What is the differential diagnosis (DDX) for fatigue?

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Last updated: February 11, 2025View editorial policy

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Differential Diagnosis for Fatigue

The differential diagnosis for fatigue is extensive and can be categorized into several groups. Here's a breakdown of the possible causes:

  • Single Most Likely Diagnosis

    • Depression: Fatigue is a common symptom of depression, and it's essential to consider this diagnosis, especially if the patient has a history of mental health issues or is experiencing other depressive symptoms.
    • Anemia: Iron-deficiency anemia is a common cause of fatigue, particularly in women of childbearing age. A simple blood test can help diagnose this condition.
    • Hypothyroidism: An underactive thyroid gland can cause fatigue, weight gain, and other symptoms. This diagnosis is more likely in patients with a family history of thyroid disease or those taking certain medications.
  • Other Likely Diagnoses

    • Sleep Apnea: This condition, characterized by pauses in breathing during sleep, can lead to fatigue, daytime sleepiness, and other symptoms.
    • Diabetes: Uncontrolled diabetes can cause fatigue, thirst, and frequent urination.
    • Chronic Fatigue Syndrome: A condition characterized by persistent fatigue that is not relieved by rest and is often accompanied by other symptoms like muscle pain and sleep disturbances.
    • Medication Side Effects: Certain medications, such as sedatives, antidepressants, and antihistamines, can cause fatigue as a side effect.
    • Dehydration: Inadequate fluid intake or excessive fluid loss can lead to fatigue, headaches, and other symptoms.
  • Do Not Miss Diagnoses

    • Addison's Disease: A rare condition where the adrenal glands do not produce enough cortisol and aldosterone, leading to fatigue, weight loss, and other symptoms.
    • HIV/AIDS: Fatigue can be an early symptom of HIV infection, and it's essential to consider this diagnosis, especially in high-risk patients.
    • Cancer: Certain types of cancer, such as leukemia or lymphoma, can cause fatigue, weight loss, and other symptoms.
    • Heart Failure: Fatigue, shortness of breath, and swelling in the legs can be symptoms of heart failure, a condition where the heart is not pumping enough blood to meet the body's needs.
  • Rare Diagnoses

    • Mitochondrial Myopathies: A group of rare genetic disorders that affect the mitochondria, leading to fatigue, muscle weakness, and other symptoms.
    • Porphyria: A group of rare genetic disorders that can cause fatigue, abdominal pain, and other symptoms.
    • Wilson's Disease: A rare genetic disorder that causes copper accumulation in the body, leading to fatigue, liver disease, and other symptoms.
    • Myasthenia Gravis: A rare autoimmune disorder that causes muscle weakness, fatigue, and other symptoms.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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