Fatigue: What's Zapping Your Energy?
Up to 98 percent of people with rheumatoid arthritis (RA) report fatigue, as do 50 percent or more of those with lupus or Sjögren’s syndrome. The percentage grows higher with obesity, depression or conditions like fibromyalgia, congestive heart failure, lung problems or chronic headaches.
Because so many people experience fatigue, doctors have a tough time sorting out causes. Take a look at what could be behind your zapped energy and learn how to get it back.
The Challenge of Fatigue
Fatigue is hard to describe and diagnose. If you find yourself with no energy, even after a full night’s rest, it may be fatigue.
In a study of how people with RA perceive fatigue, Sarah Hewlett, PhD, senior lecturer in Rheumatology Health Professions at the University of Bristol in England found patients described fatigue as “severe weariness and dramatic and overwhelming exhaustion attributed to inflammation, working the joints harder and getting unrefreshing sleep.” Patients with various chronic diseases experience fatigue as an occasional come-and-go symptom, but many RA patients experience long-lasting fatigue, says Ken Pischel, MD, head of the rheumatology division at Scripps Clinic in La Jolla, Calif.
As such, patients have a hard time telling doctors what may have led to the fatigue. In Hewlett’s study, the few RA patients who felt comfortable discussing fatigue with their doctors still reported inadequate care for it, or perhaps due to the fact that pain usually is eased with medication. Doctors may be able to only confirm fatigue’s existence, but Hewlett says this offers little help to patients.
Untangling Causes
Dr. Pischel explains that fatigue has many contributing factors. “Joint inflammation, chronic pain, hormonal changes, anemia, depression and stress are major factors.” One in five people with RA also has fibromyalgia, and many of those with fibromyalgia also experience chronic fatigue.
Sleep problems are usually the first line of investigation. But even if insomnia or restless sleep is present, more factors could be causing the fatigue.
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