Persistent Fatigue: Causes, Tests, and Treatment Options

Q: Persistent Fatigue: Causes, Tests, and Treatment Options

Hello： Your issue of fatigue and drowsiness may be related not only to mental health problems and medication side effects but also to the possibility of underlying physiological conditions, such as anemia, electrolyte and blood sugar imbalances, liver and kidney dysfunction, or h

The reasons for fatigue and the desire to sleep can vary widely. To investigate these symptoms, several tests can be conducted, including: 1. Complete Blood Count (CBC) - to check for anemia or infection. 2. Thyroid Function Tests - to assess for hypothyroidism or hyperthyroidism. 3. Sleep Studies (Polysomnography) - to evaluate for sleep disorders such as sleep apnea. 4. Blood Glucose Levels - to check for diabetes or blood sugar irregularities. 5. Vitamin and

Hello, doctor.
I would like to ask you some questions that have been very troubling for me.
Currently, I feel sleepy and lack energy all day long.
I previously took some medications for mental health issues and noticed some side effects related to drowsiness, but after stopping the medication, there was no improvement.
The doctor told me that the effects of the medication would be metabolized and the side effects would disappear within one or two days after discontinuation.
Although I have been off the medication for a month, I have taken sulpiride 50 to 100 mg a few times daily due to indigestion, but this shouldn't cause me to feel so fatigued every day, right? My persistent sleepiness and lack of energy should not be related to the medication anymore, should they? I would like to know which specialty I should consult for my constant fatigue and lack of energy, and what tests I could undergo.
In the past few weeks, I have returned for follow-up visits due to sleep issues and psychosomatic symptoms.
The side effects of the medication almost always include drowsiness, but the doctor said these would mostly resolve within a week.
The medication helps me sleep better, but it hasn't made me feel more energetic.
What should I do?

kevin, 20~29 year old female. Ask Date: 2024/04/01

Dr. Lin Zhebin reply Family Medicine

Hello: Your issue of fatigue and drowsiness may be related not only to mental health problems and medication side effects but also to the possibility of underlying physiological conditions, such as anemia, electrolyte and blood sugar imbalances, liver and kidney dysfunction, or hormonal disorders, among others.
It is recommended that you first consult with a family medicine physician.

Reply Date: 2024/04/01

More Info

Persistent fatigue can be a complex issue, particularly when it is compounded by medication side effects, underlying mental health conditions, and lifestyle factors. It’s important to approach this problem holistically, considering both physical and psychological aspects.

Firstly, it’s crucial to understand that fatigue can stem from a variety of causes. These can include medical conditions such as anemia, thyroid disorders, sleep apnea, chronic fatigue syndrome, and mental health issues like depression and anxiety. In your case, the medications you mentioned—sulpiride and others—can indeed contribute to feelings of fatigue and drowsiness. Sulpiride, an antipsychotic medication, is known to have sedative effects, which can lead to increased sleepiness, especially at higher doses.

Given that you have been experiencing persistent fatigue even after discontinuing medication, it would be wise to consult with a healthcare professional who specializes in internal medicine or a sleep specialist. They can conduct a thorough evaluation, which may include blood tests to check for anemia, thyroid function tests, and possibly a sleep study to rule out sleep disorders.
In addition to medical evaluations, it’s important to consider lifestyle factors that may be contributing to your fatigue. Poor diet, lack of physical activity, and inadequate sleep hygiene can all exacerbate feelings of tiredness. Regular exercise, even light activities like walking, can significantly improve energy levels and mood. Additionally, maintaining a consistent sleep schedule, creating a restful sleep environment, and practicing relaxation techniques can enhance sleep quality.

If your fatigue is linked to psychological factors, such as anxiety or depression, it may be beneficial to explore therapy options. Cognitive Behavioral Therapy (CBT) has been shown to be effective in treating both anxiety and depression, which can, in turn, alleviate fatigue. Medication adjustments may also be necessary; discussing your symptoms and concerns with your psychiatrist can lead to a more tailored treatment plan that minimizes side effects while effectively managing your mental health.

Moreover, consider keeping a fatigue diary to track your energy levels, sleep patterns, and any other symptoms you experience. This can provide valuable insights for your healthcare provider and help identify patterns or triggers related to your fatigue.

In summary, persistent fatigue is a multifaceted issue that requires a comprehensive approach. Consulting with the appropriate specialists, considering lifestyle modifications, and exploring psychological support can all play vital roles in addressing your concerns. Remember, it’s important to be patient with yourself as you navigate this process, as finding the right balance may take time.

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