Chronic fatigue: when exhaustion is a permanent condition

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Fatigue is one of the body's natural responses. However, if fatigue becomes permanent, we speak of chronic fatigue. What are the symptoms and causes? And when should you see a doctor?

Why tiredness is important

The thought of never feeling tired again is a dream for many people. But although tiredness is disturbing, it’s a vital sign. It forces body and mind to relax. Feeling tired after a mental or physical activity is normal. But what happens when exhaustion is permanent?

The symptoms of chronic fatigue

Many sufferers complain of not feeling rested after sleeping and being exhausted and drained during the day. Other symptoms of chronic fatigue are:

  • reduced mental and physical performance
  • concentration difficulties
  • headaches
  • stinging eyes
  • irritability
  • higher sensitivity to sensory stimuli (like bright light or loud noise)
  • depressive mood

Causes of chronic fatigue

One of the general causes is chronic sleep deprivation. Going to bed too late and getting up too early robs the body of the time it needs to regenerate. People who do little exercise also get tired more quickly. Lack of fluids as well as dieting and being underweight also lead to fatigue because the body doesn’t get enough water and nutrients. Stress, prolonged under-exertion and nutrient deficiencies also make people fatigued.

Chronic fatigue has developed into a mass phenomenon in recent decades.
Dr. med. Anne Fleck, Doctor of Preventive and Nutritional Medicine

Fatigue in connection with serious medical conditions

In addition, various diseases can also include fatigue as a symptom. The most important are: infections, sleep apnoea, anaemia, cardiac arrhythmias, metabolic diseases such as hypothyroidism or diabetes, cancer and multiple sclerosis.

Tired all the time: what helps?

You can do a lot to prevent bouts of fatigue:

  • live according to your inner clock, as far as is practical
  • take short naps (power naps)
  • eat a balanced diet
  • lose excess weight
  • drink enough water, about 2 litres per day
  • avoid alcohol and nicotine as much as possible
  • exercise regularly to get your circulation going
  • if you feel tired in the morning: boost your circulation with hot and cold showers
  • reduce stress
  • make effective use of your resources with what’s known as the “pacing strategy” (do less than your strength levels allow at the given moment. This will reduce bouts of fatigue.)
  • use relaxation techniques such as yoga

Overall: fatigue is treatable – but usually only by changing lifestyle habits. The results won’t appear overnight as the effect is more gradual.

Chronic fatigue is a mass phenomenon

Permanent fatigue is one of the most common reasons for seeing a doctor. “Chronic fatigue has become a mass phenomenon in recent decades,” says Dr Anne Fleck, Doctor of Preventive and Nutritional Medicine and author of the book Energy. Chronic fatigue is more than a temporary lack of energy, she says. Chronic fatigue is a warning sign from the body.

Chronic fatigue is more than a temporary lack of energy. Chronic fatigue is a warning sign from the body.

When should you see a doctor?

If fatigue can't be overcome with sleep, rest and outdoor exercise, you should see a doctor. Frequent bouts of fatigue can indicate a serious medical condition. This is especially true if you have additional symptoms such as night sweats, dry mucous membranes, blood in the stools, swollen lymph nodes or an unusually strong thirst.

Self-check: do I need to see a doctor?

Certain warning signs indicate that there could be something serious behind your tiredness. This self-check will show you whether you need to consult a doctor.

Severe fatigue or chronic fatigue syndrome?

There’s a distinction between chronic fatigue and chronic fatigue syndrome, CFS for short. The latter is a complex clinical picture. It’s defined as persistent fatigue for no apparent reason. Although the triggers are unclear, it's known that infections can trigger CFS.

Long covid after a coronavirus infection

Coronavirus is one of a group of viruses that can trigger CFS. Chronic fatigue syndrome is one of the most common symptoms of long covid.

Post exertional malaise (PEM)

Long covid and chronic fatigue syndrome are affected by what’s known as post exertional malaise (PEM), i.e. an intolerance to exertion. With this malaise, a person’s general physical condition worsens after only a small amount of physical or mental activity. The exhaustion can last for several days or weeks.


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