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Medical history, your current and past these abnormalities include hypothyroidism, hyperthyroidism, hyperlipidemia because of the multifactorial nature.

06.02.2015

Fatigue and weight loss causes, afternoon fatigue ms - Within Minutes

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Fatigue is sometimes referred to as asthenia, tiredness, lack of energy, weakness, and exhaustion. The causes of fatigue in an individual patient are often multiple, with many interrelated factors. Decreased physical activity has been shown to cause deconditioning and decreased endurance to both exercise and normal activities of daily living. In patients without cancer who present with fatigue, the final diagnosis is psychological (eg, depression, anxiety, and other psychological disorders) in almost 75% of patients. Low red blood cell count related to advanced cancer or chemotherapy has been associated with fatigue, and its treatment results in improvement of fatigue and quality of life in these patients. Both intrathecal and systemic opioid therapies, as well as cachexia and some antineoplastic therapies, can result in hypogonadotropic hypogonadism.
Administration of chemotherapy and radiotherapy for malignancy causes a specific fatigue syndrome.
Comorbid conditions not necessarily related to cancer, such as renal failure and congestive heart failure, may coexist and contribute to the problem. The fourth category in Table 1 is the most relevant for both clinical management and clinical trials in fatigue. In addition to the assessment of the intensity of fatigue, the clinical assessment of these patients requires clinicians to determine the impact of all factors on the presence of fatigue. To treat fatigue optimally, it is vital to identify and prioritize the different underlying factors in the individual patient. In patients with cancer treatment–related fatigue, it is important to exclude specific causes, such as hypothyroidism, hypogonadism, and anemia, and to consider other potential adverse effects of treatment.
Psychosocial interventions, such as CBT, have been found to be effective in improving cancer-related fatigue in cancer patients receiving treatment.
Whole grains (wheat germ, barley, brown rice, oats) - Tip: Make it easy to eat right with Steamed Brown Rice Bowls, which are organic and microwaveable (click for details). Joanne EglashHolistic Health ExaminerJoanne Eglash has more than 25 years of experience as a journalist and author. The debate goes on: New research seems to prove cats are better than dogsThe battle over whether dogs, or cats, are better has always divided the animal-loving community – or, at least, those who love dogs and cats. I have been doing my research this week on stress and our adrenal glands and how they relate to weight loss and maintenance.
If you are wondering if you may have adrenal fatigue and either high or low cortisol levels, here are some of the symptoms you may be experiencing. If you would like to have your cortisol levels tested we do have saliva test kits on our website that you can order and find out where your levels are.
Fatigue is also commonly associated with cancer treatment and occurs in up to 90% of patients undergoing chemotherapy. It may be present early in the course of the illness, may be exacerbated by treatments, and is present in almost all patients with advanced cancer.
Host cytokines such as tumor necrosis factor, interleukin (IL)-1, and IL-6 are capable of causing decreased food intake, loss of body weight, a decrease in synthesis of both lipids and proteins, and increased lipolysis.
In terminally ill patients with advanced cancer, treatment of anemia may not resolve fatigue adequately because of the multifactorial nature of its etiology.
Autonomic failure has also been documented in patients with severe chronic fatigue syndrome. The pattern of fatigue reported by patients with cancer who receive myelosuppressive chemotherapy is cyclical.
It is often described as a “wave” that starts abruptly within a few hours after treatment and subsides shortly thereafter.
Combined therapy with the two modalities appears to cause worse fatigue than does either modality given alone. In addition, commonly used medications, such as opioids and hypnotics, may cause sedation and fatigue. Other conditions include the chronic stress response (possibly mediated through the hypothalamic-pituitary axis), disrupted sleep or circadian rhythms, and hormonal changes (eg, premature menopause and androgen blockade secondary to cancer treatment). There is agreement that self-assessment should be the “gold standard.” Because of the complex nature of the symptoms of fatigue, an effort to identify a set of diagnostic criteria similar to those for depression has been attempted. The two most common scales, Eastern Cooperative Oncology Group and Karnofsky Performance Status, consist of a physician’s rating of the patient’s functional capabilities after a regular medical consultation.
Visual analog scales, numerical scales, the Brief Fatigue Inventory (BFI), and the Piper Fatigue Self-Report Scale have been validated. Thorough records, including recent treatment history, physical examination, and medication review, in addition to simple laboratory investigations, will help identify possible underlying causes.
A number of effective pharmacologic and nonpharmacologic symptomatic treatments are available for these patients.
There is substantial evidence that corticosteroids can reduce fatigue and other symptoms in cancer patients.
Psychostimulants (eg, methylphenidate, 5 to 10 mg in the morning and at noon or 5 mg as needed) may be useful in treating fatigue in patients with advanced cancer.


Based on a preliminary study that found significant improvement of cancer-related fatigue with a dose of 2,000 mg extract of ground root of American ginseng (Panax quinquefolius), Barton et al recently completed a double-blind trial of 2,000 mg of American ginseng vs placebo for 8 weeks in 364 fatigued cancer survivors. When appropriate in patients with advanced cancer, physical therapy may encourage increased activity and provide active range of motion to prevent painful tendon retraction. A recent controlled trial by Chandwani and Cohen et al assessed 163 breast cancer patients receiving radiation therapy who were randomized to a yoga group, a stretching group, or a waitlist group.
A recent randomized controlled trial by Montogomery et al found that the benefits of CBT on cancer-related fatigue lasted long after the CBT was finished. As you grow older, your thyroid typically becomes less efficient and even can grow in size. You can boost your energy, avoid additional weight gain and even slow down the aging process with the right nutrients, says Dr.
She's written articles, features, interviews, blogs, newsletters, and reviews for magazines such as Shape, Pregnancy and Success and for Web sites such as ediets and Yahoo.
It is intended for general informational purposes only and does not address individual circumstances. A series of four tests should show a curve that starts high at waking and drops throughout the day until a low level at bedtime… It is critically important to your health to do a saliva cortisol test series before you try to treat symptoms that appear to be caused by stress and a change in your body’s cortisol levels.
The collection of saliva samples is very easy and you send your samples directly to the lab for evaluation. Moreover, different studies of fatigue and asthenia have looked at different outcomes, ranging from physical performance to the purely subjective sensation.
When injected into a rested subject, blood from a fatigued subject has produced manifestations of fatigue. The metabolic abnormalities involved in the production of cachexia and the loss of muscle mass resulting from progressive cachexia may cause profound weakness and fatigue. It should also be considered in younger cancer patients who are undergoing aggressive antineoplastic treatments such as radiation therapy and chemotherapy and who are nevertheless trying to maintain their social and professional activities. Although the association between fatigue and autonomic dysfunction has not been established in cancer patients, it should be suspected in patients with severe postural hypotension or other signs of autonomic failure. It begins within the first few days after therapy is started, peaks around the time of the white blood cell nadir, and diminishes in the week thereafter, only to recur again with the next cycle of chemotherapy. Fatigue has been noted to decrease in the first 2 weeks after localized treatment for breast cancer but then to increase as radiation therapy persists into week 4. This syndromal approach has been useful to assess the presence or absence of the clinical syndrome of fatigue. A physical therapist completes the Edmonton Functional Assessment Tool and attempts to determine the functional status, as well as all the obstacles to clinical performance, of these patients.
For instance, patients with anemia may experience symptomatic improvement with the administration of erythropoietic therapy (epoetin alfa [Epogen, Procrit] and darbepoetin alfa [Aranesp]) at the dose and administration schedule that best fit the patient’s need. However, long-term use is associated with weight (fluid) gain, adrenal insufficiency, and thromboembolic complications. In a study by Bruera et al, 141 advanced cancer patients were evaluated for a period of 15 days so as to compare the effects of methylphenidate and placebo. Studies suggest that moderate to intense (55% to 75% of maximum heart rate) aerobic exercise for 10 to 90 minutes, 3 to 7 days per week is safe and effective. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health.
If you do not do so, you may worsen your health problems and land yourself in a hospital with the results of a cortisol deficiency crisis similar to what happens to people who have failed adrenal glands or Addison’s disease”. There are natural remedies that can help with stress relief and can bring your cortisol levels to a more normal level. In most patients, the etiology of fatigue or dyspnea is multifactorial, with many contributing interrelated abnormalities. The host production of cytokines in response to the tumor can also have a direct fatigue-inducing effect. However, many abnormalities described in Figure 1 are capable of causing profound fatigue in the absence of significant weight loss.
Patients with an adjustment disorder or a major depressive disorder can have fatigue as their most prevalent symptom.
Fatigue tends to worsen with subsequent cycles of chemotherapy, which suggests a cumulative dose-related toxic effect.
Their beneficial effects generally last between 2 and 4 weeks, and longer-term use carries the risk of serious adverse effects.
The provision of ramps, walkers, wheelchairs, elevated toilets, and hospital beds may allow the patient to remain at home in a safe environment. However, patients in the yoga group had a greater improvement in physical functioning (Short Form 36 Health Survey), compared with the stretching and waitlist groups.
One of the pre-hormones that the adrenals produce is pregnenolone which is a precursor to hormones like progesterone, estrogen, DHEA and testosterone. In one study of patients with advanced cancer, fatigue was found to be significantly correlated with the intensity of dyspnea.


Muscular or neuromuscular junction abnormalities are a possible cause of chemotherapy- or radiotherapy-induced fatigue.
Compared with women who have no history of cancer, former patients with breast cancer who had received adjuvant chemotherapy reported more fatigue and worse quality of life due to this symptom. It is impossible to be certain whether one of these identified problems is a major contributor to fatigue or simply a coexisting problem in a given patient. The results of this study showed that there was no significant improvement in fatigue in the methylphenidate group compared with the placebo group. If you have experienced unexplained weight gain, fatigue, bloating and other problems, read on to see what this means and what to do.
This chapter will discuss the mechanisms, clinical features, assessment, and management of both of these troublesome and often undertreated symptoms in cancer patients. Similar results have been noted in breast cancer patients who have been treated with high-dose chemotherapy and autologous stem cell support and in patients treated for lymphoma.
Therefore, it is of great importance to measure the intensity of fatigue and the patient’s performance before and after treating any contributing factor. In a recent double-blind placebo controlled study of 84 advanced cancer patients with fatigue, oral dexamethasone at a standard dose of 8 mg daily for 2 weeks was associated with significant improvement in cancer-related fatigue. There was also no significant benefit from methylphenidate plus a nursing telephone intervention on cancer-related fatigue. Counseling (more specifically, cognitive-behavioral therapy [CBT]) for stress management, depression, and anxiety may reduce distress and fatigue as well as improve mood. Getting the right treatment is critical to feel your best and avoid serious health problems.
If the level of fatigue does not improve after correction of these abnormalities, it is clear then that further treatment will not result in improvement in the future.
There were no significant differences in adverse events in patients in the dexamethasone and placebo group.
A 148-patient study by Moraska et al also found no significant improvement in cancer-related fatigue with long-acting methylphenidate compared with placebo.
Similar to the previous studies of Bruera et al and Moraska et al, fatigue improved among patients treated with modafinil but there was no significant difference between the active and placebo treatments. Based on these results, future studies of psychostimulants should be focused on a specific patient group, such as fatigued patients with depression or drowsiness. Symptom: Weight Gain or LossAn unexplained change in weight is one of the most common signs of a thyroid disorder. In contrast, if the thyroid produces more hormones than the body needs, you may lose weight unexpectedly. Symptom: Changes in Heart RateThyroid hormones affect nearly every organ in the body and can influence how quickly the heart beats. It can also trigger increased blood pressure and the sensation of a pounding heart, or other types of heart palpitations. Symptom: Changes in Energy or MoodThyroid disorders can have a noticeable impact on your energy level and mood.
Hyperthyroidism tends to have the opposite effect, causing excessive sweating and an aversion to heat. Tip your head back, take a drink of water, and as you swallow, examine your neck below the Adam's apple and above the collarbone.
In some cases, imaging studies are used and biopsies are taken to evaluate a thyroid abnormality.
Other Causes of HypothyroidismIn some cases, hypothyroidism results from a problem with the pituitary gland, which is at the base of the brain.
Other causes of hypothyroidism include temporary inflammation of the thyroid or medications that affect thyroid function. This is an autoimmune disorder that attacks the thyroid gland and triggers the release of high levels of thyroid hormones.
One of the hallmarks of Graves' disease is a visible and uncomfortable swelling behind the eyes. These are lumps that develop inside the thyroid and sometimes begin producing thyroid hormones. Thyroid Disorder ComplicationsWhen left untreated, hypothyroidism can raise cholesterol levels and make you more likely to have a stroke or heart attack.
In severe cases, very low levels of thyroid hormones can trigger a loss of consciousness and life-threatening drop in body temperature. Long-term treatment can result in more energy, lower cholesterol levels, and gradual weight loss. The main symptom is a lump or swelling in the neck, and only about 5% of thyroid nodules turn out to be cancerous.




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