The differential diagnosis of fatigue includes many infections, malignancies, endocrinopathies, and connective tissue disease. The psychiatric illnesses include depression, anxiety, bipolar disease, and somatoform and psychotic disorders. Depression is one of the most common underlying diagnoses when fatigue is a primary complaint.
- Depression
- Environment (lifestyle)
- Anxiety, anemia, asthma
- Diabetes
- Infections
- Thyroid, tumors
- Rheumatologic
- Endocarditis, cardiovascular
- Drugs
Anxiety. Both depression and anxiety tend to be accompanied by sleep disturbance symptoms. Anemia characteristically will cause a more generalized physical fatigue without sleep disturbances. Asthma and other lung diseases are common causes of fatigue.
Diabetes should be considered in the obese patient with fatigue. Hypothyroidism and hyperthyroidism are easily treatable causes of fatigue. Tumors and other malignancies may cause tiredness. Many infections cause fatigue, including viruses, tuberculosis, Lyme disease, and HIV infection.
Rheumatologic disorders, including rheumatoid arthritis, systemic lupus erythematosus and fibromyalgia, are common causes of fatigue.
Endocarditis is a very rare cause of fatigue associated with valvular and other cardiovascular diseases.
Drugs that may cause fatigue including analgesics, psychotropics, antihypertensives, and antihistamines. Over-the-counter medications and substance abuse (caffeine, alcohol, and illicit drugs) may cause fatigue.
1 comment:
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