As the year draws to a close, many of us experience a familiar wave of fatigue. While sometimes benign, this feeling of exhaustion, medically known as asthenia, can sometimes be a cause for concern. “Usually, a patient’s anxiety stems from not understanding the root cause,” explains Dr. Lama Giovansili, an endocrinologist. To differentiate between temporary tiredness and a more serious health issue, it’s crucial to pay attention to accompanying symptoms.
When fatigue is accompanied by “specific” symptoms,it’s time to seek medical advice. “for example, if fatigue is coupled with fever, cough, diarrhea, severe pain, or even shortness of breath,” Dr. Giovansili advises, “it warrants a consultation.” initial steps involve a clinical examination and blood tests to identify potential causes of asthenia, including a pregnancy test for women. Asthenia can indicate anemia (iron deficiency), other deficiencies, thyroid disorders (hypothyroidism or hyperthyroidism), cortisol deficiency (adrenal insufficiency), diabetes, kidney failure, autoimmune inflammatory diseases (such as polyarthritis), or even infections like COVID-19.
“We must know how to stop the escalation of additional tests and reassure the patient”
Asthenia can also be a symptom of chronic fatigue syndrome (CFS). This involves persistent fatigue lasting for more than six months, often accompanied by symptoms like muscle and joint pain, headaches, unrefreshing sleep, and malaise lasting over 24 hours after exertion. The exact causes of CFS remain unknown.”There are many hypotheses,” Dr. Giovansili continues. “Some suggest a psychosomatic origin, while others believe it’s a debilitating illness with an unknown organic cause.”
while CFS doesn’t typically lead to specific complications, managing it can be complex. “There isn’t a vrey effective or standardized treatment,” according to Dr. Giovansili. Treatment options include cognitive-behavioral therapy (CBT), gradual physical activity (walking, swimming, cycling), and symptomatic treatments like painkillers and antidepressants.
In some cases, the cause of unusual fatigue remains elusive. “Once examinations are complete, and in the absence of a suggestive context or guiding symptoms (cardiac, respiratory, cancer, etc.), it’s crucial to know when to stop unnecessary investigations or avoid labeling it as an ’infra-clinical’ problem (which doesn’t cause any detectable abnormalities),” Dr. Giovansili emphasizes.
Chronic fatigue syndrome, a debilitating condition characterized by persistent and overwhelming exhaustion, can significantly impact a patient’s quality of life. dr. Giovansili, a leading expert in the field, emphasizes the importance of a extensive approach to diagnosis and treatment.
“The challenge lies in identifying the underlying cause,” Dr. Giovansili explains. ”Often,patients undergo a battery of tests,but results come back normal,leading to a frustrating and confusing experience. This ‘diagnostic wandering,’ as we call it, can prolong the patient’s suffering and make it harder to find effective treatment.”
Dr. Giovansili stresses the need for a multi-faceted approach that goes beyond simply addressing the symptoms. “It’s crucial to rule out other potential medical conditions and to consider the patient’s overall well-being, including their mental and emotional health,” he says. “Sometimes, regaining energy sustainably involves lifestyle changes, such as learning to manage stress, practicing regular physical activity, and addressing any underlying anxiety.”
“You have to learn to live with your illness, manage your energy, work on yourself, on anxiety, on stress and practice regular physical activity,”
dr. giovansili cautions against over-medicalizing the condition, emphasizing the importance of a collaborative approach between doctor and patient. “It’s essential to empower patients to take an active role in their own recovery,” he says. ”This involves providing them with the knowledge and tools they need to manage their symptoms and improve their quality of life.”
While there is no one-size-fits-all solution for chronic fatigue syndrome, Dr. giovansili’s insights offer a valuable roadmap for both patients and healthcare providers. By focusing on a holistic approach that addresses the physical, mental, and emotional aspects of the condition, individuals with chronic fatigue syndrome can find hope and support on their journey to recovery.
