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Fatigue 

Definition

Fatigue is physical and/or mental exhaustion that can be triggered by stress, medication, overwork, or mental and physical illness or disease.

Description

Everyone experiences fatigue occasionally. It is the body's way of signaling its need for rest and sleep. But when fatigue becomes a persistent feeling of tiredness or exhaustion that goes beyond normal sleepiness, it is usually a sign that something more serious is amiss.

Physically, fatigue is characterized by a profound lack of energy, feelings of muscle weakness, and slowed movements or central nervous system reactions. Fatigue can also trigger serious mental exhaustion. Persistent fatigue can cause a lack of mental clarity (or feeling of mental "fuzziness"), difficulty concentrating, and in some cases, memory loss.

Causes and symptoms

Fatigue may be the result of one or more environmental causes such as inadequate rest, improper diet, work and home stressors, or poor physical conditioning, or one symptom of a chronic medical condition or disease process in the body. Heart disease, low blood pressure, diabetes, end-stage renal disease, iron-deficiency anemia, narcolepsy, and cancer can cause long-term, ongoing fatigue symptoms. Acute illnesses such as viral and bacterial infections can also trigger temporary feelings of exhaustion. In addition, mental disorders such as depression can also cause fatigue.

A number of medications, including antihistamines, antibiotics, and blood pressure medications, may cause drowsiness as a side-effect. Individuals already suffering from fatigue who are prescribed one of these medications may wish to check with their healthcare provider about alternative treatments.

Extreme fatigue which persists, unabated, for at least six months, is not the result of a diagnosed disease or illness, and is characterized by flu-like symptoms such as swollen lymph nodes, sore throat, and muscle weakness and/or pain may indicate a diagnosis of chronic fatigue syndrome. Chronic fatigue syndrome (sometimes called chronic fatigue immune deficiency syndrome), is a debilitating illness that causes overwhelming exhaustion and a constellation of neurological and immunological symptoms. Between 1.5 and 2 million Americans are estimated to suffer from the disorder.

Diagnosis

Because fatigue is a symptom of a number of different disorders, diseases, and lifestyle choices, diagnosis may be difficult. A thorough examination and patient history by a qualified healthcare provider is the first step in determining the cause of the fatigue. A physician can rule out physical conditions and diseases that feature fatigue as a symptom, and can also determine if prescription drugs, poor dietary habits, work environment, or other external stressors could be triggering the exhaustion. Several diagnostic tests may also be required to rule out common physical causes of exhaustion, such as blood tests to check for iron-deficiency anemia.

Diagnosis of chronic fatigue syndrome is significantly more difficult. Because there is no specific biological marker or conclusive blood test to check for the disorder, healthcare providers must rely on the patient's presentation and severity of symptoms to make a diagnosis. In many cases, individuals with chronic fatigue syndrome go through a battery of invasive diagnostic tests and several years of consultation with medical professionals before receiving a correct diagnosis.

Treatment

Conventional medicine recommends the dietary and lifestyle changes outlined above as a first line of defense against fatigue. Individuals who experience occasional fatigue symptoms may benefit from short term use of caffeine-containing central nervous stimulants, which make people more alert, less drowsy, and improve coordination. However, these should be prescribed with extreme caution, as overuse of the drug can lead to serious sleep disorders, like insomnia.

Another reason to avoid extended use of caffeine is its associated withdrawal symptoms. People who use large amounts of caffeine over long periods build up a tolerance to it. When that happens, they have to use more and more caffeine to get the same effects. Heavy caffeine use can also lead to dependence. If an individual stops using caffeine abruptly, withdrawal symptoms may occur, including headache, fatigue, drowsiness, yawning, irritability, restlessness, vomiting, or runny nose. These symptoms can go on for as long as a week.

Alternative treatment

The treatment of fatigue depends on its direct cause, but there are several commonly prescribed treatments for non-specific fatigue, including dietary and lifestyle changes, the use of essential oils and herbal therapies, deep breathing exercises, traditional Chinese medicine, and color therapy.

Dietary changes

Inadequate or inappropriate nutritional intake can cause fatigue symptoms. To maintain an adequate energy supply and promote overall physical well-being, individuals should eat a balanced diet and observe the following nutritional guidelines:

• Drinking plenty of water. Individuals should try to drink 9 to 12 glasses of water a day. Dehydration can reduce blood volume, which leads to feelings of fatigue.
• Eating iron-rich foods (i.e., liver, raisins, spinach, apricots). Iron enables the blood to transport oxygen throughout the tissues, organs, and muscles, and diminished oxygenation of the blood can result in fatigue.
• Avoiding high-fat meals and snacks. High fat foods take longer to digest, reducing blood flow to the brain, heart, and rest of the body while blood flow is increased to the stomach.
• Eating unrefined carbohydrates and proteins together for sustained energy.
• Balancing proteins. Limiting protein to 15-20 grams per meal and two snacks of 15 grams is recommended, but not getting enough protein adds to fatigue. Pregnant or breastfeeding women should get more protein.
• Getting the recommended daily allowance of B complex vitamins (specifically, pantothenic acid, folic acid, thiamine, and vitamin B₁₂). Deficiencies in these vitamins can trigger fatigue.
• Getting the recommended daily allowance of selenium, riboflavin, and niacin. These are all essential nutritional elements in metabolizing food energy.
• Controlling portions. Individuals should only eat when they're hungry, and stop when they're full. An overstuffed stomach can cause short-term fatigue, and individuals who are overweight are much more likely to regularly experience fatigue symptoms.

Lifestyle changes

Lifestyle factors such as a high-stress job, erratic work hours, lack of social or family support, or erratic sleep patterns can all cause prolonged fatigue. If stress is an issue, a number of relaxation therapies and techniques are available to help alleviate tension, including massage, yoga, aromatherapy, hydrotherapy, progressive relaxation exercises, meditation, and guided imagery. Some individuals may also benefit from individual or family counseling or psychotherapy sessions to work through stress-related fatigue that is a result of family or social issues.

Maintaining healthy sleep patterns is critical to proper rest. Having a set "bedtime" helps to keep sleep on schedule. A calm and restful sleeping environment is also important to healthy sleep. Above all, the bedroom should be quiet and comfortable, away from loud noises and with adequate window treatments to keep sunlight and streetlights out. Removing distractions from the bedroom such as televisions and telephones can also be helpful.

Essential oils

Aromatherapists, hydrotherapists, and other holistic healthcare providers may recommend the use of essential oils of rosemary (Rosmarinus officinalis), eucalyptus blue gum (Eucalyptus globulus), peppermint, (Mentha x piperata), or scots pine oil (Pinus sylvestris) to stimulate the nervous system and reduce fatigue. These oils can be added to bathwater or massage oil as a topical application. Citrus oils such as lemon, orange, grapefruit, and lime have a similar effect, and can be added to a steam bath or vaporizer for inhalation.

Herbal remedies

Herbal remedies that act as circulatory stimulants can offset the symptoms of fatigue in some individuals. An herbalist may recommend an infusion of ginger (Zingiber officinale) root or treatment with cayenne (Capsicum annuum), balmony (Chelone glabra), damiana (Turnera diffusa), ginseng (Panax ginseng), or rosemary (Rosmarinus officinalis) to treat ongoing fatigue.

An infusion is prepared by mixing the herb with boiling water, steeping it for several minutes, and then removing the herb from the infusion before drinking. A strainer, tea ball, or infuser can be used to immerse loose herb in the boiling water before steeping and separating it. A second method of infusion is to mix the loose herbal preparation with cold water first, bringing the mixture to a boil in a pan or teapot, and then separating the tea from the infusion with a strainer before drinking.

Caffeine-containing central nervous system stimulants such as tea (Camellia senensis) and cola (Cola nitida) can provide temporary, short-term relief of fatigue symptoms. However, long-term use of caffeine can cause restlessness, irritability, and other unwanted side effects, and in some cases may actually work to increase fatigue after the stimulating effects of the caffeine wear off. To avoid these problems, caffeine intake should be limited to 300 mg or less a day (the equivalent of 4-8 cups of brewed, hot tea).

Traditional chinese medicine

Chinese medicine regards fatigue as a blockage or misalignment of qi, or energy flow, inside the human body. The practitioner of Chinese medicine chooses acupuncture and/or herbal therapy to rebalance the entire system. The Chinese formula Minot Bupleurum soup (or Xiao Chia Hu Tang) has been used for nearly 2,000 years for the type of chronic fatigue that comes after the flu. In this condition, the person has low-grade fever, nausea, and fatigue. There are other formulas that are helpful in other cases. Acupuncture involves the placement of a series of thin needles into the skin at targeted locations on the body known as acupoints in order to harmonize the energy flow within the human body.

Deep breathing exercises

Individuals under stress often experience fast, shallow breathing. This type of breathing, known as chest breathing, can lead to shortness of breath, increased muscle tension, inadequate oxygenation of blood, and fatigue. Breathing exercises can both improve respiratory function and relieve stress and fatigue.

Deep breathing exercises are best performed while laying flat on the back on a hard surface, usually the floor. The knees are bent, and the body (particularly the mouth, nose, and face) is relaxed. One hand should be placed on the chest and one on the abdomen to monitor breathing technique. With proper breathing techniques, the abdomen will rise further than the chest. The individual takes a series of long, deep breaths through the nose, attempting to raise the abdomen instead of the chest. Air is exhaled through the relaxed mouth. Deep breathing can be continued for up to 20 minutes. After the exercise is complete, the individual checks again for body tension and relaxation. Once deep breathing techniques have been mastered, an individual can use deep breathing at any time or place as a quick method of relieving tension and preventing fatigue.

Color therapy

Color therapy, also known as chromatherapy, is based on the premise that certain colors are infused with healing energies. The therapy uses the seven colors of the rainbow to promote balance and healing in the mind and body. Red promotes energy, empowerment, and stimulation. Physically, it is thought to improve circulation and stimulate red blood cell production. Red is associated with the seventh chakra, located at the root; or base of spine. In yoga, the chakras are specific spiritual energy centers of the body.

Therapeutic color can be administered in a number of ways. Practitioners of Ayurvedic, or traditional Indian medicine, wrap their patients in colored cloth chosen for its therapeutic hue. Individuals suffering from fatigue would be wrapped in reds and oranges chosen for their uplifting and energizing properties. Patients may also be bathed in light from a color filtered light source to enhance the healing effects of the treatment.

Individuals may also be treated with color-infused water. This is achieved by placing translucent red colored paper or colored plastic wrap over and around a glass of water and placing the glass in direct sunlight so the water can soak up the healing properties and vibrations of the color. Environmental color sources may also be used to promote feelings of stimulation and energy. Red wall and window treatments, furniture, clothing, and even food may be recommended for their energizing healing properties.

Color therapy can be used in conjunction with both hydrotherapy and aromatherapy to heighten the therapeutic effect. Spas and holistic healthcare providers may recommend red color baths or soaks, which combine the benefits of a warm or hot water soak with energizing essential oils and the fatigue-fighting effects of bright red hues used in color therapy.

Prognosis

Fatigue related to a chronic disease or condition may last indefinitely, but can be alleviated to a degree through some of the treatment options outlined here. Exhaustion that can be linked to environmental stressors is usually easily alleviated when those stressors are dealt with properly.

There is no known cure for chronic fatigue syndrome, but steps can be taken to lessen symptoms and improve quality of life for these individuals while researchers continue to seek a cure.

Prevention

Many of the treatments outlined above are also recommended to prevent the onset of fatigue. Getting adequate rest and maintaining a consistent bedtime schedule are the most effective ways to combat fatigue. A balanced diet and moderate exercise program are also important to maintaining a consistent energy level.

Resources

Books

Davis, Martha, et al. The Relaxation & Stress Reduction Workbook. 4th ed. Oakland, CA: New Harbinger Publications, Inc., 1995.

Hoffman, David. The Complete Illustrated Herbal. New York: Barnes & Noble Books, 1999.

Key terms

Aromatherapy — The therapeutic use of plantderived, aromatic essential oils to promote physical and psychological well-being.

Guided imagery — The use of relaxation and mental visualization to improve mood and/or physical well-being.

Hydrotherapy — Hydrotherapy, or water therapy, is use of water (hot, cold, steam, or ice) to relieve discomfort and promote physical well-being.

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fatigue /fa·tigue/ (fah-tēg´) a state of increased discomfort and decreased efficiency due to prolonged or excessive exertion; loss of power or capacity to respond to stimulation.

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vocal fatigue  phonasthenia.

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fa·tigue (f-tg)

n.

1. Physical or mental weariness resulting from exertion.

2. A sensation of boredom and lassitude due to absence of stimulation, to monotony, or to lack of interest in one's surroundings.

3. The decreased capacity or complete inability of an organism, organ, or part to function normally because of excessive stimulation or prolonged exertion.

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fatigue

[fətēg′]

Etymology: L, fatigare, to tire

1 a state of exhaustion or a loss of strength or endurance, such as may follow strenuous physical activity.

2 loss of ability of tissues to respond to stimuli that normally evoke muscular contraction or other activity. Muscle cells generally require a refractory or recovery period after activity, when cells restore their energy supplies and excrete metabolic waste products.

3 an emotional state associated with extreme or extended exposure to psychic pressure, as in battle or combat fatigue.

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fatigue,

n a condition of cells or organs under stress, resulting in a diminution or loss of an individual's capacity to respond to stimulation.

fatigue, dental materials,

n dysfunction due to damage caused by recurring use or stress.

fatigue, muscle,

n a peripheral phenomenon caused by the failure of the muscle to contract when stimuli from the nervous system reach it. Occurs when muscle activity exceeds tissue substrate and oxygenation capacity.

fatigue strength,

n the ability of a material to withstand repeated stress. In dental work, the fatigue strength of materials used in fillings and dentures is an important consideration because patients will repeatedly stress their fillings and dentures when eating.

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fatigue

a state of increased discomfort and decreased efficiency resulting from prolonged exertion; a generalized feeling of tiredness or exhaustion; loss of power or capacity to respond to stimulation. Fatigue is a normal reaction to intense physical exertion, emotional strain or lack of rest. Fatigue that is not relieved by rest may have a more serious origin. It may be a sign of generally poor physical condition or of specific disease.

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fatigue

Medtalk A state of mental and/or physical exhaustion, which is often understood to be unusual for the affected person. See Chronic fatigue, Driver fatigue, Nightshift fatigue, Taste fatigue.

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Patient discussion about fatiguing.

Q. What are the Symptoms of Anemia? Lately I've been feeling very tired. My friend suggested I might be anemic. What are the major symptoms of anemia?

A. The symptoms of anemia vary according to the type of anemia, the underlying cause, and any underlying health problems. Anemia may be associated with other medical conditions such as hemorrhage, ulcers, menstrual problems or cancer -- and specific symptoms of those conditions may be noticed first.

The body also has a remarkable ability to compensate for early anemia. If your anemia is mild or developed over a long period of time, you may not notice any symptoms. Symptoms common to many types of anemia include the following:

Easy fatigue and loss of energy
Unusually rapid heart beat, particularly with exercise
Shortness of breath and headache, particularly with exercise
Difficulty concentrating
Dizziness
Pale skin
Leg cramps
Insomnia

Hope this helps.

http://www.webmd.com/a-to-z-guides/understanding-anemia-symptoms

Q. Has anyone tried natural hormones for hypo-thyroidism or fibromyalgia? I am on the low normal range for hypo-thyroidism (do not take meds for) and was diagnosed years ago with fibromyalgia. I take Ultram for the pain which also helps my fatigue factor but I still feel so sluggish sometimes and just want to sleep. I'm on an anti-depressant as it is. I've been hearing more about natural hormone therapy for these conditions and was wondering if anyone out there has tried this.

A. The Ultram and the anti-depressants do that and as for the natural hormone treatments they don't really work. The Gulf War that gave me hypo-thyroid and hypo-prolactimia which is the Pituitary Gland acting up. On top of the fibro,fatique,pain and recovering from arsenic poison I was put on hormone treatments and it made things worse. I blew up like a balloon, I was still tired and it never corrected the problem with my glands. I tried everything out there and I wasn't getting any better until now. A friend of mine told me of this product called Vitalitea and that it could help me.I was desperate to get my health back and boy did I. Go to Ai3global.com/greentea and click on product and wellness and read it. Check out the www on the healing properties of quality green tea and not the stuff you by at the local store. My fatique, and chronic pain is gone. My Fibromyalgia is so, so mild. I do fun things again after 7 year of suffering. You won't regret it. It is all natural.

Q. Has anyone heard of the Fibromyalgia & Fatigue Centers? If so how was your experience? Dear friends, I am unable to sleep for the past few months and I was having disturbed lifestyle. I am terribly upset and have been undergoing huge stress. My whole body is paining and I am literally having sleepless nights. I feel that my muscles are being overworked and pulled over. I can see some weird symptoms and I did consult my doctor and after several tests he did diagnose as fibromyalgia, bad! Has anyone heard of the Fibromyalgia & Fatigue Centers? If so how was your experience?

A. Hi Justin,
I have heard of the treatment centers you are asking about BUT have not persoanally had experince with them. From what I have learned they deal only with Fibromyalgi and are a help to suffers. I am sure you can find more out online or someone her that has experince with them will answer. I have been dealing with the worst of my symptoms for 4 years and it is not an easy condition BUT as you learn more about it you will find some "tricks" to dealing with some of it. I understand the sleepless night, chronic fatigue and the pain! I encourage you to learn more and look nto the treatment centers anything that might help could be worth trying! I wish you the best!