How Is Chronic Fatigue Syndrome Diagnosed
Right now, there’s no test to tell if someone has chronic fatigue syndrome. Doctors ask a lot of questions . They also will do a thorough physical exam.
Doctors also usually order blood, urine , or other tests to check for conditions that cause similar symptoms. They may send a person to see other specialists to help with the diagnosis.
A doctor may suggest meeting with a psychologist or a therapist who can see whether mental health disorders might contribute to or mask CFS.
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.
Primary Or True Muscle Weakness
This shows itself as an inability to perform what you want to do with a muscle, even the first time you try. There is a reduction in the force which the muscle can exert, however hard you try. The muscle is not working properly – it has become abnormal.
When this kind of weakness occurs the muscles are often floppier than usual and reduced in bulkiness. It can happen, for example, following stroke. It is also seen in a condition called muscular dystrophy . Both of these conditions result in weakened muscles which cannot move the usual load. It’s a real change in muscle power.
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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:
Fatigue Is Always A Sign Of A Serious Medical Condition
At some point, nearly everyone suffers from fatigue. In most cases, it’s acute fatigue — fatigue that occurs suddenly but lasts less than three months and is usually caused by lifestyle or environmental factors such as physical exertion, stress, lack of sleep, dehydration, or inadequate diet. In most cases, it’s easily treated by addressing the cause: by reducing stress getting more rest, sleep, or better nutrition or hydrating properly.
Chronic fatigue lasts longer — for more than a few months — and it’s more likely to be associated with an underlying medical condition.
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What Percentage Of Patients Complain To Their Primary Care Doctor About Fatigue That Interferes With Their Daily Lives
Fatigue is one of the most common complaints in medicine, accounting for an estimated 10 million doctor office visits each year.
Because fatigue is a common feature of everyday life but also a common symptom of so many different medical conditions, it can be difficult for doctors to properly assess and treat. In many cases, the most important medical response to persistent fatigue is to get tested for potential underlying physical or psychological medical conditions.
Evaluation Of The Patient With Muscle Weakness
AARON SAGUIL, CPT , MC, USA, Madigan Army Medical Center, Tacoma, Washington
Am Fam Physician. 2005 Apr 1 71:1327-1336.
The online-only version of this article offers more detailed information on additional selected causes of muscle weakness.
Muscle weakness is a common complaint among patients presenting to the family physicians office. Although the cause of weakness occasionally may be apparent, often it is unclear, puzzling the physician and frustrating the patient. A comprehensive evaluation of these patients includes a thorough examination and coordination of appropriate laboratory, radiologic, electrodiagnostic, and pathologic studies.
It is essential to consider depression as a possible diagnosis several screening tools for depression have been validated for use in outpatient settings.
Primary muscle weakness must be distinguished from the more common conditions of fatigue and asthenia.
If the diagnosis is still inconclusive after the history, physical examination, and laboratory, radiologic, and electromyographic evaluation, a muscle biopsy is required for patients who have a suspected myopathy.
A = consistent, good-quality patient-oriented evidence B = inconsistent or limited-quality patient-oriented evidence C = consensus, disease-oriented evidence, usual practice, opinion, or case series. See page 1245 for more information.
Strength of Recommendations
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Is It Possible That I Have Pots And Was Incorrectly Diagnosed
This is entirely possible. Given how common POTS symptoms are and how unfamiliar many doctors are with this condition, diagnostic mishaps happen. POTS is frequently misidentified as chronic fatigue syndrome, fibromyalgia, myofascial pain syndrome, anxiety disorder, ADHD, irritable bowel syndrome, myositis, etc. It is also possible that you have both POTS and one of these conditions, which may complicate the diagnosis. Sometimes people with POTS are told that its all in your head, implying that the cause of their symptoms is psychological. If you feel like something is physically wrong, dont hesitate to seek a second, and even a third or fourth opinion.
COVID-19 and POTS: Is There a Link?
Although many people recover quickly from COVID-19, the disease caused by the coronavirus, others who recover may continue to experience symptoms for months. Researchers are still determining the cause of these extended symptoms, but some COVID-19 “long-haulers” may actually be dealing with POTS.
Seeing A Sleep Specialist
A sleep specialist will conduct a thorough evaluation and sleep study, in which you are monitored while sleeping, and then develop a treatment plan.
Your better sleep treatment plan may include medication as well as good sleep hygiene techniques â ways to prepare your body for sleep. Avoiding caffeine after lunch, not consuming alcohol within six hours of bedtime, and not smoking or using any type of nicotine product before bedtime are some sleep hygiene techniques. Experts may also teach you relaxation techniques and cognitive therapy, in which you learn to replace sleep worries with positive thoughts.
âWe also use a very powerful technology called âstimulus control,ââ says Auger. Essentially, stimulus control is a behavioral technique that limits the time you spend in bed.
“It teaches people to use the bedroom for sleep and sex, and to leave the bedroom after about 20 minutes if they canât fall asleep and engage in a relaxing activity,â he says. âIt can be as powerful as medications and possibly more powerful in the long term.â
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What Exams Procedures And Tests Diagnose The Cause Of Fatigue
For the evaluation of fatigue, the health care practitioner will take a complete history of the patient’s fatigue, along with questions in regard to associated symptoms. The health care practitioner may inquire about the following activities and symptoms to determine the probable cause of the fatigue:
Quality of Life
Does the level of fatigue remain constant throughout the day? Does the fatigue get worse as the day goes on, or does the fatigue begin at the start of the day? Is there a pattern to the fatigue ? Does the fatigue occur at regular cycles? How is the person’s emotional state? Does the person feel unhappiness or disappointment in life? Sleep pattern determination. How much sleep is the person getting? During what hours does the person sleep? Does the person awake rested or fatigued? How many times does the person awake during sleep? Are they able to fall back asleep? Does the person get regular exercise? Any exercise? Has the person had any new stressors in their life? Change in relationships, jobs, school, or living arrangements? What is the person’s diet? Is there a high intake of coffee, sugar, or excessive amounts of food?
The definitive diagnosis depends on discovering the underlying cause of the fatigue this is determined by evaluating the history, the physical exam and the appropriate test results.
Heart Attack Or Stroke
While you may be on the lookout for chest pain to signal problems with your heart, you should also add sudden-onset fatigue to the list, per the American Heart Association. .
In addition, the AHA points out that fatigue or confusion can be one of the initial symptoms of a stroke. Other signs might include a severe headache, arm weakness and difficulty with walking or talking.
If you have sudden exhaustion along with any other symptoms of a heart attack or stroke, call 911 immediately. In either case, your likelihood of recovery is better the sooner you get treatment.
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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.
What Can You Do For Exhaustion
Here are six tips to help you feel better when you feel overwhelmed by stress and exhausted by life.
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When To Call Your Doctor
If your fatigue prevents you from engaging in work or school, social or personal activities, then you should see your doctor, Dr. Patane says.
“When in doubt, it never hurts to speak to your doctor about this. It can be a simple evaluation, and we may be able to say there’s nothing seriously wrong and suggest lifestyle modifications,” he says. “One of the best ways to get better from fatigue is with good sleep hygiene and by slowly increasing daily exercise.”
Overuse/ Too Much Exercise
Feeling fatigued after vigorous exercise or working for a prolonged period can be normal for the legs. The key is to rest here, because, without proper rest, muscles, including those in the lower body can have a hard time recovering properly.
Enough rest and working within the limits of your body must be made sure. Take plenty of breaks throughout the day, if you frequently use your legs while working out. This will assist in avoiding stress, strain, and injury.
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Where To Get Help
- Your doctor
- Wilson J, Morgan S, Magin P, et al. 2014, Fatigue a rational approach to investigation, Australian Family Physician, vol. 43, no. 7, pp. 457-461, The Royal Australian College of General Practitioners. More information here.
- Fatigue, 2013, MedlinePlus, US National Library of Medicine. More information here.
- Fatigue, Mayo Clinic, USA. More information here.
- Fatigue in the workplace, WorkSafe Victoria. More information here.
Hypothyroidism Tends To Make People Feel Sluggish
Hypothyroidism tends to make people feel tired, sluggish, and depressed.
It is a condition in which the thyroid gland does not make enough thyroid hormone. Inflammation of the thyroid gland is the most common cause. Other symptoms may include hair loss, depression, heavier menstrual periods, weakness, unintentional weight gain and being more sensitive to cold.
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If You Complain Of A Generalized Lack Of Energy You Are Complaining Of:
Fatigue refers to a lack of energy. It is different from weakness, which refers to a loss of strength or power, and drowsiness, because you can feel tired without feeling drowsy or sleepy. Although people sometimes use these terms interchangeably, from a medical perspective the symptoms are distinctly different.
Chronic fatigue is one aspect of the specific medical condition myalgic encephalomyelitis/chronic fatigue syndrome, but ME/CFS involves more than just fatigue. You can have chronic fatigue without having chronic fatigue syndrome. ME/CFS is extreme, long-term fatigue that is associated with other multiple symptoms. Also, in ME/CFS, other possible causes of fatigue have been ruled out.
Myth: Cool Air Can Keep You Awake
Blasting your AC or opening the window may keep you cool, but this does little to counteract drowsiness. Think of how well people sleep on cold winter nights. In fact, keeping your room cool is a commonly given tip for getting better sleep. Playing loud music is also useless in fighting driver fatigue.
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Specific Causes Of New Onset Muscle Weakness
- Polio. A severe spinal cord disease that causes paralysis. It is prevented by the polio virus vaccine. Polio is almost wiped out in the entire world. There have been no cases in the US since 1979. Now, it only occurs in 2 countries.
- Acute Flaccid Myelitis . A rare infection of the spinal cord. It acts like polio did. It causes sudden onset of arm or leg weakness in one or more places. The main cause has been an enterovirus. There has been a rise in cases since 2014.
- West Nile Virus myelitis. See the Mosquito Bite care guide for details. Also acts like polio did.
- Guillain-Barre syndrome. A severe nerve weakness that starts in the feet and moves up the body over several days. It affects the same parts on both sides of the body. It can follow some viral infections.
- Tick paralysis. A rare problem from a tick that has been attached for 5 or more days. Often it is hidden in the hair. Once the tick is removed, the weakness clears. It takes a few hours to a day.
- Poisoning. Some types of poisoning can cause weakness, often with confusion.
- Viral myositis. Muscle pain in the leg muscles is seen with some viral infections, such as influenza. The pain can make some children not want to walk. This is different than weakness. The muscle pain lasts a few days to a week.
A Vitamin Or Nutrient Deficiency
A vitamin deficiency, such as not getting enough vitamin D or vitamin B12, could cause you to feel severely tired, per the Cleveland Clinic. Dehydration can have the same effect.
You could also feel suddenly exhausted if you’ve recently started a high-protein diet. It’s not the protein itself making you tired, but the lack of carbohydrates. Severely restricting carbs causes your body to enter ketosis, where it breaks down fat for energy, per the Mayo Clinic. The side effects of ketosis include fatigue as well as headache, weakness and bad breath.
These side effects are usually temporary, but if ketosis is causing your sudden energy crash, you may want to add more fiber-rich, complex carbohydrates to your diet, such as fruits, vegetables and whole grains like oatmeal and brown rice. The Dietary Guidelines for Americans recommend carbs make up 45 to 65 percent of your total daily calories.
Similarly, skipping meals or following a very low-calorie diet could sap your energy. Keep in mind that people assigned female at birth should avoid eating fewer than 1,200 calories per day, and people assigned male at birth should eat at least 1,500 calories per day, according to Harvard Health Publishing.
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Getting Adequate Rest Can Fight Short
In most cases, chronic fatigue is not substantially improved by rest. Chronic fatigue often makes it more difficult to get adequate rest. Similarly, fatigue can interfere with sleep, resulting in unrefreshing sleep, difficulty falling asleep, frequent awakening, or sleep apnea.
Rest is unlikely to relieve fatigue caused by a medical condition.
How Treating Insomnia Can Improve Depression
The first step to better sleep is to diagnose and treat the sleep disorder and/or the underlying depression. âIf you treat the insomnia in someone with depression, you will improve their chances of achieving remission from the depression,â Auger says.
Your primary care doctor may be able to educate you about sleep habits that will help your insomnia. In some cases, your doctor may treat insomnia with prescription sleeping aids. Some individuals will respond to them. Others may not if they have another underlying sleep disorder such as sleep apnea that is also robbing them of quality sleep.
Your primary care doctor may also refer you to a sleep specialist.
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