Doctor, I Don’t Feel Well …

One of the most common complaints we hear about in the office is that of generalized fatigue. Most often, patients will describe a sense of feeling exhausted and generally describe it as “I’m just not feeling well.” Fatigue is what we think of as a vague symptom yet the etiologies are numerous. If fatigue is a problem for you, here are things to consider prior to your doctor’s visit:

Systemic diseases

A simple blood test may tell your doctor why you feel so tired. A comprehensive chemistry panel can detect the presence of diabetes, kidney and liver disease, as well as the presence of electrolyte abnormalities. Thyroid disease can also be detected through blood work. Anemia, a common cause of fatigue, can be checked by a complete blood count. Heart disease, especially in women, may present with fatigue with a cardinal complaint. Your doctor may want you to have a further evaluation with a stress test or an echocardiogram to evaluate your heart’s function.


How is your diet? Remember if we are putting the wrong fuel in the engine, that engine won’t run as effectively as it could. Ask yourself if you are really getting enough exercise and pay attention to the possibility of dehydration. Caffeine intake, while stimulatory in the short run, can interfere with deep sleep when taken in excess or consumed later in the day. And of course, alcohol consumption can also interfere with quality sleep. Try to limit computer and television consumption prior to bedtime as it can disrupt our circadian rhythm.

Sleep disorders

Are you having difficulty sleeping? You probably know if you have insomnia which will certainly contribute to your fatigue. But did you know that there are other sleep disorders that prevent you from getting the deep sleep you really need? If you find yourself getting drowsy during the day or your partner informs you that you are snoring, you may indeed have sleep apnea. Your doctor may ask you to have a sleep study to uncover sleep apnea or several other conditions that interfere with your critical rest.

Depression and Anxiety

Never underestimate the role of depression and anxiety which can often present with exhaustion. Your doctor should also make certain that your medications are not causing your symptoms.

If no etiology can be found, you may have a condition termed chronic fatigue symptom which will need to be managed in the long term. So, don’t settle for tired! Make that appointment and rev up your energy level!

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