Fatigue (थकान) — (Hindi + English Medical Terms)

Fatigue (थकान) — सम्पूर्ण मार्गदर्शिका

Contents

1. Definition
2. Prevalence & importance
3. Differential diagnosis
4. Causes
5. Post-viral / ME/CFS / Long COVID
6. Clinical assessment & red flags
7. Investigations
8. Treatment — stepwise
9. Rehab & pacing
10. Special populations
11. Insomnia link
12. References

📌 Related important guides (public links):
• Insomnia (अनिद्रा) — Complete Guide  |  • Meningitis — Symptoms & Treatment  |  • Seizure First Aid (दौरे)

Fatigue क्या है? (Definition)

Fatigue यानी थकान — यह शरीर या दिमाग दोनों में ऊर्जा की कमी महसूस होना है। जब fatigue आराम से ठीक नहीं होती या रोज़मर्रा के कार्य प्रभावित हों तो clinical assessment जरूरी है। (Definition reference: Mayo Clinic). See: Mayo Clinic — Fatigue definition.

Prevalence & importance

Fatigue is one of the most common complaints in primary care. Persistent or unexplained fatigue should prompt systematic evaluation to exclude treatable causes (anaemia, hypothyroidism, infection, malignancy). For in-depth clinical approach see Cleveland Clinic: Cleveland Clinic — Fatigue overview.

Differential diagnosis (brief)

Fatigue causes range across medical, psychiatric, sleep-related and medication-induced categories — the clinician’s job is to rule out red-flag conditions early and then manage common reversible causes.

Causes — Medical, Psychiatric & Lifestyle

Medical

• Anaemia (iron deficiency)
• Hypothyroidism
• Diabetes mellitus
• Chronic infections (TB, hepatitis, HIV)
• Cardiac, renal or hepatic dysfunction

Psychiatric

• Major depressive disorder, anxiety disorders

Sleep-related

• Obstructive sleep apnoea (OSA), insomnia, circadian disorders

Lifestyle & meds

• Poor sleep, excessive alcohol, sedative medications, poor nutrition

Post-viral fatigue, Long COVID & ME/CFS

Post-infectious prolonged fatigue occurs after many infections. ME/CFS is a clinical syndrome with profound fatigue and post-exertional malaise. Authoritative guidance: NICE (NG206) for ME/CFS and CDC pages for ME/CFS; WHO also provides classification context. Read more: NICE — ME/CFS guideline, CDC — ME/CFS overview, WHO — Chronic fatigue info.

Clinical assessment & Red flags

1. Detailed history: onset, duration, diurnal variation, sleep quality, PEM (post-exertional malaise), mood, meds.
2. Red flags: weight loss, persistent fever, haemoptysis, focal neuro signs, severe cardiorespiratory symptoms — urgent workup needed.
3. Screening tools: PHQ-9 (depression), Epworth Sleepiness Scale, Fatigue Severity Scale.

Investigations — first and second line

First-line: CBC, TSH/free T4, blood glucose/HbA1c, LFT/RFT as indicated, ferritin, B12. Second-line guided by suspicion: chest X-ray, ECG/echo, autoimmune serology, infectious screens, PSG for suspected sleep apnoea. (Clinical references: Mayo Clinic & Cleveland Clinic pages.)

Treatment — stepwise & practical

1. Treat the cause

Correct anaemia, treat hypothyroidism, manage heart failure/CKD, treat infections and stop offending drugs.

2. Sleep optimization

Evaluate and treat OSA (CPAP) and insomnia (CBT-I). See our Insomnia guide: Insomnia — full guide.

3. Rehabilitation & pacing

Energy conservation (pacing) in ME/CFS; graded, supervised exercise for other causes of deconditioning; occupational therapy for workplace return.

4. Pharmacologic (targeted)

No universal drug for fatigue — treat underlying disease. For selected indications (eg. modafinil in narcolepsy/selected OSA cases) use specialist guidance. For depression-related fatigue, treat depression.

Rehab, pacing & practical tips

• Use activity logs; alternate rest & activity.
• Prioritise tasks; reduce multitasking.
• Focus on nutrition, hydration, sleep schedule and gentle exercise as tolerated.

Special populations

Children, pregnant women and older adults have special considerations — check paediatric or geriatric protocols and investigate red flags early.

Trusted external resources (clickable)

• Mayo Clinic — Fatigue (definition & overview)
• Cleveland Clinic — Fatigue causes & treatment
• NICE — ME/CFS guideline (NG206)
• CDC — ME/CFS overview
• WHO — Chronic fatigue syndrome FAQ
• Wikipedia — Fatigue (general)
• Wikipedia — ME/CFS

इन authoritative links से आपकी पोस्ट की credibility बढ़ती है — Google E-E-A-T के मद्देनज़र यह अच्छा संकेत है।

FAQ — quick

Q: क्या fatigue का कोई universal treatment है?

A: नहीं — इलाज underlying cause पर निर्भर करता है; lifestyle और sleep optimization अक्सर मदद करते हैं।

Q: कब डॉक्टर को दिखाएँ?

A: अगर unexplained fatigue 2–4 सप्ताह से बनी रहे या red flags हों।

References & further reading

1. Mayo Clinic — Fatigue overview. Link.
2. Cleveland Clinic — Fatigue causes & treatment. Link.
3. NICE guideline NG206 — ME/CFS. Link.
4. CDC — ME/CFS overview. Link.
5. WHO — Chronic fatigue info. Link.

लेखक: Dr. Mahafooz Ansari