Asthenia

Everything about the causes, symptoms, and treatments of the different types of chronic fatigue.

Symptoms and Causes

Asthenia is characterized by a lack of energy that is perceived even at rest, worsens with physical activity, and does not improve with rest. This chronic fatigue is persistent and makes it difficult to carry out daily tasks.

Chronic Fatigue Syndrome (CFS) is a recognized and complex condition characterized by intense and prolonged exhaustion (more than 6 months), which does not improve with rest and is often accompanied by other symptoms such as muscle pain, sleep disorders, or cognitive impairments. Unlike common asthenia, CFS requires a multidisciplinary medical approach.

Depending on the circumstances, asthenia may be temporary or persist over time (chronic asthenia), significantly impairing patients’ quality of life. Asthenia is classified into four grades based on symptom severity:

  • Grade 1 or mild asthenia: increased fatigue that does not interfere with daily activities.
  • Grade 2 or moderate asthenia: difficulties begin to arise in carrying out everyday tasks.
  • Grade 3 or severe asthenia: inability to perform activities of daily living.
  • Grade 4 asthenia: the patient remains bedridden with total incapacity to carry out any daily activity. This is usually the result of serious illnesses or aggressive treatments.

The manifestation of chronic tiredness may be a condition in itself, derived from physiological factors, or the consequence of an underlying disease, whether physical or mental, or its treatment.

Symptoms

Intense fatigue that does not improve with rest is the common symptom in all individuals with asthenia. The rest of the manifestations vary depending on the type of asthenia:

  • Chronic asthenia: occurs when fatigue persists for more than six months and significantly interferes with daily activities. It presents with headaches, muscle weakness, sleep disturbances, difficulty concentrating, swollen lymph nodes in the neck, fever, or social withdrawal.
  • Mental, emotional, or nervous asthenia: has a psychological origin and is associated with irritability, apathy, and cognitive difficulties (lack of attention, difficulty learning, memory problems, or inability to make decisions).
  • Psychophysical asthenia: affects both the body and mind. Symptoms include physical weakness, mental exhaustion, insomnia or excessive sleepiness, mood swings, and concentration problems.
  • Seasonal asthenia: manifests during seasonal transitions, mainly in spring (spring asthenia) or autumn (autumn asthenia). It is characterized by lack of energy, poor concentration, memory impairment, loss of appetite, weakened immune defenses, or decreased libido.
  • Muscular asthenia: sensation of lack of strength in the muscles.
  • Senile asthenia: lack of energy in older adults, presenting as both physical and mental weakness.

Causes

Chronic tiredness can be caused by three main factors:

  • Organic asthenia: the result of a physical illness, mainly chronic infections, anemia, hypothyroidism, heart failure, cancer, or autoimmune diseases.
  • Functional asthenia: no organic cause is found, so it is associated with emotional states such as depression, stress, anxiety, or burnout syndrome. It may also be related to a sedentary lifestyle, lack of restorative sleep, among others.
  • Medication-induced asthenia: caused by certain pharmacological treatments, such as antidepressants, antihistamines, steroids, beta-blockers, diuretics, or chemotherapy.

Risk Factors

The main risk factors for asthenia include:

  • Sex and age: more common in women and typically appears in young to middle adulthood (ages 20–60).
  • Having one of the conditions that, as mentioned above, can cause asthenia.
  • Intense physical or emotional stress.
  • Hormonal imbalances: dysregulation of stress-response hormones.
  • Taking medications that contribute to chronic fatigue.
  • Vitamin B12 deficiency.
  • Excessive or insufficient physical activity.
  • Schedule changes.
  • Changes in atmospheric pressure.

Complications

Untreated asthenia can become chronic and significantly decrease quality of life. Chronic fatigue may lead to depression, sleep disorders, cognitive problems, general malaise, weakness, and social isolation.

Prevention

Asthenia can be prevented by following these recommendations:

  • Engage in moderate physical exercise regularly.
  • Spend time outdoors.
  • Maintain a balanced diet.
  • Practice good sleep hygiene.
  • Eliminate harmful habits.

It is important to note that asthenia resulting from diseases or pharmacological treatments cannot be prevented.

Which doctor treats asthenia?

Asthenia is usually managed in the fields of general medicine, family medicine, and internal medicine, although specialists in neurology, psychology, immunology, or endocrinology may also be involved.

Diagnosis

The diagnosis of asthenia is clinical, as there are no tests that confirm it. It is usually based on a review of the patient’s medical and family history, lifestyle, and presenting symptoms.

Treatment

Functional asthenia does not have a straightforward treatment, since medications have not been shown to improve symptoms. Nevertheless, antidepressants, antivirals, and immunostimulants have shown the most favorable outcomes.

For chronic fatigue to subside, a personalized program combining physical exercise with medication should be designed and maintained over a prolonged period.

Organic asthenia improves as the symptoms of the underlying disease resolve. In turn, medication-induced asthenia diminishes when the drugs causing it are discontinued.

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