Some Common Causes and Features of Prolonged or Chronic Fatigue
Some Common Causes and Features of Prolonged or Chronic Fatigue
Cause | Common Features* | Tests |
|---|---|---|
Blood disorders or cancers | ||
Decreased exercise tolerance with shortness of breath during activity greater than expected for the activity Sometimes paleness | CBC | |
Cancers (such as digestive tract cancer Tumors of the Digestive System , lung cancer Lung Cancer Lung cancer is the leading cause of cancer death in both men and women. About 85% of cases are related to cigarette smoking. One common symptom is a persistent cough or a change in the character... read more | Widespread lymph node swelling, weight loss, and night sweats With multiple myeloma, low back or other bone pain, often severe at night | CBC |
Infections | ||
Sometimes jaundice, loss of appetite, and fluid in the abdomen | Blood tests to determine how well the liver is functioning and to identify the hepatitis virus Sometimes liver biopsy | |
Fever Sometimes cough and respiratory symptoms Sometimes loss of taste and smell | Blood test for SARS-CoV-2 | |
Enlarged spleen and lymph nodes, fever, and night sweats | Sometimes blood tests for antibodies to cytomegalovirus | |
Fever and night sweats Sometimes joint pains Usually in people who have heart murmurs or inject drugs intravenously | Cultures of blood samples and echocardiography | |
Fever, night sweats, and frequent infections Sometimes difficulty breathing, cough, diarrhea, and/or rash | HIV blood test | |
Recent sore throat and lymph node swelling | Mononucleosis blood test | |
Other infections (for example, fungal pneumonias such as histoplasmosis Histoplasmosis Histoplasmosis is an infection caused by the fungus Histoplasma capsulatum. It occurs mainly in the lungs but can sometimes spread throughout the body. Histoplasmosis is acquired by inhaling... read more | Fever, night sweats, and weight loss Sometimes cough, difficulty breathing, and coughing up blood | Tests based on which type of infection seems likely |
Other disorders and causes | ||
Shortness of breath, difficulty breathing when lying down that is relieved when upright (orthopnea), and/or swelling | Blood tests of kidney function | |
Connective tissue disorder (for example, rheumatoid arthritis Rheumatoid Arthritis (RA) Rheumatoid arthritis is an inflammatory arthritis in which joints, usually including those of the hands and feet, are inflamed, resulting in swelling, pain, and often destruction of joints.... read more | Fever, night sweats, weight loss, joint pain, rash, and/or other organ involvement (for example, effects on the heart or lungs) | Blood tests for abnormal antibodies |
Deconditioning | A history of lack of exercise or being bedbound or hospitalized | Only a doctor's examination |
Excessive thirst, excessive urination, increased appetite, and unexplained weight gain or loss | Measurement of sugar (glucose) level in the blood after the person fasts overnight and sometimes glucose tolerance testing | |
Drugs: Antidepressants, older antihistamines, antihypertensives, diuretics that cause low potassium levels in the blood, muscle relaxants, recreational drugs, and sedatives | History of taking a drug known to cause fatigue | Only a doctor's examination |
Headache, pain in the jaw when chewing, pain when combing hair, loss of vision, and/or muscle pains in a person over 50 | ESR and temporal artery biopsy | |
Mental health disorders: Anxiety Overview of Anxiety Disorders Anxiety is a feeling of nervousness, worry, or unease that is a normal human experience. It is also present in a wide range of psychiatric disorders, including generalized anxiety disorder,... read more , depression Depression A short discussion of prolonged grief disorder. Depression is a feeling of sadness and/or a decreased interest or pleasure in activities that becomes a disorder when it is intense enough to... read more , drug addiction Recreational Drugs and Intoxicants , panic disorder Panic Attacks and Panic Disorder A panic attack is a brief period of extreme distress, anxiety, or fear that begins suddenly and is accompanied by physical and/or emotional symptoms. Panic disorder involves recurrent panic... read more , or somatization disorder Somatic Symptom and Related Disorders (physical symptoms caused mainly by anxiety) | Anxiety, sadness, loss of appetite, and unexplained sleep disturbance With somatization disorder, an excessive preoccupation with physical symptoms | Only a doctor's examination |
Fatigue worse with exposure to heat Past symptoms of nervous system malfunction (such as numbness, loss of coordination, and weakness), particularly if people had more than one episode of symptoms | Brain and/or spinal cord MRI | |
Pregnancy | Cessation of menstrual periods, breast tenderness, morning sickness, and abdominal swelling | Pregnancy test |
Excessive daytime sleepiness Insomnia and Excessive Daytime Sleepiness (EDS) The most commonly reported sleep-related problems are insomnia and excessive daytime sleepiness. Insomnia is difficulty falling asleep or staying asleep, waking up early, or a disturbance in... read more , frequent awakenings, breathing interruptions during sleep, difficulty falling asleep, unrefreshing sleep | Sleep laboratory testing (polysomnography) | |
Inability to tolerate cold, weight gain, constipation, and coarse skin | Blood tests of thyroid function | |
Weight loss Sometimes loss of appetite, foul-smelling stool, abdominal pain, or a combination | A doctor's examination Sometimes other tests | |
Disorders of unknown cause | ||
Chronic fatigue syndrome Chronic Fatigue Syndrome Chronic fatigue syndrome, also called myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), refers to long-standing severe and disabling fatigue without a proven physical or psychologic... read more (now sometimes called myalgic encephalomyelitis or systemic exertion intolerance) | Sore throat, sleep that is not refreshing, difficulty with concentration or short-term memory, muscle aches, joint pain, headaches, and/or tender lymph nodes in the neck or under the arms | Only a doctor's examination |
Long-standing and widespread muscle and bone pain in areas outside the joints, trigger points, lower abdominal pain, gas, bloating, constipation or diarrhea, migraines, and anxiety | Only a doctor's examination | |
* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. | ||
CBC = complete blood count; ESR = erythrocyte sedimentation rate; HIV = human immunodeficiency virus; MRI = magnetic resonance imaging. | ||
