Top 9 Causes of Fatigue
Find out what typically causes fatigue and how your doctor figures out why you’re so tired.
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Heart and Lung Problems
Certain heart and lung problems can also cause fatigue. Frank denies any shortness of breath, cough, heart palpitations, or chest pains.
People with sleep apnea often snore and have brief moments in which they stop breathing during sleep. This is often witnessed by their spouses and can be very scary. These patients often experience daytime fatigue, and report frequent napping. Frank’s wife says that although Frank does snore on occasion (which she finds a tad annoying), she’s never seen him stop breathing.
Insomnia or certain sleep disorders, like Restless Leg Syndrome, can interfere with a good night’s rest. We may not feel refreshed upon awakening, and this can cause daytime fatigue. Frank denies any issues with his sleep.
The Physical Exam
After taking a detailed patient history, next comes the physical exam. On exam, I noticed that Frank looked a tad pale, although the remainder of his exam was normal.
What is going on with Frank then, you may ask? Well, whether or not the doctor may have an idea of what’s causing the fatigue, we will likely run some tests, including one for the thyroid and one for anemia. There are other rare causes of fatigue, like liver and kidney disease, and leukemia (although these are quite rare), and your doctor will likely check these items as well.
So what did I find in Frank’s labs? His hemoglobin, the test that indicates anemia, was 10.2. Normal hemoglobin for women is above 12.0 and men above 14.0. So Frank is pretty anemic and that is what’s making him so tired.
But as a physician, I can’t just stop there because I know it’s not normal for a man his age to be so anemic. I needed to find out exactly what was causing Frank’s anemia. So I had his stool tested to check for bleeding. The test did indeed show some microscopic blood in his stool that is not visible to the naked eye. I then sent Frank to have a colonoscopy, a screen for colon cancer that is routinely done for people aged 50 and over. And I knew that Frank never had a colonoscopy since he hadn’t seen a doctor in so long.
Unfortunately, the root cause of Frank’s anemia and blood loss was a bleeding polyp that came back as cancerous. He needed surgery to have a part of his colon removed. Thankfully, because we caught it early on, he is in remission and doing swell. Frank tells me that he will never again put off his routine preventative care, even though he “still hates the doctor’s office.”
The cause of fatigue is not always so serious as it was in Frank’s case. Most of the time, my patients’ labs come back normal. However, it’s still one of those symptoms that should not be ignored.
Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.