Fatigue
Tiredness; Weariness; Exhaustion; LethargyFatigue is a feeling of weariness, tiredness, or lack of energy.
Considerations
Fatigue is different from drowsiness. Drowsiness is feeling the need to sleep. Fatigue is a lack of energy and motivation. Drowsiness and apathy (a feeling of not caring about what happens) can be symptoms that go along with fatigue.
Drowsiness
Drowsiness refers to feeling more sleepy than normal during the day. People who are drowsy may fall asleep when they do not want to or at times whic...
Read Article Now Book Mark ArticleFatigue can be a normal and important response to physical activity, emotional stress, boredom, or lack of sleep. Fatigue is a common symptom, and it is usually not due to a serious disease. But it can be a sign of a more serious mental or physical condition. When fatigue is not relieved by enough sleep, good nutrition, or a low-stress environment, it should be evaluated by your health care provider.
Causes
There are many possible causes of fatigue, including:
- Anemia (including iron deficiency anemia)
Anemia
Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different type...
Read Article Now Book Mark ArticleIron deficiency anemia
Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. There are man...
Read Article Now Book Mark Article - Depression or grief
Depression
Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for shor...
Read Article Now Book Mark ArticleGrief
Grief is a reaction to a major loss of someone or something. It is most often an unhappy and painful emotion.
Read Article Now Book Mark Article - Iron deficiency (without anemia)
- Medicines, such as sedatives or antidepressants
- Persistent pain
- Sleep disorders such as insomnia, obstructive sleep apnea, or narcolepsy
Sleep disorders
Sleep disorders are problems with sleeping. These include trouble falling or staying asleep, falling asleep at the wrong times, too much sleep, and ...
Read Article Now Book Mark ArticleInsomnia
Insomnia is trouble falling asleep, staying asleep (usually through the night), or waking up too early in the morning. Episodes of insomnia may come ...
Read Article Now Book Mark ArticleObstructive sleep apnea
Obstructive sleep apnea (OSA) is a problem in which your breathing pauses during sleep. This occurs because of narrowed or blocked airways.
Read Article Now Book Mark ArticleNarcolepsy
Narcolepsy is a nervous system problem that causes extreme sleepiness and attacks of daytime sleep.
Read Article Now Book Mark Article - Thyroid gland that is underactive or overactive
Underactive
Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone. This condition is often called underactive thyroid....
Read Article Now Book Mark ArticleOveractive
Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.
Read Article Now Book Mark Article - Use of alcohol or drugs, such as cocaine or narcotics, especially with regular use
Fatigue can also occur with the following illnesses:
- Addison disease (a disorder that occurs when the adrenal glands don't produce enough hormones)
Addison disease
Addison disease is a disorder that causes the adrenal glands to not produce enough hormones.
Read Article Now Book Mark Article - Anorexia or other eating disorders
Anorexia
Anorexia is an eating disorder that causes people to weigh less than is considered healthy for their age and height, usually by excessive weight loss...
Read Article Now Book Mark Article - Arthritis, mainly adult or juvenile rheumatoid arthritis
Juvenile rheumatoid arthritis
Juvenile idiopathic arthritis (JIA) is a term used to describe a group of disorders in children that includes arthritis. They are long-term (chronic...
Read Article Now Book Mark Article - Autoimmune diseases such as systemic lupus erythematosus
Lupus
Systemic lupus erythematosus (SLE) is an autoimmune disease. In this disease, the immune system of the body mistakenly attacks healthy tissue. It c...
Read Article Now Book Mark Article - Cancer
Cancer
Cancer is the uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells.
Read Article Now Book Mark Article - COVID-19
COVID-19
Coronavirus disease 2019 (COVID-19) is a respiratory illness that causes fever, coughing, and shortness of breath, but many other symptoms can occur....
Read Article Now Book Mark Article - Diabetes
Diabetes
Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.
Read Article Now Book Mark Article - Fibromyalgia
Fibromyalgia
Fibromyalgia is a condition in which a person has long-term pain that is spread throughout their body. The pain is most often accompanied by fatigue...
Read Article Now Book Mark Article - Heart failure
Heart failure
Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...
Read Article Now Book Mark Article - Infection, especially one that takes a long time to recover from or treat, such as bacterial endocarditis (infection of the heart muscle or valves), parasitic infections, hepatitis, HIV/AIDS, tuberculosis, and mononucleosis
HIV/AIDS
Human immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). When a person becomes infected with HIV, the ...
Read Article Now Book Mark ArticleTuberculosis
Pulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs.
Read Article Now Book Mark ArticleMononucleosis
Mononucleosis, or mono, is a viral infection that causes fever, sore throat, and swollen lymph glands, most often in the neck.
Read Article Now Book Mark Article - Kidney disease
- Liver disease
- Malnutrition
Malnutrition
Malnutrition is the condition that occurs when your body does not get enough nutrients.
Read Article Now Book Mark Article
Certain medicines may also cause drowsiness or fatigue, including antihistamines for allergies, blood pressure medicines, sleeping pills, steroids, and diuretics (water pills).
Chronic fatigue syndrome (CFS) is a condition in which symptoms of fatigue persist for at least 6 months and do not resolve with rest. The fatigue may be worsened with physical activity or mental stress. It is diagnosed based on the presence of a specific group of symptoms and after all other possible causes of fatigue are ruled out.
Chronic fatigue syndrome
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term illness that affects many body systems. People with this illness are not ...
Read Article Now Book Mark ArticleHome Care
Here are some tips for reducing fatigue:
- Get enough sleep each night.
- Make sure your diet is healthy and well-balanced, and drink plenty of water throughout the day.
- Exercise regularly.
- Learn better ways to relax. Try yoga or meditation.
- Maintain a reasonable work and personal schedule.
- Change or reduce your stressors, if possible. For example, if you are able, take a vacation or resolve relationship problems.
- Discuss with your provider whether any supplemental vitamins might help you.
- Avoid alcohol, nicotine, and drug use.
If you have long-term (chronic) pain or depression, treating it often helps the fatigue. Be aware that some antidepressant medicines may cause or worsen fatigue. If your medicnie is one of these, your provider may have to adjust the dosage or switch you to another medicine. DO NOT stop or change any medicines without first talking to your provider.
Stimulants (including caffeine) are not effective treatments for fatigue. They can make the problem worse when they are stopped. Sedatives also tend to worsen fatigue.
When to Contact a Medical Professional
Contact your provider right away if you have any of the following:
- Confusion or dizziness
- Blurred vision
- Little or no urine output
- Recent swelling and weight gain
- Thoughts of harming yourself or of suicide
Contact your provider for an appointment if you have any of the following:
- Unexplained weakness or fatigue, especially if you also have a fever, unintentional weight loss, or regular sweats
- Constipation, dry skin, weight gain, or you cannot tolerate cold
- Wake up and fall back to sleep many times during the night
- Frequent headaches
- Are taking medicines, prescribed or non-prescribed, or using drugs that may cause fatigue or drowsiness
- Feel sad or depressed
- Insomnia
What to Expect at Your Office Visit
You will be asked about your medical history, fatigue symptoms, and your lifestyle, habits, and feelings.
Your provider will likely perform a complete physical examination, paying special attention to your heart, lymph nodes, thyroid, abdomen, and nervous system.
Tests that may be ordered include the following:
- Blood tests to check for anemia, diabetes, inflammatory diseases, and possible infection
- Kidney function tests
- Liver function tests
- Thyroid function tests
- Urinalysis
Urinalysis
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...
Read Article Now Book Mark Article
Treatment depends on the cause of your fatigue symptoms.
References
Clauw DJ. Fibromyalgia. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 253.
Regehr J. Fatigue. In: Kellerman RD, Rakel DP, Heidelbaugh JJ, Lee EM, eds. Conn's Current Therapy 2023. Philadelphia, PA: Elsevier 2023:14-15.
Seller RH, Symons AB. Fatigue. In: Seller RH, Symons AB, eds. Differential Diagnosis of Common Complaints. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 14.
Review Date: 6/12/2023
Reviewed By: Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.