Fatigue Evaluation

What is fatigue?

Fatigue is a persistent sensation of exhaustion that can diminish overall energy and hinder concentration. While occasional tiredness is normal, consistent fatigue that negatively impacts motivation may warrant an evaluation.

Fatigue can have various causes, and treatment depends on the specific underlying factor, ranging from lifestyle adjustments to medication.

What other symptoms are associated with fatigue?

In addition to a sense of weariness and low energy, there are other symptoms linked to fatigue, including:

  • Depression

  • Eyestrain (tired eyes)

  • Overall discomfort

  • Boredom

  • Anxiety (feeling nervous or on edge)

  • Body aches

  • Irritability (constant annoyance or quick anger)

  • Difficulty concentrating

  • A healthcare provider consulting a patient in a clinic during a fatigue evaluation.

What causes fatigue?

Fatigue can stem from various sources, encompassing lifestyle choices, medical conditions, and medications. Depending on the cause, fatigue may be either a temporary or chronic condition. Causes include:

Lifestyle choices: Drug and alcohol use, lack of exercise, and high stress levels

Medical conditions and diseases: Anemia, flu, mononucleosis, fibromyalgia, hypothyroidism, and others

Treatments: Chemotherapy, bone marrow transplants, etc.

Autoimmune disorders: HIV, lupus, diabetes, and more

Congestive heart failure: Tiredness resulting from the heart having to work harder than usual

Low iron: Insufficient iron necessary for optimal bodily function

Anorexia: Fatigue due to inadequate nutrition from irregular eating

Chronic obstructive pulmonary disease (COPD): Fatigue resulting from reduced airflow and oxygen delivery to organs

Vitamin deficiencies: Insufficient B12 or vitamin D

What is low iron?

Iron deficiency, or low iron, occurs when the body lacks sufficient iron to function properly. Iron is crucial for hemoglobin formation in red blood cells, facilitating oxygen transport throughout the body. While most iron resides in hemoglobin, some is stored in the spleen, liver, and bone marrow.

Low iron may result from:

Inadequate iron in the diet: Found in leafy greens, meat, and eggs or supplemented

Intestinal disorders: Conditions like celiac disease impede nutrient absorption, including iron

Blood loss: Occurs due to ulcers, hernias, polyps, cancers, or heavy menstruation

Pregnancy: Increased iron demand during pregnancy for both the carrier and the fetus

What conditions are associated with low iron?

In some cases, individuals with low iron may experience no symptoms. Severe cases may present symptoms such as:

  • Fatigue

  • Chest pain

  • Shortness of breath

  • Pica (cravings for nonfood items)

  • Swelling of the tongue

  • Weakness

  • Swollen spleen

What is anemia?

Anemia, or low hemoglobin, occurs when the body lacks healthy red blood cells containing hemoglobin—a protein rich in iron. Healthy red blood cells with hemoglobin assist in delivering oxygen to the body's organs. Anemia leads to less oxygen reaching the organs, resulting in frequent fatigue or cold sensations.

Anemia is typically diagnosed through screening, which may include:

  • Questions about family history

  • Blood tests and diagnostics

  • A physical exam

Various types of anemia exist, each with different causes. Treatment depends on the underlying cause, ranging from simple measures like iron supplements to more complex interventions, for which a Cohen Care provider can provide guidance and referrals.