their lupus patients’ concern about fatigue because many other important medical issues seem to take priority during each appointment. One way to make sure they are addressed is to talk about it at the beginning of the appointment. Here are some of the questions she asks her patients to get an idea of what to discuss with your doctor:
Dr. Berman said it’s important to help your doctor prioritize during your visits. She suggested writing down the top one or two issues you want to talk to your doctor about and bringing them up in the beginning of your visit, so it can focus the appointment.
In summary, there are several ways your doctor can help you manage your fatigue. The first is to look for and treat any other medical conditions that may be contributing to it. Secondly, it is important to examine your current medications and the possibility that one of them is contributing to fatigue . In addition, if you are suffering from insomnia, your doctor may want to prescribe a sleep agent. Some doctors may add an “activating” medicine, such as Wellbutrin or Provigil, to improve your ability to function with fatigue. In some situations getting more exercise may be beneficial as well. Again, talk to your doctor about your individual case of lupus and fatigue.
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When To See A Healthcare Provider
If you’re worried you may be experiencing symptoms of an autoimmune condition, be sure to see a healthcare provider for a comprehensive evaluation, which will include a thorough physical examination, blood tests, and possibly imaging tests.
If your primary care or family healthcare provider suspects an autoimmune process, you will likely be referred to a specialist, such as a rheumatologist , an endocrinologist , or a gastroenterologist .
How Would You Describe Fatigue Associated With Pots
People with POTS experience fatigue differently. Many describe it as feeling beyond exhausted. Its as if your energy is completely depleted. The fatigue is probably hundreds of times worse than your worst flu. People with POTS may also have trouble concentrating and thinking straight. Doing simple tasks may feel like youve just run a marathon.
This fatigue might come and go, hitting you without warning daily, weekly or less frequently. For some people, extreme fatigue lasts for days. Others may experience periodic attacks. It can come on at any moment even if you just woke up. And there is no amount of sleep or coffee that can make it go away.
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Treat Underlying Conditions That May Cause Fatigue
âFatigue with lupus is sometimes caused by an underlying medical problem, such as anemia, fibromyalgia, depression, or a kidney or thyroid problem. And in some cases, it can be a side effect of medication,â says Meenakshi Jolly, MD, MS, director of the Rush Lupus Clinic and assistant professor of medicine and behavioral medicine at Rush University. âIn these cases, we can often treat the fatigue by treating the condition or changing the patientâs medication.â
Ask your doctor to check if your fatigue may be related to another condition or a medication. If it is, find out about treatment.
Mixed Connective Tissue Disease
This disease actually includes characteristics of three other connective tissue disorders: scleroderma, polymyositis and systemic lupus erythematosus. It can have a wide variety of symptoms when it first develops, including fatigue, joint pain, muscle pain and others. The temporary loss of blood supply to the extremities known as Raynauds syndrome is also common. It tends to be diagnosed most often in young women.
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Eosinophilic Granulomatosis With Polyangiitis
Formerly known as Churg Strauss syndrome, this autoimmune disease is characterized by elevated levels of white blood cells called eosinophils, which often leads to inflammation in blood vessels. That, in turn, can lead to damage in the lungs, kidney, heart and other systems in the body. Most people with this disease have asthma and allergy symptoms first.
Rheumatoid Arthritis And Fatigue
Symptoms: Fatigue, morning stiffness, joint pain, inflamed joints
Rheumatoid arthritis , a type of inflammatory arthritis, is another cause of excessive fatigue. Because joint damage can result in disability, early and aggressive treatment is the best approach for rheumatoid arthritis.
Medications that may be used early in mild RA include:
- Nonsteroidal anti-inflammatory drugs
- Disease-modifying antirheumatic drugs
Other drugs used in more serious forms of RA include the anti-cytokine therapies , as well as shots and other forms of treatment.
Other autoimmune disorders, such as lupus and Sjogren’s disease, may also cause fatigue.
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Possible Causes Of Inflammation
Much of the ME/CFS research community takes inflammation as a given. In the alternative name myalgic encephalitis , which has been adopted by some researchers, encephalitis means inflammation of the brain and spinal cord.
Some researchers point to possible inflammatory triggers that don’t involve autoimmunity.
A 2012 study published in Psychiatry Research attempted to separate chronic fatigue, chronic fatigue syndrome, and myalgic encephalitis into different categories. Researchers found that ME patients had higher levels of two specialized immune proteins called cytokines, which promote inflammation. They’re called interleukin-1 and tumor necrosis factor-alpha. They also found elevated levels of neopterin, which is an indicator of pro-inflammatory immune activity.
More recently, studies have shown that inflammatory markers can accurately distinguish ME/CFS from depression or sickness behaviors.
A study published in Metabolic Brain Disease is just one of a growing body considering oxidative and nitrosative stress coupled with low antioxidant levels as a possible mechanism of ME/CFS, suggesting that these factors could point to an immuno-inflammatory pathology.
Other researchers have suggested that certain pathogens may, in predisposed people, trigger a chronic immune activation, which would create chronic inflammation and a cascade of problems. One of the main suspects in this scenario is the Epstein-Barr virus, which causes mononucleosis .
What Type Of Blood Tests Are Used To Diagnose Autoimmune Diseases
Several different blood tests may be used to diagnose an autoimmune disease. In addition to a regular complete blood count and metabolic panel, other tests that are likely to be included are anti-dsDNA, anti-RNP, anti-Sm, anti-Sjogren’s SSA and SSB, anti-scleroderma, anti-Jo-1, anti-CCP, antibody against cardiolipin, and an antinuclear antibody test. A rheumatoid factor test, which looks for rheumatoid arthritis, is also usually included during the diagnostic phase. The antinuclear antibody test looks for antibodies that could cause an autoimmune response.
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Profound Debiliating Fatigue Found To Be A Major Issue For Autoimmune Disease Patients In New National Survey
- American Autoimmune Related Diseases Association
- Fatigue is a major component of autoimmune disease research team has found. Fatigue described as “profound,” “debilitating,” and “preventing them from doing the simplest everyday tasks,” is a major issue for autoimmune disease patients, impacting nearly every aspect of their lives.
Fatigue described as “profound,” “debilitating,” and “preventing them from doing the simplest everyday tasks,” is a major issue for autoimmune disease patients, impacting nearly every aspect of their lives. It affects their mental and emotional well-being and their ability to work. And while most AD patients have discussed their fatigue with their physicians, many have not been prescribed treatment for their fatigue.
Those are among the major findings of a new online survey of autoimmune disease patients conducted by the American Autoimmune Disease Related Diseases Association , the nation’s only not-for-profit autoimmune disease patient advocacy organization, to examine the connection between autoimmune disease and fatigue. AARDA released the findings of the survey of 7,838 AD patients at a national summit held to commemorate National Autoimmune Disease Awareness Month at the National Press Club in Washington, D.C.
Major findings include:
Almost all AD patients surveyed report they suffer from fatigue.
Nine-in-10 say it is a “major issue” for them and six-in-10 say it is “probably the most debilitating symptom of having an AD.”
Fatigue Gerd Itchy Skin Brain Fog Are You Experiencing Autoimmune Disease Symptoms
Last weekend I was able to attend a wonderful seminar on auto-immune disease and its relation specifically to stress. As someone who has suffered with auto-immune response to stress for the last 12 years this just boosted my belief that it is one of the most serious and substantial causes of inflammation and chronic disease that we have today. For me it was diagnosed in the form of Hashimoto’s or Auto-immune Thyroiditis.
What is auto-immune disease? Autoimmune conditions are connected by one central biochemical process: A runaway immune response also known as systemic inflammation that results in your body attacking its own tissues. We are facing an epidemic of allergic , asthmatic , and autoimmune disorders . Autoimmune diseases include rheumatoid arthritis, lupus, multiple sclerosis, psoriasis, celiac disease, thyroid disease, and the many other hard-to-classify syndromes in the 21st century.
Your immune system is your defense against invaders. It is your internal army and has to clearly distinguish friend from foe to know you from others. Autoimmunity occurs when your immune system gets confused and your own tissues get caught unrecognized and then are under attack.
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Sleep Disorders And Fatigue
Symptoms: Chronic fatigue, feeling exhausted upon awakening, snoring
Sleep disorders are a group of conditions that disrupt or prevent restful, restorative sleep. That can take a toll on your health and quality of life, so its important to look out for signs and symptoms.
Sleep apnea is one of the most common sleep disorders. If you or your partner notices loud snoring and you wake up tired and stay that way, you could have sleep apnea. More than one-third of adults in the U.S. snore at least a few nights a week. But if the snoring stops your breathing for seconds at a time, it could be sleep apnea. Learn more about the best sleep positions and see if sleeping on your stomach is bad or not.
Obstructive sleep apnea causes low blood oxygen levels. That’s because blockages prevent air from getting to the lungs. The low oxygen levels also affect how well your heart and brain work. Sometimes, the only clue that you might have sleep apnea is chronic fatigue.
Your doctor may prescribe a medical device called CPAP that helps keep your airways open while you sleep. In severe cases of sleep apnea, surgery may help. The surgeon will remove tissues that are blocking the airways. If left untreated, sleep apnea can increase your risk of a stroke or heart attack.
But sleep apnea is just one of many sleep disorders that cause fatigue. Other common types include:
What Is Pots And Why Does It Cause Fatigue
POTS is a group of symptoms resulting from dysfunction of the autonomic nervous system. This branch of the nervous system regulates functions we dont consciously control like sweating and blood circulation.
In people with POTS, more blood collects in the lower body when standing upright. The heart beats faster to pump it up to the brain, but with little success. The causes of POTS are unknown, but the problem is thought to lie in the communication breakdown between the brain and the cardiovascular system.
POTS-related fatigue is physical in nature and the mechanism behind it is not fully understood. It may have several causes, including your body working harder to move the blood.
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What Does Fatigue Have To Do With It
I just had a blood test to check my iron levels and it got me thinking about an often overlooked issue in autoimmune diseaseFATIGUE!
Have you ever felt the fatigue of autoimmunity, but havent received answers or options to manage and improve your symptoms?
Fatigue in autoimmunity means symptoms of tiredness and exhaustion that do not improve with rest. Symptoms of fatigue can interfere with everyday life. You might experience brain fog, exercise intolerance, and headaches.
I was first diagnosed with inflammatory arthritis over 12 years ago. I was happy to finally have a reason to explain all of the random joint pain I was experiencing. I was not, however, prepared for the fatigue and brain fog that would follow me as a constant reminder of my disease.
When I asked my medical team about it, I received the frustrating response that it was just part of life with an autoimmune disease. Fatigue can be a confusing and often overlooked aspect of your disease, but it shouldnt have to be!
When we dig deep, there are several root causes we can uncover for fatigue that actually have solutions!
When I talk about fatigue, Im not talking about Chronic Fatigue Syndrome. This is an autoimmune disease that can lead to debilitating exhaustion and a host of other symptoms. This deserves mention, because its something to have ruled out as a root cause of your fatigue with your medical practitioner.
Neurovascular Unit And Vasohemodynamics
Diagram of the neurovascular unit in modulating vasohemodynamics. The neurovascular unit at the level of the cerebral microvasculature including the arterioles and capillaries is comprised of endothelial cells, smooth muscle, astrocytes, neurons, pericytes, and is modulated by surrounding microglia and perivascular macrophages. Additionally, alterations in metabolism and inflammation can modulate astrocyte end-feet to modulate cerebral blood flow . The neurovascular unit modulates blood flow throughout the brain and is regulated by energy needs of the surrounding cells and the vasoconstrictive, such as catecholamines and dopamine, and vasodilative factors, such as IL-1, TNF-, and adenosine, that are released by these cells. Pro-inflammatory molecules tend to be vasodilative, reduce vascular resistance, and increase cerebral CBF, while monoamines released by neurons have both vasodilative and vasoconstrictive properties, which can influence blood flow. Vasoconstrictive substances typically increase vascular resistance and reduce CBF.
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Common Autoimmune Disease Symptoms
Despite the varying types of autoimmune disease, many of them share similar symptoms. Common symptoms of autoimmune disease include:
- Abdominal pain or digestive issues
- Recurring fever
- Swollen glands
Many women say its hard to get diagnosed, something that Orbai agrees with. Its not black or white, she says. Theres usually no single test to diagnose autoimmune disease. You have to have certain symptoms combined with specific blood markers and in some cases, even a tissue biopsy. Its not just one factor.
Diagnosis can also be difficult because these symptoms can come from other common conditions. Orbai says women should seek treatment when they notice new symptoms.
If youve been healthy and suddenly you feel fatigue or joint stiffness, dont downplay that, she says. Telling your doctor helps him or her to look closer at your symptoms and run tests to either identify or rule out autoimmune disease.
Autoimmune Disease: Why Is My Immune System Attacking Itself?
Autoimmune disease affects 23.5 million Americans, and nearly 80 percent of those are women. If you’re one of the millions of women affected by this group of diseases, which includes lupus, rheumatoid arthritis and thyroid disease, you may be wondering why your immune system is attacking itself.
Are Chronic Fatigue Syndrome And Fibromyalgia Autoimmune Diseases
Chronic fatigue syndrome, also known as myalgic encephalomyelitis, or ME/CFS, and fibromyalgia are not autoimmune diseases. But they often have symptoms of some autoimmune disease, like being tired all the time and pain.
- ME/CFS can cause you to be very tired, have trouble concentrating, feel weak, and have muscle pain. Symptoms of ME/CFS come and go. The cause of ME/CFS is not known.
- FM is a disorder in which pain or tenderness is felt in multiple places all over the body. These “tender points” are located on the neck, shoulders, back, hips, arms, and legs and are painful when pressure is applied to them. Other symptoms include fatigue, trouble sleeping, and morning stiffness. FM mainly occurs in women of childbearing age. But children, the elderly, and men are sometimes can also get it. The cause is not known.
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