That tired feeling
Your Health - Dr. Gita Mathai
"I feel tired/weak/lethargic, I cannot work." People of all ages and both sexes often voice this complaint. They ask for tonics, vitamin pills, energy drinks - any sort of "pick me up" that will help them go about their work to efficiently.
Fatigue is incapacitating when it lasts longer than a few days, occurs frequently or is continuous. Sleep in these cases is non-refreshing.
Sometimes our muscles refuse to obey our commands to perform optimally. This is physical fatigue. It occurs because movement causes the gradual build up of a neurotransmitter called serotonin. How fast it accumulates and how tired you feel depends on your age and overall health. A physically fit person, irrespective of age, is able to metabolise and remove serotonin rapidly. They can work "against fatigue," and recovery is rapid.
Sleep is essential for the body to restore itself. Inadequate, disturbed sleep, episodes of snoring or sleep apnoea, leave us in a permanent state of tiredness.
Drinking coffee, smoking, or having glucose or energy drinks provide a temporary boost in energy levels. Once the effect wears off, however, the dip in energy levels is even greater.
Mental fatigue occurs because of alterations in the ratio of neurotransmitters in the RAS (reticulo activation system) in the brain. It may be because of long hours at work, depression or boredom. Overstimulation of the brain can cause rapid depletion of essential neurotransmitters. This is seen with constant television viewing or computer game playing. If the brain does not have a chance to rejuvenate owing to inadequate sleep, this leads to constant fatigue. Mental laziness, in which the brain is not used regularly at least to partial capacity, results in inefficiency in the release and metabolism of neurotransmitters. This also causes long- standing fatigue.
If you are suffering from fatigue, first figure out if it is due to the lifestyle you have. Nicotine use or medication such as anti histamines, cold and cough tablets or syrups, sleeping pills and anti depressives, can cause fatigue. Too much or too little exercise too can cause tiredness. Stress or depression can also reduce energy levels.
Medical conditions can cause fatigue, but other symptoms are usually present to help make the diagnosis. Tests need to be done to rule out disorders such as anaemia (very common in India), vitamin deficiencies (particularly D3), diabetes, liver diseases (including hepatitis B infection) kidney disease, lung diseases like emphysema and chronic obstructive airways disease, heart failure, thyroid disorders, fatigue from chronic illnesses like auto immune disease or cancer. Obesity also causes tiredness, probably from the effort of carrying around so much weight!
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
