Physical Causes
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| ### 2. **Mental and Emotional Causes** - **Mental Health Disorders**: Depression, anxiety, bipolar disorder, post-traumatic stress disorder (PTSD). - **Stress**: Chronic stress, acute stressors, burnout. - **Emotional Trauma**: Grief, major life changes, emotional abuse. |
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| ### 3. **Lifestyle Factors** Poor Sleep - Irregular sleep schedule, poor sleep environment, excessive screen time before bed. - **Physical Inactivity**: Sedentary lifestyle, lack of regular exercise. - **Poor Diet**: Unbalanced diet, excessive caffeine or alcohol consumption, dehydration. - **Overexertion**: Physical overexertion, overtraining in athletes. |
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Endocrine
hyper- and hypothyroidism, hyperparathyroidism,
### 4. **Environmental Causes**
- **Workplace Issues**: Long working hours, high job demands, lack of breaks, poor ergonomics.
- **Environmental Toxins**: Exposure to chemicals, pollutants, and toxins in the environment.
- **Extreme Temperatures**: Heat exhaustion, hypothermia.
### 5. **Medical Treatments**
- **Chemotherapy and Radiation Therapy**: Common in cancer treatment.
- **Surgery**: Post-operative fatigue, anesthesia effects.
- **Chronic Medication Use**: Long-term use of medications with sedative effects.
### 6. **Neurological Causes**
- **Multiple Sclerosis (MS)**: Fatigue is a common symptom.
- **Parkinson’s Disease**: Includes physical and mental fatigue.
- **Chronic Fatigue Syndrome (CFS)**: Persistent, unexplained fatigue lasting six months or more.
### 7. **Hormonal Imbalances**
- **Menopause**: Hormonal changes leading to fatigue.
- **Pregnancy**: Especially in the first and third trimesters.
### 8. **Other Causes**
- **Autoimmune Disorders**: Lupus, rheumatoid arthritis.
- **Chronic Fatigue Syndrome (CFS)**: Also known as myalgic encephalomyelitis (ME).
- **Post-Viral Fatigue**: Fatigue following a viral infection, including long COVID.
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HF, infections (endocarditis, hepatitis), COPD, asthma, interstitial lung disease, ESKD, sleep apnea, anemia, autoimmune disorders, multiple sclerosis, IBD, irritable bowel syndrome, Parkinson disease, cerebral vascular accident, and cancer
Alcohol use disorder, vitamin C deficiency (scurvy), side effects from medications (eg, sedatives and beta-blockers), and psychological conditions (eg, insomnia, depression, anxiety, panic attacks, dysthymia, and somatic symptom disorder may be the cause. Common outpatient infectious causes include mononucleosis and sinusitis. These conditions are usually associated with other characteristic signs, but patients may emphasize fatigue and not discuss their other symptoms unless directly asked. The lifetime prevalence of significant fatigue (present for at least 2 weeks) is about 25%. Fatigue of unknown cause or related to psychiatric illness exceeds that due to physical illness, injury, alcohol, or medications.
Although frequently associated with Lyme disease, severe fatigue as a long-term sequela is rare. Posttraumatic brain injury fatigue and sleep disturbance may respond to a light box and in-home dynamic light therapy. Although there is only limited evidence, hearing loss in middle-aged and older adults may increase fatigue.
There is some evidence that chronically experienced fatigue in older people is associated with reduced hippocampus volumes on neuroimaging and hippocampal amyloid deposition.