Fatigue in Adults: Evaluation and Management.

Area of Science:

• General Medicine
• Neurology
• Immunology

Background:

• Fatigue is a leading reason for primary care visits, affecting patient well-being and occupational safety.
• Fatigue is categorized as physiologic, secondary, or chronic, each requiring different management approaches.
• Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a severe, debilitating disorder with complex underlying abnormalities.

Purpose of the Study:

• To review the classification and management of fatigue, with a focus on ME/CFS.
• To highlight the diagnostic criteria and unique challenges in managing ME/CFS.
• To discuss the potential increase in ME/CFS cases post-COVID-19 pandemic.

Main Methods:

• Comprehensive review of fatigue classification and diagnostic approaches.
• Analysis of ME/CFS pathophysiology, diagnostic criteria (2015 National Academy of Medicine), and symptom management.
• Discussion of treatment strategies, including pacing, and consideration of long COVID implications.

Main Results:

• Physiologic fatigue is managed with lifestyle adjustments; secondary fatigue requires treating the underlying condition.
• ME/CFS is characterized by postexertional malaise, making exercise potentially harmful.
• Current treatments for ME/CFS focus on managing comorbidities and symptoms, as there is no proven cure.

Conclusions:

• Effective fatigue management involves accurate diagnosis and tailored treatment plans.
• ME/CFS requires specialized care, emphasizing activity pacing to avoid postexertional malaise.
• The overlap in symptoms with long COVID suggests a potential rise in ME/CFS diagnoses, necessitating further research and awareness.