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Prolonged Asthenia (Fatigue) : Definition, Causes, Treatment and Chronic Fatigue Syndrome

Monday, September 24th 2012. | General

Fatigue Definition

The fatigue is a feeling of exhaustion that can not be attributed to an effort. It does not disappear at rest. The fatigue is a nonspecific symptom, that is to say, it does not allow itself to strongly evoke a particular disease. In most cases, fatigue is associated with an already known disease and its management will be responsible for the disease.

Sometimes fatigue is isolated. The doctor then proceeds to an analysis of the characteristics of this weakness, and symptoms associated research which will differentiate asthenia and fatigue “normal” and possibly prescribe additional tests.


There are differences between the asthenia and fatigue:

  • Fatigue is a feeling of weakness may be limited to a muscle or organ. It is sometimes painful effort appears and gives rest.
  • Muscle fatigue is easily recognizable and related to physical exertion. Eyestrain appears after a prolonged effort fixing eg on a screen.
  • The auditory fatigue is connected to a prolonged and intense sound exposure.

Some forms of depression, including depression masked, can result in fatigue sometimes associated with anxiety or dark thoughts.

It is often a morning asthenia, varying from one day to the next, not influenced by rest or exertion.

Asthenia frequently disappears at the end of the day.

It can be accompanied by many symptoms, pain, altered bowel …

Some doctors may prescribe antidepressants for a short period to confirm the non-existence of a real depression.

Fatigue from overwork?

The fatigue from overwork, known as asthenia reaction must be distinguished from fatigue secondary to stress and gives the rest.

Recognition of the weakness of overwork or fatigue reaction is variable depending on the country. For the French, asthenia reaction is fourth causes of fatigue, then it is not described in the Anglo-Saxons.

It is defined by a problem of adaptation, more or less prolonged, due to situations of stress or overwork.

The cause may be professional or family related problems of housing and transportation. Sometimes there are people with a depressive tendency, offset by a long hyper investment in the work, and brutally unbalanced by a life event (divorce, job change, workplace, labor dispute, relocation problem with a child …).

Overinvestment prolonged sporting activity can lead to the same situation.

The weakness is often more pronounced at night with the feeling of not being able to recover despite a prolonged sleep. It associates irritability, muscle tension state, less work efficiency.

The diagnosis of reactive fatigue is based on careful examination of the doctor living conditions of the patient, possibly triggering factor, physical complaints …

A development schedules, proper management of leisure time, and possibly a short psychological care can improve the fatigue from overwork.

Fatigue Tests

To diagnose fatigue related illness, some tests may be prescribed.

If fatigue, stress or lack of sleep are not involved, additional tests will be necessary to investigate the cause of the fatigue starting with a blood:

- Protein C Reactiv CRP, erythrocyte sedimentation rate in search of an inflammatory syndrome

- Complete blood count (CBC): infection, anemia  

- Glucose, liver function tests, serum calcium,

- Creatinine for renal function study.

- TSH: thyroid problem

- Ferritin iron deficiency

What Asthenia causes organic?

The causes are multiple and require a precise balance.

Infectious asthenia

Infections most often cause prolonged asthenia are viral hepatitis (viral infection of the liver), infectious mononucleosis (viral infection as manifested by angina), tuberculosis, brucellosis or infective endocarditis ( inflammation of the lining of the heart).

Asthenia endocrine and metabolic

The adrenal, pituitary, and hypothyroidism (characterized by insufficient production of thyroid hormones) are accompanied by asthenia sometimes important.

 But the weakness is also present in other endocrine (glands which secrete hormones): hyperthyroidism, hyperadrenocorticism, hyperparathyroidism.

Misunderstood or unbalanced diabetes, kidney failure are also causes of fatigue.

Finally, iron deficiency causing anemia, very common in women before menopause, may be associated with prolonged asthenia.

Asthenia neurological

Muscular diseases may be associated with weakness: myopathy, myositis and muscular dystrophies (abnormal development of muscle). Neurological diseases such as multiple sclerosis, Parkinson’s disease, narcolepsy is usually accompanied, also, a weakness.

Asthenia neoplastic

Most cancers are the cause of fatigue.

Asthenia hematological

Blood diseases – including lower red blood cell count, anemia – are generally associated with fatigue.

Asthenia digestive origin

Non-infectious hepatitis (drug, toxic …), cirrhosis and overload diseases such as hemochromatosis are responsible for fatigue. Celiac disease may also manifest as fatigue, as well as inflammatory bowel disease.

Asthenia original cardiovascular and respiratory

Heart failure, arrhythmias, chronic respiratory insufficiency syndrome, sleep apnea may be the cause of fatigue.

Systemic diseases

These diseases – from inflammatory or autoimmune disease – affecting several organs and result in fatigue associated with other more specific signs: systemic lupus erythematosus (this is an infrequent condition affecting mostly the face, which is manifested by the appearance of red lesions occurring persistent and dry especially on sunny days), sarcoidosis, polymyositis (muscle atrophy), rheumatoid arthritis (the most common chronic inflammatory rheumatism) or giant cell arteritis (usually occurring towards the sixties, characterized by a deterioration of the general condition).

Asthenia original toxic or drug

The main drugs causing fatigue are psychotropic drugs (drugs that affect the mind), the central antihypertensive, beta-blockers, calcium channel blockers and cancer. Alcoholism can be manifested by asthenia.

Asthenia Treatment

The treatment of asthenia is most often the cause of.

Treatment may consist of: a correction of a deficiency in vitamins or trace elements, a hormonal deficiency, antibiotics in case of bacterial infection, treatment of cancer.

Antidepressant treatment will remove the prolonged weakness related to a genuine depression.

When there is no cause found, is called functional asthenia and is sometimes linked to unhealthy lifestyle or a burnout.In some cases, treatments called “anti-asthenic” can be used. These treatments include many molecules: amino acids, vitamins, trace elements and stimulants including caffeine.

Their effectiveness is variable and some of these drugs may have a placebo effect related to more listening and recognition of asthenia. This effect is sometimes sufficient if transient asthenia, but rarely if prolonged asthenia.

It is the physician to choose in each case the best approach: treating the cause first, and depending on it antidepressants, anti-asthenic or sometimes supportive psychotherapy.

How to live with?

The lifestyle is paramount in the treatment of asthenia,

The lifestyle can reduce the fatigue in cases of infectious disease, and sometimes the delete event of asthenia reaction.

Time arrangements

The leisure time should be preserved, with real leisure activities. Work schedules more regular transport time is often limited good “anti-fatigue”.


We know now that we ingest more calories than 50 years ago, but unfortunately at the expense of the most needed foods, especially those rich in vitamins and trace elements.Nutritional deficiencies are common, especially in women due to pregnancy and rules.

The daily diet should include fruits and vegetables, a diet sufficient good quality protein, dairy source of calcium and less fat and sugars with high glycemic index that is rapidly absorbed.

Avoid dieting

The obsession with thinness and regimes more or less absurd may cause asthenia associated with an energy deficit of food. The fatigue-related regime will then lead to compulsive snacking with access to fatty and sugary products (chocolates, biscuits, pastries …).

These foods are low in vitamins and minerals, accentuate the imbalance and are gaining weight, creating a vicious circle where the weakness worsens with depression, self-esteem, etc..

Back to sleep

Loss of sleep or poor quality sleep can lead to real asthenia. Before taking a sleeping pill that will solve the problem only temporarily, it is better to focus on improving the conditions of sleep condition by setting a quiet time in the evening, eviction stimulants (coffee, alcohol, excitement but also visual and auditory ), quiet, non superheated good bedding … and especially regular bedtimes and rising. These common sense measures may be sufficient.

Chronic Fatigue Syndrome

It is a syndrome whose main symptom is fatigue.

The chronic fatigue syndrome is a recent concept, whose definition criteria vary by country. They include, in general, persistent fatigue for at least six months, present for at least 50% of the time without medical cause identified.

Fatigue is at the forefront but may be accompanied by various disorders: mild fever, sore throat, lymph nodes palpable weakness or muscle pain, headache or joints, impaired concentration, memory, sleep disorders. For some disorders are associated with cellular immunity.

The origin of chronic fatigue syndrome is still debatable. The role of some viruses is advanced, but the syndrome is not transferable and no epidemic has been observed. Abnormal immunity and minimal endocrine abnormalities have been described (such as those found elsewhere in authentic depressions). The recognition of this syndrome in young active managers earned him the name “syndrome yuppies.”Patients with predominantly painful fall as part of fibromyalgia.

Doubt persists about the exact role of depression in this syndrome. The chronic fatigue syndrome may be due to depression or, conversely, induce a secondary depression, the person feeling diminished and devalued by this debilitating fatigue that hampers his social, professional and emotional.

The evolution of chronic fatigue syndrome is generally toward healing but sometimes only after several years. Entanglement with a depressive syndrome may still extend syndrome. The anti-depressant may be helpful. Physiotherapy or magnesium therapy seems to be an interesting contribution to these patients.

Your consultation

Please note the information on this fatigue your doctor

You will facilitate the work of your physician noting the key points of your fatigue:

- How long are you tired?

- A life event coincides there with the onset of fatigue?

- What time of day are you most tired?

- What are the consequences on social, labor, about the life of couple?

- Are there any associated symptoms? pain? Weight loss?

- What biological and radiological examinations have you done and what are the results?

- Do you take drugs and where?

- People around you Were with infectious diseases?

- Do you have trouble sleeping?

- Do you or did you special diets?

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