Fatigue is extreme tiredness that can manifest as physical weakness or mental ex

haustion. It is characterized by decreased energy, motivation and difficulty con

centrating.
signs and symptoms of fatigue:
Fatigue is a symptom of an underlying disease and is described in many ways from
feeling weak to being constantly tired or lacking energy.
There may be other associated symptoms depending upon the underlying cause.
Individuals with heart disease, lung disease, or anemia may complain of associat
ed shortness of breath or tiring easily with minimal activity.
Persons with diabetes may complain of polyuria (excess urination), polydypsia (e
xcess thirst), or change of vision.
Those who have hypothyroidism may also have symptoms of feeling cold, dry skin a
nd brittle hair.
It is important that the health care professional consider the complaint of fati
gue in the context of the whole patient to try to come to an accurate causative
diagnosis.
cause of fatigue:
The key to finding the cause of fatigue in a patient is the care the health care
professional takes in compiling a medical history. It is important to ask quest
ions not only about the loss of energy but also about other potential problems t
hat the patient may be experiencing such as shortness of breath, sleep patterns,
hair loss, color of the stools, or any of the myriad of questions that might pr
ovide information as to what organ system may be involved.
Usually, a history is taken by the health care professional asking questions abo
ut the quality and quantity of fatigue. Examples of some of the questions the he
alth care professional may ask include:
Does the patient feel well in the morning when they wake?
Does the fatigue progress through the day?
Does the person nap unexpectedly or take excessive amounts of stimulants such as
caffeine to complete daily activities?
Does the fatigue come on gradually or abruptly?
Is it a daily occurrence or intermittent/periodic?
What makes it better and what makes it worse?
How has the patient's life changed because of the fatigue?
Is the fatigue more mental than physical?
Other associated symptoms with fatigue include:
weight loss,
chest pain and shortness of breath,
vomiting and diarrhea,
fevers and chills,
muscle weakness or pain, and/or
anxiety and depression.
It is also appropriate for the health care professional to ask questions about t
he patient's social situation and to also ask about their psychologic state of m
ind. Alcohol and drug abuse screening questions should be expected as routine.
Because fatigue is such a non-specific symptom, each answer may direct the healt
h care professional to explore a different potential cause.

A full physical examination is important to look for underlying signs of illness

. The general appearance of the patient is important looking for hygiene, vital
signs, and evidence of anxiety or agitation. Examination and evaluation of the d
ifferent systems of the body (heart, lungs, abdomen, neurological system, etc.)
and combining any abnormal findings with the clues found in the history taking m
ay help make the diagnosis.
Special attention may be taken to palpate (feel) for an abnormal thyroid gland,
swollen lymph nodes, listen for abnormal heart sounds including murmurs and to c
heck for normal muscle tone and reflexes.
Depending on the findings in the history and physical examination, blood tests a
nd other imaging studies may be ordered. Initial screening blood tests may inclu
de:
CBC (complete blood count that includes a red blood cell, white blood cell and p
latelet count);
electrolytes (sodium potassium, chloride, carbon dioxide, and sometimes calcium
and magnesium);
glucose (blood sugar);
BUN/creatinine (to measure kidney function);
TSH or thyroid stimulating hormone;
monospot;
ferritin;
tests for deficiencies in vitamins B12, D, folic acid, and iron;
CPK (elevated in illnesses that cause muscle inflammation); and/or
ESR or erythrocyte sedimentation rate (non specific blood marker for inflammatio
n in the body).