Approach to Fatigue: Best Practice

Med Clin North Am. 2021 Jan;105(1):137-148. doi: 10.1016/j.mcna.2020.09.007.

Abstract

Owing to the broad differential diagnoses that can present as fatigue, a rational approach to diagnosis is paramount. Performance of a battery of diagnostic tests is unlikely to assist with diagnosis, highlighting the importance of a thorough history and physical examination. Fatigue can be a sequela of an underlying medical disease or exists as a primary condition. Management of secondary fatigue largely depends on treatment of the underlying condition. There are no FDA-approved medications for primary fatigue, now known as system exertion intolerance disease. Treatment is focused on individualized exercise therapy and cognitive behavioral therapy.

Keywords: Chronic fatigue syndrome; Fatigue; Myalgic encephalitis; Sleepiness; Systemic exertion intolerance disease; Tiredness.

Publication types

  • Review

MeSH terms

  • Cognitive Behavioral Therapy
  • Depression / diagnosis
  • Diagnosis, Differential
  • Evidence-Based Medicine
  • Exercise Therapy
  • Fatigue / diagnosis*
  • Fatigue / etiology
  • Fatigue / therapy*
  • Fatigue Syndrome, Chronic / diagnosis
  • Fatigue Syndrome, Chronic / etiology
  • Fatigue Syndrome, Chronic / therapy
  • Humans
  • Hypothyroidism / diagnosis
  • Medical History Taking
  • Primary Health Care