Do
you need help with fatigue?
Fatigue
is one of the most common complaints made to primary care doctors. Although state
of the art testing and a detailed evaluation are sometimes necessary, for most
people, paying attention to the basics can solve the problem.
The
Basics.
Sleep. It is very important to sleep at least 8 hours a day. For those whose schedules
do not allow for an early bedtime, I often suggest getting to sleep early at least
two nights a week. If you are waking up tired, your body is asking for more sleep.
If you are waking up exhausted and you snore, an evaluation for sleep apnea may
be helpful.
Exercise. Regular exercise is key to well being. People who exercise regularly feel awful
when they miss a workout. In fact regular aerobic exercise is the only intervention
proven to work for chronic fatigue syndrome. In fact, I find on nights that I
feel particularly exhausted from the days events, even though I least want to
exercise, those are exactly the nights I need exercise the most. If I do not exercise,
I go into the next day exhausted. If I force a workout, I usually feel well the
next day. For those who can not fit large workouts into their routine, I ask for
five minutes of exercise before hitting the shower. Just do as many sit ups, push
ups or jumping jacks as you can. The results will speak for themselves.
Nutrition. Eating properly to avoid sugar or caffiene highs or lows is important to alleviate
fatigue. Eating processed, carbohydrate heavy meals and snacks, usually will make
you more tired in a few hours contributing to fatigue. Caffeine has a similar
effect on people who consume caffeine more than once a day. Eating multiple small
unprocessed natural snacks and meals will help to keep you alert and alleviate
fatigue.
The
Medical Evaluation
A physical examination is the next step. This will give your doctor a chance
to talk to you and examine you to look for possible causes of fatigue. Included
in most physical examinations is a detailed laboratory evaluation that will look
for medical causes of fatigue such as anemia and thyroid disorders. Anemic patients
are often tired, pale, and fatigue easily. Patients with an underactive thyroid
can complain of dry skin, an intolerance to being cold, weight gain, hair loss,
irregular periods, dizziness and fatigue. Fortunately both conditions are easily
corrected.
Depression is one of the most common causes of fatigue in primary care offices. Many of the
symptoms of depression are mild and nonspecific, so a conversation with your doctor
is very helpful. Patient with depression are usually either in a bad situation
(horrible boss) or have a chemical imbalance in their brain. They break down serotonin
too quickly, so their brain serotonin levels are low. Medication which will interfere
with the breakdown of serotonin, allows the brain serotonin levels to rise, and
consequently the depression will lift. Interestingly the majority of my patients
in whom the depression is not strictly situational, have a family history of depression.
Although medication is one treatment for depression, sleeping well, eating well
and exercising frequently are sometimes successful treatment strategies.
Alternative
Approaches
Vitamin
testing and replacement. Vitamin defeciency is an increasingly common diagnosis.
As most of our food supplies are heavily processed, some of that processing compromises
nutrition. For anyone who has ever grown a tomato in their backyard, the taste
and texture is quite a bit different than what we can purchase at the local grocery
store. Specialized testing is now available that measures the levels of vitamins
in the body's cells. There are excellent reference labs that perform this detailed
analysis to give a great composite picture of what is necessary to replace. Once
this information is obtained, the patient can be sent to a quality vitamin supplement
facility or special order custom vitamins can be made. Good results are often
noted with this approach.
Conclusion
Fatigue
is usually the result of an array of variables. But a good evaluation with attention
to the basics can often bring good relief to a chronic problem.
Copyright
Tareq Abedin, MD 2007
