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Symptoms > Fatigue > When to See a Doctor About Fatigue
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When to See a Doctor About Fatigue

By Jodi Helmer

You’ve tried stretching, eating more veggies and doing mini-meditations. You’ve even cut out caffeine – but you still feel tired. A do-it-yourself energy booster might not be enough to solve your problems with fatigue. Doctors can help, but when is it time to make that appointment?

“If fatigue is interfering with your day-to-day activities and you’re not able to do the things you want to do because you don’t have enough energy, it’s time to seek medical attention,” says Elinor Mody, MD, director of the Women’s Orthopedic and Joint Disease Center at Brigham and Women’s Hospital in Boston. “Your doctor can help find the cause of the fatigue and offer appropriate treatment.”

Take the tests. Anemia, depression, sleep apnea and liver disease are just some of the causes of fatigue. Doctors will review your medical history, assess your symptoms and order tests.

“We run standard lab tests to check for iron levels, vitamin D deficiency and thyroid problems to help us rule out some of the more common causes of low energy,” explains Miles Hassell, MD, medical director of the Integrative Medicine Program at the Providence Cancer Center in Portland, Oregon. “It’s important to make time to have the tests done so that your doctor can get to the root of the problem.”

One type of anemia, also called “anemia of chronic disease,” is often seen in people with rheumatoid arthritis (RA). Effective treatment of arthritis usually resolves this type of anemia.

Be prepared. The more information you can provide your doctor about your symptoms, the better. Arrive at your appointment with notes on the times of day (or month) when your energy is at its lowest, and specify any other symptoms you’ve been experiencing, such as dizziness, rashes or pain.

Follow the doctor’s orders. Depending upon your test results, your doctor might suggest anything from getting more exercise and starting iron supplements to using antidepressants as energy boosters. It’s important to follow the recommended course of action – and to report back to your doctor if your symptoms worsen or if you have a reaction to any part of the treatment.

People with RA often experience inflammation-related fatigue. Doctors can improve this type of fatigue by prescribing higher doses of your drugs or another drug to control the body’s inflammatory process. Once inflammation is under control, fatigue usually diminishes.

hilda golde
20 Apr 2010, 11:29
wow after reading these comments,i don't feel so all alone. I'm always tired to the point of washing 2 or 3 dishes seems like a pile. I don't go to family gatherings anymore, barely go to the store, when my refrigerator is totally empty. I have Hep C titer negative, Raynauds disease and my hands go completey numb, My legs want to go out on me once in a big while; i feel like someone hits me behind my knee to make my leg bend. i have arthritis possibly rheumatoid, osteosporsis, hot flashes like crazy. I'm 47 years old. I'm embarrassed because i feel so lazy. I want to get up and clean and stare at the dust on my furniture feeling guilty because i don't have the energy to stand up. i use to excercise, but too tired to do that. i have no health insurance. Can't afford it and have been turned down a few times anyway. I'm on celebrex and norvasc for my raynauds disease(poor blood circulation. this is frustrating and i too have arthrits on my L5 disk which pinches the nerves on my legs I bought some prenatal vitamins a couple of people have told me that it helps. i'm on my third day of taking them. I pray that it gives me some energy any little bit of energy sure would be a blessing. Good luck to all of you.
dan
18 Apr 2010, 14:49
in addition to fatique cam RA also cause chronic (i mean 24/7) nausea-no vomiting just the constant feeling of getting ready to-and just total flu-like symptoms that totally keep me down and unable to be productive. it's really disableing at times.
Cheryl
08 Apr 2010, 09:38
Has anyone tried Sunrider foods? It is total nutrition so that the body can do it's normal work. This regeneration will take some time, especially if you have been ill a long time. Bodies can heal themselves. You can ask me questions at brucecheryl.quibell@shaw.ca There is no knowing how your journey will progress. You need to give it at least three to five months trial.
laurie
07 Apr 2010, 10:04
I am so exhausted all of the time I can't stand it. I am a year out from cancer treatments (the second time, cervical then breast) and the last year has been just awful for sleeping. I just read up on the latest from U of M. and they say part of the problem is from the chemo drugs (cysplatin) I had. The other part is I suffer from chronic pain (neuropathy). My hands, arms, legs and feet feel like they are on fire all of the time, plus I have chronic back pain due to an accident years ago. I read an article also from the U that states what drugs are used for treatment (which I am not on) and also that accupuncture may help. It also states that accupuncture may help relieve night sweats and hot flashes. I plan to go to the doctor to discuss this and see if they will change the meds and send me to an accupuncturist. Maybe this info will help someone else out there too.
Annette
06 Apr 2010, 23:56
Tired all the time and just want to sleep. I also have terrible asnd unbearable pain in my lower back. Can arthritis cause this? I do a job where I have to stand up with little movement all day. I hardly do any exercise. Any suggestions to ease the terrible back pains?
Helen
06 Apr 2010, 16:42
An easy way to get tested free of charge is to donate blood. It's extensively tested and if something like hep shows up you will be notified. Why pay expensive lab fees. It's a win-win situation.
Tess
06 Apr 2010, 15:04
Also add A&B to the Hep C test and do not let the dr talk you out of it. They try. Health care workers especially.

When Your immune system is hampered nothing works right. Inflamation builds and tissue loss occurs and the first sign is FATIGUE! Dr's will say depression and numerous things because to treat the illnesses it causes pays way better than curing you. The cure is slim but new meds are on the way. GET TESTED Please for your family because a simple razor mixup or toothbrush can spread it. The tattoos and piercings of today are the miseries of tomorrow. This post is not meant to harm or hurt anyone. If you ever had an airgun shot you could have it. So many ways this is spread and even sex. They say small chance but betcha a dime to a donut with uterine devices like a loop its a big ole Probably.
tess
06 Apr 2010, 14:50
Everyone experiencing fatique get checked for Hepatitis C. 10 years of searching and being diagnosed and treated with Premarin for 7 years, a renal stent, etc. I found the underlying cause of all of this FATIGUE= Hep C. No Doctor is looking for it and I been to specialist, all kinds. Your bloodwork can be fine and your infected. All they kept saying was go back to work. Now to old and damage done treatment failed me. Get help as soon as the first signs of all of these post show up
Helen
06 Apr 2010, 13:12
Hi everyone,

It sounds like we are all in the same boat. Seven or eight years ago I was diagnosed with osteoarthritis of the spine along with degenerative disc disease. Four years ago I was diagnosed with rheumatoid arthritis, Sjogren's, and just recently my doctor has started to suspect lupus. I've continued to work as a nurse for the American Red Cross. I do mobile blood drives. It's a very physical job with crazy and very long hours. I don't know how much longer I can last. My pain level has pretty much ended any enjoyment I used to have in life and the fatigue has taken just as much. I just don't know what to do to get my life back. I teach a yoga class twice a week. I been practicing for thirty-five years. I used to love it, but have now come to dread my class. My rheumatologist has told me not to stop. I've gone through almost every drug out there. I'm currently on Orencia and Celcept, with Oxycodone for the pain. It only offers minimal relief. I walk all day long with my job(three days a week) and on the weekends with my husband. He's been patient but I know he can't understand what I'm going through. How can one explain? I'm planning to start juicing as soon as I can afford to buy a machine. Does anyone out there have experience with that?
BJ
06 Apr 2010, 12:23
Margaret, I bet they were testing your inflamation factor, which should be no higher than 1. So Sweety, you are in a load of pain I am sure. My Inflamaion factor was at it's highest a 8 and I wanted to kill myself from the pain. I am now on Orencia and Plaqunel they seem to be lowering it quite a bit. My last rate was 1.8 which is still really high but not as bad as a 8.

So, bottom line is it is bad, get to a Rheumatologist ASAP. You need Auto immune meds and anti-inflamatories.
Hugs,
BJ
Jan
06 Apr 2010, 10:21
Hi, Boy did I find that Remicade stopped most of the fatigue. Enbrel helped me with fatigue in the past. I would suggest getting one of the IVs--they really work! I was on Enbrel for a yr and now have been on Remicade and a lower dose of Methotrexate for 3 yrs. Also, I drink a lot of green tea. My dr. told me that is the best thing to drink and it has just enough caffeine to keep me going. I go to water aerobics every day at the YMCA. I sometimes don't want to go but it works. Good luck and don't give up!
Jan
Linda
08 Feb 2010, 12:45
I have been diagnosed with RA also, I have all the same tired feelings. I am taking Methotrextate, Plaquenil, and folic acid. It has been going on for a long time. Sounds like everybody has the same systems.
ra sufferer
24 Jan 2010, 01:38
to traci and rosalie case,
sorry for your woes! your not alone!
first, traci, those are symptoms of ra,i have ra and my sister has shogrins. i honestly feel these two diseases are truely connected somehow. and for r.case, i dont know why your on plaquenil, or nap. those drugs are the least effective in my specialists opinion. i went to a boob named Dr. sunderam in milwaukee,he had me on those same drugs! he is an idiot and was uncaring to my pain.i fired him immediately! im seen by a caring ra specialist,for 6 yrs now. my ra hasnt gotten any worse, but it hasnt gotten any better. more or less stabalized.
the swelling in my finger joints stopped, but i do feel fatigued more,sleep habbits are messed up,and my body aches all the time.
im taking metho once a week,vicidin(thank god for that)for the pain, whichit only keeps my painsomewhat tolerable, presnidone, and folic acid. im starting a pain clinic this week to see if they can help. ive been depressed for years,and i know that has played into my sickness.but its not what caused my ra. good luck to all of you. i hope
you find a cure, and defineatly better quality of life.
Skye
21 Jan 2010, 16:41
Im tired all the time. I get enough sleep at night! I dont have RA I went to a doctor about it and he said that I do not have RA. But I do have arthritis in my hands because I'm doubke jointed. But I want to know why I never have any energy and always tired. Thanks.
Judy
03 Nov 2009, 15:31
I get all that lab work on a regular basis and it is always normal. I rarely drink anything with caffeine. I just dont feel like doing anything but lying in bed and sleeping (which of course I don't do) I am so sick of feeling like this.
Dee
16 Sep 2009, 12:10
I also have RA, in pain most of the time, tired for some reason, I exercise daily that does not help, the fatique is really starting to take on an ugly face, I just need alot of support, and the right meds, it seems ever since I had the bunion surgery things have taken a turn for the worst.

Cheers
DV... (:
leslie
18 May 2009, 01:42
Ive had RA for about a year; I AM SO TIRED OF BEING TIRED! The RA makes me tired, Methotrexate (6) makes me tired, Anemia makes me tired and I try not to take the Naproxen because that makes me tired! Ive gained weight because of my lack of energy and all I can do after work is sleep. I have kids and a grandson I want to do things with; Do I need to switch from Methotrexate to something else?
margaret
25 Apr 2009, 20:31
I wake up at night and my hand feels like it is on fire. The tingling is awful. Also, my elbows are always sore to touch. My blood work came back as a 13 for RA. is this bad?
Rosalie Case
22 Apr 2009, 10:48
I have recently been switched to metharaxate - am also taking plaquenil, prednisone, folic acid, and naproxen. I have been diagnosed with RA. But recently I am so tired I really can hardly hold my head up and get so tired I don't have any appetite. I just want to lay down and sleep. Can this be from the metharaxate?
Traci
21 Apr 2009, 18:03
I was diagnosied in 2006 with lupus sle and sjogrens. I have been on methotrexate inj and plaquenil, folic acid, and lyrica. My hands hurt so bad they are so stiff and painful that they wake me at night, my left knee is very painful and stiff and very difficult to climb stairs. Are these symptoms of Rheumotid Arthritis? I am very fatigued and I don't have any engery. I feel like I am watching my life go by without me. I would appreciate any information that you can give me. Thank you for your time.

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