An endocrinologist’s perspective: chronic fatigue syndrome

An endocrinologist’s perspective: chronic fatigue syndrome


Loss of strength, weakness, lethargy, rapid fatigability, powerlessness, “woke up and already tired”, drowsiness, “I do not feel rested after a full sleep”, decreased concentration, memory impairment, etc. A significant proportion of people who seek advice from an endocrinologist or doctors of other specialties experience these or similar symptoms. The latter are not specific, since they can be with a number of diseases and painful conditions.

Let’s figure out which common endocrine diseases can cause symptoms of chronic fatigue.

With a decrease in thyroid function (hypothyroidism):
loss of strength is often combined with dry skin, hair loss, swelling of the face, hands and lower extremities, constipation, chilliness, memory impairment; in women – with menstrual irregularities.

With an excess of thyroid hormones in the blood (thyrotoxicosis):
weakness and increased fatigue are accompanied by constant heart palpitations, increased excitability and sweating, tremors of the hands and / or body, sleep disturbances, weight loss with increased appetite, in some cases with bulging, pain and redness of the eyeballs.

With elevated blood glucose levels (type 1 diabetes mellitus):
patients complain of thirst, frequent urination, dry mouth, itchy skin, changes in visual acuity, weight loss with increased appetite. In type 2 diabetes, such symptoms occur much less frequently, since they develop only with pronounced decompensation of carbohydrate metabolism several years after the manifestation of the disease. With a moderate increase in blood glucose, in most cases, there are no symptoms.

Disorders of phosphorus-calcium metabolism
Disorders of phosphorus-calcium metabolism can be suspected in persons with general and muscle weakness, bone pain, low mood, complaints of thirst, frequent urination, vomiting and diarrhea (not due to other reasons), urolithiasis, frequent recurrence of gastric ulcer and duodenal ulcer bowel, low-trauma (that occurred with minimal trauma) fractures, muscle cramps, with chronic kidney disease, long-term use of glucocorticosteroids, with low or no sun exposure, including people who are completely covered by clothes for religious or national reasons or who do not leave home.

Testosterone deficiency
Testosterone deficiency in men is also often accompanied by rapid fatigue, mood lability with a tendency to depression, decreased sex drive, memory impairment, hot flashes, increased sweating, palpitations, decreased muscle mass, and sleep disorders.

Adrenal insufficiency
In adrenal insufficiency, asthenia is always accompanied by weight loss, decreased appetite and orthostatic hypotension (darkening of the eyes and / or dizziness when standing up). In addition, cravings for salty foods and darkening of skin folds and postoperative sutures may appear.

Hypercortisolism
Hypercortisolism (excessive production of cortisol by the adrenal glands) is characterized by muscle weakness in the arms and legs, an increase in body weight with predominant fat deposition on the trunk with relatively thin limbs, the appearance of bright purple, wide (usually more than 1 cm wide) stretch marks on the skin, increased blood pressure , disorders of carbohydrate metabolism (impaired tolerance to carbohydrates or type 2 diabetes), impaired sexual function, a decrease in the body’s resistance to infections.

If you have noted a combination of asthenic symptoms with the above manifestations, consult an endocrinologist. A specialist will help eliminate endocrine disorders and normalize hormone levels, if necessary.

For the prevention of endocrine diseases, consume iodized salt with food, consume dairy products daily, maintain a normal and stable weight, sleep well (at least 7-8 hours a day), engage in aerobic physical activity, walk in the fresh air, take preventive doses of vitamin D.

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