Chronic fatigue treatment

Fatigue

Fatigue, also called asthenia and commonly known as tiredness, refers to a subjective feeling of exhaustion occurring spontaneously or following physical or mental activity.

What is fatigue?

Fatigue, also called asthenia and commonly known as tiredness, refers to a subjective feeling of exhaustion occurring spontaneously or following physical or mental activity. Fatigue is one of the most common symptoms among the general population attending medical consultations; it places a significant burden on healthcare in both primary care and specialised medicine, as most patients experiencing fatigue consult multiple specialists without receiving an accurate diagnosis or fully effective treatment, often receiving only palliative care. There is currently a significant gap in healthcare in Spain in terms of multidisciplinary teams dedicated to managing fatigue, despite its importance as a common reason for medical consultations. It is important to distinguish between two types of fatigue: on one hand, whether the fatigue is continuous or fluctuates throughout the day (constant fatigue without fluctuations); and, on the other hand, fatigue in which the patient ‘runs out of batteries’ (known as energy slumps). The causes are multiple and range from an excess of physical or intellectual work, sleep deprivation, endocrine imbalances, anaemia, cardiovascular diseases, the side effects of certain medicines, the consumption of alcohol and drugs, oncological processes, affective disorders such as depression and anxiety, stress, chronic pain… to name just the most common ones.

InstituteMYM would like to remind you that today, living without fatigue is possible.

How do we diagnose fatigue?

Diagnosis always starts with a thorough medical history and a detailed physical examination by an internal medicine specialist. These two tools allow us to assess fatigue (make a presumptive diagnosis) and request additional complementary tests. The core aspects identified during the first clinical interview form the basis for a complete differential diagnosis. Among the main causative factors are:

1. Lifestyle habits: for patients experiencing fatigue, it is very useful to assess how well and how long they sleep. Is the sleep restorative? Or does the patient present daytime hypersomnia?
2. Temporal factors: when it is chronic, it is important to ask if it is associated with muscle pain; and if weakness accompanies fatigue, it warrants investigation for a broad spectrum of rheumatic diseases.
3. Constitutional factors: when associated with involuntary weight loss, loss of muscle mass, fatigue, fever, chills, night sweats or lack of appetite, the possibility of a more serious organic condition (e.g. cancer, infection) must be considered.
4. Infectious factors: viruses such as hepatitis B and C, Epstein-Barr, cytomegalovirus and parvovirus B19 stand out as causes of chronic conditions.
5. Internal factors: impairment of vital organs such as the heart (heart failure), lungs (respiratory failure in initial stages, asthma), liver (liver diseases, fatty liver), kidney (early-stage kidney failure), and anaemic syndromes (anaemias and their precipitating factors).
6. Hormonal and endocrine factors: diabetes, vitamin D deficiencies, hypothyroidism, adrenal insufficiency (Addison’s disease), and male hormone deficiency (hypogonadism) in men should be evaluated.
7. Unrecognised early stages of pregnancy can also be accompanied by fatigue and may be a reason for seeking medical consultation.

In such cases, a series of additional tests are typically initiated. Depending on the patient’s medical history and physical examination, the following tests may be requested individually, based on the initial diagnostic orientation rather than routinely: chest X-ray, electrocardiogram, and complete blood and urine analysis.

At instituteMYM, we specialise in diagnosing and treating fatigue

How do we treat fatigue?

Treatment is developed individually based on the findings from the medical history, physical examination, and complementary test results. Treatment includes correcting or managing endocrine disorders (diabetes, hypothyroidism, adrenal insufficiency, male hormone deficiency), supplementing vitamin deficits, specifically treating rheumatological diseases, or addressing depressive syndromes. To provide effective treatment for fatigue, it is essential to understand the patient’s biopsychosocial context in order to develop a personalised therapeutic plan. Such a therapeutic plan is much more effective if developed by a multidisciplinary team (various specialists addressing other factors that frequently accompany fatigue, such as stress and pain). Regular follow-up and control are fundamental and must be carried out by the entire multidisciplinary team to prevent new fatigue crises. At the same time, we can use many personalised therapies, such as physiotherapy, nutrition, psychology, and psychopharmacology, as well as acupuncture as a neuromodulation technique, all aimed at helping the patient to ‘recharge their batteries’.

At instituteMYM, we can improve your fatigue.