Fatigue is one of the most common reasons for patients to seek evaluation by an endocrinologist. Appropriate evaluation for endocrine and metabolic causes could include tests for hypothyroidism or adrenal insufficiency or low testosterone or vitamin B12 deficiency or iron deficiency. But frequently these tests are negative and that we need to consider other possible causes. I
Infectious diseases like mononucleosis and Lyme disease may require evaluation by an ID specialist. Rheumatologic diseases like lupus or rheumatoid arthritis may require a rheumatologist. There may be stress or depression which could be treated by the primary doctor or a counselor.
One of the most common causes of fatigue is its effects from medications and disorders. It is not unusual for our patients to be taking as many as 10 different medications. Many of the common medicines for blood pressure and high cholesterol and diabetes and heart disease can cause fatigue. Some people are much more susceptible to these side effects than others.
Probably the most common cause of all is a sleep disorder. People develop increased difficulty sleeping as they get older. Sometimes after menopause lack of estrogen results in night sweats that prevent deep restful sleep. Sleep apnea should always be considered in people who are overweight or snore at night. Simply getting up to go to the bathroom several times per night can interfere with restful sleep. People may become much more sensitive to caffeine and simply do not “turn off” when they go to bed. Their mind keeps racing. It is important to have a comfortable bed and some air movement in the bedroom and not get overheated while trying to sleepWe do not always find the cause of fatigue but the search is frequently worthwhile.