Is fatigue a disease?

Article by Specialist Doctor I Vo Khac Khoi Nguyen - Orthopedic Trauma Doctor - General Surgery Department - Vinmec Central Park International General Hospital

Fatigue is quite common in life, especially in modern society. Fatigue is a subjective feeling of the patient, but can manifest in many physical and mental symptoms. You can be tired at the end of a workday and this can recur and repeat for days, or even months. So is fatigue a disease?

In the past, fatigue syndrome that lasted for months was called myocarditis. This disease was first described in the US in 1934, it has been mistakenly referred to as hysteria, mental illness, psychopathy, somatic disorder. The fact that there are many diseases shows that the medical community is still not unified in the diagnosis. However, a fact shows that patients can be cured and reintegrated back into normal life, unlike mentally ill people. Currently, chronic fatigue syndrome reduces the physical and mental abilities of patients. On the other hand, the characterization of fatigue syndrome as a mental illness has led to a situation in which patients can be stigmatized, shunned and abandoned. With such an approach, treatment must include cognitive behavioral therapy and exercise therapy.

Fatigue syndrome is often overlooked by the patient himself. This omission is partly due to the patient's lack of concern for himself, or the perception that the patient is "changed in temperament".
Chronic fatigue syndrome is difficult to treat due to the alienation of relatives, medical staff and lack of community support for the patient. The difficulty is also reflected in the fact that doctors may not find abnormalities in laboratory tests to help confirm the diagnosis. Because the causative agent is not found, treatment methods are also inconsistent and specific. Patients can go to many doctors, many hospitals, but each place will give a different view of the problem. This can lead to a loss of trust and patient adherence to treatment. This is also the biggest barrier between medical staff and patients.
Until now, doctors have recognized that fatigue syndrome is a complex disease that can progress chronically. It is characterized by post-exertional discomfort, severe fatigue, debilitating illness, disturbances in cognition, sleep function, pain, and the immune, nervous, endocrine, and other systems. digestive symptoms. The severity of symptoms varies from day to day in patients and varies from patient to patient. Disease severity is classified as mildly affected, moderately affected to severely affected. Severely affected people are often at home or in bed, and may not be able to move, talk, be exposed to, or tolerate light. Discomfort after exercise is one of the main symptoms of the disease. This condition is defined as an exacerbation of a patient's symptoms following minimal physical or mental activity, occurring hours, days, or weeks after the active activity and persisting thereafter ( day, week or month).
Diagnosis of chronic fatigue syndrome is quite difficult. Until now, there is no standard test kit to help doctors diagnose the disease. When there are no specific tests or biomarkers for the disease, doctors will have no choice but to make a diagnosis based on the symptoms reported by the patient. Some symptoms are considered mandatory for diagnosis, while others are considered supportive. Diagnosis in adults is rather reluctant until they have been ill for at least 6 months and their comorbidities have resolved. For children and adolescents, the duration of illness has been shortened to 3 months, but the doctor's decision depends on the specific condition.
From the above descriptions, we easily realize that the treatment of the disease is also difficult. Treatment will involve many specialties and requires synchronous coordination. To date, there is no consistent treatment regimen. Any treatment used to relieve symptoms is considered "palliative".

Fatigue syndrome presents with multiple symptoms in multiple organ systems. Therefore, it is necessary to have a holistic view of the patient rather than just paying attention to individual organ systems.
First of all, it is necessary to distinguish fatigue syndrome from asthenia. Depression is defined as a lack of energy or a feeling of inability to perform daily tasks, pain that is more intense at the end of the day, and usually improves after a period of sleep. On the other hand, myasthenia gravis reduces or loses muscle strength, and is an important symptom in muscular diseases.
In addition to fatigue, fatigue syndrome is associated with a wide range of symptoms, including joint pain, muscle aches, headaches, anxiety, depressive symptoms, cognitive disturbances, sleep disturbances or Can't stand the effort. These symptoms may appear in the pathology of the respective organ systems.
Unclear understanding of etiology, coupled with difficulties in objective assessment and quantification of symptoms, make it difficult for physicians to diagnose fatigue syndrome. As a result, fatigue syndrome has been identified with many different names including: allergic encephalomyelitis, immune dysfunction syndrome, neuroendocrine immune dysfunction syndrome, syndrome post-viral syndrome, Iceland disease, neurasthenia, Royal Free disease.
In summary, fatigue syndrome is a challenging and emerging pathology, but there is still hope for treatment and recovery for those affected. Currently, there is no specific treatment. Treatment is aimed only at relieving symptoms. In general, patients with fatigue syndrome diagnosed within the first 2 years of the onset of symptoms respond better to treatment. Treatments to relieve symptoms must be individualized for each patient. A scientific diet, adequate nutrition, healthy living, proper work and rest are at the core of any treatment. This is also the most effective measure to prevent fatigue syndrome from appearing in modern life.
Vinmec International General Hospital now has a periodical health checkup package, suitable for each object, age, and customer needs. Through the examination, the doctor will accurately assess the current health status as well as prevent the risk of diseases that you may have, advise on a complete nutrition regimen. All examination procedures at the hospital are performed by a team of qualified doctors, combined with modern equipment. Therefore, you can be assured of the quality of medical care at Vinmec.