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

03.02.2014

Increased fatigue causes, tinnitus treatment emedicine - PDF Review

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The fatigue caused by anemia is the result of a lack of red blood cells, which bring oxygen from your lungs to your tissues and cells.
The symptoms: Many symptoms (such as fatigue, low energy, loss of appetite, and joint pain) are shared by other health conditions, including other forms of arthritis such as fibromyalgia and lupus.
Fatigue (either physical, mental or both) is a symptom that may be difficult for the patient to describe and words like lethargic, exhausted and tired may be used. Taking a careful and complete history is the key to help making the underlying diagnosis of the cause for the symptom of fatigue. Fatigue is a very common complaint and it is important to remember that it is a symptom and not a disease.
Often, the symptom of fatigue has a gradual onset and the person may not be aware of how much energy they have lost until they try to compare their ability to complete tasks from one time frame to another. While it is true that depression and other psychiatric issues may be the reason for fatigue, it is reasonable to make certain that there is not an underlying physical illness that is the root cause.
Individuals with fatigue may have three primary complaints; however, it can vary in each person. A tension headache s one of the most common types of headaches, and the exact cause is not known.
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease.
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. Administration of chemotherapy and radiotherapy for malignancy causes a specific fatigue syndrome. 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.
But commonly, depression can cause decreased energy, changes in sleeping and eating patterns, problems with memory and concentration, and feelings of hopelessness, worthlessness, and negativity. Anemia and thyroid disorders, which also cause fatigue, are even more common in people with RA, according to John Klippel, MD, president and CEO of the Atlanta-based Arthritis Foundation. However, in about a third of patients the cause is not found and the diagnosis is not known.
Examples of some treatable causes of fatigue include anemia, diabetes,thyroid disease, heart disease, COPD and sleep disorders (Table). Many illnesses can result in the complaint of fatigue and they can be physical, psychological, or a combination of the two.


Fatigue is also commonly associated with cancer treatment and occurs in up to 90% of patients undergoing chemotherapy. 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. 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. 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. 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. 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 randomized controlled trial by Montogomery et al found that the benefits of CBT on cancer-related fatigue lasted long after the CBT was finished. Anemia may be caused by an iron or vitamin deficiency, blood loss, internal bleeding, or a chronic disease such as rheumatoid arthritis, cancer, or kidney failure. Simple exercise, such as climbing the stairs or walking short distances, can cause fatigue.
Other symptoms include unexplained weight loss, feeling warm all the time, increased heart rate, shorter and less frequent menstrual flows, and increased thirst. And that means trouble for people with type 2 diabetes who can't use glucose properly, causing it to build up in the blood. Often a person complains of feeling tired and it is up to the health care professional to distinguish between fatigue and drowsiness, though both can occur at the same time.
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.
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. 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.


Without enough energy to keep the body running smoothly, people with diabetes often notice fatigue as one of the first warning signs, says Christopher D. Aside from drowsiness, other symptoms can be confused with fatigue including shortness of breath with activity and muscle weakness. 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.
There was no significant increase in toxicities in the ginseng group compared with the placebo group. 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. Also, fatigue can be a normal response to physical and mental activity; in most normal individuals it is quickly relieved (usually in hours to about a day, depending on the intensity of the activity) by reducing the activity. 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. 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.
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.



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Comments to “Increased fatigue causes”

  1. delfin:
    After localized treatment for breast cancer but its pitch and.
  2. Togrul:
    Long-acting methylphenidate compared with placebo list of natural remedies.