Chronic asthenia

"There is no test to diagnose it, but it is done through exploration, under the doctor's own criteria".

DR. JAVIER NICOLÁS GARCÍA GONZÁLEZ
SPECIALIST. INTERNAL MEDICINE DEPARTMENT

Asthenia is the medical term for fatigue. Chronic fatigue has become one of the most frequent reasons for consultation in medical practices.

In most cases it is possible to find a cause, either organic or psychic, for asthenia, but there is a large percentage of patients in whom it is not possible to identify a specific cause.

The syndrome of chronic asthenia is defined by the existence of fatigue of more than six months of evolution and that produces a greater reduction of 50% in the capacity to make the habitual tasks.

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What are the symptoms of chronic asthenia?

The cardinal symptom is tiredness, very intense, which does not improve with rest and produces a great incapacity for work, social and relationship life.

Other minor symptoms are added, which vary greatly from one patient to another. It is common to have some tenths of a fever, especially in the afternoon.

Also among the most common complaints are headaches, sore throat, muscle aches and weakness.

Other symptoms include the appearance of ganglions in the neck, difficulty of concentration, alterations of the dream and many others.

The most common symptoms are:

  • Intense tiredness.
  • Headaches.
  • Alterations of the dream.
  • Fever.

Do you have any of these symptoms?

You may have asthenia or chronic fatigue

Who can suffer from chronic asthenia?

This disease mainly affects previously healthy people and it is more frequent to appear between 20 and 50 years of age, but cases have been seen in elderly patients. Currently, there is a great controversy about its possible existence and how to define it in children.

There is a clear predominance of affected women.

What is the prognosis?

It is a chronic disease, of very long evolution, although with a slight tendency to the spontaneous improvement.

In spite of this, this disease conditions an important degree of incapacity and more than half of the patients will continue having difficulties to maintain their habitual activity five years after the beginning of the disease.

What are the causes of chronic asthenia?

The causes of chronic asthenia are not known. The most worked hypotheses relate its origin to chronic viral infections, especially those produced by viruses of the herpes group (Epstein-Barr virus and human herpes virus type 6), but this possibility has not been demonstrated with certainty.

Other theories, also not proven, relate the appearance of this disease with mild alterations of the immune system or dysfunction of muscle cells.

How is chronic asthenia diagnosed?

In the case of chronic asthenia or chronic fatigue, it is the doctor who, in the consultation, makes the diagnosis based on some defined clinical data or criteria and once he has ruled out the existence of other causes for the patient's fatigue.

There are no specific tests or analyses that allow the diagnosis to be confirmed, although to rule out these other illnesses that cause fatigue, an extensive study of analyses or complementary tests may be necessary.

The other possible causes of fatigue that should be ruled out include: drug dependency, autoimmune or immune disorders, infections, muscular or neurological diseases (such as multiple sclerosis), endocrine diseases (such as hypothyroidism), other diseases (such as heart, kidney or liver diseases), psychiatric or psychological diseases (particularly depression) or tumors.

How is chronic asthenia treated?

The most effective treatment is exercise and physical conditioning

Multiple drugs have been tested in the treatment of chronic fatigue, although most of them without satisfactory results, except in isolated cases. Of all of them, the best results have been obtained with antidepressant drugs.

Another large therapeutic group includes immunity stimulants and antivirals. The non-steroidal anti-inflammatory drugs and corticoids are sometimes effective in controlling the symptoms of the disease, especially muscle and joint pain, but do not influence the long-term evolution of this syndrome.

The only measure with demonstrated efficacy in the management of this disease is the application of specific and individualized programs of exercise and physical conditioning.

Where do we treat it?

IN NAVARRE AND MADRID

The Department of Internal Medicine
of the Clínica Universidad de Navarra

Its integrative vision and polyvalence allow us to provide the best medical assistance to multipathological and multisymptomatic patients, who present a difficult diagnosis or who suffer from prevalent diseases of a hospital nature.

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