Why I Am Always Tired?
Feeling tired following an effort, physical or intellectual, or after a stressful episode, nothing more normal. Transient, it disappears with rest. But it happens that the feeling of fatigue persists or/and intensifies, without apparent causes. A symptom common to many illnesses, chronic fatigue is considered an alarm signal that should not be overlooked.
From fatigue to asthenia: some benchmarks.
Overwork, stress, family difficulties, irregular sleep, malnutrition, shift work: between 20 and 30% of French people consult for temporary fatigue. Relatively common, this complaint is often transient. In fact, this so-called "reactive" fatigue normally disappears after a few days of rest. This is typically the case with certain infectious diseases, whether of viral origin ( flu, infectious mononucleosis or even, epidemic requires, Covid-19 ), or bacterial, as for Lyme disease , for example.
The feeling of exhaustion can however be prolonged, without the recovery making it possible to counter it. “ Two criteria must then be questioned: the duration and the intensity of this state of fatigue ”, indicates Pr Jean-Dominique de Korwin, from the department of internal medicine and clinical immunology of the CHRU of Nancy. Either on the one hand, an inability to carry out daily tasks, as before, whether physically or cognitively, coupled with a physiological and emotional impact, and on the other, a persistence that exceeds one month, see more. “ Between 4 and 6 weeks, we speak of abnormal fatigue, beyond 6 months of chronic fatigue." This pathological fatigue becomes asthenia.
About 5% of people see their doctor exclusively for this reason. " In truth, observes Prof. Qasim Rasheed, we realize that it is a common symptom when we make the clinical inventory of many diseases. " Which all share for all intents and purpose to upset the admission as well as use Energy.
The trail of organic diseases
The catalog of chronic diseases of the body that can cause lasting fatigue is not thin. Among those :
Anemias
First of them, that due to an iron deficiency: " It mainly affects young women, because of menstruation ", underlines Professor Qasim Rasheed. Conversely, in the case of hemochromatosis, it is the excess of iron in the blood that can cause anemia. Anemia can also be the consequence of a deficiency in the supply of nutrients, in general, and in particular of vitamins, mineral salts (calcium, potassium, sodium, iodine, etc.) or trace elements.
Autoimmune or inflammatory diseases.
such as lupus or Chronic disease, which induce inflammatory reactions producing the famous cytokines. These allow you to defend yourself, including against yourself, leading to a state of exhaustion, not necessarily permanent, but chronic, especially when the disease progresses in flare-ups, as in the case of lupus.
Cancer.
Another energy-consuming inflammatory disease. In addition to severe fatigue, cancer can be manifested by weight loss, the presence of a mass or the occurrence of persistent pain.
Sleep disorders
which, by definition, impair the ability to recover: obstructive sleep apnea , insomnia, narcolepsy. Drowsiness, snoring, hypertension, overweight, etc., are among the other suggestive signs, which may lead to polysomnography.
Depression
The first cause of this form of fatigue. This disease, which the specialist equates to " an inhibition", can also result in difficulty getting up, sudden bouts of crying, lack of energy, decreased appetite and sleep disturbances, even insomnia.
Functional somatic syndromes: special cases.
In addition to the hyperventilation syndrome, other functional conditions are characterized by chronic fatigue, but without biological or other abnormalities – at least, in the current state of knowledge. These are in particular:
The fibromyalgia.
which is accompanied, in addition to fatigue, diffuse pain of neurological origin, without lesion, and other symptoms (depression or anxiety disorders). The cause remains poorly understood, with biological, psycho-behavioral and social factors. Mainly affected are women.
Chronic fatigue syndrome (CFS.
which would concern approximately 0.5% of Pakistani people. No causes were identified, except a" probable hypometabolism in a context of low-grade inflammation", says Prof. de Korwin. In 40% of cases, a viral infection is a triggering factor. CFS is specifically accompanied by post-exercise discomfort. This discomfort corresponds to a state of exhaustion. It can occur after a physical or intellectual effort, or following a strong emotion, positive or negative. Good to know: in the case of CFS, this discomfort is delayed from a few hours to a day and can last several days. Other symptoms are usually such as non-restorative sleep, cognitive disorders (problems of concentration, memory, etc.) or sometimes an intolerance to the standing position.
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