Understanding Fatigue: Causes and Potential Remedies

I sometimes ask my patients as part of my exam, “Are you fatigued?” and 99 percent of the time, they say, “I am always fatigued.” It's just “life in the fast lane.” It’s the way things are these days. So I have learned to ask, “Are you more fatigued than usual?” This discussion explores fatigue—its potential causes and remedies. In some cases, addressing root issues such as chronic pain, stress, or depression alleviates fatigue, while other strategies target the fatigue itself."

Fatigue

Causes of Fatigue

There are many, many causes of fatigue. These are discussed in the following pages. Of course, the fatigue is often relieved by treating the underlying causes either directly or indirectly.

If you are struggling with fatigue, chances are, there’s something you can do to feel better.

The following are some of the more common causes of fatigue. Click on the link if you would like to know more about some common causes, medical treatment, and alternative approaches for support.

• Fatigue due to stress

• Fatigue secondary to anxiety

• Fatigue related to depression

• Fatigue due to chemical changes and imbalances

• Chronic pain as a cause of fatigue

• Chronic fatigue syndrome

• Fatigue due to underlying illness (including sleep apnea)

• Insomnia as a cause of fatigue

• Medications that cause fatigue

• Fatigue due to aging

• Fatigue due to nutritional deficits

General Approaches to Fatigue​​:

• ​Exercise: Exercise for 30 minutes every day - during the day (if you cannot work an upper extremity, work a lower extremity, and if you cannot use a lower extremity, use an upper extremity - just do something!). Sometimes you have to force yourself to get up and exercise: Once you have done that a few times, a routine starts to develop and it is easier to do.

• Progressive Muscle Relaxation Exercises: This is done by tightening muscle groups for eight seconds then relaxing them for several seconds: Begin with facial muscles, with the face, moving to the scalp - tighten muscles eight seconds, then relax; then the neck, doing with each muscle group of the chest, back, pelvis, extremities and so on. This releases some tension and stress. If you do not have time to move through all of your muscle groups, do this with those muscles you believe have the most tension.

• Deep Breathing Exercises - Helps release endorphins in your brain, which are"feel good" hormones. This technique is practiced by taking a deep breath using your diaphragm muscle located just beneath your lower ribs (instead of using neck, shoulder and upper chest muscles), pausing and then releasing the breath, then repeating several times. Some people take the deep breath through the nose and let it out through the mouth.

• Guided Imagery - Think of a relaxing situation or a place you have been and focus on only that - focusing on texture, smells and visuals.

• Mindfulness - This is when a person focuses on the present moment, feeling and experiencing the moment with awareness and acceptance, not judgment. This reportedly helps the fronto-limbic area of the brain, which is responsible, in great part, for emotional regulation and processing.

• Analytical Meditation - This meditation involves focus on an object or a concept and focusing on only that.

• Body Scanning-Focus on a part of your body and feel relaxation, warmth, release of tension

• Eat a healthy diet

• Sleep hygiene - relaxation techniques (especially progressive muscle relaxation): maintain regular bedtimes, avoid napping, avoid stimulation before bed, avoid alcohol and caffeine before bed. Make your bed and pillow(s) comfy. Try music relaxation. If you cannot fall asleep in 20 minutes, get up and do something until tired. 

• Use non-pharmaceutical methods to reduce underlying anxiety and depression

• Make your overall environment more conducive to rest and relaxation.

• Massage

• Aromatherapy - especially lavender

​Over-the-Counter Medications

• Multivitamin supplements: Especially vitamins C, B, D, magnesium, zinc, folic acid and iron as supplementation for menstruating women to help increase energy.

• ​Melatonin to help sleep (as directed over-the-counter: Start with a lower dose)

• Control pain​

Considered Natural Remedies for Fatigue

• L-tryptophan to help with sleep-related fatigue

• L-Carnitine

• CoQ10 for energy

• 5-HTP for sleep-related fatigue

• Lemon balm for sleep-related fatigue

• Valerian for sleep-related fatigue

• Ginseng for energy

• Ashwagandha for energy

• Rhodiola for energy

• Sage for energy

• Ginkgo biloba for energy

• Peppermint for energy

• St John's Wort

​Prescriptive treatment 

• Treat underlying anxiety and depression

• Control pain

• For sleep problems: Try Zolpidem (Ambien), zaleplon (Sonata), eszopiclone (Lunesta), and others (these are all controlled, potentially addictive medications, but do work for insomnia)

• Neuroleptics for sleep (common: Trazodone and Seroquel)

• Stimulants (to help decrease fatigue) are usually controlled, potentially abused/addictive.

Rest and feeling rested are extremely important in our everyday lives: It helps our bodies and minds function optimally.