Fatigue: When to see a doctor

Even though fatigue is one of the most common medical complaints, you may feel hesitant about making a doctor's appointment just to say you lack energy. But don't wait until you're so tired you can't get out of bed before seeing a doctor.

If you feel so weary or lethargic that you can't do particular activities as well or as often as you once did, it's important to make an appointment. Perhaps you used to play tennis once a week without any problem, but now you get winded during the game. Or maybe by the end of the day you often feel too tired to cook dinner or go out to a movie. These are good reasons to see a doctor.

Describing your symptoms

Start with your internist or family doctor to find out if you have an underlying medical or psychological illness. Because fatigue is a characteristic of many illnesses, you should describe your symptoms in detail to help your doctor narrow down the possible causes. How, exactly, does the fatigue feel to you? Do you have trouble concentrating? Are you mentally fuzzy—for example, do you take longer to think of words or compute simple math problems than you used to? Do you tire more quickly? Do certain activities take more effort than they used to? Answers to these questions indicate how severe your fatigue is and whether it mainly involves muscle fatigue, central fatigue, or both.

Be prepared to tell your doctor which activities you've had to limit. For example:

• You used to enjoy going out to dinner and the theater with friends, but now you can't stay awake during an evening performance.
• You no longer wake up feeling refreshed, even after you've slept all night.
• When you exercise, your muscles feel achy and weak in less time than they once did.
• You've done the newspaper crossword puzzle for years, but now your mind wanders, and you lose interest before finishing it.

This information yields further clues to the nature and severity of your fatigue. Timing is also important. Tell the doctor when you started noticing a decrease in your physical or mental energy level. Was the change gradual or sudden? When fatigue involves stress, overwork, or psychological problems, it usually comes on gradually. However, when the cause is chronic fatigue syndrome, fibromyalgia, or a side effect of medication, fatigue often starts suddenly. Did the onset of fatigue coincide with any other significant change in your life? Had you been ill? Did you have an injury? Did you start taking a new medication? Was there a death in the family or among your friends? Are you under an exceptional amount of stress? Your symptoms could be related to any of these factors.

Also, make sure to tell your doctor about any other symptoms you might be experiencing. Give details about when the different symptoms began and whether they started together or at different times. Mention physical as well as emotional symptoms. Do you get out of breath easily? Do your muscles or joints ache? Do you have trouble sleeping? Are you feeling unusually sad or anxious? Different symptoms accompanying fatigue suggest different causes. For example, feeling blue and having trouble sleeping are two signs of depression. Shortness of breath can be a sign of heart disease.

Boosting Your Energy

Fatigue, like death and taxes, may indeed be an inescapable part of life. But that doesn't mean you have to take it lying down. Boosting Your Energy is a special health report from Harvard Medical School that provides you with the latest information about fatigue and offers strategies to help you regain the physical and mental energy you need to enjoy life to its fullest.

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