Dear Doctor Ted,
Two months ago I got a bladder infection. Painful, with a high fever and quite exhausting. Antibiotic eventually helped. What remained is fatigue. I still have, sometimes at the weirdest moments, what I call a “inflator”. Then suddenly I feel exhausted and need to rest and sleep. Friends and acquaintances recognize this. They also had that fatigue after other disorders and illnesses. Like the cancer, after Lyme disease and chronic fatigue syndrome. How does that fatigue come about?
Anne (64), Leeuwarden
An interesting question. Recently, there has been a remarkable amount of attention for fatigue after a COVID-19 infection. There are quite a few corona infected people who say they “stay tired” after their infection and have virtually no energy for even normal daily activities for weeks or even months. In the morning, some patients with long-term COVID or ‘lung COVID’ (also known as post-COVID-19 syndrome) wake up exhausted after a long night’s sleep.
Even more residual symptoms
Fatigue is one of the numerous side effects of this new disease, which can also lead to long-term loss of smell or taste, persistent concentration problems, psychological complaints and a rapidly deteriorating hearing and speech or movement ability. Now that healthcare is largely still about COVID, a lot of research money is spent on, among other things, that lingering fatigue.
Also in other diseases
But as you also noted in your e-mail: there is really nothing new under the sun. Fatigue is not exclusively reserved for COVID-19. Oh no, it is a factor in many (also chronic) diseases and after countless medical treatments. Fatigue plays a role in a wide variety of conditions, such as cancer, heart disease, bowel disease, diabetes, and even after a stroke, a person can feel exhausted for long periods of time. Say: from a severe flu to sepsis. I experienced the latter myself a few years ago: blood poisoning. I was in the hospital for a week and then it took me six weeks to get back to my old self.
Inflammatory substances are released
The sudden onset of fatigue, which I also suffered greatly from at the time, is still a phenomenon that scientists and doctors don’t really know how to deal with. Even if they can’t explain it (yet), it does exist. Take conditions such as chronic fatigue syndrome (CFS, in which a person is very tired for more than six months) and also Lyme disease: doctors struggle with it because much of it remains scientifically unexplained. How can the fatigue be explained? For an important part, it is inflammatory substances that are released and that sometimes remain in the body for a long time. As with inflammatory arthritis. These substances cause severe fatigue. This is how it was discovered three years ago at Utrecht University, by Dr. Mechiel Korte. “These substances are in the blood and they reduce signaling substances in the brain”, Korte explains. “These altered signals in the brain cause the fatigue that people with inflammatory rheumatism suffer from so much.”
Only then treatment is possible
Hopefully, all this attention for the post-COVID-19 syndrome will lead to an explanation for this fatigue in other disorders as well. Because only then can a treatment be developed for it.
Edited by René Steenhorst
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