Tiredness is a symptom extremely common in medical practice, and is generally described by patients as a lack of strength or dismay to do tasks that require effort, whether physical or mental.
Other terms are also commonly used to describe tiredness, such as fatigue, exhaustion, lethargy, drowsiness, weakness, asthenia, lack of energy, mental fatigue, psychological tiredness, or shortness of breath.
Let us make an important distinction: fatigue and shortness of breath are different symptoms. Often both can appear together, as some diseases can occur with both symptoms. But tiredness and shortness of breath are distinct symptoms.
Shortness of breath, called dyspnea in the medical language, is a feeling of difficulty breathing; is the impression that the amount of air entering the lungs is insufficient. Dyspnoea may also manifest as a difficulty in expelling the already breathed air. Tiredness, on the other hand, is the difficulty of undertaking efforts or even minimal tasks such as walking, climbing stairs, or even brushing your teeth or combing your hair in more serious cases.
It is very common for patients with complaints of tiredness not to complain of shortness of breath. On the other hand, it is common for patients who complain of shortness of breath to also show some degree of tiredness.
Punctual fatigue, caused by moderate to intense physical exertion, is perfectly normal and expected. The more physically prepared the individual is, the more resilient he is to fatigue. Sedentary people, especially the obese, may feel tired very easily, sometimes just by taking a longer walk. Physical inactivity and physical inactivity are the most common causes of fatigue in the population. The less physical activity an individual does, but easily the feeling of tiredness arises.
Infectious conditions, especially viral ones, are also causes of short-term fatigue. Tires that last less than 48 hours are not clinically relevant unless they are of great intensity and for no apparent reason.
Tiredness is also common in people who lead a very busy life, with too much work and stress, and little time for leisure and rest. Generally, these are also sedentary people due to lack of time to practice exercises. Despite the sedentary lifestyle, fatigue in this group tends to arise much more from stress, lack of sleep, poor diet, and often from undiagnosed depression or anxiety disorders than from bad physical fitness. This type of tiredness is usually described as mental fatigue.
However, not all tiredness only indicates poor cardiopulmonary conditioning or overwork or stress. There are dozens of diseases that can manifest as chronic fatigue.
Let's briefly talk about 10 common causes of long-term tiredness. If you want more details about each disease, use the links provided to access the specific texts.
1. Hypothyroidism
Hypothyroidism is the name that occurs when the thyroid gland produces an insufficient amount of its hormones, which are responsible for controlling the body's metabolism, that is, the way the body stores and expends energy.
Hypothyroidism is a common cause of fatigue and asthenia; usually associated with other signs and symptoms such as dry skin, constipation, cold intolerance, joint pain, elevated blood cholesterol levels, hair loss and weight gain.
Tiredness of hypothyroidism is permanent and may be present even at rest. There are two components to the fatigue of patients with hypothyroidism: the first is effort intolerance, which makes the patient tired even after small activities; the second is a picture of discouragement, a sense of lack of energy and slowed thinking that occurs even in the absence of physical effort.
When to think that fatigue may be caused by hypothyroidism?
Hypothyroidism should be considered whenever the patient complains of chronic fatigue associated with the following situations:
Heart failure is a disease caused by the inability of the heart to pump blood properly through the body. Basically, this disease is caused by a weak heart, unable to meet the energetic demands required by the body. The main causes of heart failure are myocardial infarction, poorly controlled arterial hypertension, heart valve disease and alcoholism.
There are different degrees of heart failure. In the early stages the patient feels tired only to moderate efforts. As the disease progresses, weariness comes more and more easily, until banal activities such as combing hair and brushing teeth become tiresome. The weakness of the heart causes fluid retention in the body, leading to edema (swelling) in the legs. In later stages, there is also fluid retention in the lungs, which contributes to fatigue and shortness of breath, especially when the patient lies down.
When to think that fatigue may be caused by heart failure?
Heart failure should be considered whenever the patient complains of chronic fatigue associated with the following situations:
Swelling in the legs
Shortness of breath worsens when the patient lies down
Intolerance to moderate or small efforts, which until recently were well tolerated
History of hypertension poorly controlled for many years
History of ischemic heart disease
History of heart valve disease
Tiredness that gradually worsens over months and years
Alcoholism
3. Anemia
Anemia is the disease caused by reducing the concentration of red blood cells (red blood cells), which are the cells responsible for transporting oxygen through the body.
Anemia is a frequent cause of fatigue, and when in advanced degrees it manifests with pallor of the skin and acceleration of resting heart beats.
There are dozens of causes for anemia, the most common being blood loss through the gastrointestinal tract, which leads to iron deficiency anemia. This is a hypothesis that should always be taken into account in the elderly.
When do you think fatigue may be caused by anemia?
Anemia should be considered whenever the patient complains of chronic fatigue associated with the following situations:
Paleness of the skin
Recent blood loss, mainly of gastrointestinal origin
Elderly patients
Intolerance to moderate or small efforts, which until recently were well tolerated
Accelerated heartbeat, even when at rest
4. Chronic renal failure
Chronic renal failure is a name given to the loss of function of the kidneys, which are the organs responsible, among other things, for the filtration of toxins from the blood and for the control of body water volume. Several diseases can lead to kidney failure, the most common being:
Renal insufficiency is usually a silent disease until late stages and can cause fatigue for several reasons. The most important are anemia, accumulation of toxins in the body, blood acidity and malnutrition.
When do you think that fatigue may be caused by chronic renal failure?
Chronic renal failure should be considered whenever the patient complains of chronic fatigue associated with the following situations:
Patients with a history of diabetes mellitus for many years
Pictures of anemia with no apparent cause
Loss of appetite
Recent history of hypertension or recent worsening of existing hypertension
Swelling in the legs
5. Diabetes mellitus
Diabetes mellitus is a disease caused by the body's inability to carry glucose into the blood into cells where it is needed to generate energy. Without glucose, whole body cells "go hungry" and fail to properly perform their functions.
Insulin is the hormone responsible for transporting glucose from the blood to the cells. Type 1 diabetes occurs because of lack of insulin in the blood, while type 2 diabetes occurs due to a malfunction of existing insulin.
Untreated diabetes usually goes through tiredness, weight loss, excess urine and permanent thirst.
When to think that fatigue may be being caused by a diabetes picture?
Diabetes mellitus should be considered whenever the patient complains of chronic fatigue associated with the following situations:
Excessive thirst
Excess urine
Weight loss despite the increase in hunger
Tiredness in children
Tiredness in obese patients
Family history of diabetes
6. Pulmonary diseases
Diseases of the lungs, especially chronic bronchitis, emphysema and asthma, are common causes of tiredness.
The lungs are the organs responsible for oxygen uptake and elimination of carbon dioxide. When the lungs are sick, oxygenation of the blood is compromised, leading to fatigue.
When do you think that tiredness can be caused by a picture of lung disease?
Pulmonary diseases should be considered whenever the patient complains of chronic fatigue associated with the following situations:
When shortness of breath is a more important complaint than fatigue
When the patient complains of shortness of breath with minimal activities, such as bathing or brushing teeth, or even at rest
Chronic fatigue is a still little known syndrome that usually causes chronic fatigue with no apparent cause.
The patient with chronic fatigue syndrome does not present any alteration to the physical exam or the complementary exams. He complains of pain, but no injury is found, he complains of fever, but the thermometer never shows it, refers to muscular weakness, but the examinations of the muscles are all normal...
Exhaustion after physical or mental exertion, even after 24 hours of rest
8. Pregnancy
Tiredness is a very common symptom in pregnancy. Usually, it starts in the first trimester, disappears in the second, and returns with greater intensity at the end of gestation. First-trimester fatigue is often accompanied by frequent sleep and is usually caused by the hormonal changes of early pregnancy. In the third trimester, fatigue is more related to the baby's weight, the difficulty of expanding the lung due to the size of the uterus, the natural anemia of pregnancy and hormonal changes.
When to think that tiredness may be being caused by a pregnancy?
When the patient knows she is in the first trimester of pregnancy
When there is frequent nausea
When there is menstrual delay or change in the usual characteristics of menstruation
9. Medications
Prolonged use of medications may be the cause of chronic fatigue. Muscle relaxants, antidepressants, antihistamines, antihypertensives, beta-blockers and opioid analgesics are common causes. Excess caffeine can also lead to fatigue as well as excessive alcohol consumption.
When do you think that tiredness can be caused by some medication?
Elderly people taking multiple medications
When the hypertensive patient has very low blood pressure
When the patient takes medications for the heart and has a very low heart rate
When tiredness appears after the start of a new medication
10. Sleep disorders
Proper sleep is essential to being rested. Any sleep disorder that disrupts a good night's sleep may be the cause of chronic fatigue. In this case, tiredness is accompanied by daytime drowsiness. Obstructive sleep apnea is a common cause of tiredness and drowsiness, especially in obese people.
When to think that tiredness may be being caused by sleep problems?
Sleep disorders should be considered whenever the patient complains of chronic fatigue associated with the following situations:
Difficulty starting sleep
When you wake up, you have the feeling that sleep has not been restorative
Excessive drowsiness throughout the day
Irritation throughout the day
Obese patients
Patients who snore too much during the night
11. Depression
Depression, also called major depressive disorder, is a chronic, very common psychiatric disorder characterized by a change in the patient's mood that makes him sad beyond normal, discouraged, lacking energy, low self-esteem, and having difficulty coping with his personal and professional life.
Depression is different from common sadness, which arises when something bad happens in our lives. People without depression are sad when they have motives and improve after a while. The depressed patient does not need reason to feel sad and can not improve, however much he wants. Depression is a chronic illness that usually requires long-term treatment. Just as no one stops being diabetic just with willpower and positive thinking, depression also needs medical help to be controlled.
When do you think that tiredness can be caused by depression?
Depression should be considered whenever the patient complains of chronic fatigue associated with the following situations:
Discouragement
Low self esteem
Deep sadness
Anxiety associated
Lack of ambition
Social isolation
Other causes of tiredness
There are dozens of other causes for prolonged tiredness. To have a correct diagnosis requires medical advice. Just as an example, we can also mention the following causes of prolonged tiredness:
Varicose veins and venous insufficiency of the lower limbs
