What is asthenia and how does it differ from fatigue?
Normal fatigue is related to workload and goes away after a weekend or good sleep. With asthenia, exhaustion occurs even from small efforts, and rest does not bring recovery. The nervous system works in “economy” mode: endurance decreases, memory and attention deteriorate, and increased sensitivity to noise, bright light, and strong odors appears. Doctors distinguish between functional asthenia, associated with overwork or illness, and organic asthenia, associated with chronic diseases. The functional form is usually completely reversible, while the course of the organic form depends on the underlying disease.
- Reactive - after infections, surgeries, childbirth, injuries
- Asthenia from overwork and chronic stress
- Organic - for diseases of the brain, blood vessels, endocrine disorders
- Asthenia associated with depression and anxiety disorders
- Hypersthenic variant - irritability, impatience
- Hyposthenic variant - lethargy, drowsiness, apathy
Possible reasons
Asthenic syndrome accompanies many diseases, so the doctor is looking for a specific cause. The most common are viral infections, lack of sleep and prolonged stress. Weakness is often explained by iron deficiency anemia, especially in women with heavy menstruation, decreased thyroid function, lack of vitamin B12, and diabetes. Fatigue can be an early sign of heart disease, kidney disease, liver disease, and can also be a side effect of certain medications. Snoring with pauses in breathing during sleep can also be a cause of daytime fatigue. Separately exclude depression, in which fatigue often comes to the fore.
- Viral infections, including influenza and coronavirus infection
- Iron deficiency anemia
- Hypothyroidism
- Diabetes mellitus
- Vitamin B12 and vitamin D deficiency
- Obstructive sleep apnea syndrome
- Depression and anxiety disorders
- Chronic diseases of the heart, kidneys, liver
Symptoms
The main symptom is fatigue disproportionate to the load. It is accompanied by emotional instability and sleep disturbances: it is difficult to fall asleep, shallow sleep, there is no feeling of vigor in the morning, and in the afternoon it makes you sleepy. Tension headaches, sweating, palpitations, blood pressure fluctuations, decreased appetite and libido are common concerns. Symptoms usually worsen in the evening and after mental work. In the hypersthenic variant, irritability and hot temper predominate; in the hyposthenic variant, lethargy and apathy predominate. The severity of complaints varies, and many people have long associated them with character or age.
- Fatigue and weakness
- Irritability, tearfulness, impatience
- Decreased memory and concentration
- Sleep disorders
- Headache, dizziness
- Intolerance to loud sounds and bright lights
- Sweating, palpitations, decreased appetite
Diagnostics
The diagnosis is made after excluding diseases that may cause weakness. The doctor clarifies when fatigue began, what the person has been sick with in recent months, how he sleeps, what medications he takes, and how his mood has changed. A basic set of tests allows you to immediately identify the most common causes. Further examination depends on the findings: in case of snoring and sleep apnea, polysomnography is prescribed; in case of changes in the tests, a consultation with a specialized specialist is prescribed. Special questionnaires are used to assess anxiety and depression.
- Complete blood count and ESR
- Ferritin, iron
- TSH
- Blood glucose or glycated hemoglobin
- Vitamin B12
- Biochemistry: liver enzymes, creatinine
- General urine analysis, ECG
- Polysomnography - if sleep apnea is suspected
Treatment and recovery
Treatment begins with eliminating the cause: correction of anemia, thyroid hormones, treatment of depression or sleep apnea. At the same time, they build a routine: regular sleep at the same time, alternating work and rest, and a gradual increase in physical activity. Daily walks and moderate aerobic exercise with slow build-up help best. Cognitive behavioral psychotherapy is effective. Medicines, such as antidepressants, are prescribed only by a doctor according to indications. Drops and vitamins without an identified deficiency do not replace the search for the cause.
- Sleep 7–9 hours, bedtime and wake-up at the same time
- Dosed activity without jerking “through force”
- Walking in the fresh air, moderate aerobic exercise
- Regular meals with enough protein
- Limiting alcohol, caffeine and gadgets before bed
- Stress management techniques, psychotherapy
- Treatment of identified iron or vitamin deficiencies
