Dr. Friedman shares if endocrine problems can cause fatigue.
So first you have the symptoms of fatigue and again its usually relatively new onset, it’s usually not, that, you know, they were healthy for a while and then something happened or over a couple of months they started developing fatigue.
Then you can have other endocrine problems and endocrine symptoms that are sort of tied in with fatigue so oftentimes the person can’t exercise. They get too tired to exercise, they start to getting debilitated, and then their muscle start hurting, they feel weaker.
They are sort of inactive during the day so sometimes they have more trouble sleeping. It’s unclear which comes first. They have poor sleep and the don’t feel refreshed and they feel tired during the day.
Or they have inactivity during the day and they are sort of inactive and then they are tired enough to go to bed. So I always try to sort of ascertain which is the cause. Is the poor sleep the cause or is the daytime fatigue the cause?
The idea about depression is a crucial thing to explore. Some patients have depression first and that’s their main problem, and one of the symptoms of depression can be fatigue. Other patients have the fatigue and the debilitation and they just feel like that their life is sort of ruined. And then they feel sort of sad because of their medical condition.
Most patients seem to know which camp they fall under. I try not to have to convince the patient. So I ask the patient, are you depressed?
And they said, “Yes doc, you know I was sort of embarrassed to talk about to my other doctor, but since you asked, I feel really blue and sad and crying. I really want an antidepressant.” That happens maybe in ten percent of my patients.
The other majority of them say, “No doc, I am pretty healthy. I have great kids and my marriage is great. I am pretty happy but I just have this dead tiredness, and despite of that you know I feel a little down that I can’t do my things.
But you know I keep my mood up okay, and every doctor I have been to, said I should take an antidepressant; I tried them and they didn’t work and I had side effects from them but I really want to try to find the underlying cause.” And I would say that’s the majority of my patients.
Fatigue is debilitating. Women have jobs, they have to take care of the kids, they have to take care of the spouse, take care of their parents sometimes. And if they are dead tired and they can’t get out of bed it’s one of the worst things.
And most of these women were healthy until something happened to them and we are trying as an endocrinologist to figure out what is the problem that happened to them that caused them to go from this active, highly energetic person to a person that’s tired, run down, can’t get things done, have to take naps throughout the day.
And this is what a bread & butter endocrinologist want to try to do is try to figure out is there an endocrine cause of it.
Again, we can always find the cause and sometimes they can have non-endocrine problems, sometimes it can be things like depression can give you fatigue but I always use that sort of the diagnosis of exclusion. I try to find things that are reversible.
About Dr. Theodore Friedman, M.D., Ph.D., M.Phil.:
Dr. Theodore Friedman, M.D., Ph.D., M.Phil., specializes in hard-to-diagnose-and- treat cases of adrenal, pituitary, thyroid, and fatigue disorders. He's been with the University of California Los Angeles School of Medicine since 2005 and serves as Chief of the Endocrinology, Metabolism and Molecular Medicine Division at Charles R. Drew University of Medicine and Science. He also served as Director of the Multi-Disciplinary Chronic Fatigue Clinic at Cedars-Sinai Medical Center from 1998-2000.
Dr. Friedman has a private practice near Beverly Hills, California as well as privileges at Cedars-Sinai Medical Center and Martin Luther King Medical Center.