Health x Wellness

Chronic Fatigue: Common Causes and Treatments

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While fatigue is a common condition, it’s often thought as a temporary, fleeting state. This leads to it being often overlooked as a symptom of something else, and multiple medical conditions show fatigue as the sole visible symptom. 

“I’m tired!” appears to be the most common complaint among Singaporeans these days. Long hours, lack of sleep, and constant stress all seem to be the new normal. 

However, there may be more than meets the eye when it comes to dealing with exhaustion.

Common Causes of Chronic Fatigue 

Lifestyle Changes

Long working hours, lack of sleep, and stress at work can often lead to poor lifestyle choices, such as unhealthy eating habits (e.g. snacking) and lack of physical activity. These are common among Singaporeans, and a good work-life balance with adequate rest is key. It may not be easy to achieve right away, but working towards it bit by bit is progress, and can eventually help relieve the exhaustion caused by today’s hectic lifestyles. 

Chronic Medical Condition

There are numerous underlying medical conditions that can cause chronic fatigue. This list is not exhaustive; however, these are common conditions medical professionals look for:

Metabolic Syndrome. This is a syndrome consisting of hypertension, Type 2 Diabetes Mellitus, raised cholesterol and obesity. Metabolic Syndrome is a big risk factor for cardiovascular disease such as heart disease, kidney failure and strokes. Unfortunately, this condition is pretty common in Singapore as many people develop poor eating habits and lack of exercise. If not adequately controlled, these conditions can lead to chronic fatigue.

Hypothyroidism. Low levels of thyroid hormones, particularly thyroxine, which controls the basal metabolic rate of the human body, can cause weight gain, chronic fatigue as well as cold intolerance.

Organ failure. Fatigue commonly manifests alongside symptoms of organ failures. Apart from organ-specific damages, chronic heart failure, chronic lung disease, and chronic kidney failure can also cause chronic fatigue.

Excessive Alcohol. Long-term alcohol use and abuse can lead to fatigue. 

Drugs. Certain drugs and medications may cause fatigue as a side-effect. For example, antihistamines used for treatment for allergies and hives can cause sedation and sleepiness. 

Psychiatric conditions. Chronic fatigue can sometimes be the only presenting symptoms of depression. As mental health issues are not always visible, psychiatric conditions such as depression and anxiety are commonly overlooked and underdiagnosed in the GP setting.

Chronic Infections. Long-term infections like HIV or Tuberculosis can be a cause of chronic fatigue.

Obstructive Sleep Apnea. This condition normally manifests with snoring as well as daytime sleepiness. 

Rheumatological Conditions, such as rheumatoid arthritis, Systemic Lupus Erythematosus, and Polymyalgia can cause chronic fatigue. 

(For Men) Testosterone Deficiency. Chronic fatigue is a common indicator of testosterone deficiency syndrome (TDS), which mainly manifests with loss of libido and erectile dysfunction. While testosterone naturally decreases by age, the symptoms can be treated by replacing testosterone either through injections or a topical gel to reach normal testosterone levels

(For Women) Iron Deficiency Anemia. For female patients with heavy menses, iron deficiency is a very common yet under-diagnosed reason for chronic fatigue. As blood loss happens over a prolonged duration of time, the drop in energy level and progressive fatigue is often insidious and brushed aside as “normal”. Other symptoms of iron deficiency anemia include depression, poor conditions of hair and/or nails, and a reduction in effort tolerance. Fortunately, this can be treated with intravenous iron replacement, which often results in rapid resolution of symptoms within 1 to 2 weeks.


How to Treat Chronic Fatigue

The best way to treat chronic fatigue is to first identify if it’s caused by an underlying medical condition. This can be done with a comprehensive review of the patient’s medical condition, evaluating their medical history and the results from health screening tests. Treating any underlying medical condition can eventually relieve the symptoms of chronic fatigue. 

If the tests do not reveal any organic causes of the fatigue and it’s assessed to be lifestyle or psychological in nature, the patient can be recommended to a psychologist for further assessment and treatment.

Article contributed by Dr. Zeng Shanyong from DTAP Clinic

Photo by Muhammad Raufan Yusup and by isens usa on Unsplash