Dr. Jacqueline Gerhart: Getting Older Doesn't Mean Getting Tired
Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that usually appears weekly on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.
Dear Dr. Gerhart: I've been more tired and weak over the last year but I haven't changed anything. I just celebrated my 75th birthday - am I just getting old?
Dear Reader: Congrats on turning 75!
So you say you are tired and weak? Most people who come in with those complaints classify it as "fatigue." As you can guess, I see this very often. In fact, 21-33 percent of patients seen in primary care settings report having significant fatigue. And, symptoms of fatigue account for 7 million office visits per year in the U.S.
Unfortunately, what causes a person's fatigue is almost always multifactorial - and can develop over one's lifetime. Look at your past. How did you treat your body during your younger years? Did you eat well? Exercise? Look at your present. Are you on any medications that could be making you tired? Are you staying mentally and physically active? Have you been getting regular screening for things like breast or colon cancer? And look at your future. Do you have a sense how long your parents and family members lived and their energy levels as they aged? Do you have any reason to think you may follow in their footsteps?
Next step: Talk to your doctor. When I see people who say they are "tired all the time," I start out by asking them, what do you mean by "tired," and what is "all the time." Often they go on to describe weakness, drowsiness, mental exhaustion, decreased concentration, stress, decreased duration of exercise, increased pain or lack of motivation. For patients over age 65 , tiredness is often coupled with weakness, gait instability, lack of control over their activities and depression. These symptoms are important to distinguish from simply not keeping up with the grandkids. In defining one's symptoms, I get a sense of how long it has been going on, how severe it is, and how frequent or constant it is - and thereby can narrow down a cause.
If your physician can’t find a cause on history and exam, he may order lab work or further testing, checking for anemia, electrolyte or vitamin problems, kidney or liver function issues, hormone problems, heart failure, lung disease or cancer. We also will run through your medication list again to look for any culprits. If we find one, we may discontinue or switch it.
In some cases, when a specific cause can't be identified, a person may be diagnosed with "chronic fatigue syndrome" (CFS). This is defined as profound and debilitating fatigue that lasts at least six months and is not improved by bed rest and that may be worsened by physical or mental activity. Chronic fatigue syndrome is most common in younger women and less common as one ages.
So, are you just getting old? Well, technically yes - you are aging. I encourage you to consider how you approach your aging. Attempt to find a happy balance between concern about your symptoms and acceptance of your body's changes as you age. Embracing that balance will help you to enjoy your years to come.
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.
Date Published: 12/11/2013