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Why do you always feel tired? Medical causes and solutions

Why do you always feel tired? Medical causes and solutions

Chronic fatigue is a complex and debilitating problem, often underestimated or mistaken for simple laziness. But beyond the feeling of persistent fatigue may lie serious medical causes that require a careful and specialized approach.

At Elytis, we understand the depth of this problem and are dedicated to identifying and treating the underlying causes of chronic fatigue, offering customized solutions to help you regain your energy and vitality.

This article explores the hidden medical causes of chronic fatigue and outlines internal medicine's approach to diagnosing and treating the condition.

What is chronic fatigue and how does it differ from normal fatigue?

Fatigue is a common feeling, experienced by most people at some point. It is usually a normal reaction to intense physical or mental exertion, lack of sleep or stress. Chronic fatigue, however, goes far beyond this temporary state.

Characteristics of chronic fatigue:

  • Persistence: chronic fatigue lasts at least six months and does not improve significantly after rest.
  • Severity: is a profound fatigue that significantly interferes with daily, professional and social activities.
  • Associated symptoms: often, chronic fatigue is accompanied by other symptoms such as muscle or joint pain, difficulty concentrating, memory problems, headaches, enlarged lymph nodes and sleep disturbances.

Chronic fatigue is not just a mood or a lack of motivation. It is a real medical condition with a significant impact on quality of life.

Hidden medical causes of chronic fatigue

Identifying the exact cause of chronic fatigue can be challenging as it is often multifactorial. However, there are a number of medical conditions that can contribute significantly to its onset and persistence.

  1. Endocrine disorders:
    • Hypothyroidism: an underactive thyroid can lead to fatigue, weight gain, depression and other symptoms.
    • Addison's disease: adrenal gland failure can cause extreme fatigue, muscle weakness and weight loss.
    • Diabetes mellitus: fluctuating blood sugar levels can lead to fatigue and lack of energy.
  2. Autoimmune diseases:
    • Systemic lupus erythematosus (SLE): this autoimmune disease can affect multiple organs and systems, causing fatigue, joint pain, rashes and other symptoms.
    • Rheumatoid arthritis: chronic joint inflammation can lead to fatigue, pain and stiffness.
    • Multiple sclerosis (MS): this disease affects the central nervous system and can cause severe fatigue, muscle weakness and coordination problems.
  3. Cardiovascular diseases:
    • Heart failure: the heart stops pumping blood efficiently, which can lead to fatigue, shortness of breath and swelling in the legs.
    • Coronary heart disease: reduced blood flow to the heart can cause fatigue and chest pain.
  4. Infectious diseases:
    • Infectious mononucleosis: this viral infection can cause severe fatigue, fever, sore throat and enlarged lymph nodes.
    • Lyme disease: transmitted by tick bites, Lyme disease can cause fatigue, joint pain, rash and other symptoms.
    • Chronic hepatitis: chronic liver inflammation can lead to fatigue, jaundice and other symptoms.
  5. Sleep disturbances:
    • Obstructive sleep apnea: repeated interruptions in breathing during sleep can lead to excessive daytime fatigue.
    • Chronic insomnia: difficulty falling asleep or staying asleep can cause fatigue and irritability.
  6. Mental disorders:
    • Depression: a common mental illness that can cause fatigue, sadness, lack of motivation and other symptoms.
    • Anxiety: chronic stress and anxiety can lead to fatigue, irritability and difficulty concentrating.
  7. Nutritional deficiencies:
    • Iron deficiency: iron deficiency anemia can cause fatigue, weakness and pallor.
    • Vitamin B12 deficiency: this vitamin is essential for energy production and deficiency can lead to fatigue, weakness and neurological problems.
    • Vitamin D deficiency: vitamin D plays an important role in muscle and energy function, and deficiency can contribute to fatigue.

The importance of internal medicine in diagnosing chronic fatigue

Internal medicine plays a crucial role in diagnosing and treating chronic fatigue because of its holistic approach and expertise in managing complex conditions.

How does internal medicine tackle chronic fatigue?

  1. Detailed clinical assessment:
    • Your internist will take a thorough history, discussing your symptoms, medical history, lifestyle, stressors and medications.
    • A full physical examination will be carried out to identify physical signs of possible underlying conditions.
  2. Paraclinical investigations:
    • Laboratory tests: blood tests may be done to assess thyroid function, blood sugar levels, liver and kidney function, vitamin and mineral levels, and to detect signs of inflammation or infection.
    • Imaging investigations: depending on the symptoms, X-rays, ultrasound or other imaging investigations may be recommended to assess the condition of the internal organs.
    • Sleep tests: if a sleep disorder is suspected, a polysomnogram may be performed to monitor brain activity, breathing and other physiological functions during sleep.
  3. Differential diagnosis:
    • Your internist will consider all the possible causes of chronic fatigue and carry out further tests if necessary to rule out other conditions.
  4. Personalized treatment plan:
    • Treatment will be tailored to the underlying cause of the chronic fatigue and may include medication, physical therapy, psychological counseling, lifestyle changes and other interventions.
  5. Interdisciplinary collaboration:
    • Depending on the needs, the internist may work with other specialists, such as endocrinologists, cardiologists, neurologists or psychologists, to ensure a comprehensive and coordinated approach.

Solutions and strategies for managing chronic fatigue

In addition to medical treatment specific to the underlying cause, there are a number of strategies and lifestyle changes that can help manage chronic fatigue and improve quality of life.

  1. Rest and quality sleep:
    • Set a regular sleep schedule, going to bed and waking up at the same time every day.
    • Create a relaxing, dark, quiet and cool sleeping environment.
    • Avoid caffeine, alcohol and heavy meals before bedtime.
  2. Stress management:
    • Practice relaxation techniques such as meditation, yoga or deep breathing.
    • Identify and reduce the stressors in your life.
    • Make time for enjoyable and relaxing activities.
  3. Healthy eating:
    • Eat a balanced diet rich in fruits, vegetables, whole grains and lean protein.
    • Avoid processed foods high in sugar and saturated fats.
    • Make sure you hydrate properly by drinking enough water throughout the day.
  4. Regular physical activity:
    • Get regular moderate exercise such as walking, swimming or cycling.
    • Start slowly and gradually increase the intensity and duration.
    • Avoid overexertion and give yourself time to rest and recover.
  5. Psychological support:
    • Cognitive-behavioral therapy (CBT) can be useful for learning strategies to manage chronic fatigue and associated symptoms.
    • Support groups can provide a sense of community and understanding.

Internal medicine at Elytis: an integrated approach to chronic fatigue

At Elytis, our team of experienced internists offers an integrated approach to chronic fatigue, with a focus on identifying the underlying causes and developing personalized treatment plans.

Why Elytis?

  • Team of experts: our internists have extensive experience and are continually updating their knowledge and keeping up to date with the latest protocols and medical guidelines.
  • Modern technology: state-of-the-art equipment for laboratory tests and imaging helps to establish a diagnosis quickly and closely monitor the progress of treatments.
  • Patient-oriented: we listen to you, answer your questions and make sure you understand every step of your medical care. Open communication and active involvement of the patient in therapeutic decisions underpin the trusting relationship we build.
  • Long-term results: through regular monitoring, treatment adjustment and counseling, we make sure that your health stays optimal in the long term.

Your path to better health at Elytis

  1. Appointment and initial assessment: we set up an appointment to discuss your symptoms, medical history and any tests already done.
  2. Diagnosis and treatment plan: after evaluating the results, the internist proposes appropriate treatment options and recommends referral to other specialties if necessary.
  3. Implementation and monitoring: we keep a close eye on your health, adjusting treatment and providing ongoing support.
  4. Prevention and long-term follow-up: we give you prevention advice and schedule regular check-ups so you maintain your results.

Chronic fatigue is a complex condition that can have multiple hidden medical causes. It is important not to ignore it and seek medical help to identify and treat the underlying cause.

At Elytis, internal medicine offers an integrated and personalized approach to chronic fatigue, helping you regain your energy and improve your quality of life.

Don't let chronic fatigue control your life - seek help and start your journey to better health.

Latest medical review:

03.06.2025, Dr. Bogdana Cîrdei - Primary Doctor Internal Medicine

References:

  • "Fatigue. Cleveland Clinic, 2023.
  • "Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS)". NHS, 2024.