What factors contribute to headache, anorexia, and lethargy with kidney disease?

• Overview

Overview

What is fatigue?

Everyone feels tired from time to time. Fatigue is feeling severely overtired. Fatigue makes it hard to get up in the morning, go to work, do your usual activities and make it through your day. You might have an overwhelming urge to sleep, and you may not feel refreshed after you rest or sleep.

Fatigue often occurs along with other symptoms, such as:

• Depression and lack of desire to do the activities you once enjoyed.
• Trouble concentrating or focusing.
• Very low energy and motivation.
• Nervousness, anxiety, and irritability.
• Muscle weakness and pain.

Other signs of fatigue include:

• Tired eyes
• Tired legs
• Whole-body tiredness
• Stiff shoulders
• Malaise (discomfort/uneasiness)
• Boredom or lack of motivations
• Sleepiness
• Impatience

Possible Causes

What causes fatigue?

Many conditions, disorders, medications and lifestyle factors can cause fatigue. Fatigue can be temporary, or it can be a chronic condition (lasting six months or more). You may be able to relieve your symptoms by changing your diet, medications, exercise or sleep habits. If an underlying medical condition causes fatigue, doctors can usually treat the condition or help you manage it.

Causes of fatigue include:

• Lifestyle habits: Poor diet, excessive alcohol, drug use, too much stress and a sedentary lifestyle can all contribute to fatigue. Jet lag commonly causes temporary fatigue (symptoms usually improve in a few days).
• Medical conditions: Fatigue is a symptom of a wide range of diseases, disorders and deficiencies affecting various parts of the body.
• Sleep disorders: Insomnia, sleep apnea, and narcolepsy can cause extreme exhaustion and long-term fatigue.
• Medications and treatments: Several prescription and over-the-counter drugs, including antihistamines and blood pressure medications, can cause fatigue. Fatigue is a common side effect of bone marrow transplants, chemotherapy and treatments for a range of conditions.

What medical conditions cause fatigue?

Hundreds of conditions and disorders lead to fatigue. Some of the most common causes of fatigue include:

• Disease and infection: Cancer, kidney disease and multiple sclerosis are just a few diseases that cause fatigue. Fatigue can also be a sign of infections such as mononucleosis, HIV and flu.
• Mental health conditions: Fatigue from depression or anxiety may make it difficult or impossible to perform daily activities.
• Autoimmune disorders: Fatigue is a symptom of many autoimmune diseases, including diabetes, lupus and rheumatoid arthritis.
• Hormonal imbalances: Problems with your endocrine system (the glands in your body that make hormones) can lead to exhaustion. Hypothyroidism is a common cause of fatigue.
• Chronic conditions: Chronic fatigue syndrome (also called CFS or myalgic encephalomyelitis) and fibromyalgia cause severe, long-lasting fatigue.
• Heart and lung problems: Fatigue is a common symptom of cardiovascular conditions such as heart disease, postural orthostatic tachycardia syndrome (POTS), chronic obstructive pulmonary disease (COPD), emphysema and congestive heart failure.
• Deficiencies: Anemia and other vitamin deficiencies (such as vitamin D or vitamin B12) are often responsible for fatigue. Dehydration can cause fatigue because the body needs plenty of fluids to function.
• Weight problems and eating disorders: Anorexia, bulimia, obesity or being underweight can lead to fatigue and a range of other symptoms.

Care and Treatment

How can my doctor manage fatigue?

To find out what is causing your fatigue, your healthcare provider will ask questions about your lifestyle and medications and will conduct a physical examination. They might order some lab tests to test blood and urine. If you are a woman of child-bearing age, your provider will probably order a pregnancy test.

To relieve fatigue, your provider will treat (or help you manage) the condition or disorder that’s causing it. Depending on your health, your treatment plan may include a combination of medication, exercise, or therapy. If you’re taking a medication that makes you feel exhausted, talk to your healthcare provider about the risks and benefits of stopping the medication or trying another one.

How can I ease or relieve fatigue?

If a medical condition isn’t causing your fatigue, lifestyle changes may improve your symptoms. To reduce fatigue, you can:

• Practice good sleep habits: Aim for seven to nine hours of sleep every night. Don’t drink caffeine, use electronics, or exercise right before bed. Try to go to bed and get up at the same time every day.
• Avoid toxins: Don’t use illegal drugs, and drink alcohol in moderation, if at all.
• Eat a healthy diet: A balanced diet and plenty of water will keep your body nourished and hydrated.
• Manage stress: Yoga, mindfulness, meditation and regular exercise can help you relieve stress and gain more energy.
• See your healthcare provider: Make an appointment to rule out infections, disease, illness, vitamin deficiencies and other health conditions. You should also talk to your provider about medications you’re taking to see if they are causing your symptoms.
• Exercise often: Regular exercise is crucial for a healthy lifestyle. Though it might seem counter-intuitive, vigorous exercise can help you feel more energetic once you get used to it. But exercising too much can cause fatigue, so talk to your provider about what’s best for you.
• Maintain a healthy weight: Talk to your healthcare provider about your ideal weight, and try to stay within that range.

When to Call the Doctor

When should I call my doctor about fatigue?

It’s normal to feel tired now and then. Everyone experiences occasional, brief fatigue due to illness, sleep disturbances, travel or changes in diet or medication. But you should talk to your healthcare provider if you’re tired all the time. Call your provider if:

• Your fatigue lasts longer than a few days
• You’re having a hard time going to work or performing daily activities.
• There isn’t a clear reason (such as a recent illness) for your fatigue.
• It comes on suddenly.
• You’re older (over age 65).
• You’ve also been losing weight.

Fatigue can be a sign of a serious health condition. You should seek immediate medical attention if you have fatigue along with other symptoms, such as:

• Shortness of breath or pain in your chest, arm or upper back.
• Fast, pounding, fluttering or irregular heartbeat.
• Headache or vision problems (especially if you’ve hit your head recently).
• Nausea, vomiting or abdominal pain.
• Muscle weakness.
• Thoughts of harming yourself or others.

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Last reviewed by a Cleveland Clinic medical professional on 01/20/2020.

References

• Merck Manuals. Fatigue. (https://www.merckmanuals.com/home/special-subjects/nonspecific-symptoms/fatigue) Accessed 11/9/2021.
• Centers for Disease Control. Myalgic encephalomyelitis/chronic fatigue syndrome. (https://www.cdc.gov/me-cfs/index.html) Accessed 11/9/2021..
• Rosenthal TC, Majeroni BA, Pretorius R, Malik K. Fatigue: An Overview. (https://www.aafp.org/afp/2008/1115/p1173.html) Am Fam Physician. 2008 Nov 15;78(10):1173-1179. Accessed 11/9/2021..
• Penner IK, Paul F. Fatigue as a symptom or comorbidity of neurological diseases. (https://rdcu.be/bZ0zA) Nat Rev Neurol. 2017;13(11):662-675. Accessed 11/9/2021.

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