It’s not just fatigue.
At the end of the year, fatigue creeps in on many of us. Sometimes banal, sometimes more worrying, this feeling of exhaustion also called “asthenia” can become a source of worry. “Usually, the patient’s anxiety comes from not knowing what they have.” explains Dr Lama Giovansili, endocrinologist. To distinguish temporary fatigue from a more serious health problem, you must observe the presence of certain symptoms.
When you are very tired, it is the so-called “specific” symptoms that should prompt you to consult. “For example, if fatigue is associated with fever, cough, diarrhea, severe pain or even shortness of breath” this should encourage consultation. To begin with, “it is necessary to carry out a clinical examination and an initial blood test to look for a cause of asthenia and not forget a pregnancy test in women” says Dr. Giovansili. Asthenia may indicate anemia (iron deficiency) and/or other deficiencies, thyroid disease (hypothyroidism or hyperthyroidism), lack of cortisol (adrenal insufficiency), diabetes, kidney failure, autoinflammatory disease. -immune (such as polyarthritis for example) or even an infection (Covid or other).
“We must know how to stop the escalation of additional tests and reassure the patient”
Asthenia can also hide chronic fatigue syndrome (CFS). It is a feeling of fatigue which has been developing for more than 6 months and which combines variable symptoms such as muscle pain, joint pain, headaches, non-refreshing sleep or even a feeling of malaise lasting more than 24 hours. after an effort. The causes of this syndrome are not yet known. “There are many hypotheses. Some are in favor of a psychosomatic origin and others consider that it is indeed a debilitating illness of still unknown organic cause” continues the endocrinologist. If the syndrome does not cause specific complications for the patient, its management is complex because “not very efficient and not standardized” according to our expert. There is no specific treatment, but the following are proposed: cognitive-behavioral therapy (CBT), gradual physical activity (walking, swimming, cycling) and symptomatic treatments (painkillers and antidepressants).
Sometimes the causes of abnormal fatigue are not found. “Once the examinations have been carried out, and in the absence of an evocative context or in the absence of guiding symptoms (cardiac, respiratory, cancer, etc.), it is essential to know how to stop unnecessary investigations or to avoid put a label of “infra-clinical” problems (which does not cause any detectable manifestation, editor’s note) which will keep the patient searching for an explanation of his symptoms, complicating his long and complex treatment. You have to know how to stop it. exam escalation complementary and reassure the patient”warns Dr. Giovansili. Sometimes, regaining energy sustainably just involves lifestyle changes. “You have to learn to live with your illness, manage your energy, work on yourself, on anxiety, on stress and practice regular physical activity” concludes our interlocutor.